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The theory-practice gap in nursing: From research-based practice to practitioner-based research
Journal of Advanced Nursing
Abstract
The aim of nursing research is generally agreed to be the generation of knowledge, and whilst this is a relevant aim in theory-based disciplines such as sociology, the primary concern of nursing is with practice. Using examples drawn mainly from the field of mental health, it will be argued in this paper that the application of generalizable, research-based knowledge to individual, unique, person-centred practice, the so-called 'research-based practice' advocated by the Department of Health, is one of the main causes of the theory-practice gap. It will be further suggested that nursing requires a paradigm of clinical research which focuses on the individual therapeutic encounter in order to complement the existing sociological paradigm of theoretical research which is best suited to the generation of generalizable knowledge and theory. The paper will conclude by suggesting that such a clinically based research paradigm must not only focus on the individual nurse-patient relationship, but that it must be carried out by the nurse herself. Clinical research, if it is to make a difference to practice, must therefore be practitioner-based research.
... Instructors are more attracted towards research, nurses towards documentation and students toward completing assignment than learning. Review of literature revealed that, nurses often do not follow their academic training in practice [6,7] and they can neither use their qualification nor their scientific knowledge in health system [8]. ...
... -Le Helloco (2011) stated that the faculty of nursing generally recruit professionals with high level degree but they generally lack experience and competence in practical demonstration [3]. So they focus more in theory part even in practical setting [7]. Consequently these supervisor lack confidence, competence and hesitate to demonstrate the procedures in the clinical area. ...
... -They also fail to observe the competency gained by the student. Some instructors concentrate on marks rather than the students understanding of information [7]. -Some clinical instructors have poor communication skill which creates a weak bond between the teacher and the student [7]. ...
Nursing is a scientific profession, based on theory and art of care. Learning in clinical field is essential aspect of the nursing course. Exposure to the clinical setting helps the nursing students to gain competency in order to provide safe and effective care. Theory practice gap arises when theory is not translated into action. Transition from student to registered nurse has been described as the most stressful period due to the gap between theory taught in the classroom and clinical practice. Theory- practice gap impacts the professional image of nurses that affects their self-esteem, interrupting their personal development and professional growth. Factors associated with the gaps are related to training, teaching faculty and clinical learning environment. Professional skill, communication competency of the instructors and nurses are the influential human resources. Donabedian model may be considered to identify the gap. Simulation used for lab teaching translates theoretical learning into practice. Models of Collaboration will strengthen the bridge between hospital and teaching institutes.
... Their practical experience contributed to the present research, and vice versa. Being both practitioners and researchers not only allows for such rapid shifts but also provides an opportunity for serendipitous encounters in which practical work helps to bridge the gaps left by theory (45). This combination may be most relevant in mental health studies, where the attitudes associated with relationships are a very important aspect that affects both the helpers and the helped (45). ...
... Being both practitioners and researchers not only allows for such rapid shifts but also provides an opportunity for serendipitous encounters in which practical work helps to bridge the gaps left by theory (45). This combination may be most relevant in mental health studies, where the attitudes associated with relationships are a very important aspect that affects both the helpers and the helped (45). The helpers' identification with the predominantly female and child refugees contributed to the inclusion of the help recipients' perspective, with sensitive responsiveness playing an important role in creating a safe atmosphere for the refugees. ...
Introduction
World Health Organization studies have shown that one in every five people who have experienced war or other conflicts suffers from a mental health disorder, the most vulnerable groups being children and women. According to international guidelines, mental health care should be made available immediately in the event of disaster. With the first influx of Ukrainian refugees to Hungary at the outbreak of the war, the Research Group of Childhood Mental Health at Eötvös Loránd University and Semmelweis University in Budapest immediately decided to help by transforming itself into a support group for refugee families. The members of the support group are all women. The aim of the present study is to explore the motivation behind the transformation of the research group and the help it provided. A further aim was to compare the group’s experiences with descriptions in the literature of impacts on helpers who work with refugees.
Methods
The current paper reflects on the transformation from researchers to helpers and the effects of that transformation at group and individual level using the focus group method and consensual text analysis. The transformation of the support group necessitated the involvement of students, whose experiences are also examined.
Results
We identified five main categories: context; the help recipients’ perspective; the personal level; the professional level; and the level between the personal and professional.
Discussion
The analysis revealed the way in which the voluntary helping developed, the resulting difficulties, and coping options. Volunteering among Ukrainian refugees has both positive and negative psychological consequences. While stress and trauma threaten the psychological well-being of the helpers, positive aspects, such as flexibility and professional development, are also reported. Due to the strong motivation among group members and their experience in practical work, the all female research group was quickly able to transform itself into a support group.
... This approach to generalising knowledge and practices has been challenged by Rolfe (1998) in nursing and Eraut (1994) in education, since standardised and generalised procedures and application of principles do not create a consistent response from either patients or students since it denies the differences between people, their contexts and the setting. Rolfe describes nurses as gardeners treating each plant differently, individually tailoring their approach and the procedure or behaviours used rather than being agriculturists. ...
... The lack of an emotional response of a feeling of compassion or empathy caused them some difficulty with people they felt unable to relate to. This supports earlier focus group findings by Street (2001, 1999 forms of knowledge and learning used in practice including reflective practice (Rolfe 1998, Schon 1983, 1987) the use of experience, (Titchen and Esser 2001, Eraut 1994, Benner 1984, intuition (Benner 1984, Benner andWruble 1982) (Benner and Wruble 1989, Watson 1988, Benner 1984, Roach 1987, Leininger 1986. Although this study reveals nursing as central to palliative care, it also argues that continuity of care, values and knowledge are also central to other disciplines with the care provided between services by the fluid work across the locations of care by the social workers, occupational and physiotherapist, consultant and lead nurse. ...
p> This thesis explores the multiple and dynamic constructions and processes of care that inform how care is provided, experienced and conceptualised within an NHS integrated palliative care service in England. Drawing upon the literature and research from palliative care and the debates about care within the philosophical, sociological, health and educational domains, a wide range of constructions were revealed. How these constructions have influenced and continue to influence care within palliative care was explored guided by a philosophical position that values multiple truths and ways of knowing.
An holistic ethnography was undertaken over a period of six and a half months within the palliative care service that provided a combination of hospice, community and hospital palliative care. Observations of care were undertaken in each of the three areas of the service focusing on care practices, care talk, care processes and documentation. Semi structured interviews were undertaken with staff, people being cared for, family members and stakeholders. A thematic and hermeneutic analysis of the data was undertaken to reveal and interpret the emerging constructions of care, and how these informed and shaped palliative care practice.
The palliative care services had a democratically shared leadership which valued the multiple voices, knowledges and processes within and across the service enabling it to adapt to the centralising and hierarchical pressure of the NHS, whilst retaining a service that provided personalised responsive holistic and supportive care.
This thesis argues that care can be conceived of as a set of complex, multidimensional, temporal and dynamic processes informed by multiple knowledges and shaped by personal professional and structural values within society. Care within palliative care is constructed by these multiple processes and influences. Care is relational and can only be an ethically just process when the multiple voices are heard, respected and negotiated within the processes. Care is therefore not concrete, but shaped and reshaped over time. </p
... However, a limitation of research findings on therapeutic communication and nurse-patient relationships, is that an approach that works with one forensic service user may not work with another because of specific, unique needs [69]. In addition, effective therapeutic communication styles appear to depend on nurses' personalities, and the extent that they are authentic [70]; and very importantly, on cultural factors, which will affect what the service user perceives as caring, empathetic and respectful communication [6]. ...
