The wicked problem of healthcare student attrition

Abstract

The early withdrawal of students from healthcare education programmes, particularly nursing, is an international concern and, despite considerable investment, retention rates have remained stagnant. Here, a regional study of healthcare student retention is used as an example to frame the challenge of student attrition using a concept from policy development, wicked problem theory. This approach allows the consideration of student attrition as a complex problem derived from the interactions of many interrelated factors, avoiding the pitfalls of small‐scale interventions and over‐simplistic assumptions of cause and effect. A conceptual framework is proposed to provide an approach to developing actions to reduce recurrent investment in interventions that have previously proved ineffective at large scale. We discuss how improvements could be achieved through integrated stakeholder involvement and acceptance of the wicked nature of attrition as a complex and ongoing problem.

Nursing students’ resilience, depression, well‐being, and academic distress: Testing a moderated mediation model

“…Despite an increase in the number of students enrolling in nursing schools, the USA continues to experience a shortage of Registered Nurses (American Association of Colleges of Nursing, 2019). Moreover, many nursing students do not complete their education (Dante, Petrucci, & Lancia, 2013; Hamshire, Jack, Forsyth, Langan, & Harris, 2019). Although there are several contributors to nursing student attrition (Hamshire et al., 2019), academic failure is central (Pitt, Powis, Levett‐Jones, & Hunter, 2012).…”

“…Moreover, many nursing students do not complete their education (Dante, Petrucci, & Lancia, 2013; Hamshire, Jack, Forsyth, Langan, & Harris, 2019). Although there are several contributors to nursing student attrition (Hamshire et al., 2019), academic failure is central (Pitt, Powis, Levett‐Jones, & Hunter, 2012). Indeed, academic distress—defined as perceptions that internal or external factors accompanied by perceptions that one is unlikely to persist to graduation has a negative impact on one's academics progress—are common foci of national public health surveys of the general college student body (Healthy Minds Network, 2020).…”

The Rural Nursing Workforce Hierarchy of Needs: Decision-Making concerning Future Rural Healthcare Employment

“…Students want to feel empowered within the clinical setting, and being involved in the decisions that directly affect the everyday activity enhance that sense of belonging and meet the need of managerial factors [ 45 ]. Again, where there is little room for professional growth in the workplace, then they are less likely to choose or even stay regardless of practical, fiscal, and family benefit [ 46 ].…”

Challenging the deficit discourse: Insight from university staff about first-generation students in South Africa and the United Kingdom

“…Using our previous change management experiences in higher education (Bird, Forsyth, Stubbs & Whitton, 2015;Hamshire, Forsyth & Whitton, 2013;Hamshire, Jack, Forsyth, Langan & Harris, 2019;Hamshire, Willgoss & Wibberley, 2013), we considered how we could effectively question the dominant values and expectations about university curricula, teaching and assessment. Working in partnership with an illustrator, we subsequently used the data collected in this study to develop a set of workshop resources to promote conversation about empathy and agency.…”