No description available.

No description available.

This study aims to measure the attitudes and beliefs toward hospitalised older adults that student nurses bring in to nurse education and to evaluate whether they change during professional socialisation. A number of previous studies have explored the attitudes of student nurses towards older people. However many of those studies have produced inconclusive results. Moreover dated attitudinal measures have been utilised to answer a broad range of questions relating to older people. This research attempts to address the deficits in previous research. Phase I of the study describes the qualitative approach in the form of six semistructured focus group interviews. Participants include trained nurses from the care of older adults areas <i>(n= 5 + 4)</i>;<i> </i>and from the acute clinical areas <i>(n= 4)</i>; nursing lecturers <i>(n = 6)</i> and student nurses <i>(n = 9+8)</i>. Data are subjected to interpretational analysis and ten themes are explicated. A systematic approach is used to identify intergroup commonalities which are then incorporated into an eighty item questionnaire. Phase II describes the quantitative approach in the form of a twenty item Likert questionnaire. Convenience sampling is utilised in the selection of subjects. 295 questionnaires were returned from a total of 388 (77% return rate) from trained nurses in the acute areas <i>(n= 62, 82%)</i>; from care of older adults areas <i>(n= 63, 69%)</i>; nursing lecturers from a school of nursing and midwifery <i>(n= 55, 93%)</i>; two cohorts of student nurses <i>(n= 64, 78% - 50, 63%)</i>. Comparative results demonstrate that there are significant intergroup differences. Both student cohorts appear the least positive whereas the lecturers and nurses who worked with older adults seem to be the most positive. The nurses who work in the acute areas seem to be significantly less positive when compared to the nurses who work with older people. The results indicate that nurses who spend most time with student nurses have less positive attitudes and beliefs than other groups. This may well have a detrimental effect on how student nurses view older people. Awareness of our attitudes and beliefs are crucial so that older adults receive the care they deserve. Thus the policy implications which arise from the research relate to the implementation of strategies to raise the awareness of biases against entering a career in nursing older people.

This thesis describes an exploration of the relationships between student nurse personal epistemologies and approaches to studying. It presents an argument for the inclusion of concepts from personal epistemology research into nurse education practice to improve both student-oriented teaching activities and student self-oriented metacognitive activities. Furthermore, this study adds to the evidence base for higher education practice and supports interventions to promote the development of students ~ who are aware of how their beliefs about knowledge affect their approaches to studying. The study is underpinned by Schommer's Independent Epistemological Belief System model and a conceptual framework derived from personal epistemology and learning styles literature. Personal epistemology (or beliefs about knowledge) has become of increasing interest to educational psychologists and is arguably a relevant area of study for nurse education to inform our understanding of how student nurses approach learning. Personal epistemology has been defined as; ... system[s] of personal or implicit beliefs about the nature of knowledge and learning as a context or set of assumptions within which their learning and thinking take place. (Paulsen & Wells 1998) An initial quantitative survey was followed by a qualitative constructivist grounded theory study using a sequential mixed-methods design for the purpose of complementarity and expansion of findings. This approach provided a contextualised description of student nurse personal epistemologies and an understanding of how they influenced the way the students approached studying and learning. A pilot study preceded the main study to enable an examination of the measure of personal epistemology (Epistemic Beliefs Inventory, Schraw et a12002) and to provide theoretical sensitivity for the grounded theory study. The quantitative component results from the main study were used to inform the semi-structured interviews in the grounded theory component of the study. The survey sample size was 197 respondents following the pilot study which had 283 responses. Ten students participated in interviews for the grounded theory study. The key findings indicate approaches to studying are mediated by epistemological beliefs, but cannot be separated from the social context in which studying occurs. The effects of beliefs were with regard to: How students perceived their ability to improve as learners; ? How quickly knowledge could be acquired; The medium and process through which that knowledge was obtained. In addition, results indicated sub-communities of students in the sample population held subtly different beliefs about knowledge and study approaches. Implications for nurse education practice are that epistemological beliefs play an important, yet subtle part in how students study and learn. Mechanisms for engagement in the form of activities to raise metacognitive awareness and to support learners in their development as knowers are proposed as recommendations for teaching practice. The implications for further research indicate a need for exploration of how the constructs of personal epistemology can be better modelled and applied to nurse education research. An important area for further study is nurse teachers' epistemological beliefs, how they are expressed in the classroom, and how they extend through the curriculum and the institution. Arguably, this is a relevant and legitimate area for further research because of current issues in nurse education over graduate entry and exit and student attrition rates, which are of international concern.

In practice disciplines, such as nursing, there has been increasing concern about examinations, which, it is argued, are problematic, since nurses' performance in written examination appears to bear little relationship to their level of proficiency in the clinical setting. To be realistic, nursing examinations have to be closely related to what the nurse does in practice. The Problem-Solving Case History, the development and evaluation of which forms the basis of this thesis, was, therefore, developed as a written simulation test involving the care management of a group of patients during a span of duty. The test confronts students with the kind of information they have to interpret and act upon in the clinical situation. This requires them to recall the principles of nursing care in a way similar to real-life. This study concerns the description and validation of the Problem-Solving Case History. Both qualitative and quantitative approaches are used to evaluate its implementation and to investigate its validity and reliability. A variety of methods was used to collect data for the validation. The methods include thought verbalisation, semi-structured interviewing, questionnaires and statistical tests of reliability. Answers are sought to the following questions: • How valid and reliable is the PSCH in testing problem-solving skills? • Can the PSCH test be used as a measure of professional competence? • Does the PSCH simulate the 'real-life' situation or event? • How reliable is the judgement made by markers of the students' performance? There is evidence, from the data analysed, that the PSCH seems to have clear application in nursing education and that it is closely related to practice. Data have elicited the use of problem-solving skills and the individual differences of approach to common tasks. It is recognised that professional competence can never be assessed fully without the inclusion of performance assessment in the work-place. Nevertheless, written papers will always have a part to play in assessing professional competence.

