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This study explores and analyses the experiences and perceptions of community nurses (District Nurses, Health Visitors and School Nurses) involved in mentoring Project 2000/Diploma in Higher Education student nurses within one site of a College of Nursing. It addresses the significance of mentorship in nursing education and in particular, the mentoring role of community nurses from their own perspective. Conceptual frameworks derived from the literature review on mentorship in nursing education are adopted in operationalising the research aims and the formulation of questions for data collection. The exploratory and descriptive nature of the study lends itself to utilising two methods of gathering data: postal survey questionnaires and semi-structured interviews. One hundred (100) respondents participated in the former, while twenty (20) informants took part in seventeen (17) interviews carried out by the researcher over a period of four months. The findings of the study indicate that mentoring Project 2000 student nurses is a complex, time consuming and skilled activity, and that there are positive as well as constraining factors which affect the effectiveness of the mentoring process and the quality of the mentors. It also suggests that mentors require educational and managerial support, continuing professional development, and recognition for their role. Recommendations are made for improving the mentoring process and the quality of mentors. It is hoped that the information will improve the quality and utility of nurse education, and enhance the quality of interpersonal relationships between mentors, students, and clients or patients in the community.

The central contention of this thesis is that story as an aid to learning, particularly student nurses' own stories of practice, is not being used to its full potential in nurse education. The dominant tendencies in nurse education are briefly outlined; the first, a ‘top- down’, managerialist approach, which is theory-focused, and where ‘reflection-on-action’ from an essentially theoretical perspective, with assessment strategies related to extrinsic criteria, is predominant; and the second, a ‘bottom-up’ approach, focused on practice itself as a resource for learning, with ‘reflection-in-action’ (moment-to-moment decision-making) as its major pedagogic strategy. This thesis argues that these approaches are too often treated in isolation from one another, but that for nurse education to be effective, professional practice must unite the two, and that story is an imaginative and stimulating method by which this can be achieved. The thesis outlines the ways in which story has been explored in the literature, but the emphasis is on the ‘humanness’ of stories and the varied and diverse roles they could play in the development of nurse education. This discussion of the unique contribution that story can make to nurse education is placed in the context of two major theories of learning: constructivist and social constructivist, with particular emphasis on the seminal work of Schon. The research methodology adopted is that of narrative, and data were provided by student nurses’ written stories and learning accounts of practice, and notes taken during focus groups. The data were supplemented by the use of my own stories of experience of clinical practice. In all, 55 students’ written stories and learning accounts were collected, and then analysed using a three stage approach: first, reading the stories and learning accounts; second, a two- part analysis using content analysis and analysis of form; and third, a structured presentation of findings. Therefore, whilst accepting that direct learning from story is difficult to demonstrate, the evidence presented in this thesis illustrates the different ways in which stories can be an aid to student learning from practice, particularly by encouraging students to differentiate and structure clinical experiences that might otherwise remain undifferentiated and unstructured, and acknowledge and identify the tacit nature of their learning in practice and develop strategies for making it explicit. The evidence presented in this thesis supports the contention that inclusion in the curriculum of students’ stories of clinical practice can contribute towards the transformation of nurse education.

The explosion of Information, Communication and Technology (ICT) use over the last 10 years within healthcare, and particularly within nursing practice, is changing the ways in which patient care is delivered. However a concern highlighted by various policy review and research evidence is that barriers to ICT usage are experienced by some groups of student nurses, particularly those who are mature and female, in a way that constrains potential impact on their professional development. This research adds to and develops the research evidence in the field by examining in what ways, and the extent to which, a group of mature, female, nursing students utilise ICT within the boundaries of one pre-registration nursing programme based on partnership working between a School of Health situated within a large university and its related NHS Trusts. By way of a qualitative, case study approach this study examines the biographical, university and clinical placement use of ICT for this group of student nurses. Consideration is given to the interconnectedness of these experiences as these students begin to develop their professional identities and learning as nurses. The experiences of this group of students are determined through interviews and observation of clinical practice. Three research questions define the parameters of the research. These are: 1) How are mature, female nursing students accessing and using ICT within nursing education? 2) What are the barriers that may prevent mature, female students from accessing and using ICT within nursing education? 3) What actions do mature, female nursing students consider may be taken to improve their knowledge and subsequent use of ICT in both their academic studies and clinical placement work? Findings from the research suggest that experiences of ICT relate to biographical history and the extent to which student nurses are supported and encouraged to engage with ICT in their university programme and on clinical placement. In particular the data suggests that for many student nurses the feeling and experiences of being generationally, emotionally and hierarchically 'locked out' of using ICT raises real challenges for the extent to which government and regulatory policy is being effectively enacted for particular groups of student nurses. This study, therefore, contributes to knowledge in and around pedagogical practice for pre-registration nurse education programmes. In particular it raises the importance of locating policy development in this area around the explicit privileging and enabling of ICT usage in all practice situations. In other words the development of a collective efficacy in nurse pre-registration programmes that is suggestive of notions of being ICT 'logged in' rather than being 'locked out' for mature, female student nurses.

