Educational Research in Clinical Practice - Learning strategies of public health nursing students

Author(s):

Esther Hjälmhult

Conference:

ECER 2009

Network:

22. Research in Higher Education

Format:

Paper

Session Information

22 SES 01 C, Learning Approaches and Strategies in Higher Education

Paper Session

Time:

2009-09-28

09:15-10:45

Room:

HG; HS 29

Chair:

Barbara Zamorski

Contribution

The aim of this study was to develop understanding of how public health nursing students learn in clinical practice and explore the main concern for the students and how they acted to resolve this main concern. The purpose was through my doctoral dissertation (Hjälmhult 2007, 2009) to develop knowledge to contribute to quality improvement within higher education and the practical field. The welfare society has become more and more dependent of knowledge and knowledge development and in Norway and internationally the interest is increasing in order to understand how learning is connected to working life (Lave & Wenger 1991, Boud & Garrick 1999, Clutterbuck 2001). Recent reforms and adaptations at every level in higher education in Norway have influenced professional education and simultaneously emphasized the limited amount of research within this area. The focus has been on basic education and on the framework conditions more than the learning process (Coetzee 2003, Gopee et al. 2004, Charleston & Happell 2005). Interest has even been focused on such factors as organising and economic conditions and academic learning rather than real-life educational studies (Bøgeskov 2003, Jensen & Lahn 2005, Nielsen & Kvale 2006, Kvale 2007). In addition, according to Jensen (1999), professionals have been trapped in a tradition of abstract knowledge free from context, even in professional education, where theoretical knowledge is considered more important than knowledge developed by experience. This study focused on public health nurse education. In Norway this is a postgraduate programme requiring a BSc in nursing and 1 year of full-time work as a registered nurse (Ministry of Education and Research 2005). Public health nurse education includes 10 weeks of practical training in districts within different rural or urban municipalities. Contracts between the University College and municipalities establish a framework for practice, and considerable administrative work is needed to provide sufficient placements. The supervisor is a practising public health nurse and could be more or less enthusiastic about supervising a student. The faculty teacher has a peripheral facilitator role, meeting the student and supervisor two to three times during the student’s placement. A public health nurse in Norway works with children and adolescents 0-20 years and focuses on health promotion and disease prevention. The workplaces are at Child Health Services and School Health Services. The services are free of charge and have almost 100 % dissolution from the target groups.

Method

The grounded theory methodology developed by Glaser and Strauss (1967) and Glaser (1978, 1998, 2005) was used for this design. Grounded theory focuses on social processes and is well suited for studying complex and hidden processes (Morse 2001). Grounded theory is a method for conceptualising people’s patterns of behaviour and comprises concepts, categories and their properties. The core category should grab the most significant from the social field explored. Glaser (1978) outlines four criteria for achieving quality: fit, work, relevance and modifiability. I gathered data through 55 interviews with 21 female public health nursing students and their written weekly reports (108). They ranged in age from 26-43 years. Data were analyzed according to grounded theory methodology with open, selective and theoretical coding. I informed Norwegian Social Science Data Services about the study.

Expected Outcomes

Findings. The grounded theory of conquering operational space explains how the students work to resolve their main concern. A social process with three identified phases, positioning, involving and integrating, was generated from analysing the data. Their subcategories and dimensions are related to the student role, relations with a supervisor, student activity and the consequences of each phase. Public health nursing students had to work towards gaining independence, often working against ‘the system’ and managing the tension by taking a risk. Many of them lost, changed and expanded their professional identity during practical placements. The students learning processes in clinical training is complex and dynamic and the theory of ‘Conquering operational space’ can assist supervisors in further developing their role in relation to guiding students in practice. Relationships are one key to opening or closing access to situations of learning and directly affect the students` achievement of mastering.

References

Boud D & Garrick J (eds.) (1999) Understanding Learning at Work. Routledge, London. Bøgeskov L (2003) Uddannelse i krise [Education in a crisis]. Ugebrev 3, 6–8. Charleston R & Happell B (2005) Coping with uncertainty within the preceptorship experience: the perceptions of nursing students. Journal of Psychiatric and Mental Health Nursing 12, 303–309. Clutterbuck D (2001) Everyone Needs a Mentor: Fostering Talent at Work. 3rd ed. Chartered Institute of Personnel and Development, London. Coetzee M (2004) Learning to nurse children: towards a model for nursing students. Journal of Advanced Nursing 6, 639–648. Glaser BG (1978) Theoretical Sensitivity: Advances in the Methodology of Grounded Theory. Sociology Press, Mill Valley, CA. Glaser B G (1998) Doing Grounded theory: Issues and Discussions. Mill Valley, Sociology, Press California. Glaser BG (2005) The Grounded Theory Perspective III: Theoretical Coding. Sociology Press, Mill Valley, CA. Glaser BG & Strauss AL (1967) The Discovery of Grounded Theory: Strategies for Qualitative Research. Aldine, New York. Gopee N, Tyrell A, Raven S, Thomas K & Hari T (2004) Effective clinical learning in primary care settings. Nursing Standard 18, 33-37. Hjälmhult E (2007) Erobring av handlingsrom. Helsesøsterstudenters læring i praksis. (Dissertation) Avhandling for graden doctor rerum politicarum The Norwegian University of Science and Technology (NTNU), Trondheim. Hjälmhult E (2009) Learning strategies of public health nursing: conquering operational space. Journal of Clinical Nursing, (In press). Jensen K (1999) Mellom tradisjon og fornyelse [Between tradition and renewal]. In Mesterlære: Læring som Sosial Praksis [Master/apprentice: learning as community of practice] (Nielsen K & Kvale S ed.), ad Notam, Oslo. Jensen K & Lahn L (2005) The binding role of knowledge: an analysis of nursing students’ knowledge ties. Journal of Education and Work 3, 307–322. Kvale S (1996) Interviews: an Introduction to Qualitative Research Interviewing. Sage, Thousand Oaks, CA. Kvale S (2007) Contradictions of assessment for learning in institutions of higher learning. In Rethinking Assessment in Higher Education: Learning for the Longer Term (Boud D & Falchikov N ed.), Routledge, London, pp. 57–71. Lave J & Wenger E (1991) Situated Learning: Legitimate Peripheral Participation. Cambridge University Press, Cambridge. Ministry of Education and Research (2005) Rammeplan og Forskrift for Helsesøsterutdanning [National curriculum and regulation for public health nursing education]. Ministry of Education and Research, Oslo. Morse J M (2001) Situating grounding theory within qualitative inquiry. In Using Grounded Theory in Nursing (Schreiber RS & Stern PN eds.), Springer Publishing Company, New York, pp. 1–15. Nielsen K & Kvale S (2006)The workplace – a landscape of learning. In Learning, Working and Living (Antonacopoulou E, Jarvis P andersen V, Elkjaer B & Høyrup S ed.), Palgrave Macmillan, London, pp. 119–135.

Author Information

Esther Hjälmhult

Bergen University College

Department of Health and Social Sciences

Nesttun

158

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