Purpose

The purpose of the study was to investigate vocational knowing, in terms of vocational language for nursing assistant students, made available in literacy practices within the context of subject integrated teaching of four vocational subjects on a Swedish Health and Social Care Program (HSCP). This contribution focuses on the literacy practices that the students on the HSCP were involved in in relation to the teaching of communication, relevant for nursing assistants in patient arrival, in the assessment of the patient’s individual need of nursing interventions.

Research questions

1.       What does subject integrated teaching of vocational subjects make available in terms of vocational knowing in relation to teaching communication?

2.       What does literacy practices in relation to the teaching of communication make available in terms of vocational knowing and vocational language?

3.       What is the teachers’ object (as manifested) in the teaching of communication, in terms of vocational knowing and vocational language?

Theoretical framework

For this paper, two theoretical perspectives were used for framing and analyzing collected data: Cultural Historical Activity Theory (CHAT) (Engeström, 1987; Engeström and Miettinen, 1999; Engeström & Sannino, 2010) and New Literacy (NL) (Hull, 1997; Street, 2001; Karlsson, 2006). The theories were combined for enabling an in-depth analysis of literacy practices in relation to the teaching of communication within a subject integrated vocational context. CHAT was used for highlighting an understanding of human activity as object-oriented, and as preserved, altered, and developed in a social, cultural and historical context, while NL was used for the emphasis on the specific action of literacy, that together with other actions constitutes the main activity. Selected concepts from CHAT, namely actions, tools, rules, goals, tensions and contradictions, were used to analyze what was made available in terms of vocational knowing in the literacy practices. Secondly, specific analytical questions from the theoretical framework of NL, dealing with expected reading in relation to what, how, and for what purpose, were used for analysis of the literacy practices in teaching communication of the theme unit (Street, 2003; Street, 2015).

Material and method Data was collected ethnographically and in form of a case study (Yin, 2009; Denscombe, 2010; Barton and Hamilton, 2012), during two school-weeks in autumn 2012 in a group of second-year students, at a Swedish upper-secondary Health and Social Care Program. The school was selected because of its organizational implementation of subject integrated teaching. The selection process was performed in a previous mapping (Christidis, 2014) conducted during spring 2012 of the HSCPs in Stockholm county. The case study comprised of observations, notes and audio-recordings of teaching, informal conversations with teachers and students, handouts that were distributed during teaching and student papers. Special attention was given to data in relation to the teaching of communication. Subject integration was performed in a theme unit called VIPS which comprised of four vocational subjects, Nursing Care 2, Ethics and life issues, Psychiatry and Special Pedagogics 1. The theme unit involved documentation of the nursing care process, such as anamnesis, measures for nursing care, evaluation and follow-up, and communication, ethical aspects such as values and integrity, and psychosis. Data analysis Data were analyzed according to the selected concepts of CHAT for their manifestation during teaching and for teaching of the selected content. The scheme for contradictions by Engeström and Sannino (2010) was used to identify tensions and contradictions, as well as their character and placement order in the main activity itself and proximity to other activities. Literacy practices were analyzed with regard to expected reading with questions of what, how, and for what purpose, which helped identify the literacy practices used and their implementation in teaching as well as outcome in relation to the object of activity. Altogether, these concepts were used to analyze intended (object) and delivered or manifested actions (goals), and the relation in between. The analysis of data was concentrated to the question of availability of vocational knowing in terms of vocational language in subject integrated teaching in the specific theme unit, and in relation to the teaching of communication within a health care context.

Preliminary results showed that teaching communication functioned as a platform for literacy practices involving writing, discussion of text on communication from the course book, teacher constructed text on psychosis, reading as well as listening to the texts read aloud either by teacher or by students, making available for the students the development of a vocational language, through the interrelation of the two texts. With the course book as starting point, the students and the teacher as facilitator of the process summarized the main content of communication on the whiteboard. Selection of content noted was related to the diagnosis of psychosis in relation to the teacher constructed text on psychosis. Likewise, concepts, definitions within communication presented during teaching were put in relation to the subject matter. A health care context was strengthened through teacher’s input of secondary experience from conversations during patient arrivals. During literacy practices, student use of teacher as facilitator and use of their peers for discussing course book content in relation to a health care context was shown to be of importance for making available for the students a vocational language in accordance with the professional responsibilities of the nursing assistant. The teacher’s secondary experience as input in teaching of communication was shown to be of importance for further guiding the students towards a health care context. Subject integrated teaching of four vocational subjects in relation to communication make available for the students a multi-perspective approach on the subject matter, i.e. of the patient arrival, unraveling the complexity of assessing nursing interventions needed in a state of psychosis in regard to symptoms, in regard to ethics, such as the patient’s integrity, self-determinacy, and also in regard to the individual needs of nursing care.

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