The "five senses of success" in nursing students: Assessing first-year support engagement.

OBJECTIVES: This study aimed to identify School and University support services available and accessed by nursing students transitioning into a university environment as many struggle to adjust to competing demands of personal commitments and expectations at university.
METHODS: A mixed methods design was used, based on activity theory and Lizzio's Five Senses of Success frameworks as exploratory guides. This study was conducted amongst the first year cohort at one campus of the Bachelor of Nursing (BN) program in Queensland, Australia. An initial baseline assessment of what University and School-based support services were on offer for students, and how the students interacted with the support services was conducted. This was followed by a survey to identify awareness and access to support services. Focus groups were then conducted to clarify the previous results and to determine engagement with these support services.
RESULTS: A randomly selected number of students (n = 150) in the first-year 2014 cohort of the BN program (n = 300) were included in this study. The survey was completed by 54 students and three semi-structured focus groups were conducted. The analysis indicated that the support services in place were successful in reaching the majority of students and contributed to their sense of success at university. Specifically students identified that a whole cohort approach to support enhanced their transition to university.
CONCLUSION: Identifying lesser known services early in the first year will ensure that students are supported and encouraged to use all services, contributing to their sense of success at university.

What is known?

The transition experience of students into higher education can be difficult, and more so in undergraduate nursing degrees.

What is new?

This study identified the importance of recognising the specialised needs of undergraduate nursing students and how a transitional support model can assist in student success.

Introduction

Supporting new students with their transition into university is a core priority for higher education institutions. Transition to higher education is not easy, with students often confronted with challenges including adjusting to different teaching styles, identifying academic standards and expectations and managing workloads [1]. Apart from being enrolled in a new program and institution, students often leave their home, friends and family behind to come to a new place to which they need to adapt [2]. The issues of first year transition, student engagement, support and retention are important to consider for students enrolled in undergraduate nursing programs at tertiary institutions. This study identified the range of support services available and whether nursing students’ perception of engagement with these services created a positive outcome.

Background

The profile of nursing students in Australian universities is diverse [3]. Nursing cohorts include direct entry students from school, students who have transferred from other programs, first-in-family students, and many older, educationally unprepared individuals [3,4]. For many first year nursing students, learning to balance the demands of education, work, home and social life can be challenging [1,5]. For some students, commencing nursing education also causes fear and anxiety due to the unique requirements of nursing, including clinical procedures and concerns about dealing with bodily fluids and death [6]. Such issues can result in additional feelings of stress and conflict for commencing students and further challenge their ability to successfully transition into the university learning environment [7]. Researchers postulate that there is a continuum from surviving to thriving during the student transition cycle [8]. It is proposed that student support services can assist in a successful transition to university, and the quality of support is regarded as a key to the challenges of progression and retention [9]. In Britain, higher education institutions offer support in multiple ways at many time points, for example support from academic staff and co-curricular support such as study skills sessions and the provision of printed or online resources [10].

In Australia, support for the first year experience is at the forefront of many University approaches to retention. Western Sydney University (formerly the University of Western Sydney) takes a whole-of-institution lifecycle approach with their support initiatives [11]. A lifecycle approach is considered best practice [12] however it can be challenging to evaluate such globally-based support initiatives. Much of the research, therefore, focuses on elements or strategies within the whole-of-institution approach, identifying gaps in the literature at the School or Faculty level. Murdoch University has implemented a role of First Year Advisor within Schools to engage students and link them with additional student support [13]. The University of Tasmania offer a UniStart program to develop academic study skills [14] whilst RMIT University has implemented peer mentoring [15]. The range of evaluation methodologies for these strategies varies from informal or ad hoc student evaluations [13] to well-structured evaluation processes [14,15]. As the first challenge is retention, most transition evaluations focus on engagement, reach and student experience rather than a measurement of student learning outcomes.

Griffith University has adopted a whole-of-institution lifecycle approach, led centrally by research-based initiatives and tailored locally at the School level. The School of Nursing and Midwifery (SoNM) facilitates a number of curricular and co-curricular activities to assist students transition to university and these are provided in conjunction with a range of centrally-offered university support services (e.g. library and learning support, student health and wellbeing services and services targeting more specific support needs).

