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.

Understanding the experience of nursing students: part 1

What do nursing students want from their university library? That question was on my mind for a while, reinforced by a context of negative feedback and middling-at-best satisfaction. It was clear that we weren’t quite hitting the mark as a service, but what were we missing? In this blog post I’ll give you an overview of a project I ran to learn more about nursing students’ experience of the Library and to consider what changes we could introduce to their (and other students’) benefit. I’ll focus on my overall approach and some of the key outcomes from the project.

What was the aim?

This project, referred to in shorthand as Nursing UX, was designed to address the lack of granular feedback currently provided to the Library by nursing students. Whilst we did receive some feedback from students, this never felt detailed enough to make any meaningful service improvements. I therefore wanted to understand more about students’ current level of knowledge about the Library, and build on that to consider what more we and the department could be doing to support students. Ultimately I wanted to complete the research with a set of specific recommendations to take back to the Library’s Leadership Team.

As much as this was a project designed to support nursing students, I also wanted to make sure that - wherever possible - the recommendations would benefit other students in the department and perhaps even the University as a whole.

The research aimed to identify where we were missing the mark with students

What did the research involve?

I used a range of user experience (UX) methodologies in this project. If you’re not familiar with UX, take a look at some of the ways we’ve used it at York. The techniques were:

• Classroom voting, where I asked whole cohorts to complete a short questionnaire at the end of one of their lectures. This was designed to identify the overall level of knowledge of different library services in each cohort, as well as their general feelings and preferences for those services.
• Touchstone tours, in which students led me around the Library and explained how they use the space and what they like and dislike. This technique aimed to see what resources and services were a priority for students, but it was also illuminating to see what they didn’t mention on the tour.
• Semi-structured interviews, in which I asked students to draw a cognitive map of their process for writing an essay. This was the launching off point for a discussion about their academic experience generally, gradually focusing down to questions about their experience of using the Library.

I then brought together the results from all three methodologies, thankfully with the help of an intern who had much better capabilities with statistical analysis than me! For that reason I won’t go into the methodology, but I’ll talk about some of the key findings from the different elements of the research.

What were the key findings?

In this section I’ll give an overview of some of the key findings from the research - some surprising, some reinforcing things I’d heard elsewhere.

Comms, comms and more comms

One message came out very clearly in the results: students who have a greater knowledge of the Library are more likely to use either physical or electronic resources. Not rocket science perhaps, but it was nonetheless useful to confirm that it’s worth taking the time to ensure that students know about our services. I thought I was doing this relatively well, so it was a much needed wake up call to realise that lots of students hadn’t grasped some fairly basic introductory information. For example, one student commented:

I didn’t know about this until recently, that [YorSearch] will tell you exactly where it is in the library, it will give you a code … I would just walk up and down thinking ‘where the hell is this book’!

This is despite me having talked about this numerous times in teaching sessions and through classroom activities, so clearly something wasn’t quite clicking for some students. It was really worrying to me that many students might have been in the same boat, and were too anxious to ask for help (more on that below). I therefore created a comms plan for how I would get messages to students, incorporating face-to-face opportunities and email follow up. This has been in place this academic year and seems to be working well, although it’s sometimes been a challenge finding time in busy periods for this kind of bespoke interaction. It’s been worth it, however, as it’s given me more face time and, hopefully, credibility with the students.

I’ve also learned not to be afraid to repeat things. Even if many people in the room already know about it, there might be that one person who’s still wondering the shelves looking for a book! There’s a fine balance here, of course, as we also want students to become independent and to ask for help when they need it.

Our messages to students were sometimes getting muddled or forgotten

Students’ anxiety is a real problem

It’s easy to forget that many students will never have stepped foot in a library before, let alone one of the scale of an academic library. No wonder then that students they’ve reported feeling overwhelmed. One student sums it up perfectly:

When you come to the library it’s really daunting, because you’ve got loads of people who know what they’re doing, sat at desks, typing away.

This isn’t the only time I’ve heard this feedback from students, so it clearly wasn’t limited just to the nursing students. It did seem, however, to be a more widespread issue within this group. This is ultimately a crucial issue for academic libraries; our universities will expect students to be making use of our resources, but many appear too intimidated to do so. Nursing UX showed that students who used the Library more frequently were more likely to provide more positive feedback. There is absolutely, then, a vested interest for libraries to encourage students to use our services; it’s for their benefit, but also means that we get a positive result for what is becoming a key metric.

So how do we make students feel welcome and not overwhelmed? I have no ‘lightning in a bottle’ answers sadly (add a comment if you do!), and this is something we’re still thinking about here at York. It’s at least partly to do with what students see when they enter the building (read more on this from our UX Space project), but it also means breaking down barriers to support. We’ve got a really helpful and friendly group of staff at our Help Desk, but many students seem worried to approach them for assistance. Roving help might be a way forward - going to students at the point of need - but we’ve got some more thinking to do on this. For now it’s really illuminating to know that students have that anxiety about using the Library, so talking to them openly and honestly about their concerns can only be a good thing.

Some students felt too intimidated to use the Library. Hardly the warm welcome we were aiming for

That's it for now. Check back next week for part 2, where I'll talk about some of the other findings and what we're doing as a result.