Providing learning support to nursing students: A study of two universities

Ann Ooms
a
, Sue Fergy
a
, Di Marks-Maran
a,
*
, Linda Burke
b
, Karen Sheehy
c
a
Kingston University/St Georges University of London, 30 Beacon Crescent, Tilford Road, Hindhead, Surrey GU26 6UG, United Kingdom
b
School of Health and Social Care, University of Greenwich, United Kingdom
c
University of West London, United Kingdom
a r t i c l e i n f o
Article history:
Accepted 29 July 2012
Keywords:
Nursing education
Student support
Non-traditional students
Culturally and linguistically diverse students
Widening participation
a b s t r a c t
In universities where signicant numbers of nursing students come from non-traditional backgrounds,
and where an equally signicant proportion of students have English as a second language, provision of
learning support is essential to ensure success and progression, and to prevent attrition. This paper
presents an evaluative study of the support services provided to undergraduate nursing students in two
universities in the United Kingdom (UK). Both universities have signicant numbers of students from
non-traditional backgrounds and who have English as a second language, and both institutions have in
place a large array of student support mechanisms. The aims of the study were to identify all existing
student support mechanisms across the two universities, to illuminate the prole of students who enter
pre-registration programmes at the two universities (age, gender, educational background) and to
measure the perceptions of students of the use and usefulness of the support mechanisms provided by
their university. Survey method evaluative research was the chosen research approach.
Findings showed that the support services that appear to have the greatest impact on student success
in their nursing programme are the programme leaders/module teachers, small study skills groups
(known as APPL and L2L) and, for the 50% of students who required it, academic literacy and numeracy
support sessions. For students who have English as a second language and with non-traditional entry
qualications, numeracy and academic literacy support is particularly valued.
2012 Elsevier Ltd. All rights reserved.
Introduction
An evaluation research study was undertaken into the use and
perceived effectiveness of the support services offered to nursing
students at two universities. Both universities have signicant
numbers of students from non-traditional backgrounds and who
have English as a second language. Both institutions provide a large
array of student support mechanisms. The intention was to paint
a substantive picture of the effectiveness of student support across
two institutions that face similar challenges related to the
demography of their students. This paper is an important addition
to the literature on student support as it identies which support
services are perceived as most and least helpful to nursing students
from a wide demography.
Literature review
The literature review was undertaken using the keywords
wideningparticipation, student support andnon-traditional students.
Journals searched included higher education titles and nursing
education titles, as well as the publications pages of websites of rele-
vant UK government departments. Articles and government publica-
tions over the past 15 years were included in the literature review.
The massication of higher education (Guri-Rosenblit et al.,
2007) has provided educational opportunities to an ever-
widening group of people. Over the past two decades there has
been an increase in non-traditional students entering higher
education. In dening non-traditional, Harvey (2012) suggested
that these are students entering higher education who have pop-
ulation characteristics not normally associated with entrants to
higher education e they come from social classes, ethnic groups or
age groups that are historically underrepresented. He also suggests
that non-traditional students may also include gender groups in
some areas, such as females in engineering and males in nursing, as
well as students with a disability.
Morey et al., 2003 describe non-traditional students as:
mature students;
those from lower socio-economic backgrounds;
rst generation undergraduates;
students from ethnic minorities;
students who are disabled
* Corresponding author. Tel.: 44 (0) 1428609600.
E-mail address: marksmaran@btopenworld.com (D. Marks-Maran).
Contents lists available at SciVerse ScienceDirect
Nurse Education in Practice
j ournal homepage: www. el sevi er. com/ nepr
1471-5953/$ e see front matter 2012 Elsevier Ltd. All rights reserved.
http://dx.doi.org/10.1016/j.nepr.2012.07.011
Nurse Education in Practice 13 (2013) 89e95
The increased numbers entering university globally has led to
the need for changes in the way student support is provided. There
is an increasing amount of literature available related to student
support in higher education, especially within the context of high
numbers of students who enter university as part of widening
participation initiatives and/or who have English as a second
language. Much of the literature, however, is related to higher
education students in general, rather than nursing students. A
study into the role of factors for improving retention in higher
education, showed that non-academic factors, especially self-
condence and motivation to achieve, were the strongest reasons
for student success in higher education (Lotkowski et al., 2004).
