Exploring the attrition of student nurses from a four year comprehensive basic nursing education programme in a selected college of nursing in KwaZulu-Natal : a case study approach.

Abstract

Background: Unlike other traditional professions which struggle to attract post matric candidates, nursing attracts young students in large numbers. However, the throughput is a challenge because of high student attrition. Study purpose: This study aimed at analyzing attrition of student nurses in a four year comprehensive basic nursing education programme to inform student support initiatives, thereby increasing throughput rates. Methodology: A pragmatic stance using a mixed methods approach and a case study design was adopted. The nursing college served as the case and two campuses served as the units of analysis. Quantitative data was collected through a self-administered questionnaire from 294 students and document review. Qualitative data was collected from the educators and students through four focus group interviews and two individual interviews. Results: The study revealed that for every cohort of students admitted to the programme from 2005 until 2012, less than 55% completed within regulation time except in 2011. Trends in dropout revealed that the highest attrition was at first year level (80.6%) and the Anatomy and Physiology course had the highest dropout (72.1%). A significant relationship was revealed between students who repeated a class in secondary school and those who failed and between home language and those who experienced academic failure. Factors contributing to student nurse attrition ranged from the pre-enrolment phase through to the integration and engagement phases. The main factors cited included that nursing was not the career of choice; the mismatch between what they expected in nursing and what they experienced in reality; an overloaded curriculum; difficult courses; poor study habits and teaching methods. Limited resources and student support both in academic and clinical emerged as contributing factors. A number of non-academic reasons emerged from the quantitative data which were corroborated by qualitative data. The satisfaction level between students that were progressing well and those experiencing failure was not the same. Recommendations: Student attrition is a complex phenomenon which requires a structured way of addressing it. A well thought out programme of student support is required which should include academic monitoring and tracking of students‟ progress for early identification of at risk students.