Theory before practice: Implicit assumptions about clinical nursing education in Australia as revealed through a shared critical reflection

Laurie Grealish
Faculty of Health, University of Canberra, Canberra ACT

Lacey Anne Smale
Faculty of Health, University of Canberra, Canberra ACT

PP: 051 - 064

Abstract

The transfer of nursing education into the higher education sector occurred over a 10-year period in Australia (1985-1994). Australian nurse leaders settled on a single outcome measure to be applied for all nursing graduates in the form of national competency standards. While this move enabled diversity, the lack of consistency in curriculum design has subsequently led to increasing confusion for clinicians who support students' learning in clinical placements.

Using a shared critical reflection method, the authors reviewed (1) the evaluation comments from nurses in one nursing unit of a hospital in one Australian jurisdiction and (2) an historical review of nursing literature at the time of the transfer of nursing education into the higher education sector.

The reflection suggests that the aim of the transfer, to create critical thinking graduates, has been undermined by the implicit clinical education practices that have since emerged. In order to address the contemporary challenges for clinical staff working with students from multiple universities, as well as increased student numbers to address the nursing shortage, we recommend a new approach to curriculum design: a national clinical curriculum drawn from social, as well as cognitive, learning theory that at once informs clinicians of students' potential abilities and provides the scope to accommodate the increasingly difficult and critical learning requirements of tertiary-based nursing students.

Keywords

clinical curriculum; pedagogies; social learning; nursing; culture


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References

Andrew, N., & Tolson, D. (2008). Building on Wenger: Communities of practice in nursing. Nurse Education Today, 28(2), 246-252.

Barrett, D. (2007). The clinical role of nurse lecturers: Past, present, and future. Nurse Education Today, 27, 367-374.

Bell, P. (1983). Nursing education in a tertiary setting. The Australian Nurses Journal, 12(3), 44-45, 51.

Billett, S. (2002). Toward a workplace pedagogy: Guidance, participation and engagement. Adult Education Quarterly, 53(1), 27-43.

Billett, S., Barker, M., & Hernon-Tinning, B. (2004). Participatory practices at work. Pedagogy, Culture & Society, 12(2), 233-258.

Bolton, G. (1981). A training in discipline and conformity? The Australian Nurses Journal, 11(4), 34-36.

Boschma, G., Davidson, L., & Bonafacio, N. (2009). Bertha Harmers 1922 textbook - The Principles and Practice of Nursing: Clinical nursing from an historical perspective. The Journal of Clinical Nursing, 18, 2684-2691.

Bottorff, J. L., & D'Cruz, J. V. (1985). The nursing curriculum and knowledge of most worth. The Australian Journal of Advanced Nursing, 2(3), 9-17.

Brookfi eld, S. (2009). The concept of critical reflection: Promises and contradictions. European Journal of Social Work, 12(3), 293-304. Commonwealth of Australia. (2008). Review of Australian higher education final report. Canberra: Australian Government Publishing.

Daly, J., Clark, J., Lancaster, J., Orchard, C., & Bednash, G. (2008). The global alliance for nursing education and scholarship: Delivering a vision for nursing education. International Journal of Nursing Education Studies, 45(8), 1115-1117.

Darbyshire, C., & Fleming, V. E. M. (2008). Mobilising Foucault: History, subjectivity and autonomous learners in nurse education. Nursing Inquiry, 15(4), 263-269.

Darbyshire, P. (1993). In defence of pedagogy: A critique of the notion of andragogy. Nurse Education Today, 13(5), 328-335.

Dunn, S., & Hansford, B. (1997). Undergraduate nursing students' perceptions of their clinical learning environment. Journal of Advanced Nursing, 25(6), 1299-1306.

Edmond, C. B. (2001). A new paradigm for practice education. Nurse Education Today, 21(4), 251-259.

Elcock, K. S., Curtis, P., & Sharples, K. (2007). Supernumerary status - An unrealized ideal. Nurse Education in Practice, 7, 4-10.

Eraut, M. (1999). Developing professional knowledge and competence 4e. London: The Falmer Press.

Eraut, M. (2004). Informal learning in the workplace. Studies in Continuing Education, 26(2), 247-273.

Featherstonhaugh, D., Nay, R., & Heather, M. (2008). Clinical school partnerships: The way forward in nursing education, research and clinical practice. Australian Health Review, 32(8), 121-126.

Gibbons, A. (1982). A smooth transition to a tertiary diploma. The Australian Nurses Journal, 11(11), 56-58.

Gray, G. I. (1981). Emerging trends in nursing. The Australian Nurses Journal, 10(9), 38-40.

Grealish, L., & Ranse, K. (2009). An exploratory study of first year nursing students' learning in the clinical workplace. Contemporary Nurse, 33(1), 80-92.

Grealish, L., & Trevitt, C. (2005). Developing a professional identity: Student nurses in the workplace. Contemporary Nurse, 19(1-2), 137-150.

Gribben, B., & Cochrane, C. (2006). Critical companionship: Our learning journey. Practice Development in Health Care, 5(1), 14-19.

Guile, D., & Young, M. (1998). Apprenticeship as a conceptual basis for a social theory of learning. Journal of Vocational Education and Training, 50(2), 173-192.

Hart, G. (1985). College-based education: Background and bugs. The Australian Nurses Journal, 15(4), 46-48.

Hart, G., & Rotem, A. (1994). The best and worst: Students' experience of clinical education. The Australian Journal of Advanced Nursing, 11(3), 26-33.