This study also found that students who are not provided with
social and academic support are at risk of dropping out. This
supports Rivis (1996) who argued that changes in Government
policy, patterns of entry and the organisation and delivery of
education have focused attention on quality and effectiveness of
the learning experience. This has also generated increased
demands for student support, advice and guidance.
UK government policy and legislation has directly and indirectly
emphasised the importance and imperative of providing support to
university students. Dearing (1997) recommended that higher
education institutions need to reviewon a regular basis the support
services they offer to their students. The Department of Business,
Innovation and Skills in the UK (2011) highlights the need for
universities to deliver a better student experience and to increase
the opportunities for social mobility for students from non-
traditional backgrounds. This supports the ndings of the Student
Charter Group (2011) who highlighted the need for students to
be provided with appropriation information throughout their
higher education experience to ensure that they know what is
expected of them and that they can make the transition from
university to employment.
Support for developing learning skills (e.g., literacy, essay-
writing, referencing, numeracy) has emerged as an issue for
students from non-traditional backgrounds. Academic literacy has
been shown to be directly related to academic success (Yeld, 2003;
Preece and Godfrey, 2004; Holder et al., 1999). In the UK, Yorke and
Longdon (2007) found that the development of learning skills is
best when it is contextualised and embedded in the curriculum.
This supports one of the recommendations of Dearing (1997) who
highlighted the importance of the development of key skills of
communication, numeracy, the use of information technology and
learning how to learn.
The importance of student support as a means of improving
retention in year one is well documented. The House of Commons
Committee of Public Accounts (2008) found that some university
students may feel that academic and pastoral support does not
meet their needs, and that universities need to give personal
tutoring high priority, including training and support to help tutors
to enable them to be fully effective in their support role.
Drew(2001) identied three contextual areas that affected what
helped or hindered student learning in higher education: course
organisation, including resources and facilities; assessment; and
learning activities. In this third area, students identied a range of
skills and activities that helped them to integrate into university
life, including receiving support. Additionally, students who arrive
at university with limited life/coping skills tend to make greater
demands on academic and support staff (Marchbank and Letherby,
2000).
Monk and Robson (1999) suggest that successful participation in
higher education also depends on continuing life skills develop-
ment in students. Gutteridge (2001), in a meta-analysis of ten
studies found that there are three main dimensions of life skills
which may be most crucial to successful participation in higher
education: self-management, self-appraisal and effective commu-
nication. This suggests that support services for students need to
incorporate these three dimensions and that support needs to focus
on the broader learning environment within the institution. This
has been reported elsewhere (Packham and Miller, 2000; Dix and
Hughes, 2004). MacDonald and Stratta (2001) argue that while
teachers in higher education focus on helping non-traditional
students adjust to existing higher education ways of working,
what is needed is a radical rethink of how we approach a more
diverse student population.
Widening participation in healthcare involves more than
increasing the numbers of traditionally under-represented groups.
It is also about ensuring that they are retained, and that they
succeed and progress (Parry, 2003). Price (2002) identied that the
transition to university education can be difcult for nursing
students, especially if they are unsure of how best to work with an
academic tutor. The need to support student nurses is of great
signicance according to Jinks (1997) who states:
How pre-registration nursing students are cared for by nurse
teachers is important in terms of students replicating this
behaviour when delivering patient care
(Jinks, 1997, p. 123)
Gidman (2001) concluded that there was no consensus as to the
most appropriate system of providing this personal tutorial
support. She also highlighted the need for further research studies
in this area.
