Supporting students to return to study following course interruption (SuTuRe).

BACKGROUND: The pre-registration BSc Nursing course in the UK is renowned for being challenging due to its requirement for 2300 hours each for theoretical and practice-based learning. It is therefore inevitable that some students may need to interrupt their study at some point during the course. In many cases, these students do not return and leave the course, which has an impact on the future nursing workforce. AIMS: To examine the reasons why pre-registration student nurses interrupt their studies and consider ways to enable them to return successfully and complete the course. METHODS: The research project was based in one higher education institution (HEI) in the North West region of England. Interrupted students due to return to study in semester 1 of the 2022/23 academic year (n=95) were invited to participate in semi-structured interviews. FINDINGS: Health, including mental health was the dominant factor leading to the interruption of study for the students. CONCLUSION: This research has led the HEI to introduce an improved support package for students. Alongside other recommendations it is hoped the changes will reduce attrition and lead to an improved interruption/return-to-study experience.

The role of school climate on student disclosure of private information and cyberbullying: a comparison of regular and vocational school students in China.

Introduction: Adolescents are experiencing an unprecedented cyber-saturated environment where the disclosure of private information should be approached with caution. This study aims to investigate the effects of school environment, including student support, teacher support, and opportunities for autonomy, on students' disclosure of private information and their experiences with cyberbullying. Methods: In September 2022, a total of 1,716 students (mean age = 14.60, SD = 1.35) from three regular and vocational schools in China participated in the survey. Results: The results showed that 35.6% of the participants had experienced victimization by cyberbullying, and 12.6% had perpetrated cyberbullying. Vocational school students reported significantly higher rates of cyberbullying and lower levels of perceived school climate than students from regular school. Student support in the school environment was found to negatively affect both cyberbullying perpetration and victimization, with this impact appearing to be stronger in regular schools as compared to vocational schools. Opportunities for autonomy and the disclosure of private information were positively correlated with experiences of cyberbullying. Discussion: This study introduces a novel perspective that perceived school climate influences adolescents' disclosure of private information and their involvement in cyberbullying. The findings could provide implications for future research and practices aimed at child protection in cyberspace.

In experts' words: Translating theory to practice for teaching self-regulated learning.

INTRODUCTION: Health professions education (HPE) should help students to competently self-regulate their learning, preparing them for future challenges. This study explored the perspectives of expert self-regulated learning (SRL) researchers and practitioners on the practical integration of SRL theories into teaching. METHODS: An exploratory qualitative research study was conducted involving semi-structured interviews with acknowledged research leaders in the field of SRL and/or experienced professionals dedicated to teaching SRL strategies for complex skills in different disciplines. The data were analyzed using an iterative thematic approach guided by a six-step framework. RESULTS: Fifteen interviews were conducted with experts from six countries representing diverse contexts, cultures, and disciplines. We identified five themes related to translating theory to practice for teaching SRL in HPE: theoretical issues, cultural aspects, stakeholders' participation, teaching complexity, assessment, and feedback. CONCLUSIONS: This study presents a useful starting point for teaching SRL. The experts suggest a supportive learning environment with the guidance of competent teachers by using general and task-specific teaching and learning strategies, as well as sufficient sources and cycles of feedback, all tailored to the culture and context. These findings call for a shift in faculty development programs to foster teachers to support second-order scaffolding in HPE.

How the mapping of threshold concepts across a master's programme in health professions education could support the development of mastersness.

INTRODUCTION: Global trends towards the professionalization of Health Professions Education (HPE) have catalyzed the proliferation of degree-awarding programmes in HPE. We apply the theoretical lens of threshold concepts to explore the required levels of Master's in HPE (MHPE) learning and teaching, with a view to determining how students might be supported to engage meaningfully with learning. METHODS: Qualitative data were collected with a series of nominal group discussions. The methodology and data analysis followed a consensus building approach. RESULTS: Four threshold concepts were identified: Being in the HPE world, the nature of HPE knowledge, the nature of HPE practice and the nature of HPE scholarship. We also mapped the threshold concepts to the World Federation for Medical Education (WFME) master's level academic skills and the Scottish Quality Assurance Agency (QAA) facets of mastersness. CONCLUSION: It is envisaged that our findings will enhance alignment between the outcomes and assessment in an MHPE programme, form the basis of understanding feedback received from students, and inform teaching and supervisory practices. The findings also complement the WFME and QAA frameworks by clarifying the depth and complexity of academic skills expected at master's level and informing teaching and learning approaches to support the development of the identified threshold concepts.

