Development and evaluation of work task vignettes: An interview study with experts in the domain of elder care nursing

Author(s):

Veronika Leicher(presenting / submitting)Regina H. Mulder

Conference:

ECER 2014

Network:

01. Continuing Professional Development: Learning for Individuals, Leaders, and Organisations

Format:

Paper

Session Information

01 SES 01 B, Professional Development

Paper Session

Time:

2014-09-02

13:15-14:45

Room:

B033 Anfiteatro

Chair:

Natallia Yakavets

Contribution

Relevance

In the past, present and also in the future educational research in vocational education will aim at developing learning environments that qualify for the specific requirements of different work domains.

Elder care nursing is a dynamic field of work in which knowledge and work conditions change frequently and where complex situations have to be handled effectively (Berings, Poell & Van Veldhoven, 2010; Shin & Kim, 2013). Similar to hospital nurses, elder care nurses are supposed to ensure high standards of quality and professionalism. But in contrast to nursing in hospitals elder care nurses face different tensions inherent in characteristics of their work. For example a prevalent tension in the domain of elder care nursing lies in the implementation of medical and care-giving activities without limiting residents´ autonomy and decisions (Leicher, Mulder & Bauer, 2013). Development of knowledge and skills in vocational education and training for elder care nurses has to take these tensions of the domain into account. Learning with vignettes which describe realistic work tasks and learning to select action strategies by analyzing care specific aspects as well as psychological factors can make an important contribution to the education of elder care nurses.

The goals addressed in our study were (1) to find out how vignettes have to be designed using them in the context of vocational education and training, workplace learning and research on elder care nursing. (2) And in collaboration with experts in the domain of elder care nursing we wanted to develop and evaluate vignettes describing realistic work tasks of elder care nurses.

Theoretical Framework

Vignettes are short, descriptive stories of an incident of practice presented to elicit rich but focused opinions and reactions to its content and to encourage producing thoughtful explanations and finding potential solutions (Finch, 1987; Jeffries & Maeder, 2004; Schoenberg & Ravdal, 2000). Learning with vignettes describing realistic work tasks and selection of possible strategies to accomplish the described work task can encourage elder care nurses to be able to function more effectively at work as well as find multiple ways to cope with tensions and to deal with different demands of their work field. Therefore vignettes have to be designed carefully and depict a situation which acts as a prompt to the respondent´s personal experience and their reflection on the described situation (Schoenberg & Ravdal, 2000).

Learning environments, like problem based learning that reflect the complexity of the context in which application of knowledge and skills takes place can facilitate learners self- directed learning and foster flexible thinking (Savery & Duffy, 1996).Therefore problems in problem based learning settings have to describe serious situations which force the need for solving the specified problem (Barrows, 1996).

Different reviews of the use of vignettes in research (Richman & Mercer, 2002; Hughes & Huby, 2002; Spalding & Phillips, 2007; Wilks, 2004) proposed aspects which should be considered regarding to the construction, content and style of the vignette. Vignettes are short stories (50-200 words) without dialogues, addressing readers’ ability and style (Jeffries & Meader, 2004). Regarding the content vignettes have to describe realistic, relevant and complex situations that require knowledge to cope with and allow finding multiple solutions which could be implemented in everyday work life (Hughes & Huby, 2002).

In this study we developed four work task vignettes describing the topics of assistance with eating a meal, assistance with getting dressed, interaction with dementia patients and providing advice on medical treatments. In order to make sure that they meet the specified requirements we collaborated with professionals of the work context and conducted interviews to generate possibilities to change vignettes when necessary.