Within the SoNM, the academic transition support role, Commencing Student Coordinator (CSC), for commencing undergraduate nursing students, focuses on co-curricular support, coordinating Orientation, implementing academic skill development sessions, offering pastoral care and linking to other School-embedded and centrally run transition support activities. The Bachelor of Nursing (BN) Program Director, supported by campus deputies, is responsible for the BN program and oversees the quality and implementation of the curriculum and provides academic advice. Course Convenors have responsibility for course curricular activities designed to support transition and achieve student learning. All academics in these roles have an opportunity to provide academic advice, group or individual student support and can refer students to School-based or University-based services for additional support.

In working to achieve support for the first year BN student, the School adopts the Five Senses of Success Framework [16], assisting students to develop their sense of: 1) capability, 2) purpose, 3) resourcefulness, 4) connection, and 5) identity, also known as academic culture. The Five Senses of Success Framework provides a conceptual map of students’ needs and concerns through the higher education journey. This framework has been used previously within the School to explore the transition experience of Enrolled Nurses to undergraduate nursing studies [17], the experiences of undergraduate midwifery students [18] and the efficacy of student lifecycle activities for first-year Bachelor of Nursing students [19].

This study, grounded within [16] Five Senses of Success Framework, aimed to identify the support services available to first year commencing nursing students transitioning into the University environment, map student awareness and access in relation to these services, and identify possible reasons for lack of engagement or early disengagement. Knowledge from this study will inform future decision making to improve, or redesign programs supporting first year undergraduate nursing student transition.

Methods

A mixed methods sequential approach was utilised for this study [20]. The rationale for using this approach is because it is recognised to provide greater insight into the topic being explored [21]. In the first instance a baseline assessment of services was performed, informing the items included in the survey. The findings of the surveys were then used to inform the interview schedule for the focus groups [20]. A pilot focus group was undertaken with second-year students with the purpose to ensure the quality of the interview schedule [22].This study was conducted in accordance with the requirements of the Griffith University Human Research Ethics Committee (NRS/29/14/HREC).

Sample and setting

This study was conducted amongst the first year cohort at one campus of the BN program at Griffith University, Queensland, Australia. The campus was selected as it has a diverse population of students with a cross-section of socio-economic backgrounds, first-in-family, ages and gender and the year level was chosen as it had been identified as the time most influential upon retention. Participants self-selected from a large cohort of students at the Gold Coast campus who commenced in the first year of the BN in 2014. These students were from a range of ages, backgrounds, and generally representative of the cohort.

Data collection

Baseline assessment

An initial baseline assessment of what University and School-based support services were available for students, and how the students interacted with these support services was conducted. This information was collected and tabulated from existing services, promotional material and the University website. Using Five Senses of Success framework [16] as previously outlined in “2. Background”, each service was mapped against one or more of the senses of success to assist in the development of the survey.

Survey

An online, anonymous survey was deployed late in first semester to a randomly selected number of students (N = 150) in the first year 2014 cohort of the BN program (N = 300). The survey was informed by the baseline assessment findings. In addition to obtaining student demographic information (e.g. age, gender), the 17 item survey invited students to report on awareness and frequency of access in relation to each identified support service. Response options were “I am not familiar with this resource”, “I am aware of this resource however I have not accessed it”, “I am aware of this resource and have accessed this once”, and “I am aware of this resource and have accessed it more than once”. In addition to awareness and frequency of access, any difficulties in accessing support services were also examined through qualitative items. The survey was pilot tested with second-year BN students for comprehension and relevance as well as reviewed for face validity by institutional staff experienced in student success activities. Data was managed using Statistical Package for the Social Sciences (SPSS) v23 and subject to descriptive statistical analysis.

