Graduate Success BenchmarkA RESEARCH INITIATIVE BY GROW

Study protocol

Graduate Support Survey: study protocol and methodological rationale

The Graduate Support Survey

The Graduate Support Survey is one of two studies within the Graduate Success Benchmark, a research initiative by GROW. The other is the Practitioner Success Survey.

An evidence-informed framework for evaluating how practitioner-training institutions prepare graduates for professional and business life.

The Graduate Support Survey is a descriptive study examining how training providers in the health and wellness sector prepare and support graduates to establish sustainable professional careers, including self-employment and independent clinical practice.

The study is based on a central proposition: preparing someone to practise competently and preparing them to establish a viable practice are related, but distinct, educational objectives.

Professional competence is essential. However, independent practice also requires capabilities in areas such as attracting clients, managing finances, developing professional relationships and making sustainable business decisions.

Research into entrepreneurship education and small-business training suggests that business capabilities can be developed through education, although outcomes vary considerably between programmes, populations and settings [4, 10, 11].

The benchmark therefore examines not simply whether business education is provided, but what is provided, when support is available, whether learners have opportunities to apply it, and whether institutions evaluate what happens after qualification.

Why five stages?

The benchmark examines institutional support across five stages:

  1. Realistic expectations before enrolment
  2. Essential business foundations during training
  3. Transition into professional practice
  4. Business development support after qualification
  5. Graduate outcome monitoring and improvement

These stages form a proposed framework spanning the period from prospective student to practising professional.

They are informed by research in entrepreneurship, educational psychology, professional training, small-business development and educational evaluation.

The stages identify distinct points at which an institution can reasonably influence a student's preparation, access to support or subsequent professional development. They are not presented as independently tested predictors of graduate success. Much of the supporting evidence comes from related fields, such as entrepreneurship education, training transfer and small-business support.

The study assesses the provision institutions report, not the effectiveness of that provision. It cannot establish cause and effect, and its findings describe participating programmes only; they do not automatically apply to all training providers.

Stage 1. Realistic expectations before enrolment

Principle: Prospective students should have sufficient information to make informed decisions about the professional and commercial realities of their intended career.

Research has documented substantial optimism among entrepreneurs evaluating their prospects. In a study of 2,994 recent business owners, Cooper, Woo and Dunkelberg found that 81% estimated their chances of success at seven out of ten or higher, while 33% estimated them at ten out of ten [1].

The study concerned people who had already entered business, not prospective therapy students. Nevertheless, it provides relevant evidence that expectations of entrepreneurial success may be poorly calibrated.

Related research on realistic job previews offers further, indirect support. Phillips' meta-analysis of 40 studies found associations between realistic previews and outcomes including lower initial expectations and reduced turnover [2]. These findings relate to employment recruitment and cannot be assumed to apply directly to training-course enrolment.

Together, this literature provides a rationale for examining whether prospective students receive balanced information about the realities of independent practice, including the work required to establish a client base, likely financial commitments, uncertainty of income and alternative career pathways.

What the benchmark assesses: Whether institutions communicate these realities before enrolment, rather than relying primarily on descriptions of the clinical qualification or its potential career opportunities.

The benchmark does not assume that providing such information necessarily changes graduate outcomes. It treats informed career decision-making as an educational objective in its own right.

Stage 2. Essential business foundations during training

Principle: Students should acquire the professional and operational knowledge necessary to enter practice safely and responsibly, without being expected to master every aspect of business development before qualification.

The Professional Standards Authority's 2026 Standards for Accredited Registers recognise professional and ethical behaviour, business practice, competence, and education and training as relevant responsibilities within the regulation of registered health and social care practitioners [3].

These standards apply to accredited registers rather than directly prescribing the curricula of every training institution. They nevertheless establish the relevance of appropriate business-practice standards to professional registration.

Research also supports the potential value of entrepreneurship education. Martin, McNally and Kay's meta-analysis, involving 42 independent samples and 16,657 participants, found positive relationships between entrepreneurship education and both entrepreneurship-related human capital and subsequent entrepreneurial outcomes [4]. However, the authors identified substantial heterogeneity and methodological weaknesses, cautioning against simple assumptions about effectiveness.

Accordingly, the benchmark distinguishes foundational preparation from more advanced business-development capabilities.

Foundational provision may include professional obligations, ethical marketing, record-keeping, financial responsibilities, professional boundaries and the basic requirements of establishing a practice.

