Service user involvement in pre-registration children’s nursing education: the impact and influence on practice: a case study on the student perspective

Abstract

This paper reports on a study that aimed to conduct an in-depth investigation into the impact of user involvement on student learning and subsequent influence on practice as a qualified nurse. This was undertaken through a single case study that followed a narrative inquiry approach UK policy has recommended user involvement in healthcare education for a number of years; this has in turn increased requirements for involvement from Professional, Statutory and Regulatory Bodies. The Nursing and Midwifery Council (NMC, 2010) now requires programme providers to clearly demonstrate how service users and carers contribute to programme design, delivery and assessment.Although the literature base is expanding there remains limited evidence of the impact of involvement on student learning and improved outcomes for patients.Narratives were collected from a children's nursing student on completion of her three year education programme and again after practising as a qualified children's nurse for one year. Taking part in the research enabled the participant to consider and reflect on her experience of user involvement in her nurse education. Analysis followed an interpretive approach utilising 'The Listening Guide' (Douchet & Mauthner 2008) with the researcher's interpretation of how the experience was conveyed with clear acknowledgement of reflexivity. The findings identified central themes of authenticity, knowledge of self, resilience and coping, professional relationships, personalisation of care and influence on practice. This demonstrates transformative 2 learning and support to practice, with preparation for situations and ideas on how to respond with empathy and compassion. This paper contributes to the emerging evidence base specifically from a children's nursing perspective, an area with a dearth of published material. Further research with a range of students is required to explore the lasting impact on practice.

Transformative learning as pedagogy for the health professions: a scoping review

“…Interventions included collaborative or peer‐led learning, group or teamwork and mentorship, with opportunities for dialogue and the use of narrative . Similarly, what was described as ‘experiential’ learning and learning that provided for authentic experiences in natural settings were seen to be challenging often from a resource or socio‐economic perspective …”

“…As they developed more discriminating perspectives, their worldviews shifted . Accordingly, TL influenced their values, attitudes and behaviours, and how they saw and understood themselves . Students developed new interpretations of how things were, including conditions within the realm of health care .…”

“…Studies spoke of how this awareness enhanced humanistic values, such as humility and integrity, and patient‐centredness, characterised by empathy and caring . Students were also described as having authentic opportunities to build and negotiate social, professional, therapeutic and reciprocal relationships …”

“…20 A dominant theme across a large number of the included studies emphasised that for TL to occur there has to be an opportunity for questioning existing frames of reference, and for reassessing one's beliefs, habits of mind and prejudices before entering a less-known environment where the knowledge and values upon which these beliefs and prejudices are founded might be questioned. 16,18,[21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36][37] Enablers for TL are therefore becoming aware of one's prior assumptions and having one's world view challenged. [38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53] In addition, 'liberating learning environments' or 'those conducive to developing autonomous thinking and self-empowerment' 54,55 were described as necessary for reinterpreting experiences.…”

“…Interventions included collaborative or peer-led learning, group or teamwork 37,57,79-81 and mentorship, 82 with opportunities for dialogue and the use of narrative. 17,39,62 Similarly, what was described as 'experiential' learning 25,57,68 and learning that provided for authentic experiences 19,33,41,59,83 in natural settings were seen to be challenging often from a resource or socioeconomic perspective. 35,52 A total of 64 of the 99 articles made reference to reflection as a process to both facilitate and assess TL, with one article offering a 'Model of Holistic Reflection'.…”