Despite a growing literature on postmodernism in nursing and other healthcare disciplines, it continues to be dogged by mistrust, misunderstanding and outright hostility. Presenting the philosophy of postmodernism is a particularly difficult task, and most attempts fall into one of two traps: either the writer is a well-read and committed postmodernist in which case the writing tends to make too many assumptions about the background knowledge of the reader; or else the writer has only a passing knowledge of 'popular' postmodernism, in which case the writing often falls back on over-simplistic concepts which do not do justice to the issues and which are often completely misconceived. The problem is further compounded by the difficulty of writing about one discourse (I am using the word in its postmodern sense-all such 'jargon' is explained in the paper) from within a different and potentially hostile one. For the postmodernists, rational debate with their modernist colleagues is all but impossible, since (as we shall see) the logic and language of the dominant discourse of modernism rules out and refuses to acknowledge that of postmodernism (and vice versa). Postmodern texts therefore rely less on rational argument than on persuasive narrative and a deliberate subversion of many of the usual practices of writing. This introduction to postmodernism for healthcare workers attempts to straddle the two discourses in both its form and its content, and offers a mixture of argument, example and speculation.
Assessing nurses' practical capability was a challenge in the past as it is today. In 1901 New Zealand established state registration of nurses, with a standardised three-year hospital-based training system and state final examinations. Nurses' practical capability was assessed in an oral and practical examination and in general nursing questions in written medical and surgical nursing papers. This historical research identifies the practical component of nursing assessed in these examinations, categorising it as nursing the patient, the room and the doctor. It considers changes in the nursing profession's view, 1900-1945, of the best way to assess nurses' practical capability. This shifted from the artificial setting of the oral and practical examination held by doctors and matrons, to a process of senior nurses assessing candidates in the more realistic setting of a ward. The research also considers whether the nursing or medical profession defined nursing practice. By the end of the time period, the nursing profession was claiming for itself the right to both determine and assess the practical component of nursing.
The purpose of this article is to explore the ambiguous position of sister tutors, within the nursing and hospital hierarchy between 1918 and 1960. The function of the sister tutor was to train the probationers (student nurses). However, I will argue that the students' education was to come second to the service needs of the hospital, the authority of the matron and desire of the medical profession to maintain control over the nursing curriculum and nursing practice. Therefore sister tutors were caught 'in-between' several opposing forces which together militated against the individual sister tutor's work and the ability of the nursing profession to recruit adequate numbers of senior nurses into the classroom. The recruitment issue was further hampered by the widespread knowledge that much of the sister tutor's work was not student education at all, but organising lectures by medical staff and marking students' notes. In order to gauge the 'official' attitudes to the sister tutors and also the experiences of those who either worked as sister tutors or were taught by them, I used both archival and oral evidence in the research for this article. Pseudonyms have been used throughout for the oral history respondents.
The recent decision from the Nursing and Midwifery Council to make nursing a graduate profession has for some been the culmination of over a century of expectation. From the 1890s there were voices within the nursing and medical professions that nursing should be taught in universities. The purpose of this article is to explore two attempts in the mid-20th century to establish a degree in nursing at an English University; neither of which was successful. It will be demonstrated that there were too many conflicting ideas and personalities for these to have been achieved. The doctors wanted skilled assistants, many in the nursing profession considered that nurses should have 'common-sense, courtesy and kindness', in that order, the universities considered nursing to be a practical vocation, and the governments did not want the increased spending that such a move would necessitate.
The aim of this study is to identify what were desirable and undesirable student nurse characteristics in the 1950/1960s and relate them to those who had successfully completed the programme and gained State Registration and those who had not. A further aim was to undertake comparisons with modern day values of what are viewed as desirable traits in nurses.
In the 1950/1960s student nurses were hospital employees. Nurse training was based in hospital training schools and coordinated by sister tutors. Learning about nursing largely took place in clinical settings where there was limited supervision of student nurses by qualified nurses.
Content analysis approaches were used whereby positive and negative comments related to successful and unsuccessful completers were identified.
Data were extracted from individual training records relating to 641 student nurses. The records dated from 1955 to 1968. Clinical and training school reports were summarized by senior hospital figures such as the hospital matron. These reports were the focus of the analysis.
Desirable student nurse traits identified in the analysis were being a 'nice person', who is kind, compassionate and attentive to patients, conscientious, bright and intelligent. Other values such as being hard-working, reliable and punctual reflect that the students studied were primarily employees. Amenable to discipline and unquestioningly obeying a doctor's order also were part of the conventions of the time. Most negative comments related to the unsuccessful completers.
New insights into what was viewed as desirable and undesirable nursing characteristics in the 1950/1960s are identified. These insights have national and international relevance.
