July 18, 2019

Understanding the experience of nursing students: part 2

In part 1 of this blog post I introduced our Nursing UX project and revealed some of our findings. In this follow up post I'll cover some further findings and tell you about what we're doing next.

Key findings continued

Students have a love/hate relationship with ebooks

It’s not news that academic libraries have embraced the ebook, but we seem to get a lot of conflicting feedback from students about them. Nursing UX showed that students like to have ebooks; the most consistent negative feedback was about ebook availability, which is perhaps not surprising given that nursing students spend so much of their time away from campus. It was very clear, however, that the actual experience of using an ebook was very often not an enjoyable one. Students presented very practical problems with everything they want to use being accessed through a PC or other single device. For example, one student commented:

If something is in print I can look at what I have typed and the literature, I can look at both at the same time with a simple turn of my head or glance of my eyes. If it is on my computer, I have to flick between the two screens or have a split screen so ... I much prefer print

This presents something of a challenge to the ways in which we provide resources. We have to continue to provide ebooks for their ease of access and to meet student expectations, but must also look at how we enable students to use them effectively. At York we’ve started to have conversations about providing second monitors so that students can work with two screens: one for their writing and another for the ebook. I’m very hopeful that this will start to open up access to resources in a transformative way, allowing students to make the best use of our range of online resources.

Ebooks: loved and loathed in equal measure

They’re also not mad about literature searching

How much help should we give students in learning to use databases? The answer varies hugely depending on the discipline, but in Health Sciences the answer has always been ‘quite a lot’. In recent years, however, I’ve been pushing students to take more personal responsibility for this learning - with mixed results. One student writes:

We do get a session on it but I feel like they are a quick whistle tour and you are sort of left to do it on your own. Which I guess university is all about being independent and work on your own anyway, but I do feel like you are very much left in the dark and you are meant to work that out yourself. I still don’t fully understand CINAHL and Medline but I do try to use them if I can

In fact they have multiple sessions about how to search for literature, but the student’s point still stands. They’ve rightly recognised that they need to be in the driver’s seat for their own learning, but feel lost as to how to get there. This gave me a lot to reflect on with my approach to teaching. I firmly believe that we shouldn’t be spoon-feeding students with skills teaching, but neither do I want to leave them feeling adrift without support. My revised approach to teaching should help, with my sessions immediately being followed by seminars in which students unpack the material with their lecturers. They then have flipped classroom activities to undertake with an optional drop-in for support. This approach seems to be effective; the students have to take an active role, but there is staged support and advice available.

It’s also important to remember that we’re not creating librarians. Yes student nurses need to know about searching for literature - it’s an important skill for their professional lives as well as their academic ones - but they don’t need to be experts and understand every nuance of every database. I’ve therefore taken a very pragmatic approach: give students enough detail and support for where they’re at, situated in their own experience and expectations. Time will tell if it’s a more successful approach, but it’s certainly been more satisfying to teach!

Searching for resources was surprisingly not the students' favourite pastime!

Starting to write essays is the worst

In the semi-structured interviews students spoke a lot about their approach to essay writing. I thought that students would speak a lot about struggling to find sources or not knowing about how to structure their thoughts; these issues certainly came up, but the consistent difficulty was students not being able to start writing. This comment sums it up nicely:

Starting [the essay] is definitely the most challenging… I could read for days and days and not write anything … I think getting past that barrier or the fear of failure is the most challenging

As a result of this, I’ve been working with the department’s lead for academic writing to rethink some of their support in this area. So far we’ve trialled a couple of ‘Shut Up and Write’ sessions timetabled specifically for the nursing students (we’d run this previously for PhD students but never at undergraduate level). The attendance wasn’t great at either session, but the students who came really valued it - either for dedicated writing time or as an opportunity for tailored feedback. We’re going to look at how we can plan these sessions for next year. Part of the challenge is finding times when the students are both on-campus and actually starting work on a summative assessment - not easy for any group, but especially ones who aren’t always around on campus.

The hardest part of essay writing was being faced with a blank page

A studious environment makes you feel more studious

Many of the students noted that they like working in the Library because it actually feels like they’re working.

I find that I really struggle to write unless I am in the library, so I find it quite an inspiring place to write and I have been up here till about 4 am just happily writing

I find it quite an inspiring building, being around all the books ... When I see other people studying I feel I can study … even my flatmates will all make the journey here and we use [group study rooms] in the evening, we just come in and it’s like a big community

That sense of community was a recurring theme for the students. They like studying in a way which connects them to their peers, especially given that they might not see people for long periods of time during placements. For that reason many of them make a beeline for the Nursing section in the Library; they might bump into their fellow nurses and have a sense of comfort, but they’re also somehow absorbing relevant knowledge from the books across the aisle. But what use was any of that to me? With such a captive audience, I was missing a trick by not targeting messages to them directly. I therefore decided to set up a noticeboard specifically for the nurses, located near to the books which they use most often. I know, it’s not going to change the world, but I think it’s been a useful way of flagging up some key information. Just don’t ask me to measure the success on that one!

Many students preferred working with their peers around them

What next?

I’m now busy working on the recommendations from the project. Some have been very easy to achieve: buying new editions and weeding old stock, setting up the comms plan. Others are beyond my immediate ability and will require a lot more thinking from the Library as a whole. What’s important, though, is we’ve got a really strong set of actions and a robust data set to inform future planning. We’re just embarking on a new way to oversee projects in the Library, and I’m very hopeful that Nursing UX will inspire a lot of these new pieces of work.

On a personal note it was hugely eye-opening to carry out this research, and it’s given me a fresh perspective on a lot of the issues which students raised. I was a student longer ago than I’d care to admit, so it’s easy to forget just what a learning curve it was. And I was never a student nurse with the added pressure of placements! Hopefully we’re starting to put things in place which will make students’ lives easier, but just by kicking off the conversation we’re doing just that.

How do these findings compare with observations from your own institutions? Let me know by leaving a comment below.

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