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    Understanding preparedness : the influence of teaching and learning experience on bioscience integration by nursing lecturers : a thesis presented in partial fulfilment of the requirements for the degree of Doctor of Education, Massey University, Palmerston North, New Zealand
    (Massey University, 2014) Hardcastle, Jane
    This thesis explores how teaching and learning experiences influence nursing lecturers’ preparedness to integrate biosciences in their teaching practice. The biological sciences have been a problematic component of nursing education and practice for many years and bioscience knowledge levels amongst many nursing lecturers are reported to be poor. This research encompasses a detailed exploration of the teaching and learning experiences of ten New Zealand nursing lecturers to identify experiences that influence their preparedness with bioscience integration. The phenomenon of preparedness was explored from the perspective of transcendental phenomenological philosophy and the key theoretical construct of intentionality. Study participants’ subjective, conscious experiences were explored through in-depth interview and phenomenological analytical procedures to identify the universal experience and essences of how experiences came to be. Preparedness as a phenomenon is influenced by participants experiencing contrast, reflection and responsibility in learning, nursing, and teaching practice. These cognitive and affective processes occur as a result of the complex relationship between experiences, personal values and beliefs about ‘good’ nursing and teaching practice, and are found to be more influential than experience alone. This is an important discovery for nursing education as mere exposure to examples of bioscience in nursing may not affect students’ or lecturers’ perceptions of bioscience value. The way that bioscience knowledge is valued within personal perceptions of good nursing underpins lecturers’ preparedness, and shapes the way that learning, teaching and practice experiences are evaluated. The research demonstrates the importance of reflective learning and meaning perspectives in bioscience education, and the preparedness of nursing lecturers to practice integrated teaching. However, despite a willingness to integrate bioscience when teaching nurses, lecturers question their confidence with traditional academic perceptions of bioscience knowledge. The findings question contemporary pedagogies in bioscience education and epistemological perspectives of bioscience theory in the context of nursing as a practice-based profession. Recommendations are made to facilitate reflective learning, and lecturers’ preparedness with integrated teaching, through progressive spiral curricula that value clinical bioscience knowledge and the contribution of nursing lecturers’ clinical expertise.
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    "Stepping beyond the known" : the lived experience of returning registered nurse students : an interpretive descriptive study : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy, Massey University, College of Education, Palmerston North, New Zealand
    (Massey University, 1997) Idour, Margaret; Idour, Margaret
    The thesis employed a Heideggerian Hermeneutical Analysis (HHA) approach for a study of returning registered nurse students (RRNS) from a nursing/health management context. In essence, a descriptive interpretive study the intent has been to unveil the common meanings embedded in the lived experience of RRNS return to formal (advanced) studies. The phenomenon or issue of interest was pursued in the form of a question: What is meaningful and significant for participant RRNS in their everyday world on re-engaging in formal (advanced) studies? There is a marked scarcity of research from the RRNS viewpoint, so the focus of the study was to understand what RRNS themselves found to be the highlights of the experience. The study participants included RRNS coming from a management background and, therefore, very much at the cutting edge of rapid and continuing change in health care provision. In addition to personal and professional reasons for returning to study, what the narratives disclosed was the compelling need experienced by the RRNS to increase their understanding of changing requirements in the workplace. They looked for new possibilities to transform management of nursing/health services and for learning experiences favourable to that purpose. A key aspect of their concern related to the interactive nature of their lived experience as a RRNS with the entire context of their everyday world, that is, with the connections and relations between the study-work-homespace. Fourteen RRNS from an established university nursing programme offering graduate courses of study in nursing participated in extended non-structured interviews lasting 60 to 90 minutes. The interviews were held during 1993 in many different places, as chosen by participants, some in the home but mostly in the work setting. This had an unanticipated benefit because participants, acting as the researcher's host/hostess being at 'home' and comfortable in telling their 'stories' took 'charge' of the occasion. The interviews, with the consent of the participants, were audiotaped and then transcribed. The texts (transcriptions) were analysed hermeneutically using Heideggerian phenomenology as the philosophical background. HHA is centred on a particular tradition of philosophy whose concern is the meaning of Being. The concern is to make visible participants' experience of their 'world'. In this instance, it was the everyday 'world' of the participant RRNS and the lived meanings of what they experienced on return to formal (advanced) studies. Hence everyday lived experience is the focus of attention in Heideggerian phenomenology. In this research approach what is sought is understanding not explanation. It is a premise of phenomenology that, in general, an understanding of the meaning and significance of the lived experience can be acquired from the 'things' (the phenomena under study) themselves. Approaching a participant as an expert by virtue of directly experiencing the phenomenon, is basic to phenomenology. Hermeneutic analysis of the texts of the participant RRNS affirmed the authenticity of those assumptions. In the present study several common or major themes, two relational themes and one constitutive pattern were identified through the process of textual interpretation. The constitutive pattern, expressing the full complexity of the relations and connections between the themes, was found to be present in all fourteen texts; the nature of a constitutive pattern being 'that it's always there'. The constitutive pattern 'Nursing is Dwelling in Thoughtful Concern as Context Calls Forth', emerged as the major finding of the study. This pattern witnesses to the pragmatism that is inherent in nursing and commonly found in nurses' responses to the challenges presented by continuing and rapid change. For the participant RRNS nursing had become a way of engaging their energies in the workplace as appropriate to a given place, time and culture. The two relational themes accent particular aspects of the constitutive pattern. 'Nursing is a whole pile of things'; and 'Curriculum: Reflective Openness' reveal the inherent meanings of the constitutive pattern. Firstly, that nursing is diverse in practice and has many dimensions; and, secondly, that a curriculum befitting the diversity of nursing requires us to constantly challenge and test the learning experiences we provide for RRNS. The fourteen RRNS participating in the study traversed diverse pathways to acquire the understanding and skills required for altered health care structures. Adopting new relationships and 'leaping-ahead' (Heidegger, 1962), to be able to see the whole picture of what was being experienced in nursing/health care, reveals the RRNS becoming-as interpreters for both colleagues and clients. Leaping-ahead is reflective of thoughtful concern as the pattern of responding to presenting need. This way of living a life as a nurse transforms work. The participant RRNS disclose that, dwelling in such a way in nursing/health work opens up a future of possibilities which brings all the presenting needs into focus. Sharing the story of their lifeworld as RRNS, the participants have exemplified the 'reflective openness' Senge (1990, 277 - 281) advocates, as being a prerequisite for 'learning organisations'. Contemporary organisations require us to challenge our own thinking as well as being free to speak our minds {participant openness). Appreciating that, however much we value our daily life practices and understandings, they need to be 'always subject to test and improvement'. In effect, what the participants have bestowed on us is that, within the framework of a curriculum for RRNS and the content learning of a given course, we must generate a process of learning amenable to both individual and group requirements.