The positive and negative consequences of stress and its relationship with coping in medical students: A qualitative study.

Rates of mental health problems among medical students have prompted efforts to reduce stress during medical training. However, stress can be motivating and is a feature of clinical work. This qualitative study explores what makes an experience stressful, and how medical students respond to such experiences. In-depth interviews were conducted with a purposive sample of 15 medical students. Experiences were distressing when they threatened students' self-perception, goals or coping mechanisms, or when they reminded the student of distressing past events. Moderate stress was motivating and could build resilience. Students selected coping mechanisms based on their availability, acceptability, likely outcome and their previous experience of using these mechanisms. Social support, extra-curricular activities and exercise were helpful. High levels of distress, poor self-esteem and course factors, including remote placements, impaired engagement with coping strategies. Perception of stressors as being insurmountable or beyond one's control, led to increasing distress and the adoption of avoidant coping strategies. University strategies need to consider the beneficial effects of stress and seek to bolster coping resources as well as minimising unnecessary sources of stress.

International graduate entry nursing students: A qualitative study on engagement.

AIM: This study aims to elicit graduate entry nursing students' views on factors that enable and constrain their learning engagement. BACKGROUND: Learning engagement has been associated with student retention/attrition and the achievement of learning confidence and success. While all students are subject to challenges that affect their learning engagement, those experienced by international students who are learning in a foreign and unfamiliar context are of particular concern to academics. An understanding of international graduate entry nursing students' perspectives on factors that enable and constrain their engagement can inform development of learning and teaching strategies that are more responsive to the needs of this group of students and can support their learning achievement. DESIGN: A qualitative descriptive design conducted in one Australian multi campus university School of Nursing. Participants included first and second-year international students enrolled in a graduate entry Master of Nursing course. METHODS: Data, including demographic information, was collected via a theoretically informed online survey consisting of a Likert scale and open- ended questions. This study reports participant responses to open ended questions included in the survey. A thematic analysis was used to interpret findings. FINDINGS: Analysis identified participants' perspectives on factors that influenced their learning engagement in four theme areas: 1) Availability of study support resources, 2) Opportunities for social interaction, 3) Opportunities to build a sense of belonging, and 4) Constraints on development of a sense of engagement. Opportunities for social engagement emerged as a dominant finding across all themes. CONCLUSION: This research, which focused on international students' perspectives on learning engagement, contributed to existing knowledge on student engagement in higher education graduate entry nursing courses. Opportunities for social interaction within and beyond formal course learning experiences were valued by students and identified as key to their learning engagement. These findings have implications for academics and student support services who together, can influence the context of students learning to better meet their engagement needs.

Twelve tips to virtually operationalize co-creation of educational design.

Co-creation is the active involvement of all stakeholders, including students, in educational design processes to improve the quality of education by embodying inclusivity, transparency and empowerment. Virtual co-creation has the potential to expand the utility of co-creation as an inclusive approach by overcoming challenges regarding the practicality and availability of stakeholders, typically experienced in face-to-face co-creation. Drawing from the literature and our experiences of virtual co-creation activities in different educational contexts, this twelve tips paper provides guidelines on how to effectively operationalize co-creation in a virtual setting. Our proposed three-phased approach (preparation, conduction, follow-up) might help those aiming to virtually co-create courses and programs by involving stakeholders beyond institutes and across borders.

A Call to Action: How Social Work Programs Can Respond to Student Food Insecurity.