The aim of this article is to examine the experiences of the first 25 years of undergraduate nurses at the University of Edinburgh using a quantitative historical methodology.
In 1960, the University of Edinburgh, Nursing Studies Unit commenced the first undergraduate degree with nursing in the United Kingdom. By 1967, nursing was a component of the academic award itself.
A questionnaire was sent to 225 graduates of nursing at the University of Edinburgh through the alumni office. The questionnaire combined biographical data and a Likert scale. DATA/RESULTS: Quantitative data can provide the historian with wide-ranging information about large groups of people, in this case undergraduate nurses. Although some of the responses may be more positive than what the participants felt at the time, the material provides useful information as to the experiences of early undergraduate nurses.
This article has generated a previously unknown material related to the experiences of the early undergraduate nurses at Edinburgh. For example, the respondents did not feel that the course was too difficult and it appears that the University was accepting nursing as an academic subject. The additional qualitative data provided by the respondents has offered potential for further study.
Twenty years ago The Fleming Nuffield Child Psychiatry Unit, under the aegis of the Adult Education Department of the University of Newcastle upon Tyne, began a new post registration course for training registered nurses in the psychological management of children and adolescents. The writer, who participated in the first training scheme is now honorary tutor to the course, gives a practical account of her experience and views.
Interest in profiling of student progress has spread in recent years from general education. Nurse educationalists have been searching for alternative methods of monitoring continuous assessment schemes. The advantages, disadvantages and rationale for the introduction of student profiling of clinical progress into a mental health nursing course are discussed. The role, function and support required by clinical supervisors are considered in the operationalisation of a 'Profile Grids' format of student profiling. An example of a student profile document for a psychodynamic nursing elective experience is included, depicting statements of competence set out in profile grids format. Guidelines for completion of documentation and monitoring of the Central Manchester Health Authority scheme are also described.
There is little doubt that changes in the National Health Service (Government White Paper 1989), the amalgamations of Schools/Colleges of Nursing and often Midwifery and their links with Higher Education will have significant implications for the provision and education of future health care teachers. This paper discusses three key features which emerge from the development of an undergraduate course for preparing health care teachers; the development of specialisms for teachers; the multi-faceted role of the teacher; the reflective practitioner. Central to the success of the course is the notion of 'Partnership' both with the students and the Education Centres providing practice experience. Partnership with the students is exemplified by the experiential nature of the course. Partnership with Accredited Education Centres has resulted in a shift of the locus of control from Higher Education to the practice setting thereby acknowledging the equal status of the partners. It is within this framework that three key features are explored.
The development of Project 2000 will lead to the reorganisation of nursing knowledge as nurse education enters higher education. This paper explores the implications of these changes for the future of role of nurse teachers and the new choices for professional development as teachers evolve into nursing theorists, lecturer practitioners and educational managers. The paper also explores changing pedagogic relationships with students, changing assessment strategies, their new supernumerary position in clinical environments, and reference groups likely to be selected by students. Finally it examines the ways in which links with higher education and the contributions of non-nurse academics may lead to the reorganisation of course management structures.
For over a decade general education has been aware of the advantages of linking initial teacher training with in-service provision for qualified teachers. This relationship brings together student teachers and qualified experienced teachers in a way that is mutually beneficial to both parties. It provides opportunities for the student to observe and reflect on the teaching style and approaches of established professionals who in turn will gain much from working closely with trainers and students from colleges of education. This paper develops a series of issues relating to IT-INSET including educational accountability, reflective practice, and the provision of quality education.
With the development of Project 2000, nurse education is being increasingly drawn into higher education with the expansion of diploma and degree courses. This paper explores the implications of these new relationships, drawing on the sociology of the curriculum and education in its analyses. It examines the impact of these changes on the professional standing of nurses and nursing and the reorganisation of the curricular codes that underpin nurse education. A movement towards higher education will introduce a new educational culture into nurse training and the wide multi-disciplinary base of nursing knowledge and practice will offer new challenges to nurse educators. The changes in nurse education add a new dynamic to the old tensions between academic and vocational training and raise new questions about the relationship of nurse education to the academic tribalism of higher education.
This paper considers some of the evidence that can help nurse teachers more effectively prepare nurses for practice. In particular it is concerned with how students learn and how teachers can improve the learning environment. There are four main sections to the paper. The first looks at learning styles and considers the importance of matching teaching style to the learning style of the student. The second section considers the research into the process of integrating theory and practice in nursing education and the relationship between theory, the classroom and the clinical area. The next section of the paper looks at factors influencing the process of becoming a nurse. Socialising agents such as people and techniques are reviewed in the light of research evidence from nursing and similar professions. Finally the paper represents a series of ways in which it is possible to assess and improve the learning environment for the student nurse, including human aspects, equipment and information.