Harte, C. C. (1976). Cumberland sets out. The Australian Nurses Journal, 5(9), 20-22.

Herdman, E. (1998). Knowledge without power: The professionalisation of nursing. In H. Keleher & F. McInerney (Eds.), Nursing matters: Critical sociological perspectives (pp. 29-46). Marrickville, Australia: Harcourt Brace & Co.

Horns, P. N., Czaplijski, T. J., Engelke, M. K., Marshburn, D., McAuliffe, M., & Baker, S. (2007). Leading through collaboration: A regional academic/service partnership that works. Nursing Outlook, 55(2), 74-78.

Howie, J. (1988). The effective clinical teacher: A role model. The Australian Journal of Advanced Nursing, 5(2), 23-26.

Hughes, C. (1998). Practicum learning: Perils of the authentic workplace. Higher Education Research and Development, 17(2), 207-227.

Jarvis, P. (1987). Lifelong education and its relevance to nursing. Nurse Education Today, 7(2), 49-55.

Kako, M., & Rudge, T. (2008). Governing nursing: Curriculum as a rhetorical vehicle using South Australian nursing schools from the 1950s onward as an illustrative case. Contemporary Nurse, 30(2), 142-155.

Kanitsaki, O., & Sellick, K. (1989). Clinical nurse teaching: An investigation of student perceptions of clinical nurse teacher behaviours. Australian Journal of Advanced Nursing, 6(4), 18-24.

Kermode, S. (1984). The role of the clinical supervisor in college programs. The Australian Nurses Journal, 13(6), 34-35.

Lave, J., & Wenger, E. (1991). Situated learning: Legitimate peripheral participation. Cambridge, UK: Cambridge University Press.

Levett-Jones, T, & Lathlean, J. (2008). Belongingness: A prerequisite for nursing students' clinical learning. Nurse Education in Practice, 8, 103-111.

Levett-Jones, T., Parsons, K., Fahy, K., & Mitchell, A. (2006). Enhancing nursing students' clinical placement experiences: A quality improvement project. Contemporary Nurse, 23(1), 58-70.

Mander, R. (1992). See how they learn: Experiences as the basis of practice. Nurse Education Today, 12(1), 11-19.

Mann, S., Byrnes, T., Power, C., Clare, J., Saint, K., Rich, M., et al. (1999). Rhetoric to practice: The challenge of collaboration of academe and industry. Journal of Nursing Education, 38(1), 5-9.

Martins, A. C. (1980). Post-basic nursing education at WAIT. The Australian Nurses Journal, 9(9), 37-38.

Midgley, K. (2006). Pre-registration student nurses perception of the hospital learning environment during clinical placements. Nurse Education Today, 26, 338-345.

Milligan, F. (1995). In defense of andragogy. Nurse Education Today, 15(1), 22-27.

Newton, J. M., Billett, S., Jolly, B., & Ockerby, C. M. (2009). Lost in translation: Barriers to learning in health professional clinical education. Learning in Health and Social Care, 8(4), 315-327.

Newton, J. M., Billett, S., & Ockerby, C. M. (2009). Journeying through clinical placements - An examination of six student cases. Nurse Education Today, 29, 630-634.

Orr, E. (1981). The role of accountability in nursing of the future. The Australian Nurses Journal, 10(10), 44-47.

Owen, J., & Grealish, L. (2006). Clinical education delivery - A collaborative, shared governance model provides a framework for planning, implementation and evaluation. Collegian, 13(2), 15-21.

Parkes, R. (1995). Educating for the future. Australian Nursing Journal, 2(7), 22-25.

Patten, M. (1979). College-trained for primary care. The Australian Nurses Journal, 9(2), 36-38, 52.

Pelletier, D. (1985). Optimizing the transition. The Australian Nurses Journal, 15(4), 48-49.

Percival, E. (1995). Achieving national standards for the regulation of nursing. In G. Gray & R. Pratt (Eds.), Issues in Australian nursing (Vol. 4, pp. 11-28). Melbourne: Churchill Livingstone.

Polifroni, C., Packard, S., Shah, H., & MacAvoy, S. (1995). Activities and interactions of Baccalaureate nursing students in clinical practice. Journal of Professional Nursing, 11(3), 161-169.

Pratt, R. (1980). A time to every purpose. The Australian Nurses' Journal, 10(3), 50-53, 56.

Roberts, K. (1981). 'Futurizing' the curriculum - Nursing education for the year 2000. The Australian Nurses Journal, 11(3), 49-52.

Roberts, K. L. (1980). Nursing: Profession or pretender? The Australian Nurses Journal, 9(10), 33-35, 61.

Saarikoski, M., Isoaho, H., Leino-Kilpi, H., & Warne, T. (2005). Validation of the clinical learning environment and supervision scale. International Journal of Nursing Education, 2(1), 1-18.

Sweeney, J. (1986). Nurse education: Learner-centred or teacher-centred? Nurse Education Today, 6(6), 257-262.

Vanlaere, L., & Gastmas, C. (2007). Ethics in nursing education: Learning to reflect on care practices. Nursing Ethics, 14(6), 758-766.

Walker, K., & Holmes, C. (2008). The order of things: Tracing the history of the present through a re-reading of the past in nursing education. Contemporary Nurse, 30(2), 106-118.

Watson, J. (1982). Traditional vs. tertiary: Ideological shifts in nursing education. The Australian Nurses Journal, 12(2), 44-46, 64.

Wenger, E. (1998). Communities of practice: Learning, meaning, and identity. Cambridge, UK: Cambridge University Press.



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