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Beyond orientation: Evaluation of student lifecycle activities for first-year Bachelor of Nursing students
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Beyond orientation: Evaluation of student lifecycle activities for first-year Bachelor of Nursing students Peta-Anne Zimmerman a,b,c,∗ , Rebecca Eaton d , Thea van de Mortel a,b,c a
School of Nursing and Midwifery, Griffith University, Gold Coast, Australia Gold Coast Hospital and Health Service, Gold Coast, Australia Menzies Health Institute, Queensland, Australia d Griffith Health Executive, Griffith University, Gold Coast, Australia b c
a r t i c l e
i n f o
Article history: Received 28 September 2016 Received in revised form 30 January 2017 Accepted 14 February 2017 Available online xxx Keywords: First year experience Transition Nursing Orientation Co-curricular support
a b s t r a c t Background: The first year experience has been identified as a key indicator of student success in the higher education environment. Co-curricular activities that support the transition and engagement in university life are key to this, hence a number of initiatives are provided for students to engage in. Method: To assess the value of co-curricular activities to support the first year student experience, an evaluation of Orientation and Common Time experience for Bachelor of Nursing students in a metropolitan university was undertaken using Lizzio’s Five Senses of Success as a framework. Findings: The evaluation demonstrated that supporting students beyond the Orientation Day can significantly increase participating students’ confidence in their senses of resourcefulness, capability and academic culture. Conclusion: The ongoing integration of co-curricular initiatives into undergraduate programs is supported. Summary of relevance: The orientation experience of first-year university students has been well explored, but little has been reported about the efficacy of a dedicated co-curricular program once study has commenced. This is particularly true for undergraduate students studying nursing at university. This paper evaluates the co-curricular activities of the Bachelor of Nursing program at an Australian university to support the transition of undergraduate students and their confidence in engaging in the tertiary environment. © 2017 Australian College of Nursing Ltd. Published by Elsevier Ltd.
1. Introduction In Australia, recent interest in the first year experience (FYE) highlights the challenge of successful transition to university (Scanlon, Rowling, & Weber, 2007; Wilcox, Winn, & Fyvie-Gauld, 2005). The first year is an important area for investigation (Ballantyne, 2012) due to the problem of non-completion of tertiary studies (Krause, 2005). A 2008 retrospective analysis of the average attrition rate of nursing students in seven Australian universities, by Gaynor and colleagues, estimated the average attrition rate in Queensland universities was 24.5%, which is consistent with the findings of a recent systematic review of published primary studies (Gaynor et al., 2007). Yorke and Vaughan (2013) argue that the FYE is exceptionally important as it can augment, lessen or even extinguish a student’s chances of accomplishment. While Brinkworth, McCann, Matthews, and Nordström (2009) add that
∗ Corresponding author at: Office 2.47, Clinical Sciences 2 (G16), Parklands Drive, QLD, 4222, Australia. E-mail address: p.zimmerman@griffith.edu.au (P.-A. Zimmerman).
the FYE impacts on attrition and consequently on university funding, which is often bound to the number of students enrolled. Exploration of the first year student experience yields a critical insight into the broader concerns of student engagement, development, and retention with a positive first year being pivotal for a successful undergraduate experience and facilitating adaptation to the educational environment in the long term (Bowles, Fisher, McPhail, Rosentreich, & Dobson, 2013; McKendry, Boyd, & Andrew, 2010). It should therefore be the goal of higher education providers to ensure that first year students are nurtured within an expert community where they are exposed to excellence in scholarship, practice, and supervision to promote successful transition and professional development (Andrew, Robb, Ferguson, & Brown, 2011). 1.1. First-year nursing students Nursing is a discipline that has moved from vocational to professional status (Andrew et al., 2011), promoting and valuing nurturing and the holistic care of the individual (Lemonidou, Papathanassoglou, Giannakopoulou, Patiraki & Papadatou, 2004). The complex and challenging nature of undergraduate nursing pro-
http://dx.doi.org/10.1016/j.colegn.2017.02.004 1322-7696/© 2017 Australian College of Nursing Ltd. Published by Elsevier Ltd.
Please cite this article in press as: Zimmerman, P. -A., et al. Beyond orientation: Evaluation of student lifecycle activities for first-year Bachelor of Nursing students. Collegian (2017), http://dx.doi.org/10.1016/j.colegn.2017.02.004
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grams has been acknowledged, and the literature highlights that it is a steep learning curve for nursing students to adapt to and encompass both an academic and professional environment (Andrew, McGuinness, Reid, & Corcoran, 2009). Early experience is extremely influential in forming personhood and ‘moral agency’ and is a vital part of the nurse’s development (Lemonidou et al., 2004). Andrew et al. (2011) comment that nursing students want to belong to the community, to feel part of the profession, to develop a sense of professional identity, and to be adequately prepared for being both a university student and a novice practitioner from their very early stage of development. Learning to balance the demands of study, work, family, and social life can be challenging for many nursing students (Andrew et al., 2009; Higginson, 2006), and for some students, entering nursing education can induce fear and generate anxiety (Higginson, 2006). Higginson (2006) explains that some stresses are common to all students, including exams and financial worries, but many stressors are specific to nursing education such as patient death, bodily fluids, clinical procedures, role conflict, and socialisation clash. A study conducted by Mehta, Robinson, and Hillege (2008) discovered that students across three universities were scared of learning science in spite of realising the importance of science subjects in becoming a nurse. Timmins and Kaliszer (2002) find that student nurses can experience both academic and clinical related stressors, which may be caused partly by general ‘non-integration’ into the university due to frequent rotations between academic and placement settings and not spending enough time in either location sufficient to develop a sense of professional identity and belonging. However, nursing is essentially a practice-based discipline and Henderson, Twentyman, Heel and Llyod (2006) demand that a supportive learning environment be in place for the successful and smooth transfer of learning into a clinical context. Contemporary student nurses are not a homogeneous group (Andrew