Focus groups

The survey was followed by focus groups (n = 3) drawn from the survey participants. Participants were encouraged by email to participate in the focus groups. Semi-structured focus group questions were based on the findings from the survey including mapping of support services, survey results and student engagement data. For example: Please recall what support services you used this semester that you are prepared to share with this group? Piloting of the focus group interview schedule was conducted for comprehension and language suitability amongst second year BN students. Written consent was obtained for all participants. Members of the research team who had no relationship with the participants’ home campus facilitated the focus groups in second semester. Sessions were audio-recorded and transcribed verbatim. Focus group data were subject to thematic analysis [23] and aligned with the Five Senses of Success Framework [16].

Findings

Of the students who completed the survey (n = 54), the majority were female (90.7%), enrolled full-time (87%), and working 15 h/week or more in paid employment (81.5%). Participant ages ranged from 17 to 46 (M = 23.7). More than half of the sample (55.6%) did not enter the program straight from high school, with 41.5% having engaged in some prior University-level study (see Table 1).

Table 1

Participant demographic data (N = 54).

Demographic Factor	n	%
Gender
Male	5	9.3
Female	49	90.7
Age Group
17–20	26	49.1
21–30	16	30.1
31–40	9	17.0
41+	2	3.8
Relationship Status
Single	20	37
Married	5	9.3
Couple/Defacto	25	46.3
Separated/Divorced/Widowed	4	7.4
Children – Currently expecting
0	53	98.1
1	1	1.9
Children – Under 12 months
0	53	98.1
2	1	1.9
Children – Over 12 months but not attending school
0	46	88.5
1	4	7.7
2	2	3.8
Children – Primary school
0	48	90.6
1	4	7.5
2	1	1.9
Children – Secondary school
0	47	92.2
1	3	5.9
2	1	2.0
Children – Post secondary school
0	52	96.3
1	2	3.7
Unpaid Caring Responsibilities (other than children)
Yes – between 25 and 40 h/week	2	3.7
Yes – less than 15 h/week	14	25.9
No	38	70.4
Paid Work During Semester
Yes – at least 40 h/week	1	1.9
Yes – between 25 and 40 h/week	9	16.7
Yes – between 15 and 25 h/week	18	33.3
Yes – less than 15 h/week	16	29.6
No	10	18.5
Transition Straight From High School
Yes	24	44.4
No	30	55.6
Prior Study at University
Yes – completed less than 1 year	7	13.2
Yes – > 1 year but did not complete program	9	17.0
Yes – have completed a prior university qualification	6	11.3
No	31	58.5
Enrolment Status
Full-Time (3–4 courses)	47	87.0
Part-Time (1–2 courses)	7	13.0
Student Status
Domestic student	51	94.4
International student	3	5.6

Support services

Six school-based and 21 university-level support services were identified. These services were then examined to identify how they facilitated each of the Five Senses of Success [16]. Classifications were based on the following criteria; (i) services involving academic skills development were linked with Sense of Capability; (ii) services involving relationship development were linked with Sense of Connectedness; (iii) services involving vocational focus and discipline of study were linked with Sense of Purpose; (iv) services involving help-seeking behaviour were linked with Sense of Resourcefulness; and (v) services which focused on learning ‘how things are done’ at the school- and university-level were linked with Sense of Academic Culture.

Survey

A total of 54 students responded to the survey with a response rate of 36%. The majority of participants (85%) indicated there were more support services available on campus than initially expected (see Table 2). The school co-curricular activities were well attended, with 81% of participants attending Orientation day and 85% attending Common Time academic skills workshops. As indicated in Table 3, 72% of the participants attended both of these co-curricular activities.

Table 2

Participant expectations of support services/ attendance at Co-Curricula activities (n = 54).

Item	n	%
Expectations of Support Services
More than I initially thought there would be	46	85.2
Number matches my initial expectations	7	13.0
There are fewer available than I thought there would be	1	1.9
Attendance at School Co-curricular Activities
Yes, BN Orientation and Common Time Workshops	39	72.2
Yes, BN Orientation only	5	9.3
Yes, BN Common Time Workshops	7	13.0
Neither BN Orientation/ Common Time Workshops	3	5.6

Note: BN = Bachelor of Nursing.

Table 3

Support service awareness and access data (n = 54).

