When young people are actively involved in the way health care services are provided in secondary schools, those services can become more effective. Seeking feedback from students is one way of encouraging this involvement.
A school-based health clinic in Whanganui that serves six secondary schools recently ran a survey to find out if their service was meeting the needs of students.
The clinic’s three nurses had noticed a decrease in the number of students using their service. They developed and implemented a survey using Model for Improvement methodology, and tested it using plan, do, study, act (PDSA) cycles. To formulate the questions in the survey, the nurses drew on the University of Auckland health and wellbeing survey Youth ’12, the expertise of their colleagues and feedback from the clinic manager.
The survey contained 11 questions, covering three areas:
- students’ satisfaction with the timeliness and quality of the service, and the location of the clinic
- students’ knowledge of how to access other health services
- students’ overall mental, emotional and general health.
The survey offered students an opportunity to add questions, comments or concerns of their own.
The clinic’s nurses distributed 50 surveys to students attending the clinic in the course of the nurses’ regular (twice weekly) visits to schools. Selection was random: nurses did not target any particular ethnicity, age group or sex. The nurses also approached students who had accompanied attending friends to the clinic. They explained to students that the purpose of the survey was to improve the clinic, and assured them that their confidentiality would be maintained.
Twenty-six of the 50 surveys were returned. The responses showed that:
- most of the students surveyed were satisfied with the length of time they had to wait to see a nurse, and with the time nurses spent with them in a consultation
- all students felt that the nurses were respectful, and all but two said the nurses had listened to them
- 23 students felt that the nurses answered their questions extremely well
- all but three students indicated that they would be extremely likely or moderately likely to recommend their school nurse to others, and all were extremely or moderately satisfied with the convenience of the clinic’s location.
Students raised few additional comments, questions or concerns.
Overall, the survey showed that the clinic provided a safe and respectful environment, and that nurses spent quality time with students that met their needs.
Students are using the clinic more since the survey was done. ‘The increase is from students having a more informed choice,’ says the clinic’s lead nurse, Loren Mooney. ‘They know more about our service, what we provide and what it’s for.’
Clinic nurses plan to repeat the survey annually. They will use PDSA cycles to improve and refine the survey content, the target population and the distribution process. They aim to increase the response rate, and engage better with students who do not currently access their services by taking the survey into classrooms. Future surveys will invite students to give verbal and written feedback, to encourage elaboration and different responses. Questions will focus on clinic times and days, to ensure that clinic hours reflect as much as possible the times preferred by students. The nurses plan to run future surveys during the first term, rather than later in the year when students are focused on NCEA.
Student feedback surveys are a tool that health providers can use to increase participation in any school. Questions can be adapted to the local context and the measures a school wants to use.
‘We are coming to understand that student voices are very beneficial to how we provide services in schools,’ says Loren. ‘Surveys are a good tool to use.’