Graduateness in Nursing: A Case Study of Undergraduate Nursing Students' Development and Employability

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Graduateness in Nursing: A Case Study of Undergraduate Nursing Students' Development and Employability

Geraldine Lyte

PhD

2007-11

University of Manchester

228

CONTENTSPageList of Contents 2List of Tables 7List of Figures 7List of Boxes 7List of Appendices 8Abstract 9Declaration 10Copyright Statement 10Dedication 11Acknowledgements 11List of Abbreviations 12The Author 13CHAPTER ONE: Introduction 141.1 Background to the study 141.2 Aims of the research 161.2.1 Aims of the research 161.3 Questions posed by the research 161.4 Order of the thesis 17CHAPTER TWO: Literature Review 192.1 Search strategy and focus for the review 192.1.1 Procedures used for searching and selecting literature 19 2.1.1.1 Search Engines 19 2.1.2 Identification and rationale for themes to be discussed 212.2 The historical context of higher education for UK nurses 212.2.1 Education policy for nurses prior to 1986 212.2.2 Emergence of Diplomate and Undergraduate Programmes 242.3 The concept of graduate employability 28 2.3.1 Defining graduate employability 28 2.3.1.1 Skills plus approach for enhancing graduate employability 302.4 Graduate nurse employability 33 2.4.1 Defining graduate nurse employability 33 2.4.1.1 QAA and NMC outcomes for pre-registration nursing 34 2.4.1.2 Competence in nursing 36 2.4.1.3 An operational definition of graduate nurse employability 43 2.4.2 Perceptions of employability of graduate nurses 432.5 Summary of findings from the literature 50 CHAPTER THREE: The Research Process 523.1 Introduction 523.2 Research aims and questions 523.2.1 Aims of the research 533.2.2 Research questions 533.3 Research design: qualitative case study methodology 543.3.1 Introduction 543.3.2 Consideration of the range of research approaches 543.3.3 Rationale for the application of a qualitative case study design 583.3.4 Applying a qualitative case study design within a constructivist 58 paradigm3.3.4.1 Additional ontological and epistemological considerations 613.3.5 Summary of selection of qualitative case study design 623.4 The case and its context for the present research 623.4.1 The case 623.4.2 The context 623.4.2.1 The BN (2002) programme and student cohort 633.5 Research Methods 653.5.1 Orientation 663.5.2 Sampling & ethical approval 673.5.2.1 Sampling method 673.5.2.2 The university sample 693.5.2.3 The mentor sample 703.5.2.4 Additional informants 703.5.2.5 Ethical approval 713.5.3 Data gathering and tools for data analysis 723.5.3.1 Documentary reviews 72 3.5.3.2 Direct (non-participant) observation and participant observation 743.5.3.3 Interviews 763.5.4 Framework for analysis and interpretation of data 793.5.4.1 Framework analysis 803.5.4.1.1 Familiarisation 823.5.4.1.2 Development of a thematic framework 843.5.4.1.3 Indexing 853.5.4.1.4 Charting 853.5.4.1.5 Mapping & interpretation 863.5.5 Emergent themes 893.5.6 Preparing and disseminating the case report 913.6 Rigour and reflexivity 913.6.1 Reflexivity 953.6.1.1 Being reflexive 963.7 Summary of the research process 97CHAPTER FOUR: Skills and knowledge for the workplace 984.1 Introduction 984.2 Range 984.2.1 Psychomotor skills 994.2.2 Cognitive ability 1024.3 Opportunity 1064.3.1 Availability of placement experiences 1074.3.2 Consistency of learning opportunities and skills development 1084.4 Support 1124.4.1 Institutional support for skills development 1134.4.1.1 Core (transferable) skills 1134.4.1.2 Structures to support skills & knowledge attainment 1144.4.2 Support from mentors and lecturers 1144.4.3 Support from Practice Educators 1184.4.4 Competing for support 1204.5 Summary of chapter four 121CHAPTER FIVE: Personal and professional development 1235.1 Introduction 1235.1.1 Introduction to the undergraduate experience 1245.2 Ownership of learning and development 1245.2.1 Being proactive 1255.2.2 Balancing degree studies and a personal life 1345.3 Being different 1405.3.1 Undergraduate status 1405.3.2 Academia and practice 1435.3.3 Assimilating into workplace cultures 1455.4 Summary of chapter five 153CHAPTER SIX: Being ready 1546.1 Introduction 1546.2 Transition to the workplace 1556.2.1 The final placement 1556.2.1.1 Increasing responsibility 1566.2.1.2 Readiness to practice 1596.2.2 Early employment issues 1626.3 Competence to practice 1646.3.1 Achievement and application of operational competence 1666.3.2 Achievement and application of academic competence 1706.3.2.1 The dissertation 1716.4 Graduateness 1736.4.1 Graduate attributes 1746.4.2 Perceived value of being a graduate 1786.5 Summary of chapter six 181CHAPTER SEVEN: Discussion 1837.1 Introduction 1837.2 Constructing a model of nursing graduateness 1837.2.1 Efficacy beliefs 1847.2.2 Discipline-specific skills and knowledge 1877.2.3 Metacognitive traits 1897.2.4 Core skills and knowledge 1907.2.5 A model of nursing graduateness 1907.2.6 Further consideration of nursing graduateness 1917.3 Influence of health policy and reform on undergraduate nursing 195 students??? development and employability7.3.1 Factors which enhance graduate nurse employability 1957.3.2 Factors which impede graduate nurse employability 1987.4 Summary of chapter seven 200CHAPTER EIGHT: Conclusion 2028.1 Introduction 2028.2 A reflexive narrative 2028.2.1 Introspection 2038.2.2 Managing power imbalances 2048.2.3 Inter-subjective reflection 2068.2.4 Summary of reflexive process 2078.3 Methodological issues and limitations of the case study 2088.4 Recommendations for future research 210References 213Appendices 228

This research has focused on a detailed exploration of undergraduate nursing students??? development for registration and their future employability potential. There has been a particular emphasis on probing whether there is value in being a nursing graduate, within this. In the study employability refers to graduating students??? preparedness to contribute to their immediate and longer term working lives, using the combination of operational and academic competence, self-efficacy and potential for further development through reflection and lifelong learning.A review of literature has revealed that there is a general paucity of any type of related published research from the within the UK and elsewhere, especially qualitatively-based research. In particular, no research could be found which has explored in-depth, as its primary aim, what nursing graduateness constitutes at the point of graduation and registration as a nurse and, whether it contributes to the employability potential of graduate nurses for both basic and advanced practice. A qualitative, instrumental case study was applied as the research design to achieve depth of focus for this inquiry, in order to meet the aims of the research. Findings from the study have uncovered a wide range of graduate attributes which were identified within participating students??? development and perceived employability potential. From this a model of nursing graduateness has been proposed. Findings also indicated that changing healthcare needs within society coupled with the recent reforms in healthcare, NHS policy and the nursing role have placed greater emphasis than ever before on such graduate attributes within nursing as higher order thinking for effective nursing practice. Recommendations have been put forward for nursing education practice and research.

• pre-registration nursing
• graduateness
• nursing competence

• Lyte, Geraldine

• Faculty of Medical and Human Sciences
• School of Nursing, Midwifery and Social Work

uk-ac-man-scw:70334

Lyte, Geraldine

26th October, 2009, 11:46:09

Lyte, Geraldine

16th August, 2010, 13:12:53