The COVID-19 pandemic exacerbated student food insecurity on college campuses and exposed the vulnerability of institutions with no food emergency response. During the COVID-19 pandemic and for years to come, the need for social work to lead efforts on college campuses to address student food insecurity is even greater. The need will continue to be significant for social workers in higher education to support students with basic needs, including resources for food, housing, childcare, and transportation. As has been true after other pandemics and economic downturns, professionally trained social workers are critical to brokering resources for individuals in crisis. This article critically examines the role of social work education in addressing the issue of student food insecurity. Through a conceptual lens, it explores the many dimensions of this problem and highlights vital contributions that social work can make within a higher education setting to alleviate food insecurity, enhance student well-being, and promote equitable opportunities for academic success.

It's very difficult to set the boundaries, it's human nature to want to respond: exploring health professions educators' responses to student mental health difficulties through a positioning theory lens.

By virtue of their teaching role and contact with students, health professions (HP) educators are often the first point of connection for students who are experiencing mental health difficulties. Educators are increasingly expected to include some form of pastoral care in their role. Mental health-related interactions with students may have a negative emotional impact on educators, particularly when roles and expectations are not clearly defined and where boundaries are not managed effectively. Using positioning theory as a lens, this study explored how educators experienced such interactions and how this manifested in positions, storylines, and speech acts. Interviews were conducted with 27 HP educators at a faculty of medicine and health sciences. Reflexive thematic analysis using inductive coding identified themes corresponding to the nearing, weighted, ambivalent, and distancing positions participants adopted in relation to students with mental health difficulties. There was fluidity in and between positions, and more than one position could be occupied simultaneously; participants each moved through different positions in response to different relational situations. Multiple storylines informed these positions, representing how moral- and care-informed responsibility intersected with responsiveness to make certain actions possible or impossible. Normative and personal value narratives were evident in storylines, in many cases underscored by care or justice ethics. The value of positioning theory in facilitating reflective faculty development initiatives for educators engaged in these interactions is discussed.

Twelve tips for having more meaningful conversations with medical students on specialty career choice.

Making a career choice is a multifaceted process and support for medical students on career choice is pivotal. Not all medical schools have programs or guidelines to support having meaningful conversations with medical students. However, medical students have questions and are seeking answers. This article presents twelve tips for having meaningful conversations with medical students for educators, mentors and internship tutors. The twelve tips have been grouped into three categories: the conversation, the reflection and the actions students can take in the process of their specialty career choice.

Enhancing Student Wellbeing Through Social Prescribing: A Rapid Realist Review.

Objectives: A Rapid Realist Review of social prescribing in Higher Education (HE) was undertaken to determine what works, for whom, how, why, and within what circumstances. The review resulted in the development of a Realist Programme Theory articulating the way in which social prescribing can be implemented within the HE environment. Methods: Searches of 12 electronic databases were supplemented by citation chaining and grey literature surfaced by the Project Advisory Group. The RAMESES Quality Standards for Realist Review were followed, and the retrieved articles were systematically screened and iteratively analysed to develop Context-Mechanism-Outcome Configurations (CMOCs) and an overarching Realist Programme Theory. Results: A total of 57 documents were included. The overarching programme theory was developed from the analysis of these documents and comprised of a social prescribing pathway with the following components: (1) An Accessible Gateway, (2) A Skilled Peer, (3) Trusted-Safe-Credible Resources, and (4) A Healthy Setting. Conclusion: A Realist Programme Theory was developed-this model and associated principles will provide a theoretical basis for the implementation of social prescribing pathways within higher education. Whilst the direct project outputs are of particular significance to the UK HE audience, the underpinning principles can support practice within the global arena.

Twelve tips to foster healthcare student recognition and reporting of unprofessional behaviour or concerns.

Medical trainees and students are required to report concerns where they identify concerning practice or behaviours. While leadership attributes and skills are increasingly expected curricular outcomes, students still struggle to report concerns due to a variety of factors. Changing societal awareness and expectations continue to shine light on poor professionalism and unethical behaviours whose reach extends to medical training and education and that need to be systematically reported and addressed. To prepare graduates for these challenges in professional practice and for exercising skills of reporting concerns, education and training environments must ensure that speaking up is ingrained in the organisational ethos. Supported by evidence from the literature and our experience of revising and enhancing approaches, this paper outlines tips for developing and embedding an infrastructure that facilitates robust concerns reporting and management. Further, we consider mechanisms that support students to develop tendencies and skills for reporting concerns.