... Research findings and government inquiries suggest the importance of assessing and meeting forensic service users' spiritual and cultural needs, and ensuring that risk assessment, and subsequent admission to secure services, are not affected by culturally biased assumptions [69]. The inquiry into the death of David Bennett in a secure hospital discovered failure to take seriously his complaints of racism from another service user, or to provide holistic care that met his cultural and other needs [94]. ...
... (Source: Miller & Miller, 2011) Critics of the evidence-based practice movement have therefore argued that the notion of superior forms of evidence has turned clinical practice into a bland form of medicine and that the standards created by this view have led to 'watered-down' competition, a lack of autonomy, and limited innovation and creativity, as the nature of standardisation has simply rested on its politics (Timmermans & Berg, 2001). More broadly and perhaps most importantly, in the reality of clinical practice, it is essential that the individuality of the patient is accounted for (Rolfe, 1998), that demands attending to multiple forms of evidence. ...
... A foundational premise of evidence-based practice is that research is a specialist activity that should be conducted by those with research skills and the findings should be translated for practitioners who can implement the evidence into their practice (Rolfe, 1998). ...
In health research, there is an extensive literature regarding the benefits and challenges of evidence-based practice and how qualitative evidence fits within the broader need for research that underpins clinical decisions. The history and tensions regarding evidence and evidence-based practice are outlined in the chapter, with the contributions made by qualitative researchers emphasised. This is juxtaposed with a discussion of practice-based evidence and the contribution this has made in the field. Further, the chapter focuses on illuminating how naturally occurring data constitutes a form of evidence for the field of health.
... Yet, despite this need, techne and phronesis are not well recognized by academics. This results in the theories of pure researchers dictating actions of those in practice (Pryjmachuk 1996), or practitioners ignoring theoretical insights because they do not find them useful (Rolfe 1998). Standard attempts to close the perceived "gap" between academia and practice then usually involves academics trying to develop better strategies for dissemination and greater use of research findings, which makes the gap wider by suppressing professional judgment and forcing practitioners to use ill-suited research findings (Rolfe 1998). ...
... This results in the theories of pure researchers dictating actions of those in practice (Pryjmachuk 1996), or practitioners ignoring theoretical insights because they do not find them useful (Rolfe 1998). Standard attempts to close the perceived "gap" between academia and practice then usually involves academics trying to develop better strategies for dissemination and greater use of research findings, which makes the gap wider by suppressing professional judgment and forcing practitioners to use ill-suited research findings (Rolfe 1998). ...
Global environmental change requires responses that involve marked or qualitative changes in individuals, institutions, societies, and cultures. Yet, while there has been considerable effort to develop theory about such processes, there has been limited research on practices for facilitating transformative change. We present a novel pathways approach called Three Horizons that helps participants work with complex and intractable problems and uncertain futures. The approach is important for helping groups work with uncertainty while also generating agency in ways not always addressed by existing futures approaches. We explain how the approach uses a simple framework for structured and guided dialogue around different patterns of change by using examples. We then discuss some of the key characteristics of the practice that facilitators and participants have found to be useful. This includes (1) providing a simple structure for working with complexity, (2) helping develop future consciousness (an awareness of the future potential in the present moment), (3) helping distinguish between incremental and transformative change, (4) making explicit the processes of power and patterns of renewal, (5) enabling the exploration of how to manage transitions, and (6) providing a framework for dialogue among actors with different mindsets. The complementarity of Three Horizons to other approaches (e.g., scenario planning, dilemma thinking) is then discussed. Overall, we highlight that there is a need for much greater attention to researching practices of transformation in ways that bridge different kinds of knowledge, including episteme and phronesis. Achieving this will itself require changes to contemporary systems of knowledge production. The practice of Three Horizons could be a useful way to explore how such transformations in knowledge production and use could be achieved.
... The results show that the gap has been observed and studied across different fields varying from nursing (Greenway et al., 2019;Rolfe, 1998;Scully, 2011) to education (Bjo¨rck & Johansson, 2019;Carr & Kemmis, 1986;Collier, 1997) to management (Bansal et al., 2012;Tucker & Parker, 2014;Zaccaro & Banks, 2004) and environmental science (Adams et al., 2019;Bradshaw & Borchers, 2000;Zhang et al., 2018), among others. Figure 2 shows that most studies are classified in Social Sciences 1 (124/188) and Health/Nursing (43/188) research fields. ...
Plain language summary
This study aims to tackle the persistent problem known as the “theory-practice gap,” which has puzzled various fields, including public health, education, nursing, and many others, for decades. The gap refers to the challenge of applying theoretical knowledge to real-world situations effectively. Despite much research, the causes and solutions for this gap remain unclear. The study takes a multidisciplinary approach to answer three key questions: 1) What is the theory-practice gap, and what does it involve? 2) What causes this gap? 3) How can we address it? By answering these questions, the study creates a theoretical framework to understand the underlying issues of the gap. The review identifies various drivers that hinder the integration of theory and practice and evaluates their significance. It also suggests an innovative model centered on learning and reflection, emphasizing that theory and practice are interdependent. This model suggests that practical situations can generate theory through reflection and that theory can influence and improve practice. The study’s results provide a holistic approach to addressing the gap, integrating perspectives from multiple disciplines. It also highlights the need to develop tools for assessing the gap, particularly in knowledge translation. While this study is a crucial first step in accumulating and integrating knowledge about the gap, future research should aim to validate its findings among practitioners from different sectors and regions. Understanding and addressing the theory-practice gap is crucial in fields like climate change and ensures that theoretical knowledge can be effectively applied in practical contexts. This study offers a promising starting point for further research and practical solutions to bridge this persistent divide.
... Nursing staff has already experienced such things during their practical training at their institutions. For example the discriminatory behavior is found everywhere not only hospital and clinics and favoritism works so, this cannot be linked here and nursing staff has also experienced in their practical daily and routine life (Rolfe, 1998). ...
Theoretical frameworks and practical applications diverge significantly. Discriminatory attitudes, communication obstacles, and a lack of resources in healthcare settings are three of these critical gaps. There is a significant divide between students' ability to put what they learn in the classroom into practice in real-world clinical settings and the optimal degree of assumptions made in classroom instruction.
... Experts have supported that there is no 'one' solution for the gap, thus integrating solutions and improve them through learning and reflection is key. This finding is supported by multiple authors from multiple disciplines that identify learning and reflection a key factor to address the gap (Rolfe, 1993(Rolfe, , 1998Wahlgren & Aarkrog, 2021). Westling et al. (2019) and Preston et al. (2015a) have acknowledged the potential of reflection and learning to more robust theory and practice to enable real change. ...
... Since the turn of the century, the problematic disconnect between theory (broadly taken as a set of concepts to indicate and/or explain a phenomenon) and practice (the acting of that phenomenon) has been increasingly highlighted and discussed in a number of fields, for example, in education (e.g., [1,2]), tourism (e.g., [3]), and nursing (e.g., [4,5]), to name but a few. The subject and matter of sports coaching has not been immune from such deliberation (e.g., [6,7]), with the diagrammatic models and linear thinking, which previously dominated the literature, cited as the principal cause of the disconnect-see, for example, [8]. ...