et al., 2011). It is reported that the profile has changed to include older, educationally unprepared students, particularly since the early 1990s (Bittman et al., 2004). This trend is significant as mature students experience the battle of balancing academic study and home life more often than younger students (Christensson, Vaez, Dickman, & Runeson, 2011). Particularly, family commitments, financial concerns, and childcare issues are found to be the main aspects impacting on mature age students’ study (Montgomery, Tansey, & Roe, 2009). These students report feeling disadvantaged in terms of the maths and science components of the course (Mehta et al., 2008; Stewart, Mort, & McVeigh, 2001), but they tend to self-refer for learning support such as family support and support from other off-campus sources for maintaining motivation and contributing to positive learning experiences (Stewart et al., 2001). As such, mature students require a key approach to enable their successful transition to university study, and tertiary institutions are encouraged to support mature-age students through the adoption of tailored part-time study programs and bursaries (Montgomery et al., 2009). This paper is an explorative evaluation of: 1) a full day targeted induction “Orientation” and, 2) first semester “Common Time” (CT) academic support sessions, that run for 60 minutes per week, for Bachelor of Nursing (BN) students entering the first year of the program. The results of this evaluation are considered in light of the relevant literature to identify future directions for these initiatives. 2. Method 2.1. Intervention The targeted ‘Orientation’ program included welcome addresses from school officials in addition to presentations informing students about their program and the factors that predict success
in first year. Students were then introduced to key support staff and services, both within the school and across the university (e.g. course convenors, BN peer mentors, and advisors from Student Services, Library and Learning Services, and the International Office). Information and resources were provided regarding preparation for clinical placement. Subsequently students were taken on a campus tour and received an introduction to the online learning environment. The ‘CT’ program consisted of an 11-week workshop program that was aligned to clinical tasks and assessment across the first semester of study. The program structure across the semester consisted of workshops focusing on professional practice preparation, time management and effective planning, deconstructing semester one written assessment tasks, formatting and referencing guidance, exam planning and preparation, and tips for preparing for Objective Structured Clinical Assessments (OSCAs). A collaborative approach was utilised in workshop design and delivery, involving both school/academic staff and support staff from library and learning services. 2.2. Sample An initial sample of 182 students from the first-year cohort of the Bachelor of Nursing program at a metropolitan university volunteered to provide pre- and post-evaluative feedback on the first-year activities of Orientation and CT as part of standard quality improvement initiatives. Demographics were not sought as the size of the overall cohort limits the ability to target initiatives and a whole of School approach is required to support the heterogeneous student body. 2.3. Measures Pre- and post-evaluative questionnaires for both Orientation and CT were developed based upon the Five Senses of Success Model, which highlights how student success at university is dependent on students’ sense of purpose, capability, resourcefulness, connectedness, and academic culture (Lizzio, 2006). The questionnaires were anonymous and utilised as part of continuous quality improvement initiatives. As sense of purpose was determined to be a developmental process that unfolds across the entire student lifecycle, this aspect of Lizzio’s (2006) model was not investigated, as both first-year transition activities evaluated in this quality improvement process took place within the first semester of program study. In order to minimise student burden, each questionnaire was deliberately designed to be brief. The pre- and post-Orientation questionnaires included measures of student capability (e.g. “Overall, how confident do you feel that you can successfully navigate the university’s online learning environment?”), resourcefulness (e.g. “How confident do you feel that you know where to go for help or advice?”), connectedness (e.g. “Overall, did you find attending Orientation Day helped you meet new people in your cohort?”), and academic culture (“How confident are you that you know what to expect next week when you turn up for your first classes?”). To assess student confidence in relation to these senses of success, a 7-point Likert-type response scale was utilised ranging from 1 (Not at all) to 7 (Very confident). The post-Orientation questionnaire also obtained qualitative feedback, assessing aspects of the day-long program that students enjoyed the most, enjoyed the least, and what other activities or information they would have liked presented during the session. As the CT workshop series were more focused on preparing students to transition into university study and engage successfully in their coursework and assessment, the CT preand post-questionnaires concentrated on assessing the senses of
Please cite this article in press as: Zimmerman, P. -A., et al. Beyond orientation: Evaluation of student lifecycle activities for first-year Bachelor of Nursing students. Collegian (2017), http://dx.doi.org/10.1016/j.colegn.2017.02.004
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Table 1 Descriptive and inferential data for student confidence ratings pre- and post- Orientation Day and Common Time Workshop Series. Sense of Success
Orientation Day Resourcefulness Seeking help or advice Navigating the campus Capability Online navigation Class engagement Academic Culture Realistic expectations Common Time Resourcefulness Organising MRs Balancing commitments Seeking help or advice Navigating the campus Capability Online navigation Study skills Deconstructing tasks Reading literature Writing assignments Proof-reading and editing Format and referencing Undertaking OSCAs
Pre-Assessment
Post-Assessment
Significance testing
N
M
SD
N
M
SD
t
df
182 182
4.28 4.48
1.36 1.61
93 93
5.56 5.57
1.00 1.28
−8.82*** −6.09***
238.5 225.9
182 182
4.52 4.73
1.45 1.48
93 93
5.18 5.31
1.13 1.08
−4.12*** −3.74***
228.8 240.1
182
3.93
1.69
93
5.20
1.15
−7.27***
250.9
145 145 145 145
4.82 4.77 5.01 4.81
1.37 1.32 1.32 1.44
32 32 32 32
5.97 5.19 5.56 6.22
1.12 1.26 1.13 1.24
−5.00*** −1.67 −2.44** −5.64***
53.4 47.2 51.0 51.3
145 145 145 145 145 145 145 145
4.79 4.76 4.39 4.12 4.09 4.17 3.76 4.04
1.41 1.24 1.33 1.42 1.40 1.33 1.60 1.39
32 32 32 32 32 32 32 32
6.34 5.31 4.91 4.81 4.56 4.50 4.81 4.59
0.97 1.20 1.33 1.47 1.56 1.72 1.51 1.46
−7.51*** −2.34* −1.99 −2.43* −1.58 −1.01 −3.50** −1.96
63.2 46.5 45.5 44.8 42.5 36.6 47.5 44.4
Note: *p < .05. **p < .01, ***p < .001. MRs = Mandatory Requirements. OSCAs = Objective Structured Clinical Examination.
