Nursing education: what can perspectives from the social sciences contribute?

Lead Research Organisation: University of Stirling
Department Name: Nursing, Midwifery and Health

Abstract

The purpose of this seminar series is to develop approaches to the teaching of care to nurses that are informed in a meaningful way by the social sciences. Recent high profile scandals (e.g. at the Mid Staffordshire Foundation NHS Trust) have raised notable concerns about levels of basic nursing care. Evidence indicates that caring is an attribute the public see as central to the role of a nurse. Thus, whether or not there has been a decline in caring within the nursing profession, supporting nurses to provide a high level of care is important.

How might the social sciences contribute to nursing education in a meaningful manner? Caring has various components which involve individuals feeling empathy and having practical skills. The social sciences can potentially inform both. To feel empathy requires individuals to have insight into the experiences of others, something to which the social sciences have made considerable contribution in the past (though the extent to which this has been used within nursing curricula has been limited). Providing practical care can also be informed by the social sciences. The needs of individuals will differ depending on their circumstances. For example, enabling self-care for someone living in the context of deprivation will involve some very different considerations to another scenario; say with a patient who is economically more secure even if the medical condition involved is the same. Understanding social context thus has considerable potential. The social sciences can also potentially facilitate reflective practice, thus helping nurses to more confidently challenge ineffective or sub-optimal practices.

Using insights from the social sciences (and specifically geography and ethnography as proposed here) is not going to be a simplistic fix to problems experienced in the health service, but has the potential to contribute to improving practice. We explicitly address gaps between theoretical ideas and practice by bringing together different groups of people: academics (from nursing as well as social science areas of work), policy makers who contribute to developing nursing curricula and nursing students (both pre- and post-registration). We adopt the framework of 'joint interpretive forums' for our seminars. This framework will enable theoretical ideas to be explained, questioned by people with very different perspectives and developed in a way that is relevant to practice.

The views of nursing students are crucial if the contribution the series aims to make to nursing care is to be meaningful to the teachers, researchers and practitioners of the future. The social sciences have demonstrated the importance of user participation and our inclusion of student nurses will not only capture their perspectives but also provide a model for the development of nursing curricula. A core group of student nurses will contribute to seminars and also be supported to write papers as a means of widely communicating their views.

The series sets out with two seminars that consider the theoretical contributions geography and ethnography can make to nurse education. The ideas emerging from these early encounters are then developed in a third seminar through the analysis of a topical case study (Mid-Staffordshire). Hence we begin to unpack implications of practice in the face of realities to theory. The fourth and fifth seminars are dedicated to the discussion of the developing theoretical ideas from earlier seminars by those directly involved in nursing education - teachers and students. The final seminar then takes the ideas developed up to this point and engages directly with those whose responsibilities involve the development of curricula for nurses. We also use the opportunity to consider how the networks created by the series can be made sustainable so as to enable a more explicit on-going discussion regarding nursing education and the potential contributions of the social sciences.

Planned Impact

Beneficiaries of the series will include the following groups:
- Patients
- Nurses
- And academics

Any improvement in nursing care will have benefits to patients. Critical and reflexive thinking are already well developed concepts within nursing but a more explicit utilisation of theories developed with the social sciences hold the potential to develop them still further and facilitate understanding (and thus responses) to caring for people whose lives are very different to those from which the nursing students understand. In so doing the series will also enable discussion of the theory practice-gap so as to explicitly recognise and challenge assumptions of both academics and practitioners and potentially empower nurses in their roles of ensuring the wellbeing of patients and coping with the realities of working in situations of limited resources.

Publications

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Atherton I (2014) Habitat and health: why place matters. in Nursing standard (Royal College of Nursing (Great Britain) : 1987)

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Atherton I (2014) Learn to see patients in their own world. in Nursing standard (Royal College of Nursing (Great Britain) : 1987)

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Atherton I (2014) How empathy skills can change nursing. in Nursing standard (Royal College of Nursing (Great Britain) : 1987)

Related Projects

Project Reference Relationship Related To Start End Award Value
ES/L000741/1 01/04/2014 31/12/2014 £20,836
ES/L000741/2 Transfer ES/L000741/1 01/01/2015 31/03/2016 £12,315
 
Description The Principle Investigator was asked to contribute to a 'Thought leadership group' by the Nursing and Midwifery Council (NMC), the professional regulators for nursing in the United Kingdom. The NMC, apart from regulating the profession, also have responsibilities to setting requirements for undergraduate nurse education that will enable entry to the professional register. The 'Thought Leadership Group" started the process of developing new standards of proficiency for undergraduate nurse education in the United Kingdom. The request resulted from the involvement of the NMC in the seminar series. It has enabled ideas that emerged through the seminar series to be fed into the process of developing competencies. The process is ongoing and will shortly be entering a wider consultation later in 2017. The seminar series team will be continuing to engage with that process and draw on insights from the series to contribute to the ongoing development of these standards, and to encourage the use of the social sciences in undergraduate nurse education. In 2020 the NMC started discussing potential ways in which their data might be used to better understand the dynamics of the nursing workforce, and to gain insights into risks for referral to fitness to practice panels. These discussions have been enabled by the ADR UK funding, and specifically through the Scottish Collaboration for Administrative Data Research.
Sector Education,Healthcare
Impact Types Societal

 
Description Request to contribute to consultation on development of new standards for undergraduate nurse education
Geographic Reach National 
Policy Influence Type Participation in a national consultation
 