The learning of biosciences is well-documented to be problematic as students find the subjects amongst the most difficult and anxiety-provoking of their pre-registration programme. Studies suggest that learning consequently is not at the level anticipated by the profession. Curriculum innovations might improve the situation but the effectiveness of applied interventions has not been evaluated.
To undertake an integrative review and narrative synthesis of curriculum interventions and evaluate their effect on the learning of biosciences by pre-registration student nurses. Review methods A systematic search of electronic databases CINAHL, Medline, British Nursing Index and Google Scholar for empirical research studies was designed to evaluate the introduction of a curriculum intervention related to the biosciences, published in 1990-2012. Studies were evaluated for design, receptivity of the intervention and impact on bioscience learning.
The search generated fourteen papers that met inclusion criteria. Seven studies introduced on-line learning packages, five an active learning format into classroom teaching or practical sessions, and two applied Audience Response Technology as an exercise in self-testing and reflection. Almost all studies reported a high level of student satisfaction, though in some there were access/utilization issues for students using on-line learning. Self-reporting suggested positive experiences, but objective evaluation suggests that impacts on learning were variable and unconvincing even where an effect on course progress was identified. Adjunct on-line programmes also show promise for supporting basic science or language acquisition.
Published studies of curriculum interventions, including on-line support, have focused too heavily on the perceived benefit to students rather than objective measures of impact on actual learning. Future studies should include rigorous assessment evaluations within their design if interventions are to be adopted to reduce the 'bioscience problem'.
Within the last decade nurse educators have been required to introduce research into the curriculum of every pre- and post-registration programme. This has lead to a debate concerning what practitioners need to know about research and about the best way to teach the research component of any educational programme. Two main approaches may be identified: facilitating research awareness and learning research by 'doing'. Both approaches raise a number of logistical and ethical problems. Certain of these problems are compounded by the large numbers of nurses who may be required to undertake a research project as a course component. Moreover, the absence of research evidence about the most effective means of educating nurses to become discerning consumers of research leaves the teacher without a sound framework to guide educational practice. In the light of recent educational reforms, this paper considers the unprecedented opportunities for nurse and midwife teachers to explore the role of research in the curriculum and in teaching.
In this paper the author argues that two major issues for nurse educational planning in the 1990s are developing a higher education ethos within the colleges and the contracts for educational provision. Underpinning each is the concept of educational accountability.
This paper reports on a four-year longitudinal study of the implementation of Project 2000. Interviews were conducted with a variety of staff involved in the changes, as well as with a sample of students who were seen at several points during the course and once after completion. The rationale for adopting a qualitative methodology is explored and the strengths of this approach for gaining an understanding of such a complex series of changes are outlined. Some of the findings pertaining to the introduction of the Diploma course are presented and some points for consideration as courses are reviewed and developed are included.
The main purpose of the study was to identify nursing students' orientations to nursing, their experiences of caring and nursing, the meaning of nursing and the expectations applied to a nursing career, and to report the changes in the orientations between the mid-1990s and the mid-2000s. Another aim was to determine the extent to which students' age, sex, having children, pre-educational caring experiences and intentions to leave nursing might explain the changes in nursing orientations.
There is a worldwide shortage of nurses but at the same time there is an ever decreasing number of applicants that are entering nursing education. Young people are less interested in choosing nursing as a career option than they were one or two decades ago.
A sample of 426 nursing students in 1997 and 660 students in 2006-2007 from the Universities of Applied Sciences in different parts of Finland completed a questionnaire containing questions concerning the students' background factors and 26 Likert-type statements concerning their nursing orientations.
The following orientations were identified: personal responsibility, idealistic nursing, selfactualization, and family centrality. Statistically significant changes were found in all of the orientations between the two periods. Fewer nursing students in the 2000s were oriented to idealistic nursing or emphasised self-actualization. Instead, there were more family centrality oriented nursing students in the mid-2000s than in the mid-1990s.
The results reflect the changes in the student generation applying for nursing education. The results challenge nurse educators to use teaching methods that promote students' awareness of their individual nursing orientations.
Clinical teaching has become increasingly complex and difficult for nursing instructors. Pressures for public accountability in nursing education and patient care, economic stresses, marked changes in the nursing curricula, and the growth of collective bargaining units have all complicated the task of educating student nurses. Traditional issues focusing on teaching strategies, academic and clinical evaluation concerns have been extensively researched. What are the current issues facing nurse educators? Our project aimed to identify some current student nurse issues in selected nursing programmes. Using a convenience sample, data were collected from the chairmen of nursing education in selected agencies. Analysis following the Fox and Diamond framework (1965) revealed recurring issues relating to mature students, stress and the clinical environment, and the mentor needs are a few of the issues discussed in this paper.