resourcefulness and capability only. Several items were designed to evaluate confidence in relation to academic resourcefulness (e.g. How confident do you feel in relation to: “Finding your way around campus?” and “Managing your time effectively to balance university commitments, paid employment and outside life?”) and academic capability (e.g. How confident do you feel in relation to: “Having the necessary study skills to engage in your courses successfully from week-to-week across the semester” and “Understanding the specific requirements of assessment tasks”). The same response scale was utilised as that used in the Orientation Day questionnaires. While similar qualitative feedback was also sought on the post-CT questionnaire as that included on the post-Orientation Day measure, additional information was sought on whether students felt having the ability to ask questions during CT impacted their ability to successfully complete and submit assignments, and whether students felt that attending the CT workshops gave them the necessary tools and skills to complete and submit assignment work in the future. 2.4. Procedure Students completed hard copy questionnaires at the commencement and closing of the School based full-day Orientation and during the first and final CT sessions of the semester. With the pre- and post-questionnaires designed specifically to be brief (to decrease burden and minimise time taken away from each transition activity), it took approximately 10 minutes for student feedback to be obtained at each phase. The Griffith University Human Ethics Committee determined that this project did not require ethical review and approval on the basis that the primary purpose of the data collection was to evaluate/improve a university service. 2.5. Data analysis To assess differences in anonymous pre- and post-measures of student confidence for items gauging the senses of resourcefulness, capability, and academic culture, means were obtained and inde-
pendent t-tests were conducted. As there were unequal sample sizes in the pre- and post-assessments of both first year activities (see Table 1), the Welch correction was used to account for any possible issues in relation to homogeneity of variance (Zimmerman, 2004). To assess the sense of connectedness, percentages were calculated based on student reports of how many other nursing students they knew in their commencing cohort both at the commencement and at the conclusion of Orientation Day. Responses to open ended questions were categorised to identify key components relevant to their experiences (Richardson-Tench, Taylor & Beverley, 2014). 3. Results The response rates and descriptive and inferential data for both the Orientation and CT pre- and post-confidence ratings are presented in Table 1. Examination of Orientation Day data shows significant increases in each of the senses of success measured. Compared to assessments at the point of arrival, at the conclusion of Orientation Day students reported a greater ‘sense of resourcefulness’ in relation to navigating the campus and knowing who to approach for advice and support, and a greater ‘sense of capability’, in terms of navigating the online learning environment and feeling ready to confidently participate and engage in week one classes. This was identified within the qualitative data as a key aspect of the orientation experience as the campus tours (n = 60/323, 18.6%) featured as a common theme for students (Table 2). The ‘sense of academic culture’ also increased, as students reported significantly higher levels of confidence in knowing what to expect at university in week one after attending Orientation Day compared to when they first arrived. Orientation Day was also successful in enhancing the ‘sense of connectedness’ among students. Upon arrival, 47.8% of students reported knowing other students in their Nursing cohort, while 91.4% reported doing so when assessed again at the conclusion of Orientation Day. This ‘sense of connectedness’ was reflected by students identifying the most important and enjoyable aspect of the orientation experience was their engagement with the peer mentors (n = 105/323, 32.5%)
Please cite this article in press as: Zimmerman, P. -A., et al. Beyond orientation: Evaluation of student lifecycle activities for first-year Bachelor of Nursing students. Collegian (2017), http://dx.doi.org/10.1016/j.colegn.2017.02.004
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Table 2 Identification of most valuable aspects of Orientation Day activities. Most important aspect of orientation day
No. of mentions by students
Percentage of responses
Peer mentors Campus tour Presentations by University staff Meeting other students Online tour Clinical placement requirements Services available University opportunities Lunch Prizes TOTAL
105 60 30 27 23 23 20 15 12 8 323
32.5% 18.6% 9.29% 8.36% 7.12% 7.12% 6.19% 4.64% 3.72% 2.48%
Table 3 Identification of most valuable aspects of Common Time activities. Most important aspect of Common Time
No. of mentions by students
Percentage of responses
Referencing skills Exam preparation OSCA preparation Essay writing Time management Approachable support staff Career planning Research skills Total
8 5 4 3 3 2 2 2 29
27.6% 17.2% 13.8% 10.3% 10.3% 6.9% 6.9% 6.9%
that a number of enablers can assist first year students with transition to university, including the availability of student support services, accessibility to information technological services, the relevance of study material and study skills support. One of the key positive impacts on student satisfaction and confidence in our evaluation was access to peer mentors. Pikethly and Prosser (2001) similarly suggest that positive relationships may be created through first year student interaction with student guides, student peer coaches, working in small groups with staff coordinators, and improved staff-student ratios in first year classes (Pitkethly & Prosser, 2001). These supportive relationships can enhance students’ socialisation and adaptation. Bowles et al. (2013) explored students’ perceptions of factors enabling successful transition to university and found that studentcentred enablers − which are measured by perceptions of study, effort, and culture − are endogenous to the students and thus largely beyond university control, while university-led enablers − measured by perceptions of Orientation, the online environment, facilities, and social activities, are exogenous to the students. Identifying enablers of transition that can be influenced by universities provides them with the opportunity to assist students in the successful transition to higher education. The research clearly highlights that universities need to concentrate on not only encouraging students’ efforts in their studies but also on extrinsic factors such as Orientation, as it appears to be a useful tool for commencing students.
OSCA = Objective Structured Clinical Examination.
