The South African Military Health Service (SAMHS) Nursing College offers a four-year integrated nursing programme leading to registration as a professional nurse at the South African Nursing Council (SANC). Student nurses assume a dual role when entering the SAMHS to commence with nurse training – that of a soldier and a nurse. Because student nurses have to assume dual roles, hidden aspects of military culture may influence the professional socialisation of student nurses in one way or another. With a view to determining whether the military environment does indeed impose any influence on student nurses’ professional socialisation, this study set out to explore the multifaceted context in which these students find themselves. Given the organisational and locational complexity of the SAMHS Nursing College, its campuses and the three military hospitals in South Africa, the population was narrowed down to an accessible target population comprising nurse educators and student nurses of the SAMHS Nursing College (Main Campus). Included in the two samples were nurse educators at the SAMHS Nursing College who had at least three years’ experience as nurse educators and who were registered with the SANC as nurse educators, and student nurses registered at the SANC for the fouryear Integrated Nursing Programme and who were in their fourth year of training. A qualitative constructivist grounded theory study was conducted based on the researcher’s philosophical assumptions. The researcher made use of focus groups and critical-incident narratives to collect data. In keeping with the constructivist paradigm adopted for this study, Charmaz’s (2014) data-analysis approach was followed. Concepts derived from the qualitative data were used to develop a substantive model to create an awareness of the existence of a hidden curriculum, to guide role players through the impact of the hidden curriculum on students’ professional socialisation and to help them to understand how their contribution could improve the outcome of the professional socialisation process / Health Studies / D. Litt. et Phil. (Health studies)

An increase in reports of undesirable professional behaviour in the nursing profession has prompted the question: How could the internalisation of skills, knowledge, values and beliefs be guided in student nurses to help them become effectively socialised as professional nurses? Using a sequential exploratory mixed-methods approach, the study addressed the above question. The researcher used focus-group interviews and field notes to explore and describe the perceptions of professional nurses and experiences of student nurses regarding the professional socialisation of students. The data generated from these findings were further used to determine and describe educators’ (N=128) perceptions on their teaching and facilitation of professional socialisation of students, using a self-administered questionnaire. The findings of both the qualitative and quantitative data were integrated to develop and validate guidelines to support educators and professional nurses in the professional socialisation of students. To establish rigour, the researcher applied measures of trustworthiness and performed validity and reliability tests. The qualitative data were analysed by utilising Tesch’s method of data analysis. The themes that emerged as influential in the professional socialisation of students were related to the professional nurse as role model, clinical supervisor, the educator, clinical learning environment, values and beliefs of the nursing profession and cultural and gender orientations. The quantitative data were analysed using descriptive and inferential statistics. Educators’ teaching and facilitation strategies revealed that the educator as a role model, the clinical environment, teaching approaches and cultural awareness were important social determinants in the professional socialisation of students. The qualitative and quantitative data were integrated to develop guidelines that were validated by field and guideline experts. The guidelines for educators and professional nurses addressed issues such as the professional nurse as role model and clinical supervisor, the creation of a positive clinical learning environment, the educator as role model, the teaching and support of students, the work ethic of the professional nurse and educator, the students’ behaviour and cultural awareness. These guidelines propose recommendations for educators and professional nurses to support the professional socialisation of students. / Health Studies / D. Litt. et Phil. (Health Studies)

The literature concerning what medical students learn from midwives during specialist obstetric rotations is scarce. In the UK, despite a long tradition of providing midwifery attachments for medical students, it is almost non-existent. Working with midwives is arguably the only opportunity medical students have to experience holistic or social models of maternity care, focusing on normality rather than on the medical concept of risk. This study sought to discover how medical students constructed their knowledge about childbirth during a six week specialist rotation in obstetrics in a Northern English teaching hospital (NETH), with particular emphasis on whether participants assimilated any concepts from midwifery knowledge (MK). A Delphi Study, done as the first phase of the research, focused on MK, utilizing an international sample of experienced midwives. Resulting themes were used to develop the data collection tool for the second phase of the research. The research employed a qualitative case study method with students from a single year cohort comprising the case. Data were collected using a tool consisting of three problem based learning (PBL) scenarios. These were presented to the students in consecutive interviews at the beginning, the middle and the end of their obstetric rotation. Following analysis, five main themes were identified which illuminated the medical students' construction of knowledge about maternity care. These were explored and discussed. The thesis concludes with recommendations for increasing opportunities for IPE in the medical and midwifery curricula.

Cette thèse analyse la confrontation entre les réformes postales inspirées du nouveau management public, cristallisées dans la politique de rationalisation de l’activité de travail, et les pratiques professionnelles des salariés. Elle étudie les enjeux, les modalités et les limites de la définition normative du travail des conseillers financiers. Désignés par l’organisation comme des acteurs du changement, ces derniers doivent gérer la tension entre logique de marché et mission de service public, qui persiste à travers un double langage de La Poste. Sont ainsi mis en évidence des positionnements professionnels qui se construisent en décalage par rapport à la norme de référence du conseiller idéal portée par l’entreprise. Cette dernière mise donc sur ses jeunes recrues, supposées réceptives aux nouvelles logiques managériales. L’étude du processus de socialisation professionnelle de ces conseillers potentiels, inscrit dans les parcours individuels, permet d’interroger l’homogénéisation des pratiques et la persistance du modèle social postal. L’approche repose sur une comparaison territoriale (Méditerranée/Île-de-France) et générationnelle. La combinaison de plusieurs techniques d’investigation (observation participante au sein de la DRH de La Banque Postale, enquête longitudinale prospective par panel menée auprès d’apprentis conseillers financiers, monographie de bureaux de poste et exploitation de données statistiques) permet de croiser les parcours biographiques et les éléments structurels d’analyse des politiques d’emploi, de travail et de formation de La Poste. / This thesis analyses the confrontation between postal reforms inspired by the new public management, fulfilled in the rationalisation politics of the working activity, and employee professional practices. It studies the stakes, the modalities and the limits of the financial advisers normative work definition. Designated as change agents by the organisation, they must manage the dynamics between market logic and the public services mission which persists through a double language at La Poste. This puts into evidence the professional positioning that is constructed based on the referential norm of the ideal adviser portrayed by the organisation. The latest therefore counts on its young recruits, excepted to be receptive to the new managerial logics. The study of the socialisation process of its potential advisers, registered on individual career paths, allows questioning the homogenisation in the practices and persistence of the social postal model. The approach is based on a territorial comparison (Mediterranean/Parisian region) as well as generational. The combination of several investigation techniques (participative observation within the HR Direction at La Banque Postale, longitudinal panel survey conducted on financial adviser apprentices, monograph of post offices and exploitation of statistic data) allows crossing of biographical paths (personal and career) and the structural elements of employment politics analysis, work, and training at La Poste.