Table 1 Empirical studies
Author (Year)Location (University) | Methods | Study Population and Response Rate | Focus | Relevant Findings | Quality (MMAT) |
|---|---|---|---|---|---|
Cameron et al. (2014) [43] Australia (multiple) | Qualitative Interviews | 10 Indigenous psychologists. Response rate: unspecified. Purposive sampling and mass recruitment via e-mail to all members of the Australian Indigenous Psychologists Association. | Psychology Enablers and barriers for Indigenous students studying psychology. | Sources of support: family support, financial assistance, and Indigenous student support centres. Barriers: fear and anxiety about attending university, culture shock when relocating to a metropolitan area, lack of Indigenous staff and content, cultural insensitivity by staff and racism. | High |
Chur-Hansen et al. (2008) [44] South Australia (University of Adelaide) | Qualitative Interviews | 4 Indigenous students (1 medicine, 1 dentistry, 2 health sciences). Response rate: 100% of Indigenous first year students in the Faculty of Health Sciences. | Health Sciences Expectations and experiences of Indigenous health students at commencement and after 1 year. | Sources of support: wishing to make a difference for Indigenous health, the Indigenous student support centre and AIDA. Barriers: lack of knowledge about the course, lack of confidence, and family commitments. | High |
Ellender et al. (2008) [45] Australia (multiple) | Quantitative Survey | 12 Indigenous medical students who had deferred or withdrawn from their course. Response rate: 9% of withdrawn students. Purposive sampling, mass recruitment to 130 withdrawn students, advertisements in electronic newsletter. | Medicine Barriers experienced by 12 Indigenous medical students that caused them to withdraw. | Financial problems and relationship and/or family problems were the two most cited reasons for leaving. Other reasons for withdrawing included: high workload, fatigue, illness and cultural isolation, unclear expectations, and faculty staff. More support from the university may have encouraged respondents to continue. | Medium |
Farrington et al. (2001) [46] New South Wales (University of Sydney) | Qualitative Interviews | 26 Cadigal Program students from the following courses: physiotherapy, occupation and leisure studies, communication and speech disorders, nursing, medical radiation (unclear how many participated from each course). Response rate: unspecified. | Health Sciences Factors which influence participation, progression and retention of Indigenous students in full time health courses. | Sources of support: family, previous positive educational experiences, the Cadigal program and other Indigenous students. Factors that caused students to contemplate withdrawing: family and personal crises, financial difficulties and racism from non-Indigenous students. Strategy: the Cadigal program consisted of a two-week orientation program, the option of reduced load during first 2 years combined with the Aboriginal Health Science Support program, peer tutoring and access to facilities and resources. | Medium |
Garvey et al. (2009) [47] New South Wales (University of Newcastle) | Qualitative Focus groups | 16 Indigenous medical students. Response rate: 89% of Indigenous students enrolled in second or subsequent year. | Medicine Experiences of 16 Indigenous medical students and their perceptions of the factors influencing their progression. | Support provided by family, peers, senior Indigenous students and faculty staff was pivotal to students’ well-being and progression through training. Financial difficulties were cited as a reason to withdraw from studies. Other barriers that affected progression included: homesickness, personal and family issues, lack of confidence and racial discrimination. | High |
Kippen et al. (2006) [20] Victoria (La Trobe University) | Qualitative Interviews, focus groups | 16 participants (14 Indigenous (academics, public health students and key community stakeholders), 2 non-Indigenous public health academics). Response rate: unspecified. Purposive sampling. | Public Health Enablers and barriers affecting recruitment and retention of Indigenous Public Health students. | Family, positive role models and the Indigenous Student Support Centre were important sources of support. Barriers included: negative past educational experiences, family obligations, lack of Indigenous staff, cultural insensitivity by non-Indigenous staff and lack of formal articulation pathways from VET courses. | High |
Mills et al. (2014) [48] Queensland (James Cook University) | Qualitative Interviews | 11 Indigenous nursing students. Response rate: 92% of mentoring circle participants. | Nursing Describes the trial of a mentoring circle to support and retain Indigenous nursing students in a remote community. | Mentoring circle consisting of one or two mentors and 12 students met regularly over two semesters. Students formed a group identity and provided support to one another. As a group, students identified barriers affecting their ability to succeed at university and resolved those barriers through group discussions. Students identified skills required to succeed at university and developed those skills. | High |