4.2. Beyond orientation and the opportunity to meet other students (n = 27/323, 8.36%) (see Table 2). Compared to week one, at the conclusion of the CT workshop series, students reported a significantly increased ‘sense of resourcefulness’ as evidenced by increased confidence in relation to organising mandatory requirement documentation, seeking advice and support, and navigating the campus (Table 1). An increase in the ‘sense of capability’ was also noted, as students reported being significantly more confident in navigating the online learning environment, having the necessary study skills to maximise course engagement, being able to read and critique scholarly literature, and confidently format and reference assignments. Students did not however report feeling more confident at the conclusion of the CT series, compared to the start of the program, in relation to balancing their time (resourcefulness) and in relation to understanding and writing assignments or undertaking OSCAs (capability). Similarly, in the qualitative data (Table 3) more students identified referencing skills as the most useful aspect of CT while OSCA preparation (n = 4/29, 13.8%) and essay writing and time management (n = 3/29, 10.3%) received comparatively fewer mentions by students. 4. Discussion 4.1. The role of orientation The Five Senses Framework (Lizzio, 2006) and work by Tinto (Tinto, 2009), demonstrate that proactive engagement with first year students enhances the FYE and improves retention rates on a number of levels (Burnett & Larmar, 2011). The results of this study add further support for this thesis in relation to nursing students. Evaluation of our orientation process demonstrated that students experienced improved feelings of resourcefulness, capability, and connectedness, and had a better understanding of academic culture, suggesting that a structured and comprehensive orientation can improve first year engagement. McInnis (2002) similarly found
Evaluations of university induction indicate that students often experience a burden of inquiry upon arrival and that effective induction should be spread through the first semester, or even the first whole year (Briggs, Clark, & Hall, 2012). Edward (2003) offers a positive example of an intensive activity-based initial induction, designed to introduce the students to the university, the program, the staff and each other. Keup and Barefoot (2005) indicate how participation of students in seminars and workshops can sustain this socialisation process during the first year. They report students’ feelings of personal success at establishing a network of peers, producing meaningful connections with faculty and staff and using campus services. Findings from these studies directly informed the rationale for designing our orientation and transition program to span a full academic semester. This strategy was deemed a success, with nursing students who attended and engaged in both the Orientation Day and the targeted, weekly CT workshops more confident, connected, resourceful, and capable by the end of their first semester of study. Engaging first year students calls for more collaboration in terms of adopting a holistic approach to course delivery and support. The literature reports that collaborative support models, such as those presented by CT, provide an informal consultative service where students can obtain assessment support for research and writing (Einfalt & Turley, 2013). It is suggested that this collaborative support model has played an important role in raising awareness about academic skills and the processes for researching and writing, promoting peer learning opportunities and building confidence among first year students (Einfalt and Turley, 2013). The provision of scaffolded academic support in a CT format is also a more efficient and effective way of providing learning assistance to large cohorts of students. Given the findings from this evaluation, however, there appears to be further investigation required into the confidence of students in relation to their sense of resourcefulness with time management and their sense of capability in OSCA preparation and essay writing, with perhaps a different model required to address these.
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4.3. Limitations This evaluation did not identify the demographics of the cohort, and as such the findings and subsequent outcomes must be applied to the entire first-year cohort. In future evaluations, demographics may be sought to identify key sub-groups that may require further targeted initiatives. Furthermore, as no psychometric analysis was undertaken on the items designed to assess the five senses of success, the validity and reliability of these items cannot be guaranteed. Results must be therefore interpreted accordingly. 5. Implications and conclusion Supporting students’ transition into first year at university is a great challenge that requires creative solutions and collaboration. The FYE plays a critical role in assisting successful transitions to tertiary study, retaining students, and building up the educational foundations for academic success. The challenges faced by first year students are varied and complex, with nursing students in particular encountering additional challenges subsequent to the requirement of participation in clinical placements. Acquiring a deeper understanding of the issues and needs of commencing nursing students is therefore the first essential step in order to develop strategies to promote an effective learning experience in an effort to raise students’ overall satisfaction with their undergraduate experience as well as to increase the likelihood of degree completion. References Andrew, N., McGuinness, C., Reid, G., & Corcoran, T. (2009). Greater than the sum of its parts: transition into the first year of undergraduate nursing. Nurse Education in Practice, 9(1), 13–21. http://dx.doi.org/10.1016/j.nepr.2008.03.009 Andrew, N., Robb, Y., Ferguson, D., Brown, J., et al. (2011). ‘Show us you know us’: Using the Senses Framework to support the professional development of undergraduate nursing students. Nurse Education in Practice, 11(6), 356–359. http://dx.doi.org/10.1016/j.nepr.2011.03.006 Ballantyne, J. (2012). Valuing students’ voices: experiences of first year students at a new campus. International Journal of Pedagogies & Learning, 7(1), 41–50. Bittman, B. B., Snyder, C., Bruhn, K. T., Liebfried, F., Stevens, C. K., Westengard, J., et al. (2004). Recreational music-making: an integrative group intervention for reducing burnout and improving mood states in first year associate degree nursing students: insights and economic impact. International Journal of Nursing Education Scholarship, 1(1) [p. Article12]. Bowles, A., Fisher, R., McPhail, R., Rosentreich, D., & Dobson, A. (2013). Staying the distance: students’ perceptions of enablers of transition to higher education. Higher Education Research & Development, 33(2), 212–225. Briggs, A. R. J., Clark, J., & Hall, I. (2012). Building bridges: understanding student transition to university. Quality in Higher Education, 18(1), 3–21. Brinkworth, R., McCann, B., Matthews, C., & Nordström, K. (2009). First year expectations and experiences: student and teacher perspectives. Higher Education, 2, 157–173. Burnett, L., & Larmar, S. (2011). Improving the first year through an institution-wide approach: The role of first year advisors. The International Journal of the First Year in Higher Education, 2(1), 21–35. Christensson, A., Vaez, M., Dickman, P., & Runeson, B. (2011). Self-reported depression in first-year nursing students in relation to socio-demographic and educational factors: a nationwide cross-sectional study in Sweden. Social Psychiatry and Psychiatric Epidemiology, 46(4), 299–310.
