An emancipatory praxis study of nursing students on clinical practicum in New Zealand: Pushed to the peripheries
Ann McCleland
Senior Lecturer, Faculty of Health and Sports Science, Eastern Institute of Technology, Taradale, New Zealand
Allison Williams
Melbourne School of Health Sciences, The University of Melbourne, Carlton, VIC Australia
PP: 185 - 193
Abstract
The purpose of this qualitative study was to gain a better understanding of the learning experiences of nine nursing students on clinical placement in New Zealand. The students were in their third and final year of their baccalaureate nursing degree. The study specifically examined what impinged upon their learning experience in the clinical venue. Data was obtained from interviewing the students, initially individually and finally in a focus group. Themes emerged through words and concepts as the data was analysed. The themes included powerlessness; marginalization; the move from a holistic to a reductionist approach in care; the exploitation of minority students and the myth of praxis. Clinical practice was a time for nursing students to apply their knowledge to their practice, and to gain experience and confidence. Their clinical practice was normally a positive experience, but, each student spoke of the occasional negative episode. These left them with feelings of powerlessness and marginalization. The Maori students felt exploited. The students were concerned about the lack of time to debrief at the end of the day, and to share their experiences with their educator and colleagues.
The student's negative experiences were often the result of a clinical practitioner's high workload, under resourcing and the nurse educator's unavailability. An emancipatory praxis methodology was used to guide the research and hence habermasian critical theory underpinned this study. It has demonstrated within this research the necessity for strategic action, by exposing the current situation to create an awareness for favourable change. The findings from this research will enable educators and clinical practitioners to have a clearer understanding of the needs of nursing students in clinical practice. Recommendations from this study included the need for further research into nursing students clinical supervision models, and the identification of the special learning needs of indigenous nursing students.
Keywords
powerlessness; marginalization; nursing students; clinical practice
References
Andrews L, Cranston A, McCleland A (1998) Vision, self and spirit: How to honour these in nurse education. Proceedings of the Feminist Research Conference. Massey University. Palmerston North. New Zealand.
Boyle S D (1994) Nursing education in New Zealand: A case study of experiential learning. MA Thesis. Victoria University. Wellington.
Burns N, Grove S (1997) The practice of nursing research: Conduct, critique and utilisation. W.B. Saunders and Co.: Philadelphia.
Carr W, Kemmis S (1983) Becoming critical: Knowing through action research. Deakin University Press. Victoria.
Cody W K (1998) Critical theory and nursing science: Freedom in theory and practice. Nursing Science Quarterly 12(2): 44-46.
Dunn S V, Burnett P (1995) The development of a clinical learning environment scale. Journal of Advanced Nursing 22(6): 1166-1173.
Freire P (1972) Pedagogy of the Oppressed. Penguin. Harmondsworth.
Giroux H A (1993) Living dangerously: Multiculturalism and the politics of difference. Peter Lang Publishing Inc. New York.
Gray G, Pratt R (eds.) (1991) Towards a discipline in nursing Churchill Livingstone. Melbourne.
Grealish L, Carroll G (1998) Beyond preceptorship and supervision: A third clinical teaching model emerges for Australian nursing education. Australian Journal of Advanced Nursing 15(2): 3-11.
Gordon N S, Wimpenny P (1996) A critical reflection on the personal impact of managerial hegemony within nursing education. Journal of Advanced Nursing 23: 479-486.
Gore J (1993) The struggle for pedagogies: Critical and feminists discourses as regimes of truth. Routledge. New York.
Habermas J (1971) Knowledge and human interests. Beacon Press. Boston.
Habermas J (1974) Theory and practice. Heineman. London.
Hart G, Rotem A (1994) The best and worst: students' experiences of clinical education. Australian Journal of Advanced Nursing 11(3): 26-33.
Holmes C A (1993) Praxis: a case study in the depolticization of a concept in nursing research. Scholarly Inquiry for Nursing Practice 7(2): 3-12.
Howie J (1998) The effective clinical teacher: A role model. Australian Journal of Advanced Nursing 5(2): 23-26.
Le Blanc R G (1997) Definitions of oppression. Nursing Inquiry 4: 257-261.
McCabe B W (1985) The improvement of instruction in the clinical area: A challenge waiting to be met. Journal of Nursing Education 24(6): 255-257.
McLaren P L, Giarelli J M (Eds.) (1995) Critical theory and educational research. State University of New York Press. Albany.
Mahat G (1996) Stress and coping: first-year Nepalese nursing students in clinical settings. Journal of Nursing Education 35(4): 163-169.
Nehls N, Rather M, Guyette M (1997) The preceptor model of clinical instruction: The lived experiences of students, preceptors and faculty-of-record. Journal of Nursing Education 36(5): 220-227.
Parker A, Segesten K, Svensson L (1993) Supervision as a focal point in nurse education: An exploratory study of its effects on the needs of student nurses. Nursing Education Today 13(5): 343-348.
Polifroni E C, Packard S A, Shah H S, MacAvoy S (1995) Activities and interactions of baccalaureate nursing students in clinical practice. Journal of Professional Nursing 11(3): 161-169.
Rather M L (1994) Schooling for oppression: A critical hermeneutical analysis of the lived experience of the returning RN student. Journal of Nursing Education 33(6): 263-271.
Ripley D M (1986) Invitational teaching behaviours in the associate degree clinical setting. Journal of Nursing Education 25(6): 240-246.
Rolfe G (1996) Closing the theory-practice gap: A new paradigm for nursing. Butterworth-Heinemann Ltd. Great Britain.
Shah H S, Pennypacker D R (1992) The clinical teaching partnership. Nurse Educator 17(2): 10-12.
Trevitt C (1994) Establishment and evaluation of the undergraduate nursing preceptorship program in the Australian Capital Territory In Human Resource Development in Nursing: A Collection of Essays. WHO, Western Pacific Regional Office: 58-64.
Wellard S J, Rolls C, Ferguson D S (1995) Evaluating clinical educators: An employer's perspective. Journal of Advanced Nursing 21: 737-742.
Wellard S, Williams A, Bethune E (2000) Staffing of undergraduate Clinical learning programs in Australia. Nurse Education Today 20: 548-554.
Wilson-Barnett J, Butterworth T, White E, Davies S, Riley L (1995) Clinical Support and the Project 2000 nursing student: Factors influencing this process. Journal of Advanced Nursing 21(6): 1152-8.
Wilson M E (1994) Nursing student perspective of learning in a clinical setting. Journal of Nurse Education 33(2): 81-86.
Wong J, Wong S (1987) Toward effective clinical teaching in nursing. Journal of Advanced Nursing 12: 505-513.
Yong V (1996) Doing clinical: The lived experience of nursing students. Contemporary Nurse 5(2): 73-79. http://www.contemporarynurse.com/archives/vol/5/issue/2/
eContent Home
