Understanding the risk factors for student attrition across pre-registration nursing and midwifery programmes in a United Kingdom university: A sequential explanatory mixed methods study.

BACKGROUND

The World Health Organization estimates a global shortage of 4.5 million nurses and 0.31 million midwives by 2030, which presents a significant problem for workforce planning. Despite aspirational United Kingdom (UK) government policy targets and ongoing efforts, the number of nursing and midwifery vacancies continues to increase. One contributing factor is student nurse and midwife attrition.

AIM

To identify risk factors that contribute to nursing and midwifery students interrupting or withdrawing from pre-registration programmes.

DESIGN

Sequential explanatory mixed-methods design.

SETTING

A University School of Nursing and Midwifery in the Southwest of England.

PARTICIPANTS

534 pre-registration nursing and midwifery student survey respondents and 8 focus group participants.

METHODS

Students' perspectives of attrition risk factors were evaluated using a Likert scale with free text questions used to capture additional factors affecting interruption or withdrawal. Students were also invited to take part in focus group discussions. Survey data were coded and analysed utilising SPSS (Version 25) software. Survey free text narrative and focus group data were analysed using reflexive thematic analysis.

RESULTS

Survey results revealed 55 students had interrupted and returned and 281 students had considered leaving or interrupting their programme. Survey descriptive statistics data were grouped into top attrition risk factors. Free text narratives and focus group data identified four themes: multiple and overlapping challenges; the threats and opportunities of clinical placements; the availability of the right support at the right time; and, investing for a better future for myself and others.

CONCLUSION

Nursing and Midwifery students reported challenges across their pre-registration programmes resulting in risk factors that might lead to students interrupting or withdrawing. Optimal cooperation between higher education institutions (HEI) and clinical stakeholders is of paramount importance to address these challenges as is government and Nursing and Midwifery Council (NMC) acknowledgement and consideration of the identified risks linked to attrition; specifically relating to national funding arrangements and the clinical practice hours required for registration within the UK. This may also resonate with professional programmes internationally, faced with similar staffing shortages.