May et al. (2005) and Hodgson et al. (2008) found that non-
traditional health and social care students are less likely to leave
if there is:
Good student - student interaction (e.g., peer assisted learning)
Good student - lecturer relationships (e.g., student-centred
teaching methods; consistent information to students,
showing students more respect; effective and timely assess-
ment feedback)
Good student - practitioner/mentor interaction (e.g. robust
practice-based mentoring/supervision systems in place)
Good communication systems between students, the Faculty
and practice placement areas
In summary, support for nursing students is an important issue
especially for those institutions where there are signicant
numbers of students from non-traditional backgrounds. Since
provision of this support can be resource-intensive, it is also
important that universities have a clear idea of which support
services are being used by students and how students perceive the
effectiveness of these support services. There is limited research-
based literature related to the specic support needs of nursing
students.
The evaluative research study
Aims and research questions
The aimof the study was to measure the perceptions of students
of the use and usefulness of the support mechanisms provided by
their university. Three research questions were identied:
1. What is the prole of students who enter pre-registration
nursing programmes at the two universities?
2. What support mechanisms are currently available to pre-
registration nursing students at the two universities?
3. What are the students perceptions of the support services
available?
A. Ooms et al. / Nurse Education in Practice 13 (2013) 89e95 90
Research design, data collection and methods of data analysis
Ethical approval was obtained from the Research Ethics
Committee of one of the universities involved in the study; the
other university accepted this decision. A mixed-method approach
to data collection was used. Data were collected rstly, through
a mapping exercise undertaken at both universities to identify and
describe in depth all forms of existing student support across each
university (academic, pastoral, study skills and key skills support).
This identied the range of support services provided to nursing
students at both universities and subsequently, informed a survey
questionnaire that was designed for the main data collection in the
study.
For this study, a survey was carried out through student ques-
tionnaires using a combination of Likert-style and open-ended
questions. The questionnaire was designed by the research team
for this study. The Likert-style questions were in the form of
statements for which students were invited to indicate whether
they agreed, agreed a little, disagreed a little or disagreed with each
statement or, in some cases, whether they found particular support
services very helpful, helpful, unhelpful or very unhelpful. An
explanatory letter was issued and consent was obtained from all
respondents prior to the survey. The questionnaires were distrib-
uted to one cohort of 1st year and one cohort of 3rd year nursing
students at each university. Questionnaires were distributed at the
beginning of scheduled teaching sessions on a given date and all
nursing students attending on that date returned the question-
naires (n 812). Of these, 433 were fromUniversity A and 379 were
from University B. University A has greater total student numbers
per cohort than does University B. The student questionnaire was
designed to gain demographic information to illustrate a prole of
the students across both universities, as well as to gather infor-
mation related to:
Students pattern of use of the support services
Usability of the support services
Impact of the support services students used as perceived by
students
Sustainability
Quality of the support services provided
Quantitative analysis was carried out using SPSS v. 18. Qualita-
tive analysis was undertaken using the Framework Method of
analysis (Ritchie and Spencer, 1994). This method provides for both
identication of themes and a method for identication of
frequency of appearance of each theme from statements coded
from the data.
Findings - quantitative
T-Tests for equality of means were carried out on the quantita-
tive data related to gender, age, educational background prior to
entry to the nursing programme and English as a rst language.
Results showed that nursing students at University A were older
(p .016), there were more students with English as their second
language in University A than in University B (p .008). There were
no signicant differences between the two universities in terms of
gender and prior educational background. There was also no
signicant difference between the rst and third year students.
Support from programme leader
Over 90% of students across both institutions who relied on their
programme leader for support indicated that this support was
somewhat helpful/helpful. However, nearly one-quarter of
students indicated that they did not use the programme leader for
support. Over 77% of respondents agreed/agreed a little that the
programme leader helped them to complete assignments and over
80% of respondents agreed or agreed a little that the programme
leader helped them to develop their study skills. Almost three-
quarters of respondents agreed/agreed a little that the pro-
gramme leader helped reduce their anxiety and 80% agreed/agreed
a little that the programme leader helped them to be successful
students. Just over 70% of respondents agreed/agreed a little that
the programme leader helped to build their condence and 68% of
respondents indicated that the programme leader was the most
import source of student support. T-Tests indicated that nursing
students at University B were signicantly more positive about the
support they received from the programme leader than students at
University A (p .009).
