Who cares about the carers?: An analysis of the experiences of Radiography and Radiotherapy students who are carers

Zainab Hussain, Vicki Pickering, Dave Percy, Julie Abbott & Jan Bogg.

The Study

This study is part of a large scale project being conducted across Allied Health Professions

The preliminary findings for students on the radiography and radiotherapy degree programmes who are carers are presented

Why? There are now greater numbers of mature students

undertaking higher education (HE) programmes Currently national statistics are not available on the number

of students who are carers

Age 1999 2003 2004 2005 2006 2007 2008

20 and under

245,626 290,160 293,795 316,457 305,121 323,220 350,263

21-24 25,804 44,184 44,259 46,441 44,844 47,949 54,921

25-39 25,789 32,256 31,981 34,304 32,764 33,692 40,698

40+ 5,846 7,707 7,509 8,167 8,161 8,569 10,745

Total 303,065 374,307 377,544 405,369 390,890 413,430 456,627

Accepted applicants to higher education (UCAS accessed 2009)

Why? Percentage of full-time students studying selected subjects, by age on enrolment 2007 (Only the top 5 choices for mature students are shown. (Source: UCAS)

Age 20 and under

21 to 24 25 to 39 40 + Total

Social Studies

6.56 8.59 14.91 17.61 28027

Subjects Allied to Medicine

5.57 8.49 15.99 16.13 25289

Creative Arts & Design

11.74 14.71 9.76 15.3 43597

Business & Admin studies

11.08 12.26 8.27 4.18 39425

Education 3.33 4.21 6.32 8.62 13783

0%10%20%30%40%50%60%70%80%90%

Radiotherapy Entry by Age Category

Under21

21-25

Over 26

1996-2006

En

try

by

pe

rce

nta

ge

0%

10%

20%

30%

40%

50%

60%

70%

80%

Diagnostic Entry by Age Category

Under21

21-25

Over 26

1996-2006

En

try

by

per

cen

tag

e

Entry by age to radiotherapy & diagnostic radiography programmes 1996-2006

Background

There has been a growing awareness of the needs of carers

The Department for Business Innovation & Skills has modernised the student support system

This initiative may have influenced the recent increase in full-time participation by mature students 

Background

Returning to full time education can have negative consequences on family relationships

Mature students and women with children have higher debt levels than younger students

Mature students with children often discontinue their studies.

Males returning to study have been shown to be treated more positively by their families and received more encouragement than females.

Attrition

The Society and College of Radiographers 2008 reported that national attrition rates were 37% for diagnostic students and 43% for radiotherapy students.

These figures fall below national HE attrition rates but are significantly higher than other allied health programmes.

Aim of study

The aim of this study was to actively engage student carers and report their opinions and experiences

Method

Diagnostic radiography and radiotherapy students (n= 227) were invited to complete a short questionnaire and 215 responded (122 diagnostic students and the 93 radiotherapy .

Students who identified themselves as carers were invited to participate in focus group sessions.

From the findings of the focus groups absence rates were also investigated.

Why did you choose to do radiography/radiotherapy?

Why did you choose this university?

Has the programme turned out to be what you expected?

What have you enjoyed most about your programme and university?

Did you feel prepared for university study?

Do you feel you are supported?

What difficulties have you encountered?

Have you ever felt like leaving and why?

What makes you stay?

What have you gained from higher education?

Given your time again would you still choose this programme at this university?

Questions for discussion at focus groups

Results (Questionnaire)

28% of students were male, 78% female

45% of students were aged over 21 years on entry to the programmes

23% of students were aged 26+ years on entry

Results (Questionnaire)

non carer DRcarers DR

non carer RTcarers RT

0

10

20

30

40

50

60

70

80

90

100

Carers & non - carers by programme

A significant number of students (n=30, 14%) identified themselves as carers.

