Health and Social care – PostGraduate and Early Career Researchers' Blog: Scholarly Conversations

A Praxis funded Research, Scholarship and Innovation project led by Professor Joan Simons in HWSC (Health, Wellbeing and Social Care)

If you have a tutor there that is supporting you throughout your studies or that you know knows and understands your conditions or your mental health, that in itself is so helpful because you feel supported and you feel that, OK, they’re there, they understand, they get it.

Introduction

This blog post summarises a critical OU study led by Professor Joan Simons and funded by Praxis – WELS Centre for Scholarship and Innovation. It explores how Associate Lecturers (AL) at the Open University can provide practical support for students who share that they have mental health difficulties and thus help them succeed in their studies. This research is of particular importance because although there has been an increase in students with declared mental health issues over the past few years, they are the most likely to be unsuccessful in their studies or even drop out entirely. Therefore, focus group discussions were organised to identify ways to help these students continue and succeed in their studies.

Results

The results of this study showed ways that the OU can support their associate lecturers so they can, in turn, support the students they have with shared experiences of mental health issues. Firstly, students strongly preferred email as their primary communication method, as it allowed them to take the time needed to formulate their thoughts carefully. However, some noted the challenges of miscommunication via email. In contrast, phone calls were generally seen as stressful unless scheduled in advance. Secondly, some students struggled with Tutor Marked Assignments (TMA) and found that getting extra support from their tutors was hugely valuable. Finally, students had difficulties navigating the OU resources.

Discussion

Personalised communication was seen as essential in building solid tutor-student relationships. Students appreciated individualised, rather than generic, responses from tutors, which made them feel supported and valued. Timely responses and clear boundaries around tutor availability also helped alleviate anxiety. To help students who share they they have a mental health condition and based on the results of this study, Joan proposes the development of an intervention aimed at enhancing academic and pastoral support for students with shared mental health difficulties. This intervention would include regular check-ins, tutor video introductions, clear boundary-setting, and structured communication. The impact of these strategies will be assessed by tracking retention and attainment rates.

On the other hand, students also noted a significant variation in how well different tutors understood and supported mental health challenges. Some felt that a lack of understanding from their tutors hindered their progress, indicating a need for more standardised training. A warning light that students who are likely to experience mental health issues need extra support or a modification in the support they are receiving is if they are asking for repeated extensions.

Conclusion

In conclusion, based on the results of this study, Joan aims to implement various modifications to the support that students who share that they have experienced mental health issues receive. For example, comprehensive academic and pastoral support will be tailored to students with mental health difficulties. Interventions will include personalised check-ins and engaging video introductions that respect these students’ requests for precise boundary settings. Additionally, regular check-ins will be organised in time for the TMAs, and extra support will be provided if necessary. The effectiveness of future support will be rigorously assessed using questionnaires, focus group discussions with ALs and feedback sent to the OU. Additionally, participating students’ retention and attainment rates will be compared against their peers. By better understanding the needs and preferences of students who share they they have a mental health condition, the OU will be better equipped to help them fulfil their studies and continue to a successful and satisfying future.

We would love to hear about your experiences of mental health (directly or in supporting others) and study in higher education. What more should the sector be doing. Please send us a comment in the box below.

Thanks to Lesley Fearn for peer reviewing and helping to shape this blog post.

Dr Lesley June Fearn is a secondary school English teacher in southern Italy. She is also an affiliate researcher at the Open University’s (UK) Faculty of Well-being, Education, and Language Studies (WELS), where her research centres on linguistics and sociocultural theory.

Hypothetically, if you were to cut me open, you’d find ‘MIDWIFE’ written through me like a messy and macabre stick of rock.

Like so many, my professional and personal identity are so intrinsically linked with shared values; being a midwife is not just what I am, but who I am. My philosophy has always been and will ultimately remain grounded in evidence-based practice to provide safe, effective care, as well as valuing individual’s needs, wants and experiences, remaining passionate about equitable and safe clinical care with a deep sense justice both within and outside of the system. This is, after all what has led me down my professional and academic pathway.