Description Seminar 1 - Placing Patients' Lives 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach International
Primary Audience Professional Practitioners
Results and Impact This was the opening seminar in the series. 30 people drawn from nurse education and geography attended. Considerable discussion was generated as to the current contributions of geography (and the social sciences more generally) as well as the challenges and opportunities to draw on them effectively. The meeting specifically focussed on the contributions of geography to nurse education. Five geographers presented work with experts drawn from nurse education acting as respondents. Professor Gavin Andrews (McMaster University) provided an overview of the contributions geography has already made to nursing. He then went on to suggest how Non-Representational Theory might contribute to nursing education, facilitating nurses to see the experiences of patients in new and exciting ways. Drs Atherton and Kyle (members of the series organising team) then reflected on how Spencer and Whatmore's idea of 'bio-geography' might reinvigorate nursing education. Drs Sothern and Kesby then discussed their work on categorisation and risk in relation to blood transfusions. Respondents highlighted challenges with effectively utilising the ideas of social sciences in nursing education given overloaded curriculum and the availability of expertise in institutions. Similar concerns were raised by delegates as to how constraints might be overcome to enable greater use of ideas from the social sciences.


Key messages from the series were that the social sciences have contributed considerably to nurse education but much more could be achieved. Moving forward will require dialogue between groups with input to nurse education, particularly Higher Education Institutes and the Nursing and Midwifery Council. These ideas have been taken forward to be discussed and developed at later seminars.
Year(s) Of Engagement Activity 2014
URL http://socialscienceandnursing.com/seminar1/
 
Description Seminar 2 - Culture and Context 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? No
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact This was the second or the series seminars. It brought together 30 academics and practitioners from the social sciences and nursing as well as students. Presentations sparked discussions around the ethnographic insights into the complexities of nursing care and how these can be better utilised in nurse education. The thinking generated revolved around several key topics.

Presentations were provided as follows: Drs Iain Atherton and Richard Kyle provided an overview of the series and key ideas from the opening meeting; Professor Celia Lury (Centre for Interdisciplinary methodologies, University of Warwick); rofessor Kate Seers (RCN Research Institute, University of Warwick); Professor Gillian Hundt (Warwick Medical School, University of Warwick); and Professor Frances Griffiths, Professor of Medicine in Society, University of Warwick).

Responses were provided from the perspective of nurse education by Professor Gill Furze and Professor Jane Coad (both Nursing and Health Studies, University of Coventry).

Participants considered the benefits of students grappling with 'wicked problems': those problems for which there is no straightforward resolution. They also thought through the challenges of developing skills in nurses that better enables them to act as the interface between the complexities of diagnosis, treatments or nursing care and the lay patient. What came through from these discussions is the potential for honest insights into the realities of nursing rather than a more superficial medicalised or managerialised perspective. Drawing on insights into the culture of care has the potential to excite students, engaging them critically in challenging assumptions and facilitate empathetic nursing care.

Ideas from presentations and discussions have been incorporated into a blog on the seminar series web site and will contribute to a working paper. This blog and associated working paper will provide continuity into forthcoming seminars in the series where educationalists and students will consider how ideas might be practically applied.
Year(s) Of Engagement Activity 2014
URL http://socialscienceandnursing.com/seminar2/
 
Description Seminar 3 - What could social science perspectives bring to the future of nursing leadership and practice? 
Form Of Engagement Activity A formal working group, expert panel or dialogue
Part Of Official Scheme? Yes
Geographic Reach National
Primary Audience Other academic audiences (collaborators, peers etc.)
Results and Impact The seminar provided an opportunity for social scientists working in health related fields to present to an audience that included nurse educationalists. It brought together 30 academics and practitioners from the social sciences, health care research and nursing as well as student representation.

The seminar opened with an overview of the first two seminars provided by Dr Iain Atherton and Dr Richard Kyle (two of the applicants responsible for taking forward the series).

Presentations were made by the following academics: Professor Graham Martin (Professor of Health Organisation and Policy, University of Leicester); Professor Davina Allen, School of Healthcare Sciences, University of Cardiff; and Professor Ellen Annandale, Head of Department of Sociology, University of York.

Responses to these papers were provided from the perspective of nursing education by: Professor Dame Jessica Corner, Dean, Facility of Health Sciences, University of Southampton; and Professor Stephen Tee, Associate Dean (Education), Florence Nightingale School of Nursing and Midwifery, King's College London.

Discussion was generated as to the implications of ideas highlighted by the presented papers. Professor Dame Jessica Corner later stated in her opening speech as chair to the Council of Deans:

'I recently took part in an ESRC seminar series on social science and nurse education - a collaboration between King's College London, the Universities of Warwick, Nottingham and Stirling and the RCN. I participated in a seminar looking at the future of nursing leadership and practice post-Francis, with extraordinary inputs from Davina Allen from the University of Cardiff, Graham Martin from the University of Leicester and Ellen Annandale from the University of York. The picture of nursing work that shone through these studies is not reflected in the extant narrative, in the NMC code or in current discussions about selection for values and compassion in practice. This was a picture of nursing in a world dominated by managing an entirely fragmented system of care, both within institutions and between care settings, where nurses act as critical 'glue' shaping communication to bridge failing systems driven by managerialist prerogatives (waiting times, productivity models, efficiency, audits and data dashboards). This is not encompassed within a professional code focussed around compassionate interaction with single patients, yet it is a key and ongoing risk.'
Year(s) Of Engagement Activity 2014
URL http://socialscienceandnursing.com/seminar3/