Results (Questionnaire)

All students who were carers had gained entry via access 83% of carers were aged 26+ years 83% of carers were female. 27% of carers were single parents 77% described themselves as the main carer. (Of the 5

males, one identified themselves as being the main carer) 24 cared for children, 6 cared for a parent or grandparent

and one student had multiple carer responsibilities. 77% of student carers indicated that the structure of

clinical and/or academic timetables were problematic

ResultsFocus group findings 

Of the thirty 30 carers, 18 (60%) agreed to take part in the focus groups (5 radiotherapy and 13 diagnostic radiography students). The following key themes were identified.

Choice of programme Expectations Support Timetabling issues Commitment to the programme Absence

ResultsFocus group findings 

Choice of programme Combining technical/clinical expertise  Financial considerations

‘The fact that I didn’t have to worry about fees was important to me at this stage of my life. I have given up a job to do this and also the family have made sacrifices. I don’t think I would be here if I had to pay back the fees.’

 Location – more important than anything else.

ResultsFocus group findings 

Expectations Students reported that the programme was more

demanding than expected.  Students found physics, academic and reflective

writing difficult.  

‘I felt OK with most things on the course but the physics was difficult for me. This was not covered on my access course Some of it is still difficult for me now.’

‘A lecture on how to reference or do a literature search is not really that helpful. I would rather have to do it in some way and then have where I’ve gone wrong pointed out.

ResultsFocus group findings Support

Most students found the personal (academic) tutor scheme helpful. However many stated that the clinical tutor at the clinical placement site was their first choice of contact

Family support was noted as being crucial. Female students felt that their partners did not

fully appreciate the commitment required

ResultsFocus group findings Support

Most students who were carers tended to socialise in their own group and were unanimous in reporting this support as a source of motivation to stay on the course

‘We (carers) tend to hang around together. There’s quite a few of us and we all help each other. We understand what it’s like.’

Students did not feel part of the wider student community

‘We don’t have time really to socialise and go out a lot like the other students. I don’t really get involved in anything at university apart from what I have to do’.

 Some students were not aware of financial support that might be available.

ResultsFocus group findings 

Timetabling

A variety of timetabling issues were reported as problematic

9 am starts (academic & clinical) were incompatible with many childcare arrangements

Academic timetabling changes at short notice For diagnostic students - 13 week continuous clinical

placement block in year two

‘I really felt like leaving. I felt guilty not having any time with the kids during the summer. I relied heavily on parents and friends and felt guilty about that. The childcare grant does not go anywhere in covering holidays especially when you have more than one child.’

ResultsFocus group findings 

Timetabling Students reported that flexibility on clinical placement

was possible. With most clinical staff understanding the issues.

Some students had managed to make individual arrangements for clinical placement to alleviate the problems during school holidays. Not all students requested these changes 

‘I don’t want to start asking for special arrangements. They might think I can’t cope and not give me a job later on. At least when I’m working I can afford proper childcare, choose my holidays within reason and get some flexibility then.’

ResultsFocus group findings 

Commitment to the programme Most students (14/18) reported that they had at

some time considered leaving the programme. The main reasons cited for this was academic failure, financial difficulties and for diagnostic students the timing of the clinical placement block in year 2.  

All students were pleased with their career choice

Despite the sacrifices, a professional career would mean a better future for themselves and their families 

ResultsFocus group findings 

Absence Student reported concerns that absence due to

attending healthcare appointments with family members may be detrimental to their overall attendance record.

Some students also stated that they had at times, taken sick leave rather than request authorised absence as they felt uncomfortable requesting time off.  

ResultsFocus group findings  Absence

Students suggested that there should be an agreed ‘carers leave’ so that they were not disadvantaged

Students felt they did not work to the same flexible working policies and practice available to NHS and University staff. 

‘You know there’s flexibility when you work in the NHS. They’ve got family friendly working hours. Staff at the university get that too. Shouldn’t we be entitled to some carer days?’

