Students' experiences of embedded academic literacy support in a graduate entry nursing program: A qualitative study

Highlights

• GEN students bring critical thinking to academia from life experience.

• CALD GEN students may need to improve academic literacy and oral communication skills.

• Embedded literacy support ensures successful GEN student transition.

Abstract

Graduate entry nursing (GEN) programs were designed to address the predicted nursing shortfall. In Australia, although these programs attract students from culturally and linguistically diverse (CALD) backgrounds, the workload is compounded by cultural differences and a new academic learning environment which presents additional challenges. This qualitative descriptive study explored the experiences of GEN students enrolled in the introductory unit of their nursing program with embedded academic literacy support in Sydney, Australia. Twenty-four commencing GEN students were interviewed in January 2016. Interviews were transcribed verbatim and thematically analysed. Three main themes emerged which illustrated that GEN students were ‘diamonds in the rough’. They possessed a raw natural beauty that required some shaping and polishing to ensure academic needs were met. To ensure retention is high, institutions need to evaluate how best to support and harness the potential of these unique students.

Introduction

Graduate entry nursing (GEN) programs, also known as accelerated second degree nursing programs were originally designed to address the global issue of nursing shortage by enabling students to complete an accelerated program of study which recognised and acknowledged prior learning (Neill, 2012, Seldomridge and DiBartolo, 2007, Stacey et al., 2016). In Australia, this pathway was introduced in the mid-1990s (Neill, 2012) to address a predicted nursing workforce shortfall resulting from: (i) an ageing workforce, (ii) declining nurse retention and (iii) higher patient acuity (Health Workforce Australia, 2014).

There are a variety of pathways and or courses available for overseas-qualified nurses, to gain registration with the Australian Health Practitioner Regulation Agency (AHPRA), which help support integration into the Australian workforce (Australian Centre of Further Education, 2015, Southern Cross University, 2017). The GEN program in this Australian study is designed for individuals interested in pursuing a career in nursing who either have a previous postgraduate qualification or are overseas-qualified Registered Nurses (Western Sydney University, 2016). GEN programs recognise students' prior learning and experiences as facilitators and motivators, fortifying graduates’ commitment and dedication to study, and enhancing their academic ability for success (Everett et al., 2013, Stacey et al., 2014).

Despite the attractiveness of an accelerated program of study, students have identified detractors, including heavy workloads, fast pace and at times lack of support which heighten stress levels (Neill, 2012). In Australia, there has been a steady increase in both the number of overseas nurses and domestic students entering nursing courses from non-English speaking backgrounds (Glew, 2013), including those enrolling in GEN programs. Similar to the United Kingdom (UK), the Nursing and Midwifery Board of Australia requires an academic International English Language Testing System (IELTS) level of 7 in all components prior to registration of overseas-trained nurses and midwives from countries where English is an additional language (Nursing and Midwifery Board of Australia, 2015). These students require support to develop their academic literacy and English language skills for safe nursing practice (Boughton et al., 2010).

There remains a paucity of studies, particularly qualitative studies that have examined the contemporary academic support needs and experiences of GEN students (Neill, 2012). This study aimed to explore graduate entry students’ experiences of a specific unit within the GEN program and the delivery of embedded literacy support.

Graduate entry nursing programs have gained popularity as a pathway into the nursing profession in recent decades (Everett et al., 2013, McKenna et al., 2017). They appear to be particularly attractive to men and mature aged students who are highly motivated, resilient, assertive, and results-driven learners whose understanding of nursing is built upon a foundation of real life, work and previous academic experiences (Codier et al., 2015, Everett et al., 2013, McKenna et al., 2017). While GEN programs offer an accelerated pathway to a nursing degree, multiple unique challenges are experienced by these students. These may result in difficulties in adjusting to both academic and social life, in particular, adjusting to language barriers, cultural differences, conflicting expectations of teaching and learning, loneliness and social isolation (Boughton et al., 2010). In English-speaking countries such as Australia, GEN programs are more likely to attract students from culturally and linguistically diverse (CALD) backgrounds including international students for whom English is an additional language (McKenna et al., 2017, Seldomridge and DiBartolo, 2007). This could be due to the perception that a nursing degree obtained in Australia qualifies them for professional registration and permanent residency, alternatively, it could be that the nursing qualification obtained in Australia offers better career prospects upon their return to their home country (Jeong et al., 2011). Communication difficulties among CALD students associated with accents, use of colloquialisms, shortened quick speech, and complex technical language have been identified as key issues (Jeong et al., 2011). Further, lack of English-language proficiency and difficulty in adjusting to the classroom environment, have been shown to negatively impact on the academic performance of these students (Everett et al., 2013, Koch et al., 2011).

In response to the challenges experienced by GEN students, a number of educational institutions have initiated academic literacy support programs to promote successful student transition to their new academic learning environment (Boughton et al., 2010, Crawford and Candlin, 2013). These initiatives include the introduction of academic literacy experts, with qualifications in English-language education, into teaching teams to provide embedded academic literacy support for commencing nursing students (Glew, 2013). Although embedded academic literacy support has been shown to be effective in improving academic performance among first year nursing students from CALD backgrounds (Salamonson et al., 2010), the experiences of GEN students enrolled in programs with embedded academic literacy support have not been explored.