Support from module teachers
Over 94% of respondents indicated that module teachers were
helpful/somewhat helpful in providing support. Less than 10% of
respondents indicated that they did not use module teachers for
support. Almost 90% of respondents agreed/agreed a little that
module teachers helped with assignments and a similar percentage
agreed that module leaders helped to develop study skills.
However, 79% of respondents agreed/agreed a little that module
teachers helped them to feel less anxious and similar percentages
of students agreed that module teachers helped to build their
condence. Almost 84% of students agreed that the module
teachers helped them to be successful students. Nearly 75% of
students agreed/agreed a little that module teachers were a most
important source of support for them.
Support from academic skills sessions (help with essay writing/
preparation for examinations)
Over 87% of those who used the service agreed/agreed a little
that the sessions provided helped them to complete assignments.
Similar percentages of students indicated that the sessions relieved
their anxiety and helped them to be successful students. Over 75%
indicated that the academic skills sessions built their condence
and a similar percentage indicated that the sessions were a most
important source of support for them.
Support from Library/Learning resources centre (LRC) help sessions
About 75% of respondents indicated that they used the LRC for
support and over 90% of those who used the services of the LRC
found them somewhat helpful/helpful. Of these, over 60% agreed/
agreed a little that the LRC helped them to complete assignments.
In addition, over 85% of these agreed/agreed a little that the LRC
support helped them to develop their study skills. Nearly 80% of
students who used the LRC for support indicated that it helped
relieve their anxieties about assignments and a similar percentage
agreed that the LRC helped them to be successful students. Indeed,
nearly 80% of students agreed/agreed a little that the LRC was
a most important source of support for them and built their
academic condence.
Support in literacy and numeracy from dedicated learning
support staff
Both universities in this study provide learning support from
specialist teachers in literacy and numeracy. However, over half the
students did not use these support services. Of those who did use
these support services over 90% found them to be helpful/
A. Ooms et al. / Nurse Education in Practice 13 (2013) 89e95 91
somewhat helpful and just under 90% agreed/agreed a little that
these helped to develop their study skills. A similar percentage of
students agreed/agreed a little that the services decreased their
anxiety, helped them to become successful students and agreed/
agreed a little that they were a most important support service to
them. A similar percentage agreed that the literacy and numeracy
sessions helped to build their condence.
Support from student counselling services
Fewer than 10% of students used the student counselling
services but of those who did, almost 84% found them to be
helpful/somewhat helpful. Nearly 70% of students who used
student counselling agreed/agreed a little that it helped them to
be less anxious and a similar percentage of those who used the
services agreed/agreed a little that it helped them to be
successful students. Just over 64% of those who used the service
agreed/agreed a little that student counselling was a most
important source of support for them and helped to build their
condence.
Support from small group sessions (L2L and APPL)
Both universities provide specic small group sessions to help
nursing students to develop their learning skills. University A
provides yearlong modules called Learning to Learn (L2L). One
such module is provided in each of years 1, 2 and 3, and each of
the modules is timetabled, assessed and credit-awarding. Univer-
sity B provides group support sessions called APPL (Academic,
Professional and Personal Learning Support). The APPL sessions
(Fergy et al., 2011) are not compulsory and are not credit-
awarding. Although there is set content for the APPL sessions,
each APPL facilitator plans and schedules the sessions for her or
his group of students. However, the intention of both the L2L at
University A and APPL sessions at University B is to provide
learning support. One important difference between the two,
however, is that APPL group sessions include help for students to
prepare for assignments; the L2L groups do not include this remit
in their group sessions. This will be further discussed later in this
paper.
Just under 15% of students indicated that they did not make use
of the L2L or APPL sessions. Of those who did, almost 90% found
them to be helpful/somewhat helpful and nearly 80% agreed/
agreed a little that L2L/APPL sessions helped them to complete
assignments. Over 77% of students agreed/agreed a little that the
groups helped them to develop their study skills and a similar
percentage indicated that the groups helped decrease their
anxiety. Nearly 80% of those who participated in the groups
agreed/agreed a little that the groups were responsible for them
being successful students, and nearly 75% agreed/agreed a little
that the groups were a most important source of support for them.
