Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK.
Centre for Excellence in Learning and Teaching, Manchester Metropolitan University, Manchester, UK.
Nurs Inq. 2019 Jul;26(3):e12294. doi: 10.1111/nin.12294. Epub 2019 May 6.
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.
学生提前退出医疗保健教育项目，尤其是护理专业，是一个国际关注的问题。尽管已经投入了大量资金，但保留率仍然停滞不前。在这里，以一项针对医疗保健学生保留率的区域性研究为例，用政策制定中的一个概念——棘手问题理论来构建学生流失的挑战。这种方法可以将学生流失视为一个复杂的问题，源于许多相互关联的因素的相互作用，避免了小规模干预的陷阱和对因果关系的过度简单化假设。提出了一个概念框架，为开发减少大规模干预重复投资的行动提供了一种方法，这些干预此前已被证明无效。我们讨论了如何通过整合利益相关者的参与和接受流失的棘手性质，作为一个复杂和持续的问题，来实现改进。