The current picture of sports coaching suggests one where practitioners and scholars operate not so much at a particular interface, but rather on parallel lines of development; in essence, of talking past as opposed to each other. Through a critical re-reading of the practitioner–scholar divide, this paper takes issue with the existence of the separate identities featured, in addition to the argument that we merely need a better, rather straightforward, connection between theory and practice to ‘fix the problem’. Alternatively, the case made highlights how the problematic ‘othering’ nature of a theory–practice division has severely hampered the development of the field. In terms of structure, we initially challenge existing ‘anti-intellectual’ claims within coaching, essentially by advocating for better appreciating the everyday, socio-pedagogic nature of the activity. In this respect, the relegation of experience, of the inherent ‘code of coaching’ (so dear to coaches themselves), is protected against. Secondly, we promote the idea of encouraging coaches, coaching scholars, and coach educators to consider the indivisibility of theory and practice through the use of such notions as sensitizing concepts, internalisation, and authenticity to improve the ‘doing’ of the job. Of particular importance here is the development and utilisation of a critical consciousness of coaching; not only of thoroughly understanding the activity, but also in actively fashioning it through engagement with new ideas. This latter notion gives required credence, however loosely, to some guiding frame of reference; otherwise we become enmeshed in, and blinded by, the immediate. In dismantling the wall that has divided practitioners and scholars by not giving authority or indeed acceptance to such fixed positions, we alternatively advocate for the creation of a more authentic coaching life through living the theory that actively sustains it.
... Student nurse education requires the understanding of theory as well as its application in clinical practice (Corlett 2000;Mitchell et al. 2017). The theory-practice gap denotes the separation between theoretical knowledge and its application to practice (Greenway et al. 2019;Mitchell et al. 2017;Rolfe 1998). Theoretical knowledge refers to research or evidence which looks to inform practice. ...
Background
The primary aim of undergraduate, pre-registration nursing education is to prepare students to be nurses who can apply theory to practice, with clinical placements to support the practice element of the clinical programme. However, the theory-practice gap is a longstanding problem within nurse education, as nurses continue to practise with incomplete knowledge to support their actions.
Problem
In April 2020, the COVID-19 pandemic caused a reduction in clinical placement capacity that affected student learning opportunities.
Approach
Based on Miller's pyramid of learning, a virtual placement was created using evidence-based learning theories and an array of multimedia technologies with the intention of replicating real-life experiences and promoting problem-based learning. Scenarios and case studies were collated from clinical experiences and mapped against student proficiencies to produce an authentic and immersive learning environment.
Conclusion
This innovative pedagogy provides an alternative to the placement experience while enhancing the application of theory to practice.
... Video-based feedback has been recognised to assist healthcare providers in tapping into the visual and auditory patient cues present in a consultation that are not available through text-based learning (Kamin et al., 1999), where showing becomes a way of saying the unsayable (MacDougall, 2006). In line with other studies, the videos made the healthcare providers aware of taken-for-granted acts and 'tacit knowledge', which have been argued to be fundamental resources of knowledge in improving practice (Rolfe, 1998;Cheater, 2003;Meyer, 2003;Iedema et al., 2009b). Further, video recordings have been recognised to enable healthcare providers to critically engage with their own practice norms (Carroll et al., 2008;Carroll, 2009;Iedema et al., 2009b;Crenshaw, 2012). ...
Aim
To understand healthcare providers’ experiences with video recording of patient consultations.
Background
Video recordings have been recognised to be an effective method to evaluate in situ interactions in clinical practice. The video recordings are often conducted by researchers, but active involvement of healthcare providers into the process of recording is evolving. Still, little is known of how video recordings by healthcare providers may influence daily clinical practice and potentials for direct use to guide practice development.
Methods
A qualitative design was used, conducting two focus group interviews including 12 healthcare providers representing eight different healthcare services who provide municipal cardiac rehabilitation. Interpretive description was used as the methodological framework, and symbolic interactionism served as the theoretical lens.
Findings
Three themes were identified reflecting healthcare providers’ experiences with video recording of patient consultations: ‘Concerns of compromising primary work tasks’, ‘Exposing professional and personal skills’ and ‘A new learning dimension’. Overall, the three themes represent the process of video recording own practices attached to patient consultations and the personal investment attached to the video data. Also, how the recordings may provide new insights for practice development in terms of individual and team-based performance in patient consultations.
Conclusion
Video recordings by healthcaref providers may be a useful source to provide information and learning about patient consultation practice to use in research and supervision, keeping in mind their challenges of implementation into daily clinical practice.
... The management area is not alone by any means; the gap is also found in the applied sciences, education and healthcare (e.g. Adesina and Chianu, 2002;Henderson and Dancy, 2011;Pattanayak et al., 2003;Rolfe, 1998Rolfe, , 2011. ...
Purpose
The authors suggest that the research-to-practice gap, such as that found in evidence-based management, is due in part to a lack of attention to embodied knowledge. The recommendation is for change agents to bring attention to embodied knowing when implementing change based on research. The purpose of the paper is to address the research-to-practice gap.
Design/methodology/approach
This is a conceptual paper that considers limitations of the predominant approach to considering the research-to-practice gap. The literature on phenomenology, feminist theory, and learning theory form the basis for exploring these challenges as well as possible solutions for transcending the research-to-practice gap.
Findings
Strategic opportunities for introducing increased corporeal understanding are advanced. The suggestions address the research-to-practice gap at three critical stages of research-based change initiatives. These include making embodied knowledge integral to change initiatives in framing research, reducing resistance, and increasing acceptance. Among the specific strategies discussed are attending to tacit knowledge when considering the change, embracing the embrained body including attending to kinesthetic resistance and starting with the body to increase acceptance when implementing change.
Originality/value
There has been very little previous attention to the corporeal in management research and practice, including in the organizational change literature. This paper not only increases this discussion significantly but also provides suggestions for how to move forward in practice.
... The management area is not alone by any means; the gap is also found in the applied sciences, education and healthcare (e.g. Adesina and Chianu, 2002;Henderson and Dancy, 2011;Pattanayak et al., 2003;Rolfe, 1998Rolfe, , 2011. ...
... 'How to' knowledge has generally received limited attention compared to problem analysis in academia. Doing so requires different approaches that can elicit and develop practice-oriented knowledge, such as embodied techne and phronesis, as well as more abstract episteme (Rolfe 1998;Flyvberg 2001;Fazey et al. 2018b). To advance 'how to' knowledge, this study was thus framed as second order research (Umpleby 2016). ...
Meeting global targets that maintain temperatures at 1.5 °C above pre-industrial levels while adapting to the growing impacts of climate change requires significant and rapid societal change. Within this context, there has been growing interest in building community resilience to shocks and stressors and as a forward-looking process. Yet while there has been extensive attention to conceptual aspects, there has been much less on how this can be achieved in practice. This research worked with three communities in Scotland (UK) regularly exposed to flooding and other integrated challenges to learn from action about community resilience building. A carefully developed four-tiered transdisciplinary approach was applied that included: relationship-building; enhancing capacities to work with interconnections; enabling processes; and supportive action-oriented research. The findings of the analysis of the system dynamics that were occurring during the resilience-building process highlight that it is a complex and messy social process. Yet, it also shows that if quality and sufficient quantity of support and time to help surface and deliberate on underlying assumptions about communities and change is provided, it can be possible to stimulate emergence of beneficial reinforcing social dynamics that begin to support collaborative and systemic action. To further advance know how about resilience building, much greater focus will be needed on the ‘how’ of resilience. This, in turn, will require new framings of, and approaches for, community resilience and new framings of research, knowledge and knowing.