Enabling higher degree pathways for Aboriginal and Torres Strait Islander students.

Increasing the numbers of Indigenous people enrolled in research higher degrees in Australia is important for building the Indigenous academic workforce, broadening the scope of knowledge production in academic institutions and ensuring effective research outcomes for Indigenous Australians. While the numbers of Indigenous research higher degree students are increasing, universities still have a lot to do to bring that number up to parity. In this paper, we explore the value of a pre-doctoral program developed for Indigenous people interested in doing a PhD that provides them the information they need to inform their choices about undertaking a doctoral project. As the only program of this kind in Australia, this research contributes to the emerging literature on the factors that have an influence on why Indigenous people choose to undertake PhD programs and the effectiveness of initiatives to support their pathway to higher degree research. The research outcomes build on the evidence base for improving initiatives across the university sector, highlighting the need for tailored, Indigenous-led pre-doctoral support programs for Indigenous students, the value of cohort experiences and the importance of universities that value Indigenous people and their knowledge systems.

Twelve tips for developing active bystander intervention training for medical students.

Healthcare experiences of mistreatment are long standing issues, with many not knowing how to recognise it and respond appropriately. Active bystander intervention (ABI) training prepares individuals with tools and strategies to challenge incidences of discrimination and harassment that they may witness. This type of training shares a philosophy that all members of the healthcare community have a role to play in tackling discrimination and healthcare inequalities. We developed an ABI training programme for undergraduate medical students, after recognising the need for this given the students' adverse experiences on clinical placements. From longitudinal feedback and robust observations of this programme, this paper intends to provide key learning lessons and guidance on how to develop, deliver and support faculty in facilitating these types of trainings. These tips are also accompanied by recommended resources and suggested examples.

Capturing, the experiences of undergraduate student nurses undertaking a pre-registration nursing degree course using an adapted experience based co-design approach.

BACKGROUND: The quality of student experience in higher education plays an increasingly important role in attracting and retaining pre-registration nurses. Identifying and understanding the students' experiences of their course is a necessary step in the move towards improving the student experience. Experience Based Co-design (EBCD) is successfully established as an effective process for improving patient experience in a health care setting. This study presents the use of EBCD outside of healthcare, specifically in a higher education setting. OBJECTIVES: To capture, explore and understand the experiences of students' undertaking a pre-registration (adult) nursing course, and co-design potential improvements for future experiences through the application of an EBCD approach. METHODS: An adapted EBCD approach was utilised for gaining insight into what shapes students' experience of the nursing course and to collaboratively produce priority recommendations for course improvement. Semi-structured interviews, emotional touchpoint mapping and co-design events were conducted with undergraduate nursing students (n = 22) and staff stakeholders in a pre-registration (adult) nursing course (n = 19). Findings were analysed using the 'Six phases of thematic analysis' (Braun & Clarke, 2006). RESULTS: Students had varied experiences on the nursing course, both positive and negative, particularly with student support. Three priority recommendations for course improvement were identified from the findings including: facilitating and supporting student development of independent study skills, enhancing student support in the clinical practice placement environment and clarifying and enhancing the role of the academic advisor. CONCLUSIONS: Findings from this study highlight areas for improvement on a pre-registration nursing course that could impact future students' experience. Furthermore, this study appears to be the first documented as using EBCD in a higher education setting with the focus on students, that enabled students and staff stakeholders in the nursing course to co-design priority recommendations for course improvement.

Supporting Students with Disabilities during the COVID-19 Pandemic: The Perspective of Disability Resource Professionals.

Utilizing national survey data, this paper details the academic and access challenges created by the pandemic for students with disabilities, as perceived by disability resource professionals. Data included in this paper capture disability support service challenges at two unique timepoints during the COVID-19 pandemic-May 2020 [n = 535] and January 2021 [n = 631]. Disability resource professionals reported there was difficulty in the initial months of the pandemic for students to provide documentation of a disability to receive accommodations, use assistive technology in the new remote academic setting, and receive testing accommodations within the remote environment. While access and resources improved for students with disabilities over time, a portion of the surveyed disability resource professionals noted no observed improvement in students' with disabilities communication with instructors as well as a worsening of conditions for students with disabilities throughout the pandemic related to access to counseling and mental health services. In addition to highlighting key obstacles faced by this student group during the pandemic, this paper provides recommendations and implications for institutions to better serve this student group, including how institutions of higher education can coordinate a holistic approach to support student mental health.

