Discourse tensions: Professional socialisation into nursing within the university education system

Abstract

Starting university brings expectations of new experiences and a good social life (Morton and Tighe 2011), however student nurse experience may not mirror these expectations. The aim of this study was to identify any indications of 'differentness' expressed in students talk, track development and changes in student language over the duration of their programme, and explore how language might situate lecturers and students within a professional socialisation process.Using Discourse Analysis (Potter and Wetherell 1987), interviews (n=17) were conducted with 8 lecturers and 7 volunteer student nurses multiple times over 3 years (April 2013 -August 2016.Analysis uncovered three discourse tensions, each showing resonance with students and their lecturers: The university student and the student nurse; The Nursing and Midwifery Council registrant and the lecturer; Student nurses as consumers of their university education.Students did not appear to align themselves with the university after experiencing clinical practice, and lecturers' language attempted to position students away from traditional student experiences to protect professional standards.

A qualitative exploration of undergraduate nursing students' experience of emotional safety for learning during their clinical practice

“…This dissonance may exacerbate the perceived theory-practice gap because students are not offered the opportunity to apply in practice what they have learned in theory (Murray et al, 2017). Despite previous studies having identified the importance of reducing tensions between academic, organisational and practice contexts this issue persists (Steven et al, 2014;Murray et al, 2017;Jackson and Steven, 2020). Such tensions and related dissonance may negatively impact the students' sense of Emotional safety for learning (Jackson and Steven, 2020).…”

“…Despite previous studies having identified the importance of reducing tensions between academic, organisational and practice contexts this issue persists (Steven et al, 2014;Murray et al, 2017;Jackson and Steven, 2020). Such tensions and related dissonance may negatively impact the students' sense of Emotional safety for learning (Jackson and Steven, 2020). Contexts are closely related to mechanisms, such as students' emotions and their approach to their preparation as future health professionals (Morey et al, 2021).…”

“…When uncertainty permeates the students' learning experience (before and during clinical placements), and their relationships with nurses and patients, this generates inhibitory mechanisms, which may undermine any sense of emotional safety, and have knock-on effects for clinical education outcomes (Fisher and Kiernan, 2019). Thus, in clinical contexts that do not foster a favourable 'emotionally safe' learning climate, students may end up feeling very vulnerable and lose self-confidence in their ability to put into practice what they have learned (Fisher and Kiernan, 2019;Jackson and Steven, 2020). Furthermore, it is important to ensure that students are regularly signposted to relevant country specific professional body policies (e.g., Federazione Nazionale degli Ordini delle Professioni infermieristiche in Italy or its equivalent, the Nursing and Midwifery Council in the UK) regarding patient safety, which may enhance their confidence in raising concerns or asking questions in practice.…”

“…Nursing students are influenced both by time spent in class and by academic and practice staff, and other students (Eraut, 2000;Steven et al, 2014;Jackson and Steven, 2020). Thus, clinical practice becomes a place where learning occurs through a 'hidden curriculum' which is everything related to learning in an informal and unwritten way and may include accepted ways of doing, thinking, and speaking; traditions, opinions, practices, and values (Eraut, 2000;Akçakoca and Orgun, 2021).…”

“…For nursing students, the nature of educational programmes may also impact on their sense of emotional safety for learning given they entail multiple clinical placements and repeated movement between academic and clinical practice knowledge contexts (Eraut, 2000). Thus, emotional safety for learning, and learning about patient safety may be affected by tensions experienced by students between what is taught in academia, what is experienced in clinical practice, and the hidden curriculum (Steven et al, 2018;Jackson and Steven, 2020;Bagnasco et al, 2021).…”