In 2009 the decision was made that from 2013 the only route onto the UK Nursing register would be through graduate programmes. This research problematises this decision, explores the discourses surrounding it and primarily questions whether the new standards for nurse education are a form of social (re) engineering. To do this it draws on both the conceptual tools of Pierre Bourdieu (field of practice, habitus and capital) (Bourdieu 1990) and on his three distinct levels of inquiry; the position of the field within other fields; mapping the objective structure of relations between positions occupied by those who occupy ‘legitimate’ forms of specific authority in the field; and by exploring the habitus of the agents. This is achieved by applying a layered approach of critical discourse analysis, to the examination of policy and professional text and to the stories of nurses as accessed through the use of online methodologies. The data reveals a picture of nurses engaged in definitional struggles influenced from both within and outside of the profession. Nursing and nurses are both surrounded by and contributing to complex, and on occasion, conflicting discourses. Nurses’ experiences are located between their affiliations to both externally declared expectations of quality and changing role, and their understood position as bedside carers, with graduate status perceived as educating nurses away from the bedside as the nature of what is good (authentic) nursing practice changes. The thesis concludes by recognising its place as further contribution to the discourses surrounding the move to an all graduate nursing profession and makes three recommendations: investment in an academic nursing community; a call for nursing to become a politically active/ effective profession; and action to counter the perception that the graduate nursing standards are creating a profession of uncaring and dispassionate nurses.

No description available.

No description available.

This scientific phenomenological study aims to explore and better understand the lived experience of learning through reflective processes, the nature, meaning and purpose of reflective learning, what is learned and the triggers and processes that enable meaningful reflective activity. Ten final year nursing students who felt that they had experienced learning through reflective processes were invited to describe their lived experiences of the phenomenon during taped phenomenological interviews. The rich and contextualised data was analysed using the four steps for descriptive phenomenological analysis proposed by Giorgi (1985). The findings essentially differentiate between authentic reflective learning which enables the emergence of 'own knowing', and the academically driven activities often perceived as 'doing reflection'. Authentic and significant personal 'own knowing' is derived from reflective activity prompted by unpredictable, arbitrary occurrences experienced in everyday encounters in the professional and personal worlds of the participants, which stimulate meaningful existential questions that, in turn, demand attention and drive the commitment to ongoing reflection. Engagement with authentic reflective activity is often triggered by an insistent and personal 'felt' sense of a need to understand and know 'something more for the self, and this activity demands far more privacy than the contemporary literature acknowledges. On the cusp of registered practice, the participants described how the maturation of reflective activity had enabled them to engage with the struggle to locate themselves personally and professionally in the context of care, to establish and refine personal and professional values and beliefs and to consider the realities of their nursing practice. Reflection enabled the participants to recognise and affirm that they had become nurses and could fulfil the role to their own and others expectations. Their reflective knowing and understanding was active and embodied in the way they lived their nursing practice. Analysis of the lived experience of learning through reflective processes has raised a number of issues for nurse education, in particular how student nurses may be supported in coming to know themselves and to become reflective, the importance of supportive mentorship and the significance of role modelling in professional development, the psychological safety of the 'practicum' and the need for privacy for authentic reflective learning.

This study aimed to explore the influences of Supervisors of Midwives in the context of Lifelong Learning (continuing professional development) (CPO) of practising midwives. This study was designed using a mixed method approach incorporating both qualitative and quantitative approaches to data collection to enable validation of results and to gain a variety of information to illuminate the experiences of participants in this area of study. Questionnaires and focus groups were utilised in order to obtain the data. The participants in this study comprised: • the total population of midwives and Supervisors of Midwives in three NHS Trusts • the total population of LSA Midwifery Officers in England • the total population of Lead Midwives for Education in England. This study has provided a variety of evidence specifically on the developmental role of the Supervisor of Midwives which has not been explored previously. There is an increasing emphasis on informal learning to meet CPO and these need to be given a higher priority for achievement within the work environment and supervisory framework. Collaboration between supervisors, managers and educationalists requires review to ensure midwives are afforded the opportunities to meet their needs. The process of education contracting between NHS service providers and education providers is not understood by supervisors unless they hold the dual role of manager and this needs addressing if midwives are to have equal opportunity In accessing resources. The dual role of manager and supervisor also needs further research as an emergence of the 'policing' role has been raised by some midwives in this study. Conclusions - Supervisors of Midwives are in a unique position to influence midwives CPO but the lack of a coherent approach with managers and educationalists prevents this being effective. Supervisors of Midwives need to have more influence in enabling midwives to access the available resources to achieve their CPO needs. Informal learning opportunities need to be valued and developed to facilitate midwives lifelong learning to improve practice and good outcomes for women and their families.