‘I`ll make a damn good nurse’ – A Qualitative Study of Coherence and Learning in Nursing Education

Abstract

Strengthening the students’ perception of correlations between different forms of knowledge, education arenas and life spheres is an explicit goal in the education of professionals. However, the education is criticised for ignoring the value of students’ own life experiences when studying a discipline and developing a professional identity. This thesis sheds light on how nursing students themselves are working to create coherence between the theoretical and practical elements of the education, and between the content of the education and their life experiences as a whole. The thesis describes and analyses these processes through the application of narrative theory and socio-cultural learning theory. Based on empirical data from individual in-depth interviews and participant observation of nine students in the first part of the three-year Norwegian bachelor’s degree course in nursing, the themes and findings of the thesis are presented in three articles. The first two articles are based on the interview material, and use narrative theory and methodology to analyse how the students’ storytelling helps to create coherence between their personal experiences and the forms of knowledge and learning contexts that they encounter through their education. The analyses in the articles alternate between focusing on the content and structure of the students’ stories and the dynamic function of these stories as the individual student encounters the nursing course. In the last article, which is based on field notes from participant observation, a cultural analytical perspective is applied to the students’ patient-centred work in hospitals. Using key concepts of socio-cultural learning theory, the analyses show how the students’ participation in the communities of practice can be understood as part of a negotiation and meaning-making process, which in accordance with this perspective, is a characteristic of the learning process. Thus, the students’ stories and participation not only help to create coherence between different fields of knowledge and life spheres, but also contribute to the students’ ‘meaning making’ in, and identification with, nursing as a discipline and education. In the summary discussion of the thesis, the findings in the three published articles are discussed in light of the education’s dominant understanding of care and knowledge perspective. This raises questions about whether the profession’s understanding of knowledge and care inhibits the inclusion of the student’s specific educational experiences and experiences of life in general. The thesis concludes that the students’ ability to create meaning in and recognise coherence between learning arenas and life spheres are processes that have a large but so far relatively untapped potential in the nursing education.