... When training moved to educational institutions, the level of education increased but it also created a disconnect between clinical practice and academic work in the discipline (Nelson & Gordon, 2004). Much discussion has ensued regarding the distance between clinical and academic worlds in nursing, often labelled as the "theory-practice" gap (Larsen et al., 2002;Rolfe, 1998). The divergence between these two worlds has been problematized by those who feel there should be a seamless connection between theory and practice, highlighting the absence of purposeful structures to enable such a reality (Hickerson et al., 2016;Huston et al., 2018). ...
Aim
To better understand how oncology nurses (a) navigate graduate studies; (b) perceive the impact of their academic work on their clinical practice, and vice versa; and (c) engage with clinical settings following graduate work.
Design
Interpretive descriptive cross‐sectional survey.
Methods
A qualitative exploratory web‐based survey exploring integration of graduate studies and clinical nursing practice.
Results
About 87 participants from seven countries responded. 71% were employed in clinical settings, 53% were enrolled in/graduated from Master's programs; 47% were enrolled in/graduated from doctoral programs. Participants had diverse motivations for pursuing graduate studies and improving clinical care. Participants reported graduate preparation increased their ability to provide quality care and conduct research. Lack of time and institutional structures were challenges to integrating clinical work and academic pursuits.
Conclusions
Given the many constraints and numerous benefits of nurses engaging in graduate work, structures and strategies to support hybrid roles should be explored.
... The participants quickly realized that there was a difference between what they had learned theoretically and how they thought practice would be and what it actually was. While the notion of a theory-practice gap in nursing has long been recognized (see, for example, Rolfe, 1998), this was accentuated for the participants by virtue of their gender. They encountered the real situation of nursing only after entering clinical practice as an independent staff nurse. ...
... Evidence-based practice requires practitioners to use research evidence in conjunction with their professional expertise and knowledge of the constraints of the environment to make treatment decisions [31]. Sports injury prevention research has similarly inherited many of the problems inherent in the translation of this type of evidence into practice-the so-called "research-practice gap" [32,33]. One of the key causes of the research-practice gap is the uni-directionality of research [34,35], where academic researchers provide solutions that are efficacious under ideal conditions to practitioners who are expected to implement them in a broad range of real-world settings. ...
In recent years, an understanding has developed that sports injuries are the emergent outcomes of complex, dynamic systems. Thus, the influence of local contextual factors on injury outcomes is increasingly being acknowledged. These realisations place injury prevention research at a crossroads. Currently, injury prevention researchers develop universally applicable injury prevention solutions, but the adoption of these solutions in practice is low. This occurs because implementation contexts are both unique and dynamic in nature, and as a result singular, static solutions are often incompatible. In contrast, practitioners address injury prevention through iterative cycles of trial and error, aiming to optimise the injury prevention process within their own unique contexts. The purpose of this critical review is to draw attention to the misalignment between research and practice-based approaches to injury prevention. In light of this, we propose alternative research approaches that acknowledge the process-driven nature of injury prevention in practice. We propose that a core focus of sport injury prevention research should be to provide practitioners with useful and relevant information to support their decision making around their localised injury prevention practice. Through this approach, injury prevention research ceases to be about what works, and begins to engage with understanding what works in what contexts and why?
... Because of this, many nurses conducted their research farther from the site of practice and from the providers of nursing care. However, scholars have increasingly questioned the relevance of these context-free data (Holloway & Wheeler, 2002;Rolfe, 1998) noting that expert practice involves making decisions within a particular context requiring knowledge of not only external evidence but also of "contextual and idiosyncratic" internal evidence (Avis & Freshwater, 2006, p. 223 ...
... Background Scully (2011) indicates that despite the differing interpretations of the nature of the theory-practice gap, there is widespread agreement that it represents the separation of the practical dimension of nursing from that of theoretical knowledge (Rolfe 1998(Rolfe , 2002. During the process of completing this concept analysis it was possible, in the absence of any other given definition, to create and emergent definition of the theory-practice gap as: ...
In nursing literature, the phrase 'theory-practice gap' is widely used without common definition or description of its underlying concept. This review paper presents a concept analysis using Rodgers (2000) evolutionary process to define and clarify the concept of the theory-practice gap as part of a doctoral study. In so doing it provides a deeper understanding of the concept to enable its consistent application within nurse education. A theoretical definition is developed, the data search that was undertaken is described and a discussion of the attributes, antecedents and consequences is provided. We conclude by offering, a model case, which is employed to illustrate the concept.
... All rights reserved. discussion papers in JAN over the past 24 years (Rolfe 1994(Rolfe , 1996(Rolfe , 1997(Rolfe , 1998(Rolfe , 2006, which have between them been cited over 400 times and which have provoked several published responses and debates. I would like to think that these papers have had some, albeit small, influence on nursing practice and research, and it is unfortunate that papers of this type will no longer be accepted by JAN. ...
In a keynote presentation to the RCN Research Conference in 2016, I raised concerns about the gradual shift over the past 40 years in the content of papers published in JAN (Rolfe 2016). In 1976, research reports made up roughly 10% of the journal. By 2007, 91% of published papers were either research reports, systematic reviews or methodology papers. Alison Tierney, the editor at the time, defended this growing emphasis on research by suggesting that it reflected the current trend in nursing. She pointed out that JAN did at least still publish non‐research papers and claimed that ‘JAN's continuing commitment to publish scholarly work is one of its distinguishing hallmarks’ (Tierney 2007).
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... The perception of a theory practice gap is a long standing point of discussion in nursing and midwifery education (Rolfe, 1998;Landers, 2000;Corlett, 2000) with a constant narrative pointing to the difference between what students learn in pre-registration programmes and the actualities of practice (Gardiner and Sheen, 2016). Despite development in education in recent years, with a move toward graduate preregistration education in many countries, these concerns have persisted and some would argue have become more pronounced (Allan et al., 2011). ...
Literature points to a gap which exists in the preparedness of new nursing/midwifery graduates for clinical practice. In Ireland, a two year programme was established in 2013 for all new graduates employed by the public health system. This paper provides a report on the evaluation of the programme which aimed to gauge the impact of the programme on student experience, stakeholder opinion and on health service delivery. A mixed methods approach, combining qualitative and quantitative methodologies, was utilised. Students who undertook the programme, along with non-student stakeholders, were invited to participate. The quantitative element involved an online evaluation survey which was administered to all students participating in the programme, while the qualitative element involved interviews with the participants. Students believed the programme to be relevant to their practice and positively evaluated the use of blended learning, the support of tutors and the contribution to their professional development. Non-student stakeholders also positively evaluated the programme, but the direct impact on clinical practice was not particularly evident. The evaluation offers a positive view of this initiative and broadly supports the concept of early graduate education programmes. A number of recommendations are offered for the development of future programmes.
... Yanow, 2000), and much of what is most meaningful for those working with the BR concept is omitted from the analysis (e.g. Rolfe, 1998). Consequently, empiricist researchon its ownmay actually reproduce rather than close the perceived gap between theory and practice. ...
