Healthcare courses in Higher Education

The last twenty years has seen a percentage increase in mature students in higher education, not just in this country but also worldwide (UCAS 2011). The general household survey reported that the number of mature students in full-time university education rose from 3% in 1960 to 29% in 1994 (Egerton 2000). Indeed, 60% of undergraduates in the UK are now over twenty one (Direct. Gov 2011). UCAS (2011) admission figures reveal that mature student applications have increased each year since 2001, with significantly large increases in the over twenty fives.

In recent times this appears to be accelerating further, UCAS figures from 2008 and 2009 cycles report that university applications are increasing across all age ranges but particularly from mature students with an increase of 27 % from applicants over the age of 21 for this cycle (UCAS 2011). Many higher educational establishments are aware of this and value mature students for their enthusiasm, experience and skills and actively encourage mature student entry by offering flexible course admission requirements that consider a range of qualifications (UCAS 2011).

Additionally, a number of institutions offer flexible learning programmes (UCAS 2011). Recently, widening participation programmes have also surfaced to further broaden social catchment (Johnston 2003). Mature students arrive at University at different stages in life, bringing different responsibilities, expectations and skills which present differing challenges and obstacles to those students of traditional age (Fleming & Murphy 1997). Current literature suggests that established educational practices do not always adapt at the same pace as mature student participation (Rautopuro & Vaisanen 2001).

Additionally (Johnston 2003) argues that the issues of retention and success for this group are less well understood. Previous research has demonstrated that when compared to traditional age students, mature students experience increased psychological, academic, social and financial challenges (Leonard 1999). Fleming and Murphy (1997) suggest mature students face a war of attrition juggling familial relationships, financial constraints and coping with exams and essay writing which can result in a constant temptation to quit.

Baxter & Britton (2001) elaborated further, outlining that the subsequent change in identity when attending higher education altered the dynamics and the relationships within the family and amongst friends. This may happen in two ways, firstly from challenges to already established gender roles and secondly from the change to individual characteristics or self-identity. The authors argue that this may manifest itself in being seen by others as superior or as a general feeling of superiority.

In trying to manage these changes the authors postulate that students attempt to refine strategies to minimise the disruption. Often, this process becomes a stressful transition and their identities may become fragmented or compartmentalised. (Baxter & Britton 2001) Steele et al (2005) suggest that mature students have more roles to play than traditional age students, such as childcare, relationship issues and suffer more financial difficulties and academic problems and that changing identities creates tensions between these roles which an be stressful and incapacitating. This stress was compounded further when trying to balance academic life with work and family responsibilities (Steele et al 2005).

Many of the students, in their study, also suffered anxiety with regards to education re-entry, in terms of perceived pressures as to what was expected of them and what they expected from themselves. These issues impacted negatively on the students’ academic efficiency and emotional health. Steele et al (2005) went on to describe the importance of support networks as a coping echanism for these obstacles, with peer support being the most important but also including friends, family and educational tutors as critical to overcoming obstacles and maintaining well being. The sample for this study was taken from a Further Education establishment and thus the findings are not transferable to Higher education.

This does not detract from the validity of the papers conclusions within this setting only the transferability of the findings to differing settings (Mays ; Pope 2000). Additionally, the findings are congruent with previous literature dding to its validity (Bowling 2009). Chur Hansen (2003) suggested that mature students had more financial difficulties, less social support, more relationship problems and more illness induced by stress and anxiety than traditional age students. The respondents described difficulties in forming friendships with younger students due to lack of commonality. This lack of peer group support was not through lack of association or invitation but rather that the inter-relationship dynamics were one of confidant or mentor rather than a more intimate mutual friendship.

The students also found forming associations with other cohorts difficult, due to their scarcity and distribution through different years of the course. Social isolation was further compounded by the time demands of the course. The sample for this study has limitations, it was chosen due to ease of access, students were interviewed who were based at the same campus as the researcher. This limits the diversity of the sample and makes transferability of the findings problematic (Greenhalgh 1997). The researcher had also taught the students at some point in their course.

Some theorists could consider this a drawback, inhibiting respondents to disclose intimate information as they are more than likely to come into contact again in the future. However it could be argued that the intimacy of the information disclosed tempers this criticism. The conclusions offered concur with previous research which increases its validity (Greenhalgh 1997). These obstacles and issues have generally been researched within general University education. It could be argued that healthcare courses face particular and specific problems arising from the increased demands of vocational or professional education (Lowden et al 1990).

Students undertaking healthcare courses experience the added demands of longer university contact hours, full-time placements that may be away from home and the emotional demands involved with professional caring (Cuthbertson et al 2004, Lauder and Cuthbertson 1998). Harth et al (1990) elaborated further and concluded that when compared to traditional age students, mature medical students exhibited greater stress and financial difficulties and were more likely to feel lonely and isolated.

Kevern ; Webb (2003), echo this somewhat, suggesting that in addition to the challenges of juggling home life with academic pursuits, they also suffer in terms of inclusivity. The researchers postulate that Universities are structured and cultured towards more traditional age students and also suggest that institutions lack flexibility in terms of time-tables, childcare support and traditional teaching and assessment methods, and as a consequence mature women students feel isolated and marginalised from peers and the wider University social scene.

In addition the paper concluded that mature students feel that the experience they bring is not valued and that their needs go unmet. From an exhaustive literature search, it would appear that the amount of peer reviewed articles in this area is still in its infancy and sparse. Therefore this review will explore relevant literature to identify, extract and evaluate current knowledge of the main issues or obstacles faced by healthcare students in Higher Education.

This information will be organised and clarified to offer a clear and concise overview of current and relevant pertinent issues, helping to clarify and specify barriers to efficient study faced by mature students. The definition of a mature student can differ markedly, even within the UK. For the purposes of this study a mature student will be defined as one who is twenty one years old on the 30th September of the academic year in which they enter the institution (Higher Education Statistics Agency 2011).