Seeking transformation: how students in nursing view their academic writing context – a qualitative systematic review

Abstract

Writing practices in nursing education programs are situated in a tension-filled context resulting from competing medical-technical and relational nursing discourses. The goal of this qualitative meta-study is to understand, from the student perspective, how the context for writing in nursing is constructed and the benefits of writing to nursing knowledge development. A literature search using the CINHAL, Medline, ERIC, and Academic Search complete databases, using systematic methods identified 21 papers and dissertations which gathered qualitative interview or survey data from students in nursing at the pre-registration, continuing education, and graduate levels. The studies provided evidence that writing assignments promote professional identity development but overemphasis on writing mechanics when grading have a deleterious effect on learning and student engagement with writing. Relationship building with faculty should extend beyond what is needed to maximize grades. Suggestions for writing pedagogical reform are identified to facilitate a change in focus from mechanical-technical to transformative writing.

Writing activities and the hidden curriculum in nursing education

“…Assessment cultures that prioritize surface level textual corrections, thus privileging objectivism, are an academia‐wide behavior found among content expert graders who are not writing experts and can narrow gains made to writing development (Camp, 2012; Mitchell et al, 2020). Some students in this study observed that some faculty lacked relevant experience to effectively guide their writing.…”

“…Writing activities have also been situated in the theory–practice gap (Mitchell, 2018). For example, previous explorations of writing in nursing have observed the incompatibility between the tacit entrenchment of biomedically driven objectivism in academic writing and nursing's overtly taught relational, emotional, aesthetic values, and ways of knowing (Mitchell, 2017; Mitchell et al, 2020). When students express doubts about the value of writing activities to their practice (Mitchell, 2018), they may be responding to the hidden curriculum messages that show them that proficiency in skills and demonstrating their biomedical knowledge is more highly valued.…”

“…Accurate use of nursing discourse and ways of speaking/writing, tacitly learned through classroom exposure and practice‐based enculturation, is often graded and penalized in writing assignments before a student has developed a mature nursing identity (Mitchell, 2018). Student awareness of the importance of developing a masterful use of both nursing and academic language patterns may impact how they approach writing assignments (Mitchell et al, 2020).…”

“…Student participants of qualitative studies on reflective writing have said that requirements to write about the more aesthetic aspects of nursing practice interfere with their ability to prepare for the technical (and more highly rewarded) activities of nursing education (Harris, 2005), such as their preparation to pass the registration examinations required to practice in some countries (Pohlman, 2013). These feelings persist in many students despite how, in a recent qualitative synthesis, academic writing was shown to benefit nursing professional growth and helped students connect with their identities as nurses (Mitchell et al, 2020).…”

“…Valuing standardization presents faculty with competing interests for developing assignments. They can choose to assign writing, which is known to nurture the relational-holistic aspects of student professional identity development (Mitchell et al, 2020), or they can choose evaluation methods that will prepare students for the standardized registration examinations the regulating bodies in many countries use as the final screening process prior to nursing registration. If the movement toward competency-based education privileges standardization and metrics-based assessments, that movement might impact the development and evaluation of writing pedagogies in nursing education.…”