Learning is considered a means to achieve sustainability in practice and has become a prominent goal of sustainability interventions. In this paper we explore how learning for sustainability is shaped by meaning, interpretation and experience, in the context of UNESCO Biosphere Reserves (BRs). The World Network of Biosphere Reserves brings environmental conservation, socioeconomic development and research together in 'learning sites for sustainable development.' The World Network is globally significant, with 669 BRs in 120 countries, but as with many paradigmatic sustainability interventions BRs are perceived to suffer from a 'concept-reality gap.' We explore this gap from an interpretive perspective, focusing on participant interpretations of the meaning of BRs and their experiences of working with the concept-with the aim of painting a richer picture of learning for sustainability and the ways in which BRs might fulfil their role as learning sites. We provide a cross-case analysis of learning in 11 BRs around the world, drawing on interviews with 177 participants, and ask: How is the BR concept interpreted and enacted by people involved with BR work? What learning emerges through BR work, as described by those involved? We find that the BR concept is interpreted differently in each location, producing distinct expectations, practices and institutional designs. Learning occurs around common themes-human-environment relationships, actors and governance arrangements, and skills to navigate BR work-but is expressed very differently in each BR. The position of BRs 'in between' social, ecological and economic goals; local places and global networks; and government, private and civil society sectors, provides a valuable space for participants to learn to live with social-ecological complexity. We discuss our results in terms of their contribution to three pressing concerns in sustainability science: (i) power and politics in learning for sustainability, (ii) intermediaries and bridging organizations in multi-level governance, and (iii) reflexivity and knowledge-action relationships. Our comparative hermeneutic approach makes a novel methodological contribution to interpretive studies of sustainability policy and governance.
... EBL has been championed as an example of a model that supports student praxis, helping to create competent practitioners through the use of authentic learning scenarios that help to bridge the theory/ practice divide (Rolfe, 1998). ...
Midwifery training in Ireland moved to Higher Education in 2006. This shift established a physical and educational separation of theory and practice. The adoption of Enquiry Based Learning (EBL) by one Irish midwifery education institution attempted to address this division. Enquiry Based Learning (EBL) has the potential to develop student reflexivity and evidence assimilation across the career-span and may therefore enhance student praxis. EBL has been championed as an example of an educational model that supports praxis, helping to create competent practitioners through the use of authentic learning scenarios that address the theory practice divide. The current research study represents the first formal evaluation of EBL in undergraduate midwifery education in the South of Ireland. The study was a mixed-methods design that utilised focus groups, interviews and survey to ascertain the opinions of first exposure to EBL amongst a cohort of first year student midwives. Findings demonstrate the value of EBL in enhancing student midwife praxis.
... Failing to acknowledge distinctions between academic and practical forms of knowledge has led to a largely misconceived gap between research and practice and attempts to make academic knowledge or theory more practical, rather than focusing on development of practical forms of knowledge [83]. That is, reducing carbon emissions cannot be taught only through abstract knowledge like a powerpoint presentation: a learner also has to learn from doing it in practice [84,85]. ...
The most critical question for climate research is no longer about the problem, but about how to facilitate the transformative changes necessary to avoid catastrophic climate-induced change. Addressing this question, however, will require massive upscaling of research that can rapidly enhance learning about transformations. Ten essentials for guiding action-oriented transformation and energy research are therefore presented, framed in relation to second-order science. They include: (1) Focus on transformations to low-carbon, resilient living; (2) Focus on solution processes; (3) Focus on 'how to' practical knowledge; (4) Approach research as occurring from within the system being intervened; (5) Work with normative aspects; (6) Seek to transcend current thinking; (7) Take a multi-faceted approach to understand and shape change; (8) Acknowledge the value of alternative roles of researchers; (9) Encourage second-order experimentation; and (10) Be reflexive. Joint application of the essentials would create highly adaptive, reflexive, collaborative and impact-oriented research able to enhance capacity to respond to the climate challenge. At present, however, the practice of such approaches is limited and constrained by dominance of other approaches. For wider transformations to low carbon living and energy systems to occur, transformations will therefore also be needed in the way in which knowledge is produced and used.
... Permanent cognitive conflict between theory and practice can lead to the development of insecure identities. The self-awareness of students' own professional respect is still vague and attenuated early in their placements, liable to be detrimental to the nursing profession by remaining subordinate in practice and perpetuating the chasm between theory and practice (Rolfe, 1998). In Italy, the basis of registration for nurses has been a compulsory three-year university degree since 2001 and there has been a marked increase in the professional qualifications of nurses since then. ...
... In respect of the dimension of this gap, it is generally considered that larger the gap greater the problem towards effective application of theory in practical context. On the contrary, there are those who consider that the gap between theory and practice is inevitable (Lindsay, 1990;McLeod, 1996;Rolfe, 1998). Periodic meeting are conducted among teachers and teaching hospital staff nurses for good collaboration to solve various problems impacting the total patient care and theorypractice gap being one of the main issue. ...
... These kinds of knowledge are embodied and often difficult to articulate (Boiral, 2002), but are essential for working with the specificities and complexities (e.g. technical constraints, politics, local context, windows of opportunity) and ethical issues involved in facilitating change (Rolfe, 1998). Developing such knowledge and accelerating learning about doing transformation will require greater engagement of researchers and other stakeholders in learning from doing change and with the messy, ill-defined and context specific world of practice (Ison, 2010), and through iterative approaches that develop, design, and test diverse practices and processes aimed at facilitating change. ...
The concept of transformation in relation to climate and other global change is increasingly receiving attention. The concept provides important opportunities to help examine how rapid and fundamental change to address contemporary global challenges can be facilitated. This paper contributes to discussions about transformation by providing a social science, arts and humanities perspective to open up discussion and set out a research agenda about what it means to transform and the dimensions, limitations and possibilities for transformation. Key focal areas include: (1) change theories; (2) knowing whether transformation has occurred or is occurring; (3) knowledge production and use; (4) governance; (5) how dimensions of social justice inform transformation; (6) the limits of human nature; (7) the role of the utopian impulse; (8) working with the present to create new futures; and (9) human consciousness. In addition to presenting a set of research questions around these themes the paper highlights that much deeper engagement with complex social processes is required; that there are vast opportunities for social science, humanities and the arts to engage more directly with the climate challenge; that there is a need for a massive upscaling of efforts to understand and shape desired forms of change; and that, in addition to helping answer important questions about how to facilitate change, a key role of the social sciences, humanities and the arts in addressing climate change is to critique current societal patterns and to open up new thinking. Through such critique and by being more explicit about what is meant by transformation, greater opportunities will be provided for opening up a dialogue about change, possible futures and about what it means to re-shape the way in which people live.
... The participants quickly realized that there was a difference between what they had learned theoretically and how they thought practice would be and what it actually was. While the notion of a theory-practice gap in nursing has long been recognized (see, for example, Rolfe, 1998), this was accentuated for the participants by virtue of their gender. They encountered the real situation of nursing only after entering clinical practice as an independent staff nurse. ...
The aim of this study was to explore the process of Iranian male nurses’ professional socialization and how they negotiate a gendered identity. A purposive sample of 22 male nurses was recruited from six public hospitals affiliated to Tabriz University of Medical Sciences, Tabriz, Iran. Study data were collected by conducting semi-structured interviews. Data collection was continued until reaching data saturation. Totally, 25 interviews were conducted. Data analysis was carried out using Corbin and Strauss’s techniques for qualitative data analysis. The core category of the study, that is, the socialization process of male nurses who participated in the study, was “maintaining equilibrium.” Our participants’ strategies for socialization included informing, conforming, and self-establishing. The study findings can be used for developing effective strategies for male staff recruitment and retention.
The process and importance of Knowledge Translation (KT) for the field of rehabilitation counseling is described. One element of the KT process, systematic reviews of the literature, is described along with several strategies for grading evidence. Practicing clinicians, as do consumers, encounter a number of barriers to using primary source research. Rehabilitation counselors need access to the best evidence available to inform their clinical practice. Consumers of rehabilitation counseling services require high quality accessible information about evidence to support their informed decision making about participating in rehabilitation programs.
