This collaborative action research study addressed the perceived practical skill deficits in newly qualified nurses during role transition into practice. It extended over three cycles. Participants were newly qualified and experienced staff nurses in an acute NHS Hospital. A qualitative exploratory study during the first cycle found that much of what beginning staff nurses needed to know was embedded in routinised contextual activity and was not readily accessible to them. Managing and co-ordinating the work in the complexity of the clinical context is a composite skill, and a major component of clinical nursing practice. Because it is quickly internalised, it is constantly unrecognised and undervalued. A key issue was to access this knowledge and make it available to newly qualified nurses. A Critical Pathway was developed to provide the structure and preceptor support for the learning experience. This is a means of explicating and conceptualising the staff nurse role and provides an overview of components whilst suggesting a time and action framework to be progressively developed in goal directed activities. It was incorporated into a Competency-Based Preceptor Programme along with learning contracts for specific practical skills; both were designed to be adapted to the context-specific needs of each clinical area. This interactive tool was tested for adaptability and effectiveness in intervention studies in the second and third action research cycles. Qualitative and quantitative methods were used. The data confirmed its adaptability and the positive impact on preceptee competence and performance. Literature from across disciplines supported and illuminated interpretation of the study data with evidence of the infinitely complex nature and contextual dependence of practical knowledge and skills; some of which is explicit but some is submerged in the tacit dimensions of personal knowledge and performance. Practical thinking and action incorporate cognitive, perceptual and embodied characteristics and features of the task environment and are dependent on acquisition and exploitation of context-specific knowledge. The embodied and perceptual nature of nursing skills is integral to clinical nursing practice; and the evidence is that this embodied intelligence can only be demonstrated and learned in contextual activity mediated by an experienced colleague. This awareness has the potential to inform practical education and support the rationale for a more rigorous approach to practice-based education and experience.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:413927 |
| Date | January 2005 |
| Creators | Edmond, Cynthia Bertha |
| Publisher | Glasgow Caledonian University |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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