The Quality of Life of Students With Difficulties Accessing Support.

In recent years, the number of students enrolling in universities for higher education has increased, and these students are more diverse than ever before. Moreover, the number of students with disabilities in higher educational institutions is also increasing. Therefore, their support needs are becoming more diverse and specialized. To examine how best to provide support to students who are unable to locate it, this study conducted a survey in which details were collected from students who were involved with university student support organizations, analyze the relationship between subjective adjustment and objective adjustment, and examine the trends in subjective quality of life (QOL). In total, 156 university students (age: mean = 22.14, standard deviation = 2.86, range = 18-7) were surveyed between April 2018 and March 2020. The Japanese version of the World Health Organization Quality of Life, Brief Version, was used to analyze trends in subjective QOL. The average QOL of students who were less likely to receive support was lower than that of the general population. The results also indicated that QOL decreased as the level of disability and health status increased. Furthermore, the results of the analysis of the relationship between the overall domain QOL and the domain-specific QOL suggested that the psychological and environmental domains contributed the most to the overall QOL. Accordingly, students at universities require assistance in a number of areas. Furthermore, it is essential to adjust the content and combination of support according to the objective level of adjustment.

Pandemic-Era Digital Education: Insights from an Undergraduate Medical Programme.

The undergraduate medical programme at Newcastle University (NU) includes a fundamental 'Essentials of Medical Practice' (EOMP) phase comprising the first 2 years of study. This period is designed to support entrants in their transition from further education into the advanced study and practice of clinical medicine. The anatomical sciences of gross anatomy, histology and embryology, and life sciences including physiology, pharmacology and genetics are key disciplines taught within the integrated case-based EOMP curriculum. Learners apply basic science knowledge to clinical scenarios during training in practical examination, communication and reasoning skills. Within the modern pedagogic landscape, the development and introduction of technology-enhanced learning strategies have enhanced the provision of remote learning resources in pre-clinical education. However, the emergence of COVID-19 has resulted in widespread technological challenges for educators and learners, and has raised pedagogic, logistical and ethical concerns. Nonetheless, the pandemic has produced favourable conditions for the creation of valuable digital visualisation strategies for learning and teaching, and for developing and modernising universal approaches to remote education. Here, we describe our technology-enhanced adaptations to COVID-19 across the domains of teaching, learning and academic support for pre-clinical learners studying basic life sciences and clinical skills. Moreover, we outline research-informed digital visualisation solutions to pandemic-era challenges and reflect upon experiences gained within our own educational context. In doing so, we provide insights into the impacts and successes of our interventions. While providing a record of unprecedented contemporary circumstances, we also aim to utilise our observations and experiences of COVID-19 pedagogy when developing ongoing strategies for delivering curricula and futureproofing educational practice.

Undergraduate nursing students' experiences of online education: A cross-sectional survey.

During the coronavirus pandemic, UK Academics were required to adjust their learning and teaching environment and pedagogical approaches, with little guidance or time. Feelings of frustration and uncertainty around student engagement were commonplace across Higher Education Institutions. This was heightened in professionally regulated courses, such as nursing. The shift to online learning created a situation where academics were frequently faced with a 'sea of black screens' and unable to ascertain student engagement. This study investigated undergraduate nursing students' experience of online education during the COVID-19 pandemic. An anonymous survey was distributed to each year of the undergraduate nursing programme and data subsequently analysed. Responses from 54 students revealed that engagement varied between different year groups. There were significant differences between those with pre-COVID (traditional face-to-face) teaching experience (years 2 and 3) and those without (year 1) in regard to self-reported engagement with online learning. The findings from this study revealed some powerful and emotional insights into the experience of online learning amongst UK students undertaking an undergraduate nursing programme during the COVID-19 pandemic.