More advanced capabilities, such as positioning a business, developing marketing systems or responding to disappointing client numbers, may be more readily applied when learners have direct experience of running a practice.

What the benchmark assesses: Whether essential foundations are taught clearly and appropriately during the course, and whether students have opportunities to understand or demonstrate their application.

The benchmark does not reward institutions simply for including more business-teaching hours. Nor does it assume that advanced business training delivered before qualification is ineffective.

Stage 3. Transition into professional practice

Principle: The transition from education to independent practice should be supported as a distinct process of applying learning.

The educational literature distinguishes learning knowledge from transferring that knowledge into real-world activity.

Baldwin and Ford's influential review identified training design, learner characteristics and the work environment as important influences on training transfer [5]. Grossman and Salas subsequently identified perceived usefulness, motivation, realistic training environments, opportunities to perform, support and follow-up among factors consistently associated with transfer [6].

Research on goal implementation provides a complementary perspective. Gollwitzer and Sheeran's meta-analysis of 94 independent tests found that forming specific if-then implementation plans improved goal attainment across a range of settings [7]. This supports the general value of translating intentions into planned actions, although the findings do not specifically evaluate graduate practice-startup programmes.

These findings suggest a rationale for supporting graduates to move from knowing what business development involves to identifying and carrying out their first practical steps.

For students intending to establish independent practices, this might include identifying immediate priorities, developing a realistic launch plan, understanding available resources and knowing where to seek further assistance.

What the benchmark assesses: Whether institutions offer structured, practical support around graduation that helps students convert their preparation into action.

This stage is assessed separately from business teaching because possessing knowledge and being supported to apply it are not equivalent outcomes.

Stage 4. Business development when it becomes relevant

Principle: Access to further business education and support should extend beyond qualification, particularly when graduates encounter practical business-development challenges.

This stage is grounded primarily in research on learning transfer, motivation and small-business support.

Grossman and Salas identify opportunities to use training, perceived utility and follow-up as relevant to transfer [6]. Reinhold, Gegenfurtner and Lewalter's meta-analysis of 32 studies involving 5,487 participants found relationships between social support, motivation and training transfer. Peer support was the strongest predictor of motivation to transfer in their model, while feedback and coaching were the strongest predictors of transfer itself [9].

Most training-transfer research concerns employees and organisational environments. The relevance to self-employed practitioners is plausible but requires further investigation.

There is also evidence that structured business education can improve small-business outcomes. McKenzie's reassessment of experimental evidence found average improvements in profits and sales of approximately 5 to 10% following business training in developing-country settings, alongside substantial variation [10].

A separate meta-analysis by Busso, Park and Irazoque, covering 44 studies and 68 management-training programmes, found average positive effects on business practices, productivity, profits and survival. Programme content and context were associated with differences in effectiveness [11].

These findings demonstrate that business education can be beneficial. They do not, however, establish that post-qualification training is universally more effective than pre-qualification training.

The benchmark therefore treats the timing, accessibility and practical relevance of business support as dimensions worth examining, rather than assuming a particular delivery model is superior.

For example, a practitioner may understand marketing principles at graduation but encounter new learning needs after several months of trying to establish a client base.

Support at that point may be more closely connected to an immediate practical problem and offer opportunities for direct application.

What the benchmark assesses: Whether graduates can access relevant business-development support after qualification, including when difficulties arise, and whether that support offers practical guidance, feedback or opportunities to act.

Provision may be delivered internally or through external specialists, and comparable support receives equal credit either way. The benchmark does not favour GROW or any other supplier, format or commercial programme.

Stage 5. Graduate outcome monitoring and improvement

This stage assesses whether institutions collect information about graduates' experiences and outcomes, and whether they use that information to improve their provision. The benchmark does not itself collect or compare actual graduate business outcomes.

Principle: Institutions should seek evidence of what happens to graduates after qualification and use that evidence to evaluate and improve their provision.

The existence of business education does not establish its effectiveness. Evaluation requires attention to what learners subsequently do and experience.

Nabi and colleagues' systematic review of 159 entrepreneurship-education articles found that impact research was dominated by short-term and subjective outcomes and frequently provided insufficient detail about the teaching methods evaluated [14].

This highlights the importance of distinguishing educational activity, immediate learning outcomes and longer-term professional outcomes.

The UK's Higher Education Statistics Agency provides an established example of graduate follow-up. Its Graduate Outcomes survey collects information approximately 15 months after completion, including self-employment, business ownership and graduates' reflections on how their activities relate to their studies and future plans [12].

