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3. Retention in NHS funded courses

3.1 In 2002, the Department of Health (DH) commissioned a joint review between the Higher Education and Health Sectors with terms of reference to ‘consider and make recommendations on a single and consistent definition of attrition from NHS funded courses’. This resulted in a definition published in 2006 which applied to ‘completed’ cohorts i.e. the numbers who successfully complete their course of study (see Appendix 1). What this study did not do, however, was to distinguish between those who resign and those who are discontinued due to academic failure.

3.2
For nursing courses, Pryjmachuk and Richards (2008) have indicated that if students leave because of dissatisfaction with their educational experience then much can be done by nurse educators. In addition, a threat of financial penalty may well act as a springboard for innovation and development in curriculum design. If students leave due to inability, then nurse educators must distinguish between true inability and educational disadvantage.

3.3 There seems to be a dearth of information on why students leave courses and the research related to attrition is largely anecdotal, inconclusive or methodologically flawed. Exit interviews are usually voluntary and little more than anecdotal arising from those students who are generally upset, angry or disheartened.

3.4 It has been noted that nursing students have sometimes been unwilling to be overly critical of the course or department and therefore do not sometimes give the real reason(s) for leaving, In addition, some individuals may require references or wish to return to nursing in the future and hence are reluctant to be precise about the exact reason for leaving a course (McSherry and Marland 1999; Glossop 2001).

3.5 It has been documented that more than one in four student nurses leaves their courses before qualifying at a cost of almost £100 million a year to taxpayers. Figures disclosed under the Freedom of Information Act show that 6,603 of the 25,101 students due to finish degrees or diplomas in 2006 left early. This rate of attrition, 26.3 per cent, fell to 24.8 per cent on courses finishing in 2008. Nursing Standard magazine disclosed wide variation in the dropout rate of nurses between universities, from more than 50 per cent to less than six per cent (Nursing Standard 2008).

3.6 Attrition rates for the allied health professions vary across professions and HEIs with the national average attrition rates prior to 2000 for physiotherapy ranging from 6% to 10% and for occupational therapy from 7% to 12% (DH 2000a).

3.7
In the document Modernising Education, Training and Regulation, the DH (2000a) indicated that  for the allied health professions, attrition rates should not exceed 10% in pre-registration training; that attrition rates for students from ethnic minority communities should be no higher than the programme average and when contracts are due for re-negotiation, contract triggers should be agreed (either monetary or efficiency related)  that target attrition rates should not be exceeded and the quality of training not reduced (see Appendix 2 for research undertaken in relation to voluntary drop out from nursing courses).

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