Abstract:
This study, which is methodologically grounded in technical action research and philosophically informed by critical social theory, explores an important aspect of the multi-contextual environment of students' clinical learning: the factors which help or hinder student nurse clinical learning from the perspectives of sixteen nurse educators, practitioners and students from a provincial Polytechnic and its local Crown Health Enterprise.
The first action cycle involved three homogenous focus group interviews of educators, practitioners and students respectively. Multiple perspectives of the clinical learning process were explicated in their dialogue. The participants own analysis of their discussion, using affinity diagrams, revealed many commonalties and some disparities in the factors which helped or hindered students' clinical learning.
Summaries of these interviews were sent to all the participants, which allowed them to reflect on the experiences revealed. Thus, participant and researcher reflection initiated the second action cycle. This brought together representatives from the first three focus groups, in a beginning partnership, to discuss the multiple truths of, and suggest collaborative strategies to improve, the clinical learning experience.
My reflection on this interview, as well as the first three, identified common themes from the participants' dialogue. These themes were used, for organisational convenience, to report the participants dialogue; and from these themes emerged five practical issues which influenced the development of more effective partnerships. They were how to deal with the 'problem people' in the learning process, how to clarify and develop the various roles in the learning context, how to generate more effective communication, how to respond more effectively to the impact of the changing environment, and how to maximise the 'moments of partnership'.
Organisational issues were also identified that related to the schisms between the disparate organisation cultures. These cultures and philosophies have to do with the deep and invisible structures in nursing education and practice and the health care system, which construct and constrain the actions of the people within them. Reflection on these issues formed the third action cycle of this study.
The outcomes of this study were the explication of the multiple viewpoints of educators, practitioners and students, made overt in their descriptions of individual and group experiences that helped or hindered student clinical learning. This has resulted in a more mutual understanding of the clinical learning context, and a beginning enlightenment regarding the impact of the various personal and organisational cultures. It has also demonstrated that it is possible for practitioners, educators and students to work collaboratively to develop strategies for praxis. The basis has now been laid for many future research studies, where the common understanding attained will enable mutual goals to be established, to develop strategies that will achieve the goals through collaborative partnerships.