The Quality Assurance Agency's UK Quality Code and accompanying guidance also emphasise systematic monitoring, evaluation, evidence-informed enhancement and reviewing whether implemented changes achieve their intended effects [13].

These frameworks apply within UK higher education and are used here as methodological precedents, not as requirements binding every participating training provider.

For practitioner-training institutions, relevant outcomes could include entry into practice, practice continuation, employment alongside self-employment, client activity, financial sustainability and graduates' own assessments of professional progress.

Importantly, the benchmark does not assume that full-time self-employment, maximum income or rapid business growth represents the preferred outcome for every graduate. Part-time practice, portfolio careers and other professional pathways may reflect successful fulfilment of individual career goals.

What the benchmark assesses: Whether institutions systematically follow up with graduates, gather meaningful evidence about professional outcomes and use their findings to review or improve business support.

It distinguishes collecting feedback from demonstrating that the feedback informs institutional decisions.

What makes business support effective?

Across the literature, several recurring considerations provide the theoretical foundation for the benchmark:

  • Relevance: Learning should address capabilities and decisions that matter to the learner's intended activities [6, 11].
  • Opportunity for application: Knowledge acquisition alone does not establish that learning will transfer into practice [5, 6].
  • Motivation and perceived usefulness: Learner characteristics and motivation are associated with training transfer [6, 9].
  • Practical implementation: Translating intended actions into specific plans can improve goal attainment [7].
  • Feedback and continuing support: Social support, coaching and feedback are associated with transfer of training [9].
  • Outcome evaluation: Educational programmes should examine outcomes beyond immediate participation or satisfaction [12-14].

These are evidence-informed design considerations, not a checklist guaranteeing successful outcomes.

In particular, the literature does not justify assuming that business teaching must be postponed until after qualification, or that one delivery method will suit every practitioner.

The benchmark's five-stage structure is intended to examine how institutions distribute and connect support across the graduate journey.

Study design and scoring

The Graduate Support Survey is a voluntary, observational, cross-sectional study using a structured, 20-item institutional self-report instrument.

Each participating institution assesses a defined training programme against the same five-stage framework.

Four questions address each stage. Response options are scored from 0 to 5, producing a maximum of 20 points per stage and an overall index ranging from 0 to 100.

The five stages are equally weighted. This is a transparent design decision, not an empirically established finding that each stage contributes equally to graduate success.

Scores describe the extent to which participating programmes report providing the practices included in the framework. They do not directly measure the quality of delivery, graduate competence, business performance or the causal effectiveness of institutional support.

Participating providers receive their score on submission. Comparative rankings become available once at least ten eligible programme assessments have been submitted.

Rankings refer only to participating programmes and may change as further programmes join. The ten-programme threshold is an operational publication rule, not a threshold that establishes statistical reliability or representativeness.

Instrument development and methodological limitations

The benchmark is a newly developed, evidence-informed index. It describes self-reported institutional provision and is not a measure of graduate business success or institutional educational effectiveness.

Its content reflects the five-stage conceptual framework and the research summarised above.

Contemporary measurement guidance identifies relevance, comprehensiveness and comprehensibility as central considerations in instrument design [15].

The study has several important limitations.

First, participation is voluntary, introducing the possibility of selection bias. Participating institutions may differ systematically from non-participants.

Second, institutional responses are self-reported and are not checked, so the results may be affected by differences in interpretation, institutional knowledge or reporting practices.

Third, the scoring system simplifies varied forms of educational provision into a common index. Equal weighting and ordinal response categories are pragmatic choices, not empirical estimates of the relative importance of each practice.

Fourth, the supporting research draws substantially on adjacent fields, including higher education, workplace training and small-business development. Direct research identifying the most effective configuration of business support for health and wellness practitioner graduates remains limited.

Finally, the present design does not establish whether programmes with higher scores produce better graduate business outcomes. Investigating such relationships would require additional graduate-level data and an appropriate analytical design.

The reporting of findings will be informed by established guidance for internet surveys (CHERRIES) and observational studies (STROBE), where applicable [16, 17].

Research aims

The study aims to:

  1. Describe how participating training providers prepare and support graduates across the five stages.
  2. Identify patterns, common strengths and gaps in reported institutional provision.
  3. Give participating institutions a transparent basis for reviewing their provision against a shared framework.
  4. Generate descriptive evidence to inform discussion and further research into the timing, content and continuity of graduate business support.

