‘Our student support document has reduced the stigma associated with seeking help’

Recent publications such as Suicide-Safer Universities (Universities UK, 2022) identified that students on programmes that contain aspects of industry placements are the most vulnerable, both personally and academically – and this vulnerability can be exacerbated by the rigorous demands of health, social care and medical professional programmes.

Therefore, a good support infrastructure is vital for the student experience as well as for university benchmarking – including retention, progression and completion as part of the Office for Students’ B3 conditions and Teaching Excellence Framework, and university ranking through the National Student Survey, which is heavily influenced by student satisfaction.

“A good support infrastructure is vital for student experience as well as university benchmarking”

The Royal College of Nursing (RCN) suggests that clinical areas in which nursing students practice during placements can be highly pressurised and emotive for them (RCN, 2022), and these potentially stressful learning environments are not always conducive to high-quality learning and assessment (NHS England, 2024a; RCN, 2022).

To tackle such issues, NHS England introduced the Safe Learning Environment Charter (NHS England, 2024b). For all too many students, practice learning is a result of luck, due to the complexities of factors such as staff shortages, industrial strikes and, in recent years, the Covid-19 pandemic influencing their learning and assessment experience.

It is common practice for universities to have the theoretical infrastructure and processes in place for students requiring academic support within central university teams, as they are needed across the portfolio of programmes. However, access for such wellbeing and learning support can often involve lengthy and administrative-intensive processes, as so many students are accessing these services.

Critically, the translation of these plans for good practice into reasonable adjustments for actual practice is often lacking. They can also be confusing as they are often developed by non-clinical personnel or academic staff not working in the specific learning environment, so they do not reflect the real-world practicalities of the ever-changing clinical environment.

Universities have recently had a stark reminder of this responsibility following the judgment in the Abrahart v University of Bristol case in February 2024, when the High Court ruled that the university failed to make reasonable adjustments to a practical module. Sadly, Natasha Abrahart took her own life while waiting for the Disability Support Summary adjustments, following a significant decline in her mental health.

At Edge Hill University, the practice learning team and I are passionate about inclusion, practice, and quality learning and assessment within practice learning. We have introduced a one-page standardised document that can be used by students, personal tutors and academic assessors collaboratively with practice partners, including practice education facilitators, practice supervisors and assessors. It can be used regardless of whether the student has sought central support or – as in the case of Natahsa – is waiting for internal processes.

The document – ‘Potential areas for practice support’, referred to as PAPS – puts the student at the heart of its use. It encompasses physical, mental and learning support needs from a student perspective, and it can be used with many kinds of supportive concerns that might arise in practice, including pregnancy and the menopause.

The introduction of PAPS has increased the accessibility of support for students, reducing the stigma associated with seeking help within a higher education institution – students who do not wish to formally seek university support are now able to discuss potential factors which they feel might affect their learning and assessment.

It has also increased the rapport between personal tutors and students, so support can be implemented early on an individual basis, as well as collaboratively across university and practice. The initiative has improved the quality of assessment and learning within practice experience for students needing support, levelling the playing field without affecting the assessment itself.

In addition, empowering students regarding their own learning and wellbeing helps them better understand themselves, and their triggers and needs as individuals.

It enables them to reflect on how a clinical environment might impact them, form coping strategies and build resilience through collaboration and partnership working. This all helps to bridge the gap between university theory and practice, aiding in the transition from student to registrant.

As educators of the nursing workforce of the future, we must ensure we are instilling our nursing students with the necessary tools to not only thrive but enable longevity in their nursing careers in the ever-changing and demanding landscape of healthcare.

Stephanie Robinson is senior lecturer in practice learning (team leader) (nurse education), Edge Hill University

References

NHS England (2024a) Educator workforce strategy. england.nhs.uk, 23 August (accessed 17 December 2024).

NHS England (2024b) Safe Learning Environment Charter – what good looks like. england.nhs.uk, 7 February (accessed 17 December 2024).

Royal College of Nursing (2022) Nursing Under Unsustainable Pressure: Staffing for Safe and Effective Care in the UK. RCN.

Universities UK (2022) Suicide-safer universities: support for placement students. universitiesuk.ac.uk, October (accessed 16 December 2024).