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Beyond orientation: Evaluation of student lifecycle activities for first-year Bachelor of Nursing students Peta-Anne Zimmerman a,b,c,∗ , Rebecca Eaton d , Thea van de Mortel a,b,c a
School of Nursing and Midwifery, Griffith University, Gold Coast, Australia Gold Coast Hospital and Health Service, Gold Coast, Australia Menzies Health Institute, Queensland, Australia d Griffith Health Executive, Griffith University, Gold Coast, Australia b c
a r t i c l e
i n f o
Article history: Received 28 September 2016 Received in revised form 30 January 2017 Accepted 14 February 2017 Available online xxx Keywords: First year experience Transition Nursing Orientation Co-curricular support
a b s t r a c t Background: The first year experience has been identified as a key indicator of student success in the higher education environment. Co-curricular activities that support the transition and engagement in university life are key to this, hence a number of initiatives are provided for students to engage in. Method: To assess the value of co-curricular activities to support the first year student experience, an evaluation of Orientation and Common Time experience for Bachelor of Nursing students in a metropolitan university was undertaken using Lizzio’s Five Senses of Success as a framework. Findings: The evaluation demonstrated that supporting students beyond the Orientation Day can significantly increase participating students’ confidence in their senses of resourcefulness, capability and academic culture. Conclusion: The ongoing integration of co-curricular initiatives into undergraduate programs is supported. Summary of relevance: The orientation experience of first-year university students has been well explored, but little has been reported about the efficacy of a dedicated co-curricular program once study has commenced. This is particularly true for undergraduate students studying nursing at university. This paper evaluates the co-curricular activities of the Bachelor of Nursing program at an Australian university to support the transition of undergraduate students and their confidence in engaging in the tertiary environment. © 2017 Australian College of Nursing Ltd. Published by Elsevier Ltd.
1. Introduction In Australia, recent interest in the first year experience (FYE) highlights the challenge of successful transition to university (Scanlon, Rowling, & Weber, 2007; Wilcox, Winn, & Fyvie-Gauld, 2005). The first year is an important area for investigation (Ballantyne, 2012) due to the problem of non-completion of tertiary studies (Krause, 2005). A 2008 retrospective analysis of the average attrition rate of nursing students in seven Australian universities, by Gaynor and colleagues, estimated the average attrition rate in Queensland universities was 24.5%, which is consistent with the findings of a recent systematic review of published primary studies (Gaynor et al., 2007). Yorke and Vaughan (2013) argue that the FYE is exceptionally important as it can augment, lessen or even extinguish a student’s chances of accomplishment. While Brinkworth, McCann, Matthews, and Nordström (2009) add that
∗ Corresponding author at: Office 2.47, Clinical Sciences 2 (G16), Parklands Drive, QLD, 4222, Australia. E-mail address: p.zimmerman@griffith.edu.au (P.-A. Zimmerman).
the FYE impacts on attrition and consequently on university funding, which is often bound to the number of students enrolled. Exploration of the first year student experience yields a critical insight into the broader concerns of student engagement, development, and retention with a positive first year being pivotal for a successful undergraduate experience and facilitating adaptation to the educational environment in the long term (Bowles, Fisher, McPhail, Rosentreich, & Dobson, 2013; McKendry, Boyd, & Andrew, 2010). It should therefore be the goal of higher education providers to ensure that first year students are nurtured within an expert community where they are exposed to excellence in scholarship, practice, and supervision to promote successful transition and professional development (Andrew, Robb, Ferguson, & Brown, 2011). 1.1. First-year nursing students Nursing is a discipline that has moved from vocational to professional status (Andrew et al., 2011), promoting and valuing nurturing and the holistic care of the individual (Lemonidou, Papathanassoglou, Giannakopoulou, Patiraki & Papadatou, 2004). The complex and challenging nature of undergraduate nursing pro-
http://dx.doi.org/10.1016/j.colegn.2017.02.004 1322-7696/© 2017 Australian College of Nursing Ltd. Published by Elsevier Ltd.
Please cite this article in press as: Zimmerman, P. -A., et al. Beyond orientation: Evaluation of student lifecycle activities for first-year Bachelor of Nursing students. Collegian (2017), http://dx.doi.org/10.1016/j.colegn.2017.02.004
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grams has been acknowledged, and the literature highlights that it is a steep learning curve for nursing students to adapt to and encompass both an academic and professional environment (Andrew, McGuinness, Reid, & Corcoran, 2009). Early experience is extremely influential in forming personhood and ‘moral agency’ and is a vital part of the nurse’s development (Lemonidou et al., 2004). Andrew et al. (2011) comment that nursing students want to belong to the community, to feel part of the profession, to develop a sense of professional identity, and to be adequately prepared for being both a university student and a novice practitioner from their very early stage of development. Learning to balance the demands of study, work, family, and social life can be challenging for many nursing students (Andrew et al., 2009; Higginson, 2006), and for some students, entering nursing education can induce fear and generate anxiety (Higginson, 2006). Higginson (2006) explains that some stresses are common to all students, including exams and financial worries, but many stressors are specific to nursing education such as patient death, bodily fluids, clinical procedures, role conflict, and socialisation clash. A study conducted by Mehta, Robinson, and Hillege (2008) discovered that students across three universities were scared of learning science in spite of realising the importance of science subjects in becoming a nurse. Timmins and Kaliszer (2002) find that student nurses can experience both academic and clinical related stressors, which may be caused partly by general ‘non-integration’ into the university due to frequent rotations between academic and placement settings and not spending enough time in either location sufficient to develop a sense of professional identity and belonging. However, nursing is essentially a practice-based discipline and Henderson, Twentyman, Heel and Llyod (2006) demand that a supportive learning environment be in place for the successful and smooth transfer of learning into a clinical context. Contemporary student nurses are not a homogeneous group (Andrew et al., 2011). It is reported that the profile has changed to include