Support Service	Aware and have accessed service at least once		Aware but have not accessed service		Not aware of service
	Freq.	%	Freq.	%	Freq.	%
Peer Assisted Study Sessions	42	77.8	12	22.2	–	–
Course Convenor	34	63.0	20	37	–	–
Student Administration	32	59.3	18	34	3	5.7
Student Guild	26	49.1	27	50.9	–	–
Health Service	21	40.4	24	46.2	7	13.5
School Peer Mentoring Program	20	37.0	27	50.0	7	13.0
Information Literacy Librarian	18	34.0	28	52.8	7	13.2
Learning Adviser	16	30.2	35	66.0	2	3.8
Student Success Advisor	15	27.8	37	68.5	2	3.7
School Administration Officer	15	27.8	30	55.6	9	16.7
Library Workshops	12	23.1	37	71.2	3	5.8
Counselling	5	9.3	44	81.5	5	9.3
Careers and Employment	5	9.4	35	66.0	13	24.5
Uni-Key Peer Mentoring Program	5	9.3	31	57.4	18	33.3
Griffith MATES Mentoring Program	4	7.7	22	42.3	26	50.0
Welfare and Liaison	3	5.6	38	70.4	13	24.1
Commencing Student Coordinator	3	5.6	36	66.7	15	27.8
Equity and Disabilities	2	3.7	43	79.6	9	16.7
Deputy Program Director	2	3.7	34	63.0	18	33.3
International Student Adviser	2	3.9	26	51.0	23	45.1
Griffith Sports College	1	1.9	32	60.4	20	37.7
Student Representative Council	1	1.9	32	60.4	20	37.7
Griffith Honours College	1	1.9	29	54.7	23	43.4
English HELP	1	1.9	28	52.8	24	45.3
GUMURRII Student Support Unit	1	1.9	27	51.9	24	46.2
Chaplaincy	–	–	41	75.9	13	24.1
Indigenous Tutorial Assistance Scheme	–	–	31	58.5	22	41.5

All participants were aware of the support offered by Peer Assisted Study Sessions (PASS), course convenors and the Student Guild (see Table 3). PASS was the most utilised, accessed by 77.8% of participants, the majority of whom accessed the sessions more than once (70.4%). Course Convenors were the next most frequently accessed source of support (63.0%) and the support most commonly accessed only once (44.4%). Around two thirds of participants were aware of the Student Success Advisor, Library Workshops and Learning Advisers and these supports were accessed by just under a third of participants. There were a number of services that participants were aware of but did not access, including Counselling, Equity and Disabilities, Chaplaincy and the Welfare and Liaison service. Griffith MATES Mentoring Program was the least well known support, with 50% of participants unaware of the service.

A majority of participants (N = 50; 94.3%) had no issues accessing a support service. The four participants who did report issues all identified ‘Learning Advisers’ as the support service most difficult to access, with appointments “filling too fast” particularly at assessment time.

Focus groups

The focus groups (n = 3), with a total of 18 participants, provided identification of engagement in the Five Senses of Success Framework [16] and with existing university support services. The participants included a cross-section of the student cohort, including high-school leavers, mature age and international students.

Capability

The sense of capability is related to student preparation for the higher education environment. This can include their own expectations, and understanding those from the University, academic skills and ability to commit to study [1,16,19]. Accessing support services early was seen to be advantageous to this across all three focus groups as was the use of co-curricular opportunities, such as PASS.

FG3: “The first time I had an essay, I just wrote it but this semester I utilised the support services and I feel more confident and I found out I was on point and where I could make changes and then I went away, and that was really good.”

The focus group participants clearly identified that the support services available, when accessed, assisted develop their sense of capability in relation to academic success.

Connectedness

Connectedness relates to a student's sense of belonging to the University and to the program of study. This is influenced by forming relationships not only with peers but also with the teaching and support staff. Student engagement in opportunities to develop connectedness can result in learning success and satisfaction with the University experience [16,24]. Feeling alone and lacking confidence was alleviated by Orientation, peer mentors and each other. Students benefited from the awareness that others were also experiencing similar things at the beginning of studies.