Effective knowledge management (KM) practices if applied effectively are crucial elements to enhance nursing education. The study’s main objective is to utilize bibliometric analysis to propose a targeted KM practice relevant to the College of Nursing at Tobruk University. The outcome is expected to help develop an adaptable KM initiative for the College and enhance the current practices. Bibliometric analysis was employed in the study to explore a comprehensive literature review on KM in nursing education. Lens database was used to identify relevant publications using a search string and applying selection criteria for filtering in the data extraction process. Date of publication from 2014 up to the present and document types like journal articles, conference proceedings, books, and book chapters are the major inclusion criteria. Presentation of results included the growth of literature, citation analysis, top institution and country contributors, and visualization of co-occurring keywords using VOSviewer. Network, overlay, and density map visualization revealed that the type of research particular to the field is qualitative using surveys and questionnaires. In practice, delivery of health care, KM, leadership, cooperative behavior, attitude, knowledge, and practice of health personnel are among the recurring themes. The focus on humans, gender, and age are also of great consideration. The analysis revealed global trends and knowledge gaps in KM practices within nursing education. The result of the study provided initial and valuable insights for the development of KM strategies at TU’s CON and a guiding factor for eventual implementation.
The need to experience life as meaningful is fundamental to human nature. Recent years have witnessed a growing sophistication in assessing meaning in life (MIL) and new conceptualizations regarding its place within general models of well-being and coping. As part of this surge in research, increased attention has been given to the understanding, assessment, and practice of MIL in numerous arenas and contexts. However, despite these advancements, further knowledge is needed to explore the application of meaning interventions across more diverse contexts and non-clinical populations in the general community. The purpose of the present paper is to expand the existing knowledge on meaning-oriented interventions by introducing a community-based initiative that is directly responsive to this need. This includes describing its approach to meaning-making on multiple fronts: (1) Socratic Questions in the Public Sphere; (2) the Tribe Intergenerational Life Stories Project; (3) Literature, Arts, and Museums as Meaning-Making Sites; and (4) Education for Meaning. Each of these initiatives is described to propose more context-sensitive interventions that are applicable to everyday life in general society.
A justificação da análise das teses de doutoramento em enfermagem em Portugal com a finalidade de identificar os seus objetos de estudo e facilitar a reflexão, foi o tempo já decorrido desde o início da oferta desta qualificação. Partiu-se do conceito de cuidados de enfermagem inspirado em Meleis (2010) e de uma matriz formada por dois eixos - transições ao longo da vida e dimensões do cuidar. Foram analisados 60 resumos de teses de um total de 64, finalizadas entre 2002 e 2011, utilizando um desenho de estudo descritivo, com recurso à análise estatística para caracterizar as teses e à análise do discurso para identificar os conceitos centrais, os fenómenos estudados, os resultados e sugestões e a reflexão sobre os contributos das teses para a disciplina e prática de cuidados por um grupo focal, constituído por enfermeiros. O paradigma de investigação preferido foi o indutivo (55,0%) para abordar várias áreas temáticas, sendo a mais frequente a clínica (75%). Os métodos utilizados são variados sendo a “grounded theory” e a descrição interpretativa os mais escolhidos. As categorias com maior frequência em que foram agrupados os conceitos centrais são “transição”, “relação enfermeiro-cliente” e “intervenções de enfermagem”. Os fenómenos foram categorizados como: funcionalidade corporal/autocuidado nas pessoas em transição, estilos de vida e ambiente físico/social/terapêutico nas pessoas em transição, prevenção de doenças/incapacidades nas pessoas/grupos/comunidades em transição e tratamento de situações agudas e crónicas das pessoas em transição. Os resultados dos estudos confirmaram a eficácia dos cuidados para o bem-estar do cliente, para a díade cliente-enfermeiro. A principal conclusão do estudo, para além de fornecer a caracterização das teses realizadas em Portugal, é a possibilidade de utilizar o enquadramento conceptual selecionado para analisar a investigação em enfermagem, considerando-o numa fase inicial.
Action research allows teachers to evaluate and gain insight into their own practices in their teaching contexts through reflection, and inquire into ways to improve their practices and student learning outcomes. This study is a reflective self-inquiry in which the research team engages in a deliberate and retrospective analysis of the principal investigator’s teaching practices. The purpose is to identify possible factors that cause the low performance of non-major “English as a Foreign Language” students in her university English classes and propose alternative instructional practices and evaluative measures to manage their learning problems.
The practice of reference and information service (RIS) should be based on an understanding of how users seek information to fill information needs and of what they do with that information once they have found it. RIS professional education, therefore, should provide students with a strong grounding in information behavior. This study explores if and how information behavior theories and models are integrated into basic RIS courses in North American Master’s programs, building on the results of a previous syllabus study. Interviews with sixteen instructors, including full-time and adjunct faculty, revealed a range of opinions about the importance of information behavior theories and models in RIS coursework, as well as student receptivity to theories and models. The insights of the instructors and the rich detail provided by the interview method help to contextualize previous studies about information behavior content in RIS professional education.
A strong evidence base is optimal to provide the best possible interventions for health-related, practice-based professions, which is relevant to addressing cancer-related fatigue. This chapter puts forward the case for gathering credible research evidence that is assessed critically and then disseminated to relevant audiences. The concepts of clinical effectiveness, evidence-based practice, dissemination and utilisation of research are all covered here. The chapter includes a systematic review of dissemination strategies that was undertaken to identify the most suitable ways to spread the knowledge surrounding the benefits of physical exercise for women who have breast cancer. The systematic review process is presented step by step and is intended to be used as a template for readers to conduct their own systematic reviews of practice-based interventions. The review concludes that providing practitioners with valid, reliable, and ultimately ‘useful’ research evidence to inform clinical practice is a highly complex undertaking. In addition, it was determined that written materials such as information packs and booklets are associated with improvements in specific, topical knowledge and have the potential to impact reported practice; educational methods often combine several types of educational interventions with practical applications and also that a collaborative and facilitative approach is preferred; however, there are insufficient data about how this is optimally achieved.
This chapter focuses on the importance of the evidence-based movement in the field of mental distress. In so doing, the chapter takes a critical stance on what constitutes evidence in informing our understanding of mental distress and questions the superiority hierarchies that have been created in the field of medicine. It is acknowledged that within the rhetoric of evidence, randomised controlled trials tend to be in a privileged position in all areas of health.
When we, as individual practitioners, provide care to individual patients, we do this on the basis of our knowledge and previous experience; as we gain increased knowledge and/or experience the way in which that care is provided may be modified — as, indeed, it should be. While this is undoubtedly the case, and results in enhanced patient care, it also raises many questions such as how we decide what to do in individual cases or why we vary the care delivered to different patients experiencing the same (or similar) symptoms or suffering from the same condition. Do we use ‘traditional’ methods of care ‘handed down’ to us by those who have gone before? Do we base our approach on ‘trial and error’ or do we truly make our decisions on the basis of knowledge gleaned from scientific enquiry? In other words, do we use evidence to underpin our care delivery or take active steps to ‘advance’ (or change) practice? It can be argued that the focus of an advanced practitioner is to do just that.
Hintergrund und Zielsetzung
Die Anwendung von Forschungsergebnissen in der pflegerischen Praxis soll die Basis des Handelns von Pflegepersonen bilden. Forschungsergebnisse zeigen, dass die Verwendung von fundiertem Wissen die Qualität der Versorgung von Patient/-innen verbessert (Grol 2013, Kajermo et al 2008). Für DGKS/P in Österreich besteht die gesetzliche Verpflichtung (GuKG 97, §4(1)) auf dem neuesten Stand der Wissenschaft zu arbeiten und die PatientInnen haben das Anrecht auf eine Versorgung auf dem aktuellen Stand der Wissenschaft (Gesundheitsqualitätsgesetz §3 (1)).