Additionally, 77% agreed/agreed a little that the groups built their
condence.
Support from other services (e.g., nance ofce, student union)
When asked in the questionnaires to identify any other support
services that helped them, 68% indicated that they did not use any
other support services. Financial support was used by a small
number of students at both universities. Interestingly, a number of
students at University A indicated that the student union was
a source of support for them. This is likely to be because it is the
student union at University A that provides a service to help
students present their case for mitigating circumstances when they
have failed an assignment.
Comparison of support services with each other
Using descriptive statistics (mean and standard deviation) the
greatest support was received from the academic literacy and
numeracy sessions, the support sessions offered by the library/LRC,
from module teachers and from academic study skills sessions.
Statistical analysis was undertaken to ascertain the greatest impact
from each of the support services offered. The greatest impact of
the programme leader was on the development of study skills and
completion of assignments. The greatest impact of support from
module teachers, academic skills development support sessions
and the LRC were also on helping students develop study skills and
completing assignments.
However, with regard to the academic literacy and numeracy
support sessions, the greatest impact of these were to develop
study skills but this support also impacted on students perceptions
of being successful, building their condence and decreasing
anxiety.
It was not possible or appropriate to conduct reliability analysis
for all questions related to support services because the number of
students who replied to all questions was insufcient and reliability
analyses are not robust against missing data. However, Cronbachs
alpha reliability analysis was conducted for each of the 8 support
service scales. The reliability of these scales ranged from .925 to
.978 with a mean of .953, with the exception of the Pop-In sessions
support service scale which had a reliability of .800. Finally, there
were no signicant differences between the ndings of rst year
and third year students.
Findings e qualitative
Qualitative analysis of the responses to the open-ended ques-
tions was undertaken using the Framework Method of qualitative
analysis (Ritchie and Spencer, 1994). The Framework Method is
a versatile means of qualitative analysis that provides for a rigorous
structure to which the data can be applied. The two open-ended
questions were:
The best thing about student support services here is... (Q1)
Support for student learning would be better in this university
if... (Q2)
A total of 1701 statements were coded from the returned
questionnaires. Of these, 908 statements (53.4%) were in response
to Q1 and 793 statements (46.6%) were in response to Q2.
Threebroadthemes emergedfromtheanalysis of responses toQ1:
Positive general (non-specic) statements about student
support services
Positive statements about individual specic student support
services
Positive personal characteristics of support personnel
Theme 1: positive general (non-specic) positive statements
Of the 908 statements that were identied and coded from the
data in Q1, 31.7% were general positive statements about student
support provision and the impact that having support services had
on students. Of these, one-quarter were non-specic statements
about support services (e.g., helpful; good; encouraging). The
remaining three-quarters specied exactly what was good or
helpful. Within these, 55.9% identied positively the range, acces-
sibility and/or availability of support services. Just over 20% of the
specic positive statements identied that the support services
A. Ooms et al. / Nurse Education in Practice 13 (2013) 89e95 92
helped to build their condence and 11.6% of the statements in this
section identied good communication between the support
services and the students. Smaller numbers of specic positive
statements were identied in the theme of specic skills gained
from support services (4.6%) and that the support services were
student centred (8.3%).
Theme 2: positive statements about specic individual
support services
Of the 908 statements identied and coded for Q1, 59% were
about what was best about individual specic support services
available at the university. Of these, the greatest number of positive
statements (36%) was about the L2L group sessions (at University A)
and the APPL group sessions (at University B). Within these were
four sub-themes of statements. Over 21% were general statements
in the positive about these group sessions. Additionally, 35.9% were
about positive qualities of the L2L/APPL facilitator. Over 18% were
related to feeling part of a group or not feeling alone. Finally, nearly
of the statements coded about L2L/APPL groups were about help
students received related to feedback on assignments. However, all
these were from students from University B; No statements about
assessment feedback were coded from students from University A.