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    The Fijian Diploma of Nursing curriculum : an indigenous case study of a curriculum change : a thesis presented in fulfilment of the requirements for the degree of Doctor of Philosophy in Nursing at Massey University, Palmerston North, New Zealand
    (Massey University, 2011) Vudiniabola, Alisi Talatoka; Vudiniabola, Alisi Talatoka
    This thesis explores an educational change process in Fiji and used a case study methodology to examine the introduction of the 2004 Diploma of Nursing programme in the Fiji School of Nursing. The three-year competency based curriculum was developed and funded by the Australian government through the Fiji Health Sector Improvement Project (FHSIP) with limited participation of the local teachers at the Fiji School of Nursing. Many problems beset the programme, beginning with its rushed implementation at the end of an academic year and the incompleteness of the curriculum document. Teachers questioned the quality and nature of the competency based curriculum, and the absence of many supportive networks and resources to facilitate curriculum change. The majority of the staff did not understand the competency-based nature of the curriculum and its requirements. Using the vanua indigenous research framework and Fullan’s educational change theory to guide and inform the case study, qualitative methods of data collection and analysis were employed, including documentary analysis, participant observations and interviews. Talanoa, a culturally appropriate method of data collection for Pasifika people was used in both individual and group interviews. The research found indigenous nurses continue to be colonised and made to reproduce western ideologies and nursing values, perpetuated by the use of external educational aid and expertise. The execution of the curriculum project and the decision-making flowed from the Ministry of Health down to the Fiji School of Nursing, without consultation with the school’s staff, reflecting the former colonial administration where such a top-down approach was acceptable. Neo-colonialism is therefore regarded as the dominant paradigm where indigenous nursing leaders emulated the dominant behaviour of their former colonisers on their fellow indigenous subordinates. Moreover, it is argued here that foreign-influenced curricula continued to produce nurses who are not adequately prepared to care for the indigenous Fijians, and contributed to the attrition of Fijian nurses to countries whose values underpin the curriculum.
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    Self-reported confidence in patient safety knowledge among Australian undergraduate nursing students: a multi-site cross-sectional survey study
    (Elesvier, 2017-06) Usher K; Woods C; Parmenter G; Hutchinson M; Mannix J; Power T; Chaboyer W; Latimer S; Mills JE; Seigloff L; Jackson D
    Abstract Background Patient safety is critical to the provision of quality health care and thus is an essential component of nurse education. Objective To describe first, second and third year Australian undergraduate nursing students’ confidence in patient safety knowledge acquired in the classroom and clinical settings across the three years of the undergraduate nursing program. Design A cross-sectional online survey conducted in 2015. Setting Seven Australian universities with campuses across three states (Queensland, New South Wales, South Australia). Participants A total of 1319 Australian undergraduate nursing students. Methods Participants were surveyed using the 31-item Health Professional Education in Patient Safety Survey (H-PEPSS). Descriptive statistics summarised the sample and survey responses. Paired t-tests, ANOVA and generalized-estimating-equations models were used to compare responses across learning settings (classroom and clinical), and year of nursing course. Results Participants were most confident in their learning of clinical safety skills and least confident in learning about the sociocultural dimensions of working in teams with other health professionals, managing safety risks and understanding human and environmental factors. Only 59% of students felt confident they could approach someone engaging in unsafe practice, 75% of students agreed it was difficult to question the decisions or actions of those with more authority, and 78% were concerned they would face disciplinary action if they made a serious error. One patient safety subscale, Recognising and responding to remove immediate safety risks, was rated significantly higher by third year nursing students than by first and second year students. Two broader aspects of patient safety scales, Consistency in how patient safety issues are dealt with by different preceptors, and System aspects of patient safety are well covered in our program, were rated significantly higher by first year nursing students than by second and third year students. One scale, Understanding that reporting adverse events and close calls can lead to change and can reduce recurrence of events, was rated significantly higher by third year students than first and second year students. Conclusions In order are to achieve meaningful improvements in patient safety, and create harm free environments for patients, it is crucial that nursing students develop confidence communicating with others to improve patient safety, particularly in the areas of challenging poor practice, and recognising, responding to and disclosing adverse events, including errors and near misses.