Evid Based Nurs 13:21 doi:10.1136/ebn1018
  • Therapeutics
  • Randomised controlled trial

Supportive counselling may improve academic performance more than ordinary counselling in underachieving male nursing students

  1. Nasim Kanji
  1. Nasim Kanji
    Buckinghamshire New University, Uxbridge Campus, 106 Oxford Road, Uxbridge, Middlesex UB8 1NA, UK; Nasim.Kanji{at}

Commentary on: [CrossRef][Medline][Web of Science]Google Scholar

High stress levels and forebodings of failure are regarded as endemic in the process of becoming a nurse and are the most common cause of attrition.1 In this discourse failures are attributed either to a flawed educational process or, more commonly, to the personal characteristics of students.2 Early identification of students at risk of failing allows nurse educators and students to develop a remedial plan.3 So it is appropriate that Peyrovi and colleagues have embarked on testing a strategy for improving the academic performance of students in a bachelor of science nursing education programme.

The research question was whether a supportive counselling programme would have an effect on the academic performance of Iranian nursing students experiencing academic failure. The intervention to be tested included counselling sessions either on an individual level or on a group level (two or three students), depending on students’ choice, with the primary outcome being the grades obtained for the basic theoretical and special theoretical courses. The setting was a university school of nursing and midwifery in Iran. Of 62 nursing students identified with poor academic performance, 43 agreed to participate. One student in the experimental group did not continue to the end of the intervention and was excluded from the study instead of being considered for the intention-to-treat analysis.

A randomised controlled trial research design with a follow-up period of 12 months was used, although the system of allocation was unclear. The decision to use a randomised controlled trial to answer this study question itself raises some questions. The randomisation process is not explained, and there appears to have been no consistency in implementing the supportive counselling sessions on either an individual or a group basis. It is not clear which key issues were explored within the counselling sessions, whether the key factors leading to academic failure were explored or to what extent relevant support was provided.

Although the study demonstrated an improvement in mean grades on the basic and special theoretical courses, there was no statistically significant difference between the two groups, except for the mean grades of male students on both basic and special theoretical courses (0.27 against –1.43, p = 0.014, and 1.87 against –0.40, p = 0.009, respectively). Power calculation of the sample size could have been considered. The authors concluded that a supportive counselling programme can improve the academic performance of male nursing students.

This research is of value to most nursing education institutes, but replication of this study with a larger sample size identified through power calculation and a consistent approach to the intervention seems paramount.


  • Competing interests None.


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