ESRC
ECONOMIC
& SOCIAL
RESEARCH
COUNCIL

LEARNING SOCIETY
PROGRAMME

PRINCIPAL
RESEARCHERS

Dr Jenny Hewison
Senior Lecturer
School of Psychology
University of Leeds

Dr Therese Dowswell
Senior Research Fellow
School of Psychology
University of Leeds

Bobbie Millar
Academic Secretary
School of Healthcare Studies
University of Leeds

CONTACT
ADDRESS

Dr Jenny Hewison
School of Psychology
University of Leeds
Leeds  L52 9JT
Tel: 0113 233 5725
Fax:  0113 233 5749 
Email:  jennyh@psychology.leeds.ac.uk

Duration
24 months
CHANGING PATTERNS OF TRAINING PROVISION;
IMPLICATIONS FOR ACCESS AND EQUITY

OBJECTIVES

The main objective of the project was to describe the effects on the home and family life of nurses, midwives and other National Health Service (NHS) staff undertaking continuing education courses.

APPROACH

We interviewed 89 people on a range of continuing education courses, including an MSc course for radiographers, an open learning conversion (ie upgrading) course for enrolled nurses, an open learning health promotion course, a part time degree course for midwives, a part time health studies degree, and a full time specialist diploma level nursing course.  There were 81 women and 8 men (reflecting the composition of the health care workforce), half of whom had children.  We also sought the views of purchasers and providers of training for non-medical health service staff.

MAIN F1NDINGS

Practicing nurses, midwives and other NHS staff feel that they are under growing pressure to get more qualifications.  In the past, staff undertaking further training could expect it to be provided on a day release basis.  Today they are increasingly expected to attend courses in their own time, in order to save on staff costs.  The main finding of our study is that training courses now often make such heavy demands on individuals’ out-of-work time that many people experience family problems and personal stress as a result, especially if they have children.

Only 42% of the staff we talked to thought their course was fitting in reasonably well with home and family life; 48% thought it was a strain, and 10% thought it was causing serious detrimental effects.  Many people commented that lack of time to spend on family activities could lead to strain and tension in relationships.

Participants used a whole range of coping strategies to maintain their various social roles.  Participants took on additional work and responsibilities, let the housework “go to pot” and asked partners to increase their role in child care.

People with children had significantly greater problems juggling their work, training and family commitments.  Organising child care was often not easy, and some people felt guilty that they were not performing well in the role of parent, or because they had to ask friends or relatives to help with child care provision.

There were also financial costs.  Overtime might be lost for quite long periods, salary increments on conclusion of training were not expected, and some staff switching speciality dropped a salary grade on returning to work.

When asked why there were doing their course, 80% of people in the study mentioned some kind of negative factor - they felt they had to do it.  Sometimes, respondents identified aspects of their current job that they didn‘t feel they were doing well (eg teaching students) or reported that they were being overtaken by others in their immediate work environment.

However, more than half of the sample (52%) mentioned the wider professional environment as a reason for taking part in the course.  The expressions these staff used were “the way nursing is going now ... “or “with the changes in the NHS”.  Their perception was that staff who did not want to be left behind in the promotion stakes had to be seen to be keeping up to date by engaging in further study.  This perceived pressure was sometimes a source of resentment.

The figure of 80% of people referring to some kind of negative reason for doing their course was similar for those with and without children.  But people without children often added positive comments - they were interested in the subject matter, the extra knowledge would help them do their jobs better, and so on.  People with children at home were much less likely to report these kinds of positive benefits from doing their course.

When respondents were asked about their preferences of different modes of learning, the replies were very clear.  Open learning methods were preferred by only 30% of enrolled nurses, most of whom were on such courses, and hardly anybody from the other group.  The often quoted popularity of this mode of learning may reflect the limited options available to many people, rather than any intrinsic positive features. 

Managers acknowledged sometimes with regret that staff who did not engage in further training were putting themselves at a disadvantage, since experience often counted for less than qualifications when promotion decisions were being made.

POLICY IMPLICATIONS

1.   One of the themes of The Learning Age is that individuals should be encouraged to take responsibility for their own learning, with support from Government and employers.  “Support” is generally discussed in terms of financial support, as in the concept of Individual Learning Accounts.  Support in terms of time for learning has been relatively ignored in discussion to date.  For some of the target groups addressed by the Learning Age, for example the unemployed, time is not in short supply; but for those seeking to continue learning while in paid employment, time may be an extremely scarce resource.  A number of recent reports have shown that people in the UK often work long hours, and that women in particular have very little “spare” time when they seek to combine paid work with bringing up a family.  The time implications of current lifelong learning policies must be re-examined if desired levels of participation are to be achieved.

1.	In our study, developments within the nursing profession and the promotion decisions of managers exerted pressures on staff to gain qualifications in order to maintain their relative position within the service; but practical support from employers in the form of paid study time was limited.  People with children were faced with particularly difficult choices; to enrol on a course and carry the financial, social and psychological costs; or to turn down the “opportunity” of further training, and accept that their career would suffer as a result.  Structural inequalities in access were thus turned into attributes of individuals, and treated as useful selection devices in decisions relating to recruitment, promotion and the availability of future training opportunities.  The equal opportunities implications of current policies need to be re-examined.

3.	Nursing is currently experiencing a crisis in the recruitment and retention of staff.  Salary levels and other factors are clearly important, but people who have, or want to have, a family life as well as a career may also choose not to join (or stay in) a profession that makes such heavy demands on their out-of-work time.  Training will always carry costs, but financial savings may be illusory if they result in human costs that are just too high.  Lifelong learning must not be a threat, but a promise.

KEY PUBLICATIONS

Dowswell, T., Hewison, J. and Millar B. (1997) “Joining the Learning Society and working in the NHS”, Journal of Education Policy, 12: 539-550
Dowswell, T., Hewison, J. and Millar, B. (1998), “Enrolled nurse conversion: trapped into training”, Journal of Advanced Nursing, 28: 540-547
Dowswell, T., Hewison, J. and Hinds, M. (1998) “Motivational forces affecting participation in post-registration degree courses, and effects on home and family life: a qualitative study”, Journal of Advanced Nursing, 28: 13126-33
Dowswell, T., Millar, B. and Hewison, J. (1999) “The costs of learning: the policy implications of changes in continuing education for NHS Staff’., in Coffield, F. (ed) Speaking Truth to Power: Research and Policy on Lifelong Learning, Bristol: Policy Press