Diese Studie verfolgte das Ziel eine repräsentative Datengrundlage zur Einstellung von Pflegepersonen bzgl. Forschungsanwendung, sowie hinderliche und förderliche Faktoren zu erheben.
Methoden
Zur Bearbeitung des Themas wurde im Jahr 2015/16 eine multizentrische (n=6) deskriptive Querschnittsstudie durchgeführt. Die Pflegepersonen wurden mittels modifiziertem Fragebogen von Breimaier et al (2011) online über die Plattform „SoSciSurvey“ befragt.
Ergebnisse
758 Teilnehmer/-innen beendeten die Befragung. Die Ergebnisse zeigten, dass Pflegepersonen in Österreich positiv gegenüber Forschungsanwendung eingestellt sind, wobei akademisch gebildete Pflegekräfte eine deutlich positivere Einstellung haben. So sehen 88,2 % (n= 99) der DGKS/P mit akademischer Ausbildung Forschung als relevant für die Krankenpflegepraxis an, während dies nur 69,4 % (n= 404) ohne akademischen Abschluss tun.
Die Implementierung von Forschungsergebnissen in die Pflegepraxis ist weiterhin sehr gering, denn nur 13,1 % (n= 110) wenden häufig bis durchgehend aktuelles Wissen an. Auch hier zeigten sich deutliche Unterschiede. So wenden 30 % (n= 44) der DGKS/P mit akademischem Abschluss häufig bis durchgehend Forschungsergebnisse an, jedoch nur 9,4 % (n= 65) der DGKS/P ohne akademischer Ausbildung.
Als hinderlichster Faktor zur Anwendung von Forschungsergebnissen wurde fehlende Zeit (75,6 %), als förderlichster die Unterstützung durch die Führungsebene (62,8 %) empfunden. Die Studie zeigte des Weiteren, dass die Pflegewissenschaft noch Wahrnehmungsprobleme an der Basis hat. So wurden Psychologie und Medizin von den TeilnehmerInnen ohne akademischen Abschluss deutlich relevanter für ihr Handeln eingestuft, als Pflegewissenschaft.
Diskussion und Ausblick
Studien aus dem deutschsprachigen Raum (Breimaier et al, 2011, Köpke et al, 2013, Gallistl, 2016) zeigen, dass hierorts deutlich seltener Forschungsergebnisse in die Pflegepraxis implementiert werden als im internationalen Vergleich (Parahoo, 1998, Veeramah 2004). Die geringe Anwendungsrate spiegelt sich zudem in der Tatsache wider, dass nur 11 % der Teilnehmer/-innen der Meinung sind, dass ihre Kolleg/-innen ausreichend über Forschungsergebnisse informiert sind. Die Teilnehmer/-innen zeigten jedoch großes Interesse an spezifischen Fortbildungsthemen wie „Schmerz“, „Dekubitus“, etc. Zudem erkennt die Mehrheit der Befragten die Relevanz von Forschungsthemen in der Ausbildung zur Pflegeperson (vgl. Gallistl, 2016).
Pflegekräfte sind aufgefordert die gesetzlichen Bestimmungen zur Anwendung von Forschungswissen umzusetzen und die beschäftigenden Organisationen müssen die nötigen Rahmenbedingungen (zeitlich, personell, finanziell, Zugang und Aufbereitung von Forschungsergebnissen) dafür schaffen.
Examined the feasibility of conducting large-scale collaborative research projects in psychotherapy by: (a) an analysis of existing empirical literature, (b) formulation of research designs that appeared promising, and (c) visiting scholars and research centers to sample opinions and test motivations for conducting such studies. It is concluded that the expectable returns from any of the large-scale, multifactorial projects thus far proposed do not justify the large investment of manpower and funds that would be required. On the basis of the literature review and interviews with prominent researchers, it is suggested that promising directions for therapy research include: (a) focusing on the mechanisms of change via experimental case studies, (b) avoiding further investment in process and outcome studies of traditional therapy, and (c) building new techniques rather than testing old ones. (19 ref.) (PsycINFO Database Record (c) 2012 APA, all rights reserved)
We predicted that the closer the resemblance of attempted suicide to completed suicide, the greater the risk of patients later killing themselves after an unsuccessful attempt. Using two risk scales, one of 6 and the other of 18 socio-demographic and clinical items, weighted according to their value in discriminating between suicides and attempted suicides, and a rating of intent to die during the index suicide attempt, we followed up 1263 attempted suicides for two years. Ten of the twelve suicidal deaths in the first year occurred in patients scoring in the top quartile on the 6-item scale; and among high-risk scorers there was an excess of those defined as 'failed suicides' at the index attempt. The 18-item scale was superior to the shorter one, but both scales were improved by taking into account the rating of intent-to-die. The potential value of these findings is discussed in the light of some inherent problems of predicting suicide in the clinical setting.
Many practice-based researchers have expert knowledge of doing research but often experience difficulties when writing it up and communicating the significance of what they have done. This book aims to help bridge the gap. Packed with practical advice and strong theoretical resources it takes you through the basics of designing and producing your text so that it will meet established standards and high quality assurance expectations. Divided into 3 distinctive parts, key points include: Understanding writing practices Engaging with the literatures How to write up a project report or dissertation How writing is judged in terms of professional and academic writing practices Developing ideas for further study and publication Writing up Your Action Research Project is an essential text for practitioners on professional education and undergraduate courses across disciplines who want their writing to reflect the excellence of their research. It is the ideal companion to the author's You and Your Action Research Project,now in its fourth edition.
A grounded theory method was used to study nurses' clinical decision making. Field notes, in-depth interviews, and documents were analyzed. The beginning process model contained the core concept, knowing the patient, a purposeful action whereby the nurse uses understanding of the patient's experiences, behaviors, feelings, and/or perceptions to select individualized interventions. Familiarity and intimacy were the properties of the core process; the patient-nurse interaction was the context. Three conditions included time, the nurse's experience, and other nurses' input. Four strategies facilitated the core process: empathizing, matching a pattern, developing a bigger picture, and balancing preferences with difficulties. Different strategies were used, as time and familiarity with the patient varied.
There are few explicit discussions in nursing literature of how qualitative research can be made as rigorous as it is relevant to the perspective and goals of nursing. Four factors complicate the debate about the scientific merits of qualitative research: the varieties of qualitative methods, the lack of clear boundaries between quantitative and qualitative research, the tendency to evaluate qualitative research against conventional scientific criteria of rigor, and the artistic features of qualitative inquiry. A framework for understanding the similarities and differences in research approaches and a summary of strategies to achieve rigor in qualitative research are presented.
Developmental and child psychology remains a vital area in modern psychology. This comprehensive set covers a broad spectrum of developmenal issues, from the psychology of the infant, the family, abilities and disabilities, children's art, imagination, play, speech, mental development, perception, intelligence, mental health and education. In looking at areas which continue to be very important today, these volumes provide a fascinating look at how approaches and attitudes to children have changed over the years. The set includes nine volumes by key development psychologist Jean Piaget, as well as titles by Charlotte Buhler and Susan Isaacs.
It is widely believed that case studies are useful in the study of human affairs because they are down-to-earth and attention-holding but that they are not a suitable basis for generalization. In this paper, I claim that case studies will often be the preferred method of research because they may be epistemologically in harmony with the reader’s experience and thus to that person a natural basis for generalization.