Reasons for this are presented in the discussion section.
The remaining positive specic statements about individual
support services were divided amongst ten other support services.
These can be seen in Table 1.
Theme 3: personal characteristics of support personnel
The nal broad theme that emerged fromthe statements related
to the best thing about student support services was personal
characteristics of support personnel. Over 9% of statements iden-
tied qualities of approachability, availability and/or helpfulness on
the part of support personnel as positive aspects of the student
support they had experienced.
With regard to the second open-ended question (Q2) four broad
themes emerged from coding the data related to this question as
follows:
Suggested improvements to specic existing support services
Improvements needed to communication
Miscellaneous issues that need to be addressed
General negative statements about student support
Theme 4: suggested improvements to existing specic support
services
Over 42% of statements identied and coded were about
improvements that could be made to L2L/APPL groups including
that they should be branch specic, that literacy/numeracy skills
session should be incorporated into L2L/APPL and that L2L/APPL
sessions should be longer. Additionally, over one-quarter of state-
ments coded requested longer/more frequent literacy/numeracy/
academic support sessions. A further 13.6% of statements requested
improvements to the library support services while 13% of state-
ments requested that support services were available whilst
students were on clinical placements, on other campuses and, in
the case of counselling services, that there needs to be less waiting
time for appointments. Finally, 8.3% of statements were about the
need for more timetabled one-to-one sessions with lecturers/
tutors, 3.6% of statements suggested better feedback was needed
and 3.3% of statements wanted more clinical skills opportunities to
prepare for clinical placements.
Communication issues
Over 21.4% of statements identied communication issues
regarding student support that need to be improved. Only 5% of
these were general statements about the need for improved
communication related to student support. Forty-six percent of
statements made were about the perceived need for better
marketing and advertising of the support services available to
nursing students. Nearly 50% of statements made related to the
need for better access to lecturers, and almost half of these were
about a wish for lecturers to answer emails more promptly. Over
15% of statements indicated that students would like increased
visits from lecturers whilst on placements and 28% of statements
coded indicated that there is inconsistency if information given to
them by their lecturers and by other ofces.
Miscellaneous issues
Forty-ve statements could not be put into other broad cate-
gories of statements and were deemed to be miscellaneous. Of
these, 15.6% of miscellaneous statements were about suggested
changes to improve the university day (e.g., later start time for
lectures; shorter lunch break; shorter gaps between timetabled
lectures). In addition, 68.9% of the statements in this category were
related to changes students would like to see to the content and/or
teaching methods used. These included: better structuring of
lectures; time for discussion at the end of lectures; more lectures
available on Blackboard and more group work.
Discussion
Nursing students at both universities appear to value the
support they receive to enable them to succeed in their nursing
programmes and perceive the support services to be accessible and
available to many. The support services at both universities play
a part in building student condence and decreasing anxiety, and
the support personnel are perceived as helpful and approachable.
Building condence was a recurring theme that emerged from
students in this study, supporting previous work by Lotkowski et al.
(2004). The most used support services were module teachers (90%
of students), L2L/APPL groups (85% of students), programme
leaders (75% of students) and Library/LRC (75% of students). The
least used support services were counselling services (used by 15%
of students) and academic skills services (used by 25% of students).
Although only half of the students surveyed used the numeracy and
academic literacy support services in, these services were judged to
offer the greatest support to students who used them for devel-
oping study skills, building condence, reducing anxiety and
enabling themto succeed. This nding supports previous studies by
Yeld (2003), Preece and Godfrey (2004) and Holder et al. (1999),
and is likely to be a reection of the demography of the students at
Table 1
Support services offered by both universities.
- Help/support with assignments from
branch leader/module tutors/specic lecturers
- Library support services
- Numeracy skills sessions
- Academic writing skills
- Online resources (Bb)
- One-to one tutorials
- Literacy skills sessions
- Clinical skills/simulation sessions
- Dyslexia support services
Miscellaneous support services (e.g., student health
centre; nance ofce; IT; student union)
A. Ooms et al. / Nurse Education in Practice 13 (2013) 89e95 93
these two universities as a high proportion come from non-
traditional backgrounds, are often the rst in their families to
attend university and have English as a second language.