FG3: “That was one of the things I saw on Orientation day, I found really helpful. That you walked into this room with so many people and you sat down. I'm not usually shy, but I was shy! There was such a diverse group of people (*laughter*). The way they told everyone you've got support from your teachers and your peers. You want to see everyone else pass as well.”

Conducting events such as Orientation and Common Time can assist students to access peers and peer mentors, and assist their sense of being connected to the University and the program.

Purpose

When students have a clear sense of purpose in their studies, intrinsic motivation is engaged towards success [16,24]. The BN has a clear sense of purpose, to become a Registered Nurse, however having opportunities, such as PASS, that solidify this assists students’ sense of purpose.

FG3:“But, ah, it makes it more real! Umm, especially being when you go out there, we're going to be in the real world and it's not such a shock, like it helped me to retain the information I heard in the lecture the day before.”

Resourcefulness

Being able to proactively seek assistance in the University environment, including the online environment, is essential to a student's success. Resourcefulness in knowing the appropriate service to seek in relation to a situation is imperative [6]. A small number of participants recollected that they found services difficult to locate at first, identifying that they needed to be exposed to them as early as possible. However they also noted that once exposed to these services, they were able to gain help when they needed it.

FG2: “I found a campus tour. They're actually run by students. And I was very lucky I came to one late in the day and I was the only person there. This lovely student showed me around and helped me with printing services and library and showing me around the library and the campus in general. I found that a great big help.”

Some participants expressed surprise that there was a lack of engagement of other students in services that were provided.

Academic culture

A sense of academic culture is demonstrated by a student's ability to engage in the University environment and being culturally competent within that. This includes understanding of the ethical principles and values of the University [16]. The focus group participants expressed that the support services available to them had assisted them in this.

FG3: “Yeah … well I'm an international student so there's an international student advisor in the student centre building. I went to see her quite regularly … She told me everything … how to study in university … and it really helped me … I also went to English help … to check my grammar and stuff for all the essays and all the assignment and I think that definitely improved my grade.”

Discussion

The findings of this study expanded our knowledge of how nursing students at one university campus gained support as they adjusted to university life, and the importance that students placed on the availability of such support to their senses of success. It documents the support services on offer at the time the study was conducted and explores first year undergraduate nursing students’ awareness and use of these services.

Previous research has clearly identified the challenge of retaining students in their first semester or first year at University [25,26]. Universities are responding to this challenge by initiating transitional supports centrally, at Faculty or School levels and within programs or courses [11]. Research indicates that many models of support are on offer, including transitional support via roles such as First Year Advisor [13], academic development via roles such as Learning Adviser [14], as well as formal or informal support from peers or mentors [27]. Griffith University offers a range of transitional support services. The first phase of this study identified these supports and associated them with one or more of [16] success indicators. This mapping clearly identified the range and diversity of support services on offer.

It was clear that the current dissemination of information about support roles was successful in achieving reach to the majority of participants. Over 80% of the survey participants attended Orientation Day, and this was the first opportunity for a whole cohort approach to transitional support. At Orientation, students were provided with an overview of the Senses of Success Framework [16] and this made explicit the expectations that learning is co-created and students have a responsibility to develop academic skills and seek help when needed. Orientation has been associated with University success [26] and non-attendance at Orientation may contribute to the students starting to feel isolated or ‘left behind’ and may account for some of the participants' experiences of being bewildered and unable to locate or access support.

The other structured whole cohort approach to transitional support, built on the Senses of Success Framework [16], were the timetabled Common Time workshops. These workshops, attended by 85% of survey participants, are co-curricular activities implemented ‘just in time’ to support academic learning skills for assessment activities to bridge the gap between skills at time of entry to University and those required for success in a nursing course [1]. Additionally to this, the strategic combination of Orientation and Common Time has been reported as being successful in improving student confidence in the senses of resourcefulness, capability and academic culture [19].