Method

Research Method Vignettes were evaluated in an exploratory interview study with experts in the field of elder care nursing (N=12). By this study we pursued different objectives. First, we wanted to collect concrete examples for realistic work tasks expecting that they meet the topics of our previously developed work task vignettes. Second, previously work task vignettes should be evaluated by the experts regarding to the specified criteria of content and style. And third, we asked experts to describe concrete procedures for dealing with the specified work tasks. The experts work in twelve different retirement homes. Formal criteria for participation of the experts were more than ten years of work experience and a supervisory function. The interviews were conducted in spring 2013 at the participant´s workplace. For the interviews a semi-structured guideline was used starting with some opening questions regarding the participant´s professional qualifications and responsibilities. Then participants were asked to describe concrete examples for realistic work tasks. The following part of the interviews was mostly non-directive. Participants were asked to read one of the work task vignettes and answer questions regarding their style and content for example with regard to the complexity, severity and domain specifics. Finally the participants were supposed to describe procedures for dealing with the specified work tasks. A deductive strategy for categorizing the data was used. Regarding the examples of work tasks, examples with common themes were grouped together while keeping the information how many participants provided an example grouped to a theme. For analyzing further data the system of categories referred to the criteria applied in the construction process of the vignettes. Thereby categories refer to the style and the content of work task vignettes and include subcategories like realistic and conclusive description, severity, domain specifics and complexity. Information about the processes for dealing with the described work task in the vignettes, equal steps of action where grouped together.

Expected Outcomes

Findings Findings of our study refer on the one hand to a summary of relevant aspects that should be considered in the construction process of vignettes derived from learning approaches like problem based learning and research using vignettes as methodological tools. On the other hand findings refer to four developed vignettes describing work task of elder care nurses. Work task vignettes were estimated as realistic and relevant for elder care nurses by the experts. Only one work task vignette describing providing advice on medical treatments was estimated as situation that does not happen very often in professional practice of elder care nurses. Learning with these realistic work task vignettes combined with open ended questions about strategies to accomplish the work task can make an important contribution to the vocational training and education of elder care nurses. By using vignettes to initiate the learning process elder care nurses are encouraged to learn on the one hand knowledge and skills and on the other hand strategies to identify relevant aspects of the situation and decide for appropriate action strategies. In the presentation we want to give more information on the theoretical basis, research design and present the findings of our study. We also want to elaborate on the interpretation and implications of the results and how the vignettes can be used in practice of vocational education and in research.

References

Barrows, H. S. (1996), Problem-based learning in Medicine and Beyond: A brief Overview, New Directions for Teaching and Learning, 68, 3-12. Berings, M.G.M.C., Poell, R.F., & Van Veldhoven, M.J. (2010). Antecedents of nurses’ on-the-job learning. In M.J. van Woerkom & R.F. Poell (Eds.), Workplace learning: concepts, measurement and application (pp. 71–87). London: Routledge. Finch, J. (1987). The Vignette Technique in Survey Research. Sociology, 21 (1), 105-114. Hughes, R. & Huby, M. (2002). The application of vignettes in social and nursing research, Journal of Advanced Nursing, 37 (4), 382-386. Jeffries, C. & Maeder, D.W. (2004). Using vignettes to build and assess teacher understanding of instructional strategies. The Professional Educator, 1 & 2, 17-28. Leicher, V., Mulder, R.H. & Bauer, J. (2013). Learning from errors at work: A replication study in the domain of elder care nursing. Vocations and Learning, 6, 207-220. Richman, J. & Mercer, D. (2002). The vignette revisited: evil and the forensic nurse, Nurse Researcher, 9 (4), 70-82. Savery, J.R. & Duffy, T.M. (1996).Problem based learning: An instructional model and its constructivist framework. In B.G.Wilson (Ed.),Learning environments.Case studies in instructional design (p.135-148).New Jersey: Educational Technology Publications. Shin, I-S. & Kim, J-H.(2013). The effect of problem-based learning in nursing education: a meta-analysis. Advances in Health Science Education, 18, 1103-1120. Schoenberg, N. & Ravdal, H. (2000). Using vignettes in awareness and attitudinal research. Social Research Methodology, 3 (1), 63-74. Spalding, N.J. & Phillips, T. (2007). Exploring the Use of Vignettes: From Validity to Trustworthiness, Qualitative Health Research, 17 (7), 954-962. Wilks, T. (2004). The Use of Vignettes in Qualitative Research into Social Work Values, Qualitative Social Work, 3 (1), 78-87.

Author Information

Veronika Leicher (presenting / submitting)

University of Regensburg

Educational Science

Regensburg

Regina H. Mulder

University of Regensburg, Germany

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