Faculty of Health and Social Care Sciences, Kingston University and St. George's University of London, Kingston Hill, Kingston upon Thames KT2 7LB, United Kingdom.
Nurse Educ Today. 2010 Feb;30(2):202-7. doi: 10.1016/j.nedt.2009.07.014. Epub 2009 Nov 12.
Student attrition in nursing causes concern, but is not a new phenomenon. Challenges in defining and understanding attrition, changes in the commissioning of nurse education and developments within the United Kingdom National Health Service (UKNHS) and the profession contribute more generally to making this a complex topic for managers and for research. In this paper we discuss findings from an integrative review of the UK literature and discuss three levels of possible contributory factors identified from the literature (micro/individual; meso/institutional; and macro/political and professional). In conclusion, we argue that a concern with attrition is legitimate and that strategies should be put in place to respond to each level of contributory factors. Factors contributing to attrition are complex and interact. We argue that some degree of attrition is inevitable if we are to maintain standards within the profession. There is, therefore, an ethical and professional imperative for attrition in some circumstances. We suggest that Tinto's model relating to social integration might inform further research.
学生流失在护理中引起关注，但这并不是一个新现象。在定义和理解流失方面的挑战、护士教育委托方式的变化以及英国国家医疗服务体系（NHS）和该行业的发展，更普遍地使这成为管理者和研究人员的一个复杂话题。在本文中，我们讨论了对英国文献进行综合审查的结果，并讨论了文献中确定的三个可能促成因素的层次（微观/个体；中观/机构；宏观/政治和专业）。最后，我们认为，对流失的关注是合理的，应该制定策略来应对各个层次的促成因素。导致流失的因素是复杂的且相互作用的。我们认为，如果我们要保持专业标准，一定程度的流失是不可避免的。因此，在某些情况下，流失存在伦理和专业上的必然性。我们建议，廷托（Tinto）关于社会融合的模型可能为进一步的研究提供信息。