Students perceived accessing support services as helpful and advantageous for their transition to University, and this increased the students’ sense of capability [16]. Findings revealed that 94% of participants had no difficulties in accessing a support service and noted the importance of early access. Some services, such as PASS, were well known and well utilised. Peer led and small study skills groups have been identified in the literature as beneficial for student learning [15,28] and the high uptake and multiple use of PASS suggests first year nursing students valued this service for their learning and sense of success. Course Convenors were well known to participants and, in the context of the way teaching activities are organised at Griffith, this should not be a surprising finding as Course Convenors organise and deliver the majority of teaching resources and provide an ongoing academic advisory role to students.

Some services such as Chaplaincy, Disability, Welfare and Counselling services were known but not accessed by the majority of participants. This may be a case of self-selection, with students not believing they are ‘in need’ of the service. It is possible that the transitional university experience and the need for self-directed learning uncovers issues for students, such as learning difficulties or mental health issues, which were not apparent before University. Existing research suggests that not all nursing students are aware of or declare learning difficulties such as dyslexia [29,30] or mental health issues [31] and these students may need more than knowledge of a service (e.g. Disability or Counselling) before deciding to access it. Half of the survey participants were not aware of other services such as the Griffith University MATES mentoring program. Future efforts should therefore be made in improving student awareness of the lesser known services.

Participants identified that the Orientation and Common Time programs supported their connections with peers and staff and led to a sense of community and an enhanced learning environment, in line with the findings of [19]. However, some participants had difficulty finding the information they needed. Support service providers need to meet the needs of the students' help-seeking behaviour [16] to improve the students' chances to succeed. Navigating the online environment was noted as being challenging by a small number of students. Difficulty accessing digital information and the lack of user-friendliness are common problems learners’ experience [32]. Therefore, gaining feedback from students on what information was difficult to access is crucial for quality improvement and strategies need to be in place to support these students to improve their information technology skills.

The range of support services provided by the School and the University clearly support commencing students’ sense of belonging and purpose [16]. This academic culture was perceived to be a positive element in the study. Whilst the majority of students indicated that they had actively engaged in these services, some students reported their surprise that some of their peers had not utilised the supports available.

Limitations

This study was conducted on one campus of a multi-campus school. To abide with University policies on surveying students during semester studies, a sample of students (N = 150) were surveyed. A response rate of over a third of these students was obtained, so a small sample size was a limitation of this study. The sample included a large number of participants that had commenced University studies before their enrolment in nursing. Their previous experience of University, either unsuccessful or successful, may have given them a comparative experience and they may have been highly motivated to participate in the survey. Survey data collection was undertaken late in first semester, so students who had withdrawn early may not have received or responded to an invitation to participate in the study. Finally, using a self-report mechanism for students to identify awareness and engagement with school- and university-based support services, participant responses may have been prone to self-report bias [33].

The students who participated in the focus group meetings were volunteers from the survey respondents, and may have had personal reasons for self-nominating. Although some students who had agreed to participate in a focus group did not attend on the nominated day, three small focus groups were undertaken with a total of 18 participants. Despite the problems with recruitment to the focus groups, data analysis showed a consistent pattern and research indicates that qualitative studies that obtain a sample of 12 participants are likely to have reached data saturation [34]. Although our sample is small, the process we used to identify the services students used and the learnings we gained can be used by educators from across the higher education setting.

Conclusion

Fostering a culture that can support transition and sustain the integration of students is a priority in order to retain students who are capable of academic success. This study identified the range of support services available to first year commencing students transitioning into a University environment. The survey of a random sample of first year nursing students that mapped student awareness of and access to these services identified that some students were not aware of particular support resources. The results demonstrated that the support services in place at the time of the survey were successful in reaching the majority of students and contributed to their sense of success at University. The feedback from the focus groups identified similar findings to the survey. Identifying the lesser known services early in the first year at Orientation and Common Time will ensure that students are supported and encouraged to use all services that could contribute to the senses of success at University.

Conflicts of interest

None.

Funding

This work was supported by the Griffith University Grants for Teaching and Learning for the project, “Building Academic Capacity in the Bachelor of Nursing: Developing a Scholarship of Learning and Teaching in a Nursing Education Community of Practice.”