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Hurdles lower foreign student numbers

The need for better English, a strong dollar and fewer clinical training places are proving to be a disincentive overseas, writes Annabel McGilvray.

After years of rapid growth in international student numbers, nursing schools around Australia are contemplating tightening their belts in anticipation of less growth or even a reduction in enrolments in 2012.

The schools are blaming the strong Australian dollar, restricted clinical training places and a stalled job market for the anticipated drop in numbers next year.

On top of this, student recruitment agents say confusion about an increased English language skill qualification required to work in the field is driving prospective students to look elsewhere.

“It would appear that there is something of a downturn in the international market,” says the chair of the Council of Deans of Nursing and Midwifery (Australia and New Zealand), Professor Patrick Crookes.

Crookes is the dean of the University of Wollongong’s Faculty of Health and Behavioural Sciences and says their applications are tracking similarly to last year but the situation is different elsewhere where there is more exposure to the international market.

In Victoria, Deakin University’s School of Nursing and Midwifery is contemplating a drop of as much as 25 per cent in international enrolments in 2012 on the basis of current applications. Head of the school Professor Maxine Duke says they reduced their target for enrolments in anticipation of this drop.

“We reduced the target this year by about 40 students across the three campuses to compensate for the expected reduction in international student numbers because of changes to English language standards, rising strength of the dollar and reduction in vacancies for registered nurses.”

Duke says this will not mean changes to staffing, but may impact on the provision of some support services for those international students that do enrol. A worst-case scenario put forward by the university earlier this year predicted a $2.3 million fall in revenue across the Faculty of Health, Medicine, Nursing and Behavioural Sciences as a consequence of the change to English language skill requirements alone.

For other providers, such as the Australian Catholic University where international students make up about 55 per cent of the total nursing student cohort, numbers are being deliberately scaled back to decrease reliance on the international market as well as improve student experience and graduate outcomes.

Head of the ACU School of Nursing Dr Thomas Harding says one reason for scaling back is a perceived recent dip in the number of jobs for new graduates. This is attributed to increasing numbers of older nurses choosing not to leave the workplace in uncertain economic times.

More importantly, Harding says there has been mixed feedback from clinical partners about the standard of the international students going through the course. “They’re very concerned about the level of English language skills that many of the international students bring to the workplace.

As communication is probably the single most important factor in terms of determining that a nurse is a competent practitioner, that has been significant and has been something we’ve really had to listen to.”

Beyond ACU, the English-language standard of international nursing students has been a concern for many in academia and the industry for a long period. Earlier this year the national nursing regulatory body, the Nursing and Midwifery Board of Australia sought to address this by raising the English language skills requirement for registration to 7 on the International English Language Testing System (IELTS).

In response, schools around the country have adjusted their own intake requirements to reflect the increased skills requirement. Both Deakin and ACU were among those to bump up their IELTS requirement from 6.5 to 7.

Chief executive of the International Education Association of Australia Phil Honeywood said the new requirements, requiring better English of nurses than engineers, are driving international students elsewhere. “You could be losing nurses who have the right aptitude and the right academic potential simply because there’s a high barrier for English.”

The dip being experienced now comes after 15 years of exceptional growth in international nursing student numbers.

Associate Dean International with the University of Melbourne’s Faculty of Medicine, Dentistry and Health Sciences, Professor Lesleyanne Hawthorne has been analysing international student enrolments in the medical and allied health fields since 1996 and says her most recent research shows nursing recently exceeded accounting as the preferred course of study of international students. “There’s been massive growth in international students enrolling in entry to practice and nursing degrees,” she said.

As an indication, the number of international students studying for a bachelor of nursing around the country grew from 762 in 1996 to 6124 by December 2009.

The other big area of growth has been in the post-basic nursing training – those courses that will qualify a diploma-level foreign nurse to practice as a registered nurse in Australia, effectively a bachelor degree upgrade. In that stream, numbers have grown from 545 in 1996 to 2566 in 2009.

“That tells you immediately that there’s about 10,000 international students in the system doing nursing degrees that will have as an outcome, full registration,” says Hawthorne.

But even when demand was strong the growth in both international and domestic student numbers has been held back recently by restrictions on the numbers of clinical placements, which are necessary for nurses to complete during their training.

The University of Western Sydney, with one of the highest proportions of international students in the country, was unable to graduate some students from its Bachelor of Nursing at the end of the three-year study period as they hadn’t been able to do the required clinical training.

Health Workforce Australia is working to try and overcome this bottleneck with the creation of alternative training pathways, while some universities such as La Trobe are running successful offshore nursing degrees. La Trobe’s offshore course runs in Singapore and Hong Kong – where the Australian clinical training pressures don’t apply. However, these courses don’t qualify graduates to work in Australia.

Back onshore, looking to the future, nursing school leaders say the stalled international student numbers are unlikely to last long. Ongoing work by state and federal governments, together with individual schools, to expand the number of clinical places should remove the bottleneck during coming years.

At the same time demand for graduate nurses is expected to rise sharply again as the workforce continues to age. And as prospective students adjust to the new English-language requirements, that barrier may also prove to be not so restrictive.

Ultimately, it seems these pivotal numbers may finally come down to provider reputations and the fickle dollar.

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