 Students perceived the attendance of carers was higher than students without carer responsibilities. 

 

ResultsExploration of absence rates for carers and non-carers.

In response to the issues raised by students on attendance, absence data on the 122 diagnostic radiography students and the 93 radiotherapy students were collected from directorate records and analysed using SPSS Version 16.

Diagnostic Radiography programme absence for carers was significantly lower than that of non-carers. For the radiotherapy programme there were no significant differences between absence for carers and non-carers

It was reassuring that most students were pleased with their career choice.

It is of concern that students did not examine programme structures before application as location was the decisive factor

The need for embedding effective study skills into the curriculum was highlighted by all students particularly with regard to Year 1

Students considered leaving the course following academic failure.

Discussion

Student carers felt excluded from the wider university community,

Lack of social and academic integration have been reported as reasons for attrition (Cullen 1994, NUS Survey 2009)

McGivney 2003 suggested that a sense of inclusion or exclusion was particularly important for students with children

Support they received from their peer group was one of the most positive aspects of university life which may explain why students in this study did not report feelings of isolation.

Discussion

Students felt well supported on clinical placement; Despite these positive relationships, some students

expressed reluctance to request flexibility in placement areas even when experiencing difficulties.

The fact that students would rather take time off as ‘sick’ rather than request authorised absence is worrying.

Transparent procedures would be beneficial to students and staff

Discussion

Attendance has been identified as a determinant of academic performance and attainment (Newman 2008).

Academic departments should not only monitor attendance but also encourage it by making their academic and clinical programme structure, where possible, more accessible to all students.

Discussion

There was a lack of awareness of the financial support available to students, and the application process was not clear. This is in agreement with a recent national study on student parents conducted by the NUS.

The NHS student bursary allowance pays a net maximum amount of £123.25 per week for one child. For two or more eligible children the weekly net maximum is £182.75.

Finance

Department of Health - attrition for allied health professions programmes should not exceed 10% and attrition amongst ethnic minority group students should not exceed the average attrition rate. It is therefore reasonable to suggest that this should apply to students who are carers

The Equality Act 2010 – HEIs will have to consider how their policies, programmes and service delivery affect people with protected characteristics.

Policy & Practice

The NHS has adopted family friendly, flexible working polices

The NHS has a stated commitment to equality and by having a diverse workforce, needs of local populations are met.

Thus those responsible for delivering medical and allied health programmes have a duty to ensure they recruit and retain a diverse student population.

Policy & Practice

Programme structure should be designed with consideration for this group

Students should be actively encouraged to discuss their carer responsibilities at the earliest opportunity

Programme leaders and admissions tutors should be explicit about the structure of the programme

There should also be targeted financial advice The student absence policy is currently being reviewed

for all allied health professional undergraduates at this university.

This study is also contributing at faculty and institutional level to the discussion on developing inclusive practice

Recommendations

Acknowledgements

Thanks to Helen Orton, Bev Ball, Flora Al- Samarraie, Jo sharp and Joy Burrill for help in the facilitation of the large scale study, and to all students who took part.

References

Universities and Colleges Admissions Service: Available from,< http://www.ucas.ac.uk/> [accessed 09/09, 2009].

Ross A, Archer L, Thomson D, Hutchings M, Gilchrist R, Charine J, et al. Potential mature student recruitment to higher education. Department for Education

National Union of Students. Meet the parents: The experience of students with children in further and higher education, January 2009

Cullen MA. Weighing it up: A case study of discontinuing access students. University of Edinburgh, Centre for Continuing Education Research Report 1994; Occasional Paper Series 2(1)

Society of Radiographers. Improving student retention guidelines and good practice 2008. Available at: http://doc-lib.sor.org/improving-student-retention-guidelines-and-good-practice/5-retention-radiography-courses

Maynard E, Pearsall S. What about male mature students? A comparison of the experiences of men and women students. Journal of Access Studies 1994;9:229-229.