older, educationally unprepared students, particularly since the early 1990s (Bittman et al., 2004). This trend is significant as mature students experience the battle of balancing academic study and home life more often than younger students (Christensson, Vaez, Dickman, & Runeson, 2011). Particularly, family commitments, financial concerns, and childcare issues are found to be the main aspects impacting on mature age students’ study (Montgomery, Tansey, & Roe, 2009). These students report feeling disadvantaged in terms of the maths and science components of the course (Mehta et al., 2008; Stewart, Mort, & McVeigh, 2001), but they tend to self-refer for learning support such as family support and support from other off-campus sources for maintaining motivation and contributing to positive learning experiences (Stewart et al., 2001). As such, mature students require a key approach to enable their successful transition to university study, and tertiary institutions are encouraged to support mature-age students through the adoption of tailored part-time study programs and bursaries (Montgomery et al., 2009). This paper is an explorative evaluation of: 1) a full day targeted induction “Orientation” and, 2) first semester “Common Time” (CT) academic support sessions, that run for 60 minutes per week, for Bachelor of Nursing (BN) students entering the first year of the program. The results of this evaluation are considered in light of the relevant literature to identify future directions for these initiatives. 2. Method 2.1. Intervention The targeted ‘Orientation’ program included welcome addresses from school officials in addition to presentations informing students about their program and the factors that predict success
in first year. Students were then introduced to key support staff and services, both within the school and across the university (e.g. course convenors, BN peer mentors, and advisors from Student Services, Library and Learning Services, and the International Office). Information and resources were provided regarding preparation for clinical placement. Subsequently students were taken on a campus tour and received an introduction to the online learning environment. The ‘CT’ program consisted of an 11-week workshop program that was aligned to clinical tasks and assessment across the first semester of study. The program structure across the semester consisted of workshops focusing on professional practice preparation, time management and effective planning, deconstructing semester one written assessment tasks, formatting and referencing guidance, exam planning and preparation, and tips for preparing for Objective Structured Clinical Assessments (OSCAs). A collaborative approach was utilised in workshop design and delivery, involving both school/academic staff and support staff from library and learning services. 2.2. Sample An initial sample of 182 students from the first-year cohort of the Bachelor of Nursing program at a metropolitan university volunteered to provide pre- and post-evaluative feedback on the first-year activities of Orientation and CT as part of standard quality improvement initiatives. Demographics were not sought as the size of the overall cohort limits the ability to target initiatives and a whole of School approach is required to support the heterogeneous student body. 2.3. Measures Pre- and post-evaluative questionnaires for both Orientation and CT were developed based upon the Five Senses of Success Model, which highlights how student success at university is dependent on students’ sense of purpose, capability, resourcefulness, connectedness, and academic culture (Lizzio, 2006). The questionnaires were anonymous and utilised as part of continuous quality improvement initiatives. As sense of purpose was determined to be a developmental process that unfolds across the entire student lifecycle, this aspect of Lizzio’s (2006) model was not investigated, as both first-year transition activities evaluated in this quality improvement process took place within the first semester of program study. In order to minimise student burden, each questionnaire was deliberately designed to be brief. The pre- and post-Orientation questionnaires included measures of student capability (e.g. “Overall, how confident do you feel that you can successfully navigate the university’s online learning environment?”), resourcefulness (e.g. “How confident do you feel that you know where to go for help or advice?”), connectedness (e.g. “Overall, did you find attending Orientation Day helped you meet new people in your cohort?”), and academic culture (“How confident are you that you know what to expect next week when you turn up for your first classes?”). To assess student confidence in relation to these senses of success, a 7-point Likert-type response scale was utilised ranging from 1 (Not at all) to 7 (Very confident). The post-Orientation questionnaire also obtained qualitative feedback, assessing aspects of the day-long program that students enjoyed the most, enjoyed the least, and what other activities or information they would have liked presented during the session. As the CT workshop series were more focused on preparing students to transition into university study and engage successfully in their coursework and assessment, the CT preand post-questionnaires concentrated on assessing the senses of
Please cite this article in press as: Zimmerman, P. -A., et al. Beyond orientation: Evaluation of student lifecycle activities for first-year Bachelor of Nursing students. Collegian (2017), http://dx.doi.org/10.1016/j.colegn.2017.02.004
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Table 1 Descriptive and inferential data for student confidence ratings pre- and post- Orientation Day and Common Time Workshop Series. Sense of Success
Orientation Day Resourcefulness Seeking help or advice Navigating the campus Capability Online navigation Class engagement Academic Culture Realistic expectations Common Time Resourcefulness Organising MRs Balancing commitments Seeking help or advice Navigating the campus Capability Online navigation Study skills Deconstructing tasks Reading literature Writing assignments Proof-reading and editing Format and referencing Undertaking OSCAs
Pre-Assessment
Post-Assessment
Significance testing
N
M
SD
N
M
SD
t
df
182 182
4.28 4.48
1.36 1.61
93 93
5.56 5.57
1.00 1.28
−8.82*** −6.09***
238.5 225.9
182 182
4.52 4.73
1.45 1.48
93 93
5.18 5.31
1.13 1.08
−4.12*** −3.74***
228.8 240.1
182
3.93
1.69
93
5.20
1.15
−7.27***
250.9
145 145 145 145
4.82 4.77 5.01 4.81
1.37 1.32 1.32 1.44
32 32 32 32
5.97 5.19 5.56 6.22
1.12 1.26 1.13 1.24
−5.00*** −1.67 −2.44** −5.64***
53.4 47.2 51.0 51.3
145 145 145 145 145 145 145 145
4.79 4.76 4.39 4.12 4.09 4.17 3.76 4.04
1.41 1.24 1.33 1.42 1.40 1.33 1.60 1.39
32 32 32 32 32 32 32 32
6.34 5.31 4.91 4.81 4.56 4.50 4.81 4.59
0.97 1.20 1.33 1.47 1.56 1.72 1.51 1.46
−7.51*** −2.34* −1.99 −2.43* −1.58 −1.01 −3.50** −1.96
63.2 46.5 45.5 44.8 42.5 36.6 47.5 44.4
Note: *p < .05. **p < .01, ***p < .001. MRs = Mandatory Requirements. OSCAs = Objective Structured Clinical Examination.