Almost a third of all positive statements made by students were
about the L2L/APPL groups. The positive qualities of the group
facilitator, being part of a group and not feeling alone were
important aspects of these groups. This supports previous studies
by Fergy et al. (2011) and Yorke and Longden (2007). It also appears
to demonstrate that such planned and structured learning support
sessions are an important aspect of student support.
Programme leaders and module teachers provide a signicant
amount and range of support to students at both universities.
Students at University A receive particular support from module
leaders in terms of study skills and assignment help and feedback.
However, students at University B rely on their APPL groups/facil-
itators for help with assignments as this is an integral feature of
APPL groups at University B but is not a feature of the L2L groups at
University A. Students at University A have other support services
to use for assignment completion, largely relying on module
teachers for this. It can be concluded that it is not where this
support is offered, so long as it is offered somewhere.
Both universities provide extensive online resources and
support to students but an interesting nding from the study was
that all positive statements made about the provision of online
resources came from University A; no students from university B
identied online resources as being a support to them. Further
studies would need to be undertaken into why this is so. Learning
support from the Library/LRC staff was viewed positively by both
sets of students. The desire for more group work/smaller classes by
nursing students in this study supports the ndings of May et al.
(2005) who found that students from non-traditional back-
grounds value good student-to-student interaction in class.
The majority of statements about suggested improvements
were about improvements to L2L/APPL groups. This is an inter-
esting nding given that these groups received the most number of
positive statements. In addition, over one-quarter of the statements
made about specic improvements needed was for numeracy and
academic writing skills to be incorporated into L2L/APPL group
sessions, despite the fact that these support services were amongst
the least used support services. This nding is likely to reect the
demographic nature of the students at these two universities.
Issues related to communication need to be addressed by both
universities as students indicated that improvements are needed in
terms of availability/accessibility of lecturers and inconsistency of
information fromlecturers. Students perceive that both universities
need to improve their marketing of support services available. This
is a surprising nding as both universities have in place rigorous,
user-friendly and creative methods for advertising available
support services. Further studies are needed into why they may not
be reaching the students who need them.
There was an unexpectedly high number of negative statements
made by students at University A about the disorganisation of the
university in general. This is likely to have occurred because at the
time this study was undertaken, the health faculty at University A
was moving to a new purpose-built campus which, although has
improved facilities for students generally, caused a good deal of
upheaval and perceived disorganisation as all major campus moves
are likely to do. This is likely to also have inuenced some of the
other more general but nevertheless negative statements made by
students from University A in this study. Now that students are
settled into the new campus, further studies would be needed at
University A to see if this perception of disorganisation still exists.
Overall, the support services that appear to have the greatest
impact on student success in their nursing programme at these two
universities are the programme leaders/module teachers, APPL/L2L
groups and, for the 50% of students who required it, academic
literacy and numeracy support sessions. For students who have
English as a second language and with non-traditional entry
qualications, numeracy and academic literacy support is particu-
larly valued. Many of the positive perceptions of this support lie in
the supportive attitudes/behaviours of staff who provide these
services. Students appear to perceive support services positively
when they specically help with assignments, enable them to
develop their study skills, build their condence and decrease their
anxiety.
Conclusion
Provision of good student support is important in order to retain
students and enable them to succeed. Todays universities are
developing support strategies to enable students to achieve.
However, provision of support services is resource-intensive and all
universities need to ascertain whether the support services they
provide are meeting the needs of students. Robust evaluation of
support service provision is essential to ensure that the right
services are being provided to the right students at the right time.
This large study attempted to take a robust approach to evaluative
research through examining the use, usability, impact quality and
sustainability of support services within schools of nursing in two
universities. The ndings have implications for targeting support
services in the future at these two universities and the study itself
can serve as a template for other universities/faculties wishing to
evaluate their support service provision.
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