An educational panopticon? New technology, nurse education and surveillance

Epling, Michael; Timmons, Stephen; Wharrad, Heather

doi:10.1016/s0260-6917(03)00002-9

Cited by 17 publications

(10 citation statements)

References 11 publications

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“…Reflection is a way to promote the development of autonomous, qualified, and self‐directed professionals (Stoddart, Cope, Inglis, McIntosh & Hislop 1996; Epling, Timmons, & Wharrad, 2003). It provides the means for nursing professionals to realize the value of nursing knowledge by adapting and transforming knowledge to meet changing circumstances (Fakude & Bruce, 2003).…”

Section: Resultsmentioning

confidence: 99%

Concept analysis of reflection in nursing professional development

Tashiro¹,

Shimpuku²,

Naruse

et al. 2012

Japan Journal Nursing Sci

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Reflection is used as a method or tool that connects knowledge and experiences. Through the process of reflection, students/nurses become aware of themselves, which helps them review and improve clinical skills. They also become more able to communicate with patients and colleagues. Reflection enhances self-directed learning and professional maturity. Nurses who use reflection can be better positioned to provide excellent patient care.

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Section: Resultsmentioning

confidence: 99%

Concept analysis of reflection in nursing professional development

Tashiro¹,

Shimpuku²,

Naruse

et al. 2012

Japan Journal Nursing Sci

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“…The impact of surveillance also spills over into nurse education, where the profusion in computer‐based learning systems parallel the proliferation of electronic systems generally (Epling, Timmons, & Wharrad, ). This creates a crucible in which faculty can “see” everything students do, which can be understood as parochial in its supervision or as emancipatory as instructors are able to use data generated to improve courses and student learning (Epling et al, ). The learning management system functions in many respects like the electronic health record, with nursing students standing in for nurses in this configuration.…”

Section: The Effects Of the Electronic Health Recordmentioning

confidence: 99%

Electronic health record as a panopticon: A disciplinary apparatus in nursing practice

Dillard‐Wright

2019

Nursing Philosophy

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Working through the nights as a senior staff nurse in shock/trauma critical care, I gradually realized that I was ensnared in a complex web of expectations and behaviours, with the electronic health record a constant presence, both intrusive and surreptitious. The electronic health record seemed to take on a life of its own, a person behind the curtain. As patients grew sicker, the record grew more insistent, firing off endless reminders, prompts and commands. The electronic health record housed orders for the nurse to execute at the same time as it demanded feeding; extracting data from patients like flour from grist. All the while, the electronic health record monitored and recorded, quantifying the actions of nurses as they care for their patients. These actions are then transformed into discrete, minable data points that go on to construct a map of the patient experience, capturing vital patient information. This transformation also becomes an audit trail for nurses' behaviours, surveillance in absentia. The ghostly tentacles of managerial discipline emanate from AbstractThe specific arrangements of power/knowledge that characterize nurse interactions with the electronic health record form a panopticon. As health care moves into the 21st century, sophisticated technologies like the electronic health record shape the terrain of professional possibilities. The longer it is in use, the more it is possible to excavate the inherent disciplinary function of electronic health record. A panopticon is a generalizable, replicable apparatus of power that cultivates discipline when similar behaviours are desired from a group of people. This paper traces the arrangements of power/knowledge that characterize nurse interactions with the electronic health record rooted in a trauma critical care setting. Examining the apparatuses of power/knowledge enforced through panopticism in nursing makes the invisible visible. This in turn enables nurses to address the intended and unintended consequences of the electronic health record. If nurses are to effectively shape the direction of their own futures and the future of health care, nurses will need to unpack the invisible techniques of power such as the electronic health record as a panopticon. In the process of building a visible identity, contextualizing nursing knowledge to better care for patients on the one hand and understand the relationships of power that limit us on the other, nurses are neither apolitical nor powerless. Considering the dialectic of power/knowledge in the healthcare setting helps to illuminate spaces to recharacterize nursing, reveal the contributions and knowledge of nurses, and consolidate the professional power of nurses to affect meaningful change and self-governance in the healthcare setting. K E Y W O R D Scontrol, Foucault, knowledge, nursing, panopticon, power

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“…Weston 2008). New technologies are frequently perceived as a threat to professional authority, particularly where they enhance surveillance (Epling et al, 2003) or mandate clinical process (Kent et al, 2015). However, such fears are not new and have been expressed before in relation clinical guidelines, evidence-based medicine and decision-aids.…”

Section: Perspectives On Professional Authority and Protocolsmentioning

confidence: 99%