resourcefulness and capability only. Several items were designed to evaluate confidence in relation to academic resourcefulness (e.g. How confident do you feel in relation to: “Finding your way around campus?” and “Managing your time effectively to balance university commitments, paid employment and outside life?”) and academic capability (e.g. How confident do you feel in relation to: “Having the necessary study skills to engage in your courses successfully from week-to-week across the semester” and “Understanding the specific requirements of assessment tasks”). The same response scale was utilised as that used in the Orientation Day questionnaires. While similar qualitative feedback was also sought on the post-CT questionnaire as that included on the post-Orientation Day measure, additional information was sought on whether students felt having the ability to ask questions during CT impacted their ability to successfully complete and submit assignments, and whether students felt that attending the CT workshops gave them the necessary tools and skills to complete and submit assignment work in the future. 2.4. Procedure Students completed hard copy questionnaires at the commencement and closing of the School based full-day Orientation and during the first and final CT sessions of the semester. With the pre- and post-questionnaires designed specifically to be brief (to decrease burden and minimise time taken away from each transition activity), it took approximately 10 minutes for student feedback to be obtained at each phase. The Griffith University Human Ethics Committee determined that this project did not require ethical review and approval on the basis that the primary purpose of the data collection was to evaluate/improve a university service. 2.5. Data analysis To assess differences in anonymous pre- and post-measures of student confidence for items gauging the senses of resourcefulness, capability, and academic culture, means were obtained and inde-
pendent t-tests were conducted. As there were unequal sample sizes in the pre- and post-assessments of both first year activities (see Table 1), the Welch correction was used to account for any possible issues in relation to homogeneity of variance (Zimmerman, 2004). To assess the sense of connectedness, percentages were calculated based on student reports of how many other nursing students they knew in their commencing cohort both at the commencement and at the conclusion of Orientation Day. Responses to open ended questions were categorised to identify key components relevant to their experiences (Richardson-Tench, Taylor & Beverley, 2014). 3. Results The response rates and descriptive and inferential data for both the Orientation and CT pre- and post-confidence ratings are presented in Table 1. Examination of Orientation Day data shows significant increases in each of the senses of success measured. Compared to assessments at the point of arrival, at the conclusion of Orientation Day students reported a greater ‘sense of resourcefulness’ in relation to navigating the campus and knowing who to approach for advice and support, and a greater ‘sense of capability’, in terms of navigating the online learning environment and feeling ready to confidently participate and engage in week one classes. This was identified within the qualitative data as a key aspect of the orientation experience as the campus tours (n = 60/323, 18.6%) featured as a common theme for students (Table 2). The ‘sense of academic culture’ also increased, as students reported significantly higher levels of confidence in knowing what to expect at university in week one after attending Orientation Day compared to when they first arrived. Orientation Day was also successful in enhancing the ‘sense of connectedness’ among students. Upon arrival, 47.8% of students reported knowing other students in their Nursing cohort, while 91.4% reported doing so when assessed again at the conclusion of Orientation Day. This ‘sense of connectedness’ was reflected by students identifying the most important and enjoyable aspect of the orientation experience was their engagement with the peer mentors (n = 105/323, 32.5%)
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Table 2 Identification of most valuable aspects of Orientation Day activities. Most important aspect of orientation day
No. of mentions by students
Percentage of responses
Peer mentors Campus tour Presentations by University staff Meeting other students Online tour Clinical placement requirements Services available University opportunities Lunch Prizes TOTAL
105 60 30 27 23 23 20 15 12 8 323
32.5% 18.6% 9.29% 8.36% 7.12% 7.12% 6.19% 4.64% 3.72% 2.48%
Table 3 Identification of most valuable aspects of Common Time activities. Most important aspect of Common Time
No. of mentions by students
Percentage of responses
Referencing skills Exam preparation OSCA preparation Essay writing Time management Approachable support staff Career planning Research skills Total
8 5 4 3 3 2 2 2 29
27.6% 17.2% 13.8% 10.3% 10.3% 6.9% 6.9% 6.9%
that a number of enablers can assist first year students with transition to university, including the availability of student support services, accessibility to information technological services, the relevance of study material and study skills support. One of the key positive impacts on student satisfaction and confidence in our evaluation was access to peer mentors. Pikethly and Prosser (2001) similarly suggest that positive relationships may be created through first year student interaction with student guides, student peer coaches, working in small groups with staff coordinators, and improved staff-student ratios in first year classes (Pitkethly & Prosser, 2001). These supportive relationships can enhance students’ socialisation and adaptation. Bowles et al. (2013) explored students’ perceptions of factors enabling successful transition to university and found that studentcentred enablers − which are measured by perceptions of study, effort, and culture − are endogenous to the students and thus largely beyond university control, while university-led enablers − measured by perceptions of Orientation, the online environment, facilities, and social activities, are exogenous to the students. Identifying enablers of transition that can be influenced by universities provides them with the opportunity to assist students in the successful transition to higher education. The research clearly highlights that universities need to concentrate on not only encouraging students’ efforts in their studies but also on extrinsic factors such as Orientation, as it appears to be a useful tool for commencing students.
OSCA = Objective Structured Clinical Examination.
