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All of the students interviewed had views on what helped to enhance student learning. These opinions have been split into three subthemes. The first concerns the students’ thoughts and feelings about the importance of confidence (self-efficacy). The second is the impact the environment makes on this learning and finally is the relationship between learning and change. The data revealed occasions when poor marks and/or negative feedback from recent academic endeavours raised anxiety levels of some of the students and undermined confidence more so than ‘failures’ from the past. Yet, it was clear that although some negative experiences of learning happened a long time ago they still had the power to undermine self-efficacy and become a self-fulfilling prophecy. One student talked about ‘not being good’ at essays based on one previous module. The more confident students seemed to be the more motivated and less prone to experience high anxiety levels than those with less confidence.

Reagan attended the substance misuse unit because she said that she was ‘fed up’ with the negative comments she was getting from her colleagues about substance users and did not want to end up ‘like them, all twisted and bitter.’ She also points out that she has major doubts about her ability to learn because of an experience she had when she was a child in primary school:

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It was maths, and the teacher… I was trying to… I was really good with sums and this one particular day she said to me… she gave me a sum and I couldn’t do it quick enough and then she put me in the corner of the room, my head down. So then there’s a lot of shame attached to not being quick enough, not knowing.

She felt that she needs to win the approval of a teacher early on, otherwise this lingering fear of not being ‘good enough’ resurfaces and interferes with her ability to learn, especially when she is put under stress.

Another student (Susan) felt that returning to learning after a long gap when she left school was the problem:

Yeah. I think I was alright at school. I think it’s because I left it so long before I started again. I think that’s where my fear comes from. I enjoy learning. I think, it’s not actually…what’s the right word…I think it’s just my lack of confidence. I don’t think it’s actually I struggle with learning, I think I just lack a bit of confidence.

Here Susan is somewhat hesitant when she is asked about the influence of experiences of learning. She mentions ‘fear’ arising out of ‘leaving it so long.’ This implies that learning is a struggle although she says ‘she just lacks a bit of confidence.’ This and other stories from students indicate that their confidence to overcome learning obstacles is somewhat fragile and that a significant factor that influences their learning is the way the teacher ‘operates.’ This concept of ‘operating’ contains attributes such as enthusiasm and knowledge but also contains issues around confidence. Confidence grew when students felt that the teachers believed in their

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abilities to learn. Penny cites a lack of confidence about her ability to learn, not helped by her previous experience of undertaking a unit at this university:

Although I like doing it and I like coming to university, it can be quite challenging, because like I say, I didn’t enjoy my last course. I don’t know. I think it’s just…I’m not a very confident person anyway and think it’s a bit different when you’re at work because you’ve got a uniform on, haven’t you, and you have that different confidence, but I think I can do the work but academically I think I struggle. Learning is scary.

The experiences of learning have made her come to the conclusion that the problem is her [my italics] rather than entertain the possibility it might be due to factors such as the extent to which the teacher used strategies to engage, how the information was delivered, the amount of participation ‘allowed’ in the lecture and so on. She describes two types of confidence both of which are important but not equal in value. There is the confidence to do your job well, which she suggests is made easier because of the ‘uniform.’ The confidence to be ‘good’ at learning requires you to be confident as a person, which is clearly not how she feels. Her lack of confidence that she alludes to comes right after describing her last academic course. She seems to have considered the confidence gained from working as an adult nurse as inferior to that needed to be successful at academic tasks, even though working in Accident and Emergency (A and E) is acknowledged to be one of the busiest and most anxiety provoking areas of the NHS:

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So I was a bit reluctant and then when I came like I really enjoyed it and I told a lot of my colleagues, oh go on that one, [the substance misuse module] you know. It helps. But I think you do, you change as a person anyway and you get more confident and then towards the end of the course you do feel a lot more confidence in the way you are.

Creating a climate in which the student perceives that you care is a feature of acceptance, the third component of SPACE. Trusting in students and creating a climate of warmth and acceptance gives the student the confidence (self-efficacy) to believe in their ability to learn and therefore change.