As of March 2021, 39,070 midwives appeared on the NMC register (NMC, 2021), and a proportion of registrants work outside of providing direct clinical care – myself included – in a range of roles which include research, academia, education, policy, leadership – the list goes on. Each one of those roles provides for a complex and integrated network of experts who in their own way, influence excellent care.

Leaving clinical work for midwifery education was, amongst other reasons, driven by the need to influence excellence in practice and facilitate robust, evidence-based education for students and thereby maybe, just maybe, they might feel empowered to provide excellent, compassionate clinical care and become passionate advocates.

I sensed acutely that transition from clinician to educator, encountering a profound sense of loss of clinical care, which I recognised as the movement from expert to novice (Foster, 2015), a phenomenon well documented in a variety of professions. I soon made that transition, however when COVID-19 reached our shores in early 2020, a country wide call was made to registrants for them to return to the front lines (Nursing Times, 2020) to provide maternity care, as well as redeployment across other areas of the healthcare system, many of my colleagues being dual registered.

I didn’t return to practice (despite many nights of anguish trying to rationalise how I could continue my educational role, manage family life, AND support my front-line colleagues). I ultimately knew that my expertise was best placed supporting students and providing an education, after all, these were to be the future workforce that would, despite living through one of the most challenging times in healthcare, go on to be leaders in their clinical field.

Having this experience, I anticipated the same seismic shift when I moved into full time doctoral research and prepared accordingly for that feeling of loss. Fast forward to now, and I only just feel comfortable referring to myself as a PGR rather than hiding behind my other professional identity as a midwifery clinician and educator. I know this is common amongst peers, it’s something I’ve reflected on at length with other PGRS who work currently or previously within healthcare.

But recently those feelings have returned with vigour.

Maternity care in the UK is going through significant scrutiny following independent reviews of maternity services at NHS trusts (DHSC, 2021), addressing profound inequality and poor outcomes in black and minority ethic women (MBRRACE-UK, 2020; FiveXMore, 2021) and implementation of Better Births (2016) through the maternity transformation programme. This is all against a background of an ongoing pandemic and serious workforce staffing and retention concerns across midwifery (RCM,2021) and nursing (Guardian, 2021). It has been hard therefore to reconcile feelings of being needed back ‘at the coal face’ with the guilt of continuing my research. I now recognise this dissonance as moral distress, which whilst most aligned with being powerless within a healthcare system, can be experienced in other areas.

I have, through peer reflection, been comforted by the fact that, firstly, I am not alone, as many PGRs with a healthcare background are feeling the same. Secondly, that having identified a gap in knowledge, I can focus on improvement from a different perspective, and that whilst it is tempting to temporarily abandon postgraduate research (as a wise person called ‘responding to the call to action’) and return to clinical work in the time of crisis, ultimately making a difference with research is a valid goal contributing to the wider body of knowledge, and of as much value as walking the wards. Ultimately this will shape a better, more reflexive researcher, academic and clinician.

How are others feeling? Is this a phenomena particular to healthcare PGRs?

by Anna Madeley @AnnaTheMidwife

Anna is a full time doctoral researcher in her second year at the Open University and a registered midwife. Prior to starting at the OU, Anna worked in a variety of maternity settings including practice development, her last clinical post as a senior midwife establishing and running a home birth team before moving into midwifery education as a Senior Lecturer. Anna remains connected with midwifery education with specialist teaching and interests in all aspects of contemporary midwifery practice, physiologically informed care, research, individualised and complex care planning and supporting home birth. Anna’s previous MSc research explored the experiences of midwives supporting women with complex needs (physical, medical, obstetric and psychological) who choose to birth at home. Her doctoral work explores the experiences of women who make non-normative choices in pregnancy.