The benchmark does not claim that higher scores establish superior graduate outcomes. Its principal contribution is a structured description of institutional practice and a foundation for subsequent investigation.

Sponsorship

The study is sponsored and coordinated by GROW, which also provides business education for practitioners and training organisations.

This commercial interest is acknowledged as a potential source of bias. The assessment is designed to be supplier-neutral: support delivered internally and provision accessed through external organisations are considered against the same criteria.

Participation does not imply endorsement of GROW or any particular business-education programme.

References

  1. Cooper AC, Woo CY, Dunkelberg WC. Entrepreneurs' perceived chances for success. Journal of Business Venturing. 1988;3(2):97-108. https://doi.org/10.1016/0883-9026(88)90020-1

  2. Phillips JM. Effects of realistic job previews on multiple organizational outcomes: a meta-analysis. Academy of Management Journal. 1998;41(6):673-690. https://doi.org/10.2307/256964

  3. Professional Standards Authority. Standards for Accredited Registers. Revised standards effective July 2026. https://www.professionalstandards.org.uk/publications/standards-accredited-registers

  4. Martin BC, McNally JJ, Kay MJ. Examining the formation of human capital in entrepreneurship: a meta-analysis of entrepreneurship education outcomes. Journal of Business Venturing. 2013;28(2):211-224. https://doi.org/10.1016/j.jbusvent.2012.03.002

  5. Baldwin TT, Ford JK. Transfer of training: a review and directions for future research. Personnel Psychology. 1988;41(1):63-105. https://doi.org/10.1111/j.1744-6570.1988.tb00632.x

  6. Grossman R, Salas E. The transfer of training: what really matters. International Journal of Training and Development. 2011;15(2):103-120. https://doi.org/10.1111/j.1468-2419.2011.00373.x

  7. Gollwitzer PM, Sheeran P. Implementation intentions and goal achievement: a meta-analysis of effects and processes. Advances in Experimental Social Psychology. 2006;38:69-119. https://doi.org/10.1016/S0065-2601(06)38002-1

  8. Greene FJ, Saridakis G. The role of higher education skills and support in graduate self-employment. Studies in Higher Education. 2008;33(6):653-672. https://doi.org/10.1080/03075070802457082

  9. Reinhold S, Gegenfurtner A, Lewalter D. Social support and motivation to transfer as predictors of training transfer: testing full and partial mediation using meta-analytic structural equation modelling. International Journal of Training and Development. 2018;22(1):1-14. https://doi.org/10.1111/ijtd.12115

  10. McKenzie D. Small business training to improve management practices in developing countries: re-assessing the evidence for 'training doesn't work'. Oxford Review of Economic Policy. 2021;37(2):276-301. https://doi.org/10.1093/oxrep/grab002

  11. Busso M, Park K, Irazoque N. The Effectiveness of Management Training Programs: A Meta-Analytic Review. Inter-American Development Bank; 2023. https://doi.org/10.18235/0004815

  12. Higher Education Statistics Agency. Definitions: Graduate Outcomes. https://www.hesa.ac.uk/support/definitions/graduates

  13. Quality Assurance Agency for Higher Education. UK Quality Code: Advice and Guidance, Principle 5, Monitoring, Evaluating and Enhancing Provision. 2026. https://www.qaa.ac.uk/en/the-quality-code/2024/advice-and-guidance-2024/quality-code-advice-and-guidance-principle-5

  14. Nabi G, Liñán F, Fayolle A, Krueger N, Walmsley A. The impact of entrepreneurship education in higher education: a systematic review and research agenda. Academy of Management Learning & Education. 2017;16(2):277-299. https://doi.org/10.5465/amle.2015.0026

  15. Mokkink LB, Herbelet S, Tuinman PR, Terwee CB. Content validity: judging the relevance, comprehensiveness, and comprehensibility of an outcome measurement instrument: a COSMIN perspective. Journal of Clinical Epidemiology. 2025;185:111879. https://doi.org/10.1016/j.jclinepi.2025.111879

  16. Eysenbach G. Improving the quality of Web surveys: the Checklist for Reporting Results of Internet E-Surveys (CHERRIES). Journal of Medical Internet Research. 2004;6(3):e34. https://doi.org/10.2196/jmir.6.3.e34

  17. von Elm E, Altman DG, Egger M, et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Bulletin of the World Health Organization. 2007;85(11):867-872. https://doi.org/10.2471/BLT.07.045120