Why students leave in the UK: Integrative review of the international research literature

AIMS AND OBJECTIVES: The purpose of this integrative review of the literature was to find and review international research studies that explored student attrition to determine what is known about the topic and to identify gaps in the research with a view to addressing the situation in the UK. BACKGROUND: Attrition from nursing programmes is a serious problem in the UK. It is recognised as a complex phenomenon, not attributable to a single cause. Regardless of actual attrition rates and trends, departments of nursing are challenged to perform in a business-like manner. Consequently, every student lost to a programme of study equates to a financial penalty for the department and to the future workforce and community. DESIGN: Integrative review of the literature. METHOD: Using electronic databases and specific search terms, 18 articles were identified and reviewed. Findings from the identified international research literature were analysed using qualitative content analysis. RESULTS: Four broad themes that accounted for factors of relevance to attrition were identified: Social, Prediction, Programme and Personal. CONCLUSIONS: Retention studies are fraught with methodological problems. These include incomplete or inaccurate data and low response rates. Attrition early in programmes may be attributed to a failure to understand the roles of nurses in contemporary societies. This has led to dissatisfaction with programmes and academic failure, as students may underestimate the intellectual demands of their programmes. Attrition later in the programme may be attributed to a combination of personal factors that culminate in a personal crisis. RELEVANCE TO CLINICAL PRACTICE: The research literature suggests that stereotyping of nurses is a major factor in attrition. Both professions need to find ways of communicating contemporary roles to wider society.