Schulz et al. (2018) [49] Queensland (Australian Catholic University) | Qualitative Focus groups | 10 Indigenous midwifery students. Response rate: 77% of Indigenous students enrolled in the Away-from-Base Bachelor of Midwifery degree. | Nursing Evaluates two enhancements to a Midwifery course: appointment of an Indigenous Academic Liaison Midwife (IALM) and an additional clinical placement in a high-volume tertiary hospital. | Regular contact with the IALM helped students stay connected with and focussed on their study. Students respected the IALM as a culturally appropriate professional role model, who provided encouragement, cultural support and advocacy. The one week placement in a high-volume tertiary hospital was designed to minimise time students spent away from community. Students were supported by hospital staff and the IALM to ensure close supervision and culturally sensitive support. | High |
Stuart et al. (2015) [50] Queensland (Not specified) | Qualitative Interviews, focus groups | 5 Indigenous nursing students (former Indigenous Health Workers). Response rate: 100% of eligible students. | Nursing Enablers and barriers experienced by Indigenous Health Workers studying Bachelor of Nursing. | Recognition of prior learning and course exemptions alleviated workload stress and enabled students to complete their degree faster. Support from the Indigenous nurse academic and receiving financial support were cited as essential for students to remain at university. Other sources of support included: the Indigenous student support centre, a personal desire to make a difference and the support of family, workplace and other Indigenous students. All participants reported encountering racism during their course, which impacted on their desire to remain at university. | High |
Usher et al. (2005) [51] Australia (multiple) | Qualitative Interviews | 22 Indigenous nursing students. Response rate: unspecified. Purposive sampling. | Nursing Enablers and barriers experienced by Indigenous student nurses. | Adequate financial support was cited as critical for students to continue with their studies. Other important sources of support included: Indigenous Student Support Centres, support from non-Indigenous academics, support from family and other students and flexibility within the course. Challenges faced by students included racism, isolation and homesickness, family obligations and lack of adequate educational preparation. | High |
West et al. (2013) [28] Australia (multiple) | Mixed methods Data analysis and interviews | Quantitative: 25 schools of nursing. Sample size: 65% of nursing schools. Interviews: 8 Indigenous nursing students, 13 nursing academics (5 Indigenous, 8 non-Indigenous). Response rate: unspecified. Purposive sampling. | Nursing Enrolment and completion rates for Indigenous student nurses across Australia. Student and staff perceptions of enablers to successful course completion. | National average completion rates are 36.3% for Indigenous nursing students and 64.6% for non-Indigenous nursing students (a difference of 28.3%). Individual student characteristics such as motivations for study, personal attributes (such as seeking support) and previous life and work experiences strongly affected their likelihood of successful completion. Family support, support from both Indigenous and non-Indigenous academics was also deemed critical for success. | High |
West et al. (2016) [52] Queensland (Not specified) | Qualitative Interviews | 8 final year Indigenous nursing students. Response rate: unspecified. Purposive sampling. | Nursing Indigenous nursing students’ perspectives enablers and barriers to their successful course completion. | Racism was identified as one of the biggest barriers to successful course completion. Previously identified barriers such as financial hardship and academic preparedness were no longer barriers due to students being more prepared to seek support. Students’ willingness to embrace support was identified as critical to successful course completion. Other personal attributes such as perseverance and a desire to make a difference for Indigenous health helped students to remain with their studies. | High |
West et al. (2016) [53] Queensland (Not specified) | Qualitative Interviews | 3 Indigenous midwifery students. Response rate: 100% of students who had provided continuity of care to Indigenous women. | Nursing Experiences of Indigenous midwifery students providing continuity of care to Indigenous women. | The relationships the students had with the Indigenous women, and the affirmation they received from those women and the wider community, gave students confidence and provided them with the motivation and resilience to continue with their studies. | High |
Young et al. (2007) [54] South Australia (University of South Australia) | Quantitative Survey | 33 current or former Indigenous students (17 nursing, 4 midwifery, 4 human movement, 1 occupational therapy, 3 physiotherapy, 1 podiatry, 1 naturopathy, 2 other). Response rate: 32% of Indigenous students who had been enrolled in a health sciences course between 2000 and 2005. | Health Sciences Investigates reasons for attrition of Indigenous health students and looks at support service usage. | Students’ reasons for withdrawing were varied and multifactorial. The most cited reason was difficulty balancing competing obligations. Other reasons for withdrawing included: literacy struggles, and lack of communication from the university leading to feelings of isolation and disengagement. Financial support and flexible delivery were identified as allowing students to remain with their studies when they otherwise would have withdrawn. | Medium |