Faculty of Education - Theses
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ItemGraduate nurse preceptorship( 2004)Recent research has established that the supervision relationship is the single most important factor for the effectiveness of any professional supervision (Kilminster & Jolly 2000). However there is a lack of reliable research identifying the effects of supervision in health care and, until recently, little research in Australia or internationally acknowledging the effectiveness of supervision specifically in acute health care settings (Sloan 1998, Palsson, Hallberg & Norberg 1994, Begat, Severisson & Berggren 1997, Hyrkas, Koivula & Paunomen 1999). The established research highlights the importance of developing Australian based graduate preceptorship research, particularly from the perspective of the graduate nurse and nurse preceptor, focusing on these nurses' experiences in the context of the acute health care setting. This pilot study was therefore intended to provide insights into the effectiveness of the preceptor in the supervision role within the Australian acute healthcare setting. The primary focus of this project was to ascertain the extent to which nurse preceptors effectively address graduate nurses' professional needs. The data collected in this study enabled the identification, exploration and cross checking of shared and alternate themes, and the development of a theoretical framework, encompassing these participants' graduate preceptorship experiences, incorporating a range of interrelationships and interactions.
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ItemEvaluation of a Cancer/Palliative Nursing Care subject and a comparison of processes and outcomes for traditional classroom and distance education teaching modes of delivery( 2000)This Evaluation is concerned with the educational outcomes of a postgraduate subject, 'Cancer/palliative care nursing 1'. The subject is taught in the classroom as well as by distance education in the print medium and, as well as considering the outcomes for the subject per se, the Evaluation also compares the outcomes for each teaching mode. The questions addressed in the Evaluation are: a) does the delivery of the subject (regardless of the method used) have the outcomes that might be expected of a postgraduate diploma level subject? and b) are students taught by distance education mode disadvantaged by comparison with students who are taught by traditional classroom methods? There is an abundance of literature on distance education, most of which uses, explicitly or implicitly, classroom teaching as a largely unexamined exemplar by which distance education is judged. This thesis critically examines the distance education literature and identifies factors salient to a comparison of these two methods of teaching. The Evaluation method is based on the theory-driven approach advocated by Chen (1990) and incorporates an adaptation of the program logic framework put forward by Funnell (1996). It incorporates two methods of evaluation: the subject's outcomes measured against a prescription; and, a comparison of the distance education outcomes with classroom teaching outcomes. A prescription of how the subject should be delivered and the outcomes that should be expected was developed from stakeholder interviews, informed by a critical review of the distance education literature and the evaluator's knowledge of the discipline. A method of measuring the actual delivery of the subject against the prescription (regardless of the teaching mode) was devised and a minimum acceptable standard of success established. Substantive methods used include both qualitative and quantitative data gathered by questionnaires, interviews, classroom observations and a content analysis of the study guide used by distance education students. The Evaluation findings are that on most, but not all, outcome measures the subject met the set standard of success. One outcome unspecified in the prescription (although implied) was the increased clinical confidence engendered by undertaking this subject. Students taught by the traditional mode gained from classroom interaction although the degree of interactivity was found to depend on the personal qualities of lecturers and students and the structure of teaching sessions. Distance education students were not disadvantaged by this teaching mode and on some measures, such as being able to study at their own pace or the grades they achieved, could be said to be advantaged.
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ItemA discursive model of professional identity formation and cultural agency in midwifery education : a framework to guide practice and research( 2002)The study of professional identity formation of midwives, grounded in the clinical frontline professional conversations of students with their preceptors/midwives, was developed to inform practice and research in postgraduate midwifery education. It also set out to contribute to the development of a methodology and conceptual model concerning the discursive acts/actions of the students and their preceptors/midwives in particular social episodes, which could be integrated into naturalistic modes of social science. The professional identity of three student participants and the social conditions of institutional practice are immanent throughout their discourses related to safe midwifery practices at the intersection of both private purposes and social exigencies. The acts/actions of private experience and public expression were performed according to a social system of customs, rules, and regulations to promote safe and skilled midwifery practice. The students were exposed, during their induction into practice and through systematic appraisals of their professional development, to the overt judgments of midwives in the culturally rich environment of maternity services. In this research project, self-identity, multiple personas, and social structures in frontline conversations were studied. Positioning theory, developed by Harre and others, was used to make determinate the storylines, positioning, and illocutionary force of each student's agency in discourse and presented as a dynamic alternative to the concept of role. Positioning theory is presented as a dynamic alternative to the concept of role in analysing social episodes in professional education. The current pedagogy of reflective practice has been critiqued to elaborate a new epistemology of midwifery education rooted in social realism. The localised psychological spaces, afforded in educational discourses and framed by dimensions of public/private positioning and individual/collective accountability, were explored to present a schematic model, after Harre, of personal being in professional identity formation. Three ontological domains include the semiotics of midwifery practice, agency of students, and professional structures, which appeared in some form within each social episode and presented in the students' accounts. The orienting theory of discursive positioning permits the study of the relationship between these ontological levels and allows progress toward a transformational model of social action in midwifery. This model offers a more dynamic theory of socially situated learning in codifying the ontology of experiences and concepts for future midwifery practice.
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ItemClinical congruence : where graduate nurse clinical reality meets organisational clinical requirements( 2004)In the mid 1980s, education associated with the requirement for registration as a Nurse in the State of Victoria moved from a hospital-based system into the university setting. This move brought with it many and varied requirements for change within the health care setting. The students of nursing were now no longer a part of the workforce, they were transient visitors in the patient care setting with very specific clinical requirements to be met; and they were there for less time! This research project is not about whether this change in preparation should have occurred. It is well accepted amongst the profession that this was necessary to raise the status of the nursing professional. We now have registered nurses with a primary degree in nursing or health science. The question here however, is what clinical capacities do the newly graduates and registered nurses have when they enter the clinical workforce, and what clinical capacities are required by the health care institutions that are employing them. Have these institutions an accurate and realistic knowledge of the clinical capacities of the newly graduated registered nurses they employ? This research concentrated on the self-perceived and reported clinical capacities of newly graduated registered nurses as they entered the clinical environment and the clinical capacities required by the clinical areas that employed them. Clinical congruence was then measured between these two sources. The findings demonstrated that in a supported environment, where graduates can expect and receive clinical support and mentorship, clinical congruence:is likely to be achieved. However, in an environment where clinical skills are required to be undertaken at an unsupervised level, there were a significant number of distinct clinical skills for which the graduates report unpreparedness. Graduates and Nurse Managers alike agreed that increased clinical experience during the undergraduate preparation time is optimal, but the universities indicated that the fiscal and chronological constraints of a three-year degree program, in an environment where there is a cost incurred for the clinical experience, is difficult to achieve. This research demonstrates, in a tangible way, the need for a supported Graduate Transition Program to facilitate the consolidation and / or achievement of clinical competency for the graduates as they enter the workforce. This support will assist in ensuring the maintenance of a dynamic nursing workforce into the 21st century to meet the needs of the Victorian community at a time when it is most vulnerable during the period of ill health.