The research reported in this thesis explored the perceived value of transition support programs for newly registered nurses in New South Wales and the health care facilities offering such programs. Although transition support programs have been designed and implemented in various forms since the transfer of nurse education to the tertiary sector, there remains little evaluative evidence of the value of such programs. Two groups of registered nurses formed the participants in this study. The first were new graduate nurses who completed a transition support program within the past 12 months. The second comprised experienced nurses who worked with new graduate nurses during their transition support program. The study was carried out in seven hospitals in area health services across and around Sydney, representing both small and large facilities with bed numbers ranging from 195 to 530. Data were collected from four sources including the printed materials made available by sample hospitals. Questionnaires, interviews and observations were used to determine the purposes, outcomes and strengths and weaknesses of transition support programs. The data were analysed using descriptive statistics and theme extraction. The themes described the ways in which the transition support programs were used to facilitate the transition of the newly registered nurse to confident beginning practitioner. There was widespread belief from the study participants that some aspects of nurse education at university were inadequate. As a result, various structures and policies were required to support the new graduate nurses as they entered the workplace. The transition support programs were used to increase nursing staff for the study hospitals and to provide new learning opportunities for new graduate nurses to enable them to develop the clinical and professional skills required of competent registered nurses. The rotational aspect of the transition support programs were used to provide staff for the less popular areas of the hospital as well as a variety of experiences and skill development opportunities that were considered lacking in the current undergraduate education of nurses. The work environment where the programs operate were described as difficult with nurses exposed to violence and bullying practices from fellow staff and frequently required to work with a less than ideal number or appropriate skill mix of nursing staff. The hospitals also used the transition support program to exert a controlling influence over the new graduate nurse by way of roster management, assessment of skills and the expectation that each nurse would complete a transition support program before being offered full time work. The thesis concludes with recommendations and future research avenues. It would be useful for hospitals to conduct formal evaluations of the transition support program they offer to provide the most effective program possible. One source of information could be sought from the new graduate nurses regarding their needs during the first six months of employment. It is also suggested that a study be commenced that investigates the reasons behind the perception that nurse education at universities in New South Wales is inadequate.

Primary health care as a model for the provision of health services was introduced by the World Health Organization In the mid 1970s. Initially viewed as a means of health promotion and advancement of wellness in developing countries., it was soon to be adopted by industrialised countries to assist in relieving the demand on acute care services. This was to be achieved through education of the community towards good health practices and the preparation of nurses to practice in the community, outside of the acute care environment Australian nurses were slow to respond to this philosophy of health care and this study has sought to examine why this is so. It has been found that there are a multitude of reasons for the lack of action In the decade or more following the Declaration of Alma Ata and the major Issues have been identified and elaborated. Some of the major reports of the time that were associated with and had some Influence on health care and nurse education have been examined to identify recommendations and how much they support the ethos of primary health care. These include the Sax committee report of 1978 and a submission by the Department of Employment and Industrial Relations In 1987. As part of the investigation, nursing curricula from around Australia in the mid 1980s have been examined to determine the degree of the primary health care content according to guidelines recommended by the World Health Organization. It was found that generally at that time, there was a deficit In the preparation of undergraduate students of nursing for practice In the area of primary health care when the world, including industrialised nations, was making moves towards this model of health care delivery. Factors Influencing the slow response of nursing have been examined and finally recommendations for further studies have been put forward.

