Future in mind: Systematic review of compassion-based interventions in higher education and feasibility study of Compassionate Mind Training with pre-registration Mental Health Student Nurses

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Nurse education faces challenges in meeting student nurse recruitment and retention targets and addressing increasing psychological wellbeing problems for higher education (HE) students, in the context of a national nursing workforce crisis, including burnout risk. Compassion-based interventions (CBIs) are emerging as effective techniques for preventing and addressing psychological problems. This thesis firstly describes a systematic review with narrative synthesis, which identified recruitment and retention strategies, and participant experience data collected in CBIs trialled in HE. The review found (n=33) studies, with a total sample size of (n=4,897) HE students, with most studies (n=23) relying on course credit and / or remuneration to recruit and retain participants. None of the included studies described research focused on pre-registration student nurse wellbeing. The thesis then recounts the design and implementation of a novel mixed methods, single group feasibility study of a specific CBI, Compassionate Mind Training (CMT), for first-year pre-registration Mental Health student nurses. The study’s design, conduct and analysis followed the Medical Research Council’s guidance for developing complex interventions. Study aims addressed feasibility and acceptability uncertainties regarding intervention and study processes, and predetermined benchmarks for considering next steps were established. The study was conducted online during the COVID-19 pandemic. Recruitment of (n=38) participants and retention of (n=35) was achieved. Participants’ group mean ratings for CMT’s enjoyableness, usefulness, clarity, and their intention to practice CMT techniques remained high during the study, with qualitative feedback also indicating intervention acceptability. Response rates for pre and post-test psychological wellbeing measures used demonstrated their feasibility, with group mean scores for those measures moving in positive directions pre to post-test. Study limitations include its quasi-experimental nature, the potential influence of the observer effect, and unintentionally high participant burden. Nonetheless, on balance, a further, randomised pilot trial, comparing CMT with mindfulness, is recommended. This research would incorporate student nurse and nurse educator involvement in the planning stages, including considering rewards for participation, and delivering the interventions in-person rather than online.