4.2. Beyond orientation and the opportunity to meet other students (n = 27/323, 8.36%) (see Table 2). Compared to week one, at the conclusion of the CT workshop series, students reported a significantly increased ‘sense of resourcefulness’ as evidenced by increased confidence in relation to organising mandatory requirement documentation, seeking advice and support, and navigating the campus (Table 1). An increase in the ‘sense of capability’ was also noted, as students reported being significantly more confident in navigating the online learning environment, having the necessary study skills to maximise course engagement, being able to read and critique scholarly literature, and confidently format and reference assignments. Students did not however report feeling more confident at the conclusion of the CT series, compared to the start of the program, in relation to balancing their time (resourcefulness) and in relation to understanding and writing assignments or undertaking OSCAs (capability). Similarly, in the qualitative data (Table 3) more students identified referencing skills as the most useful aspect of CT while OSCA preparation (n = 4/29, 13.8%) and essay writing and time management (n = 3/29, 10.3%) received comparatively fewer mentions by students. 4. Discussion 4.1. The role of orientation The Five Senses Framework (Lizzio, 2006) and work by Tinto (Tinto, 2009), demonstrate that proactive engagement with first year students enhances the FYE and improves retention rates on a number of levels (Burnett & Larmar, 2011). The results of this study add further support for this thesis in relation to nursing students. Evaluation of our orientation process demonstrated that students experienced improved feelings of resourcefulness, capability, and connectedness, and had a better understanding of academic culture, suggesting that a structured and comprehensive orientation can improve first year engagement. McInnis (2002) similarly found
Evaluations of university induction indicate that students often experience a burden of inquiry upon arrival and that effective induction should be spread through the first semester, or even the first whole year (Briggs, Clark, & Hall, 2012). Edward (2003) offers a positive example of an intensive activity-based initial induction, designed to introduce the students to the university, the program, the staff and each other. Keup and Barefoot (2005) indicate how participation of students in seminars and workshops can sustain this socialisation process during the first year. They report students’ feelings of personal success at establishing a network of peers, producing meaningful connections with faculty and staff and using campus services. Findings from these studies directly informed the rationale for designing our orientation and transition program to span a full academic semester. This strategy was deemed a success, with nursing students who attended and engaged in both the Orientation Day and the targeted, weekly CT workshops more confident, connected, resourceful, and capable by the end of their first semester of study. Engaging first year students calls for more collaboration in terms of adopting a holistic approach to course delivery and support. The literature reports that collaborative support models, such as those presented by CT, provide an informal consultative service where students can obtain assessment support for research and writing (Einfalt & Turley, 2013). It is suggested that this collaborative support model has played an important role in raising awareness about academic skills and the processes for researching and writing, promoting peer learning opportunities and building confidence among first year students (Einfalt and Turley, 2013). The provision of scaffolded academic support in a CT format is also a more efficient and effective way of providing learning assistance to large cohorts of students. Given the findings from this evaluation, however, there appears to be further investigation required into the confidence of students in relation to their sense of resourcefulness with time management and their sense of capability in OSCA preparation and essay writing, with perhaps a different model required to address these.
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4.3. Limitations This evaluation did not identify the demographics of the cohort, and as such the findings and subsequent outcomes must be applied to the entire first-year cohort. In future evaluations, demographics may be sought to identify key sub-groups that may require further targeted initiatives. Furthermore, as no psychometric analysis was undertaken on the items designed to assess the five senses of success, the validity and reliability of these items cannot be guaranteed. Results must be therefore interpreted accordingly. 5. Implications and conclusion Supporting students’ transition into first year at university is a great challenge that requires creative solutions and collaboration. The FYE plays a critical role in assisting successful transitions to tertiary study, retaining students, and building up the educational foundations for academic success. The challenges faced by first year students are varied and complex, with nursing students in particular encountering additional challenges subsequent to the requirement of participation in clinical placements. Acquiring a deeper understanding of the issues and needs of commencing nursing students is therefore the first essential step in order to develop strategies to promote an effective learning experience in an effort to raise students’ overall satisfaction with their undergraduate experience as well as to increase the likelihood of degree completion. References Andrew, N., McGuinness, C., Reid, G., & Corcoran, T. (2009). Greater than the sum of its parts: transition into the first year of undergraduate nursing. Nurse Education in Practice, 9(1), 13–21. http://dx.doi.org/10.1016/j.nepr.2008.03.009 Andrew, N., Robb, Y., Ferguson, D., Brown, J., et al. (2011). ‘Show us you know us’: Using the Senses Framework to support the professional development of undergraduate nursing students. Nurse Education in Practice, 11(6), 356–359. http://dx.doi.org/10.1016/j.nepr.2011.03.006 Ballantyne, J. (2012). Valuing students’ voices: experiences of first year students at a new campus. International Journal of Pedagogies & Learning, 7(1), 41–50. Bittman, B. B., Snyder, C., Bruhn, K. T., Liebfried, F., Stevens, C. K., Westengard, J., et al. (2004). Recreational music-making: an integrative group intervention for reducing burnout and improving mood states in first year associate degree nursing students: insights and economic impact. International Journal of Nursing Education Scholarship, 1(1) [p. Article12]. Bowles, A., Fisher, R., McPhail, R., Rosentreich, D., & Dobson, A. (2013). Staying the distance: students’ perceptions of enablers of transition to higher education. Higher Education Research & Development, 33(2), 212–225. Briggs, A. R. J., Clark, J., & Hall, I. (2012). Building bridges: understanding student transition to university. Quality in Higher Education, 18(1), 3–21. Brinkworth, R., McCann, B., Matthews, C., & Nordström, K. (2009). First year expectations and experiences: student and teacher perspectives. Higher Education, 2, 157–173. Burnett, L., & Larmar, S. (2011). Improving the first year through an institution-wide approach: The role of first year advisors. The International Journal of the First Year in Higher Education, 2(1), 21–35. Christensson, A., Vaez, M., Dickman, P., & Runeson, B. (2011). Self-reported depression in first-year nursing students in relation to socio-demographic and educational factors: a nationwide cross-sectional study in Sweden. Social Psychiatry and Psychiatric Epidemiology, 46(4), 299–310.
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Please cite this article in press as: Zimmerman, P. -A., et al. Beyond orientation: Evaluation of student lifecycle activities for first-year Bachelor of Nursing students. Collegian (2017), http://dx.doi.org/10.1016/j.colegn.2017.02.004