"Reinforcement may be contingent, not only on the occurrence of a response, but on special features of its topography, on the presence of prior stimuli, and on scheduling systems. Operant techniques are important in defining the behavioral effects of physiological variables—surgical, electrical, and chemical—in specifying what aspects of behavior are to be attributed to hereditary endowment, in tracing features of mature behavior to early environment, and so on. They are important in clarifying the nature of defective, retarded, or psychotic behavior." Within the field of human behavior "the contingencies of reinforcement which define operant behavior are widespread if not ubiquitous. In its very brief history, the study of operant behavior has clarified the nature of the relation between behavior and its consequences and has devised techniques which apply the methods of the natural science to its investigation." (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A 10-year follow-up is presented of 484 patients who made serious suicide attempts. Of this group 23% had died, 9% from natural causes, 3% from accidents or from uncertain causes, and 11% from suicide. Suicide frequency is highest in the period immediately after the suicide attempt. Especially interesting is the distribution according to sex. During the first 5 years there is a preponderance of male suicides (which is in agreement with the findings of other investigators), but after 10 years this difference in sex disappears. Suicides are found especially among men from 50 to 60 years of age, disabled pensioners, and persons who have attempted suicide several times, and to a lesser degree among persons living alone and criminals.
Despite considerable top-down pressure on nurses to undertake research, the available evidence suggests that relatively few nursing studies are submitted for publication Given the need to increase the degree to which research informs practice, this shortfall in output must of necessity constitute a cause for concern Therefore, it seems timely that a full-scale investigation into the possible reasons for non-submission is conducted This study, therefore, in an attempt to meet this aim, used factor analysis on the scores from an attitude-to-research scale completed by 230 nurses The results suggested that five coherent factors underpinned the sample's general attitudes to research These were labelled ‘nurses’ subjective barriers to research’, ‘organizational/structural barriers to research’, ‘doctors’ reactions to Nursing Research’, ‘health care professionals’ reactions to research’ and ‘impact of Nursing Research’ The variables clustering on two of these factors suggested a predictive relationship with two relevant outcome behaviours relating to research When this was tested, the predictions were supported, indicating that these factors could be used as a quick and simple screening tool to highlight individuals or groups of nurses who might benefit maximally from specific attitude change programmes In this way, it might be possible to increase Nursing Research activities and output
Features include the selection and sampling of cases, the problems of access, observation and interviewing, recording and filing data, and the process of data analysis.
The reflection that accompanies the evidence a candidate presents in the performance-based product is a critical part of the candidate's development. Through reflection the candidate begins the ongoing process of blending the art and science of good teaching practice. Reflection requires thoughtful and careful reporting and analysis of teaching practice, philosophy, and experience. Understanding why an activity or practice was productive or nonproductive in the classroom is a key element in the progression from novice to master teacher. The reflection cycle and the guiding questions included in this packet are designed to assist licensure candidates in the reflection process. They will enable candidates to better understand the reflection process and address the question; "How does this piece of evidence demonstrate my knowledge and skill level in this activity?". The following reflection cycle offers a prescriptive structure while allowing the flexibility necessary for candidates to demonstrate their knowledge, skill, and ability in the unique context of their area and environment. The reflections of the novice teacher are also vital to the assessors charged with the responsibility for judging whether the teacher has met the required level of performance for each standard based activity. Through their responses to the guiding questions, candidates will better be able to put evidence into perspective for the review team members by explaining how the evidence or artifact addresses the standard through the activity.
This study examined the relationship between methods of disseminating research findings and their subsequent utilisation. Results indicated that registered nurses with access to a summary of research findings were more likely to consider putting them into practice than their colleagues with no access to the research.
Kurt Lewin, the originator of action research, proposed that it was valuable not only for innovating change, but also the process of change could lead to new insights into the nature of the problem that was being tackled. This action research project developed and evaluated a teaching model that aimed to help RGN (registered general nurse) students to bridge the theory-practice gap. During the course of this work, the possible reasons for a theory-practice gap started to become clear. This paper provides a discussion of these factors. The viewpoint for this discussion is that of the student nurse. The student is assumed to 'own' the problem and it is from her perspective that the theory-practice gap is analysed. The paper includes a critical examination of books, lectures, the school curriculum and ward nursing practice. Finally, possible solutions to the theory-practice problem are discussed and it is hoped that these will provide a rational basis for tackling the problem.
There are few explicit discussions in nursing literature of how qualitative research can be made as rigorous as it is relevant to the perspective and goals of nursing. Four factors complicate the debate about the scientific merits of qualitative research: the varieties of qualitative methods, the lack of clear boundaries between quantitative and qualitative research, the tendency to evaluate qualitative research against conventional scientific criteria of rigor, and the artistic features of qualitative inquiry. A framework for understanding the similarities and differences in research approaches and a summary of strategies to achieve rigor in qualitative research are presented.
A grounded theory method was used to study nurses' clinical decision making. Field notes, in-depth interviews, and documents were analyzed. The beginning process model contained the core concept, knowing the patient, a purposeful action whereby the nurse uses understanding of the patient's experiences, behaviors, feelings, and/or perceptions to select individualized interventions. Familiarity and intimacy were the properties of the core process; the patient-nurse interaction was the context. Three conditions included time, the nurse's experience, and other nurses' input. Four strategies facilitated the core process: empathizing, matching a pattern, developing a bigger picture, and balancing preferences with difficulties. Different strategies were used, as time and familiarity with the patient varied.
Editor's note
. We invited Dr Peplau to provide a personal reflection on the recent history of psychiatric nursing and her thoughts on immediate challenges facing the profession. The paper is an individual scholar's commentary on the way that psychiatry has waxed and waned over the years, in relation to nursing. This historical review discovers and reports a challenge to current practice. Dr Peplau describes a professional shift that is pulling nurses toward the subordinate role observed earlier this century. The paper draws attention to how contemporary practice can be positively influenced, e.g., by giving a structure to the allocation and conduct of nurse–patient time.
The aim of this paper is to show the way in which the decision trail of a qualitative research process can be maintained. It is argued that the trustworthiness (rigour) of a study may be established if the reader is able to audit the events, influences and actions of the researcher. The actual study containing the recording of this decision trail aimed to express the concerns of older patients who were admitted to the acute care sector. The study took place in two care of the elderly wards in a 1000-bed National Health Service hospital in the UK, in 1991. Eventually, 14 patients were interviewed, each on several occasions, and their concerns are expressed in themes, namely: routine geriatric style of care, depersonalization, care deprivation and geriatric segregation. I describe the preparations that were undertaken before patient interviews could commence. The literature recording the process of the interviewer's experience as data in qualitative research is scarce. I show the researcher's participation in making the data as part of an existential phenomenological research process. Existential phenomenology relies on recording influences while generating data such as significant literature, media reports, my value position and journal data.
Reflective practice has emerged in the U.K. and beyond as an important issue not just in nursing but in many other professions. However, it remains problematic; it is difficult to conceptualize and many aspects of it are open to debate. Reflective practice is also contentious because, at a fundamental level, it raises a number of important issues for professional practitioners and the way they view their practice. The intention of this paper is to: explore some of the issues that have emerged as the profession of nursing and other professions have gained a better understanding of reflective practice; broaden the scope of the debate and refocus it; raise issues which are in need of further research.
This paper is concerned with the interrelationships between the three concepts of theory, research and practice. In the course of discussing the interrelationships between these concepts, research is identified as the link between theory and practice on both a formal (explicit) and informal (tacit) level. The role of formal and informal research in the development of nursing expertise is also given some consideration.
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