The main aim of this thesis was to examine internal representation in the context of nurse education using two main output variables - namely imagery and identity. The initial basic argument for the thesis was that procedures to facilitate the acquisition of psychomotor skills that have been developed in sports science could fruitfully be applied to the development of skills in other areas, such as nurse education. Study one approached this through the use of an imagery training programme - PETTIER (Holmes & Collins, 2001) on an undergraduate nursing curriculum. PETTIER served as the independent variable with the dependent variable - performance - being measured through Obje&tive Structured Clinical Examinations (OSCEs). Unexpected results revealed no significant differences between the control and experimental groups, with the control group actually performing better overall. Given this, the explicit choice was made to pursue investigation into the other plausible factors affecting behaviour, in order to explicate and underpin the results obtained. Study two investigated students' perceptions of and preparation for the OSCEs using a skills training questionnaire. Results revealed common concerns, specifically related to skills practice. Furthermore these concerned the amount of practice time provided; the practice environment; and the amount of support and training during teaching. In light of these findings, study three pursued a contrasting and comparative investigation from the professionals' perspective on the curriculum. This specifically examined perceptions of the assessment structure and expectations within the curriculum; the content of the curriculum; levels of support and provision for training; and the application of theory and practice. This aimed to identify any coherent or conflicting views between the students' receiving the curriculum and the staff delivering the curriculum. Results revealed coherency in the professional view that theory and practice were equally as important for nurse education. However, students commonly perceived practice as the most important aspect. Also, some students often struggled to apply theory to practice and vice versa. In light of this it became apparent that students may in fact identify differently with the content of the curriculum. Therefore, appraisal of the content may have different significance for students and affect behaviour differently both internally and/or externally. Study four investigated this using Identity Structure Analysis (ISA)/lpseus (Weinreich & Saunderson, 2003).This explored how students applied themselves to the various aspects of nursing in the contexts of healthcare and broader affiliations, and how these fitted into students' broader sense of identity. It also looked at typologies within nursing and whether identity fitted into three distinct categories depending on construals. Study five followed this up using two individual case studies. The purpose of this was to encapsulate meaning behind individual construals and typologies and explicate the findings of ISA/lpseus and the implications for nurse education. Results found that construals are grounded in experiences which can affect development, behaviour and identity towards nursing and the broader affiliations in individuals' lives. In conclusion identity in nursing should be investigated further in order to provide stronger evidence in regards to typologies and how these may be influencing students' behaviour and development in nurse education. Such research could have important implications for the future of nurse education and be a positive step towards future curriculum revisions.

The lecturer practitioner role in nursing is widely seen as offering hope for the future of nurse education, by overcoming the 'theory-practice gap', and establishing and maintaining effective links at many different levels between education and practice. It is clear, however, that there are a number of issues of concern about the role. These can be summarised as: lack of role clarity about overcoming the theory-practice gap; varying conceptions of the role and unclear job descriptions; and role conflicts and overload, from the conflicting demands of service and education settings Despite current political support for strengthening the links between higher education institutions and practice settings, a new governmental emphasis on the support of students in practice, and a growing in-depth evaluative literature about the role, there is no research examining its systematic development, or measuring and addressing aspects of lecturer practitioners' occupational stress and burnout. Initial project planning work found that lecturer practitioners perceived themselves as 'adding value' to education provision, with personal and professional gains for postholders. However, their key concerns were: absence of role clarity; absence of effective joint review/appraisal;a bsenceo f formal support In, order to develop and address aspects of lecturer practitioners' work roles and their employment position, this action research project was established. Using a spiral methodological framework, and a multi-methods approach to data collection to triangulate the findings, new knowledge about lecturer practitioner roles was uncovered, and employment practices were developed as a result. The project established three new mechanisms, and these outcomes can be summarised as: joint appraisal policies and materials; orientation/induction policies and materials; group support network. In addition, previously validated measures of occupational stress and burnout were used to meas. ure those conceptsi n this group of lecturer practitioners, and the impact of the project. They were found to be generally no more stressed or burnt out than comparable workers, and the project was unable to demonstrate statistically significant differences in beforeand after-scores. Synthesis of quantitative and qualitative findings indicates that these LPs were 'thriving rather than just surviving'.

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