Professional nurses’ views of their role in the professional socialisation of students

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CHAPTER 2 ;RESEARCH DESIGN AND METHODS

INTRODUCTION

This chapter offers a detailed discussion on the research design and methods, including the data collection, population and sample, measures to ensure trustworthiness, validity, reliability and ethical considerations.

RESEARCH OBJECTIVES

The first two objectives of this study were to qualitatively explore and describe the perceptions and experiences of professional nurses and students on the professional socialisation of students. The third objective was to quantitatively determine and describe the perceptions of educators on their teaching and facilitation of professional socialisation to students. The last objective was to develop and validate guidelines to support nurse educators and professional nurses in the professional socialisation of
students.

RESEARCH DESIGN

The research design refers to a plan regarding the process that is followed to solve the research problem (Babbie & Mouton 2011:647). This study was guided by the question:
How could the internalisation of skills, knowledge, values and beliefs be guided in student nurses to help them become effectively socialised as professional nurses? A sequential, exploratory, mixed-methods design was followed to answer the above question. In mixed-methods research the researcher collects, analyses and integrates data and draws inferences from both qualitative and quantitative research approaches in a single study (Teddlie & Tashakkori 2009:7).

Mixed-methods research

The main reason for using a mixed-methods design was that the combination of a qualitative and quantitative design would address the research problem from different perspectives. The rationale for using mixed-methods research was as follows:
 Using mixed methods means that better understanding of the research problem can be established (Creswell & Plano Clark 2007:8–13). The researcher could obtain a full understanding of the factors influencing professional socialisation from the perspectives of both professional and student nurses. In addition,
educators addressed the professional socialisation of student nurses from a teaching perspective.
 The strengths of the qualitative and quantitative methods complement each other, thus generating the best answer to a problem (Connelly 2009:31; Denscombe 2007:109–111). The qualitative approach aims at understanding and obtaining rich in-depth information, where subjectivity and the context in
which the data are obtained are important. In contrast, a quantitative approach focuses on objectivity, precise measurements and predictions; however, the knowledge generated using this method alone may be too abstract and general and not directly applicable to situations (Johnson & Onwuegbuzie 2004:19–20). Through exploring and describing the phenomenon of professional socialisation, multiple perspectives that were rich in detail were obtained from professional nurses and students in a natural setting. The setting in which the data were collected was familiar to the participants and they could therefore share their perceptions and experiences with ease. These perspectives could be examined further in the light of the educators’ teaching and facilitation of professional socialisation of students on a larger scale, and precise measurements could be employed. This resulted in comprehensive evidence from the perspective of not only professional nurses and students but also the educators.
 The combination of qualitative and quantitative approaches could provide better answers to questions than if a single approach had been adopted (Connelly 2009:31). The perceptions and experiences of participants in phase I provided detailed and personal evidence, which would not have been possible if only a quantitative approach had been adopted. Conversely, the quantitative data generated in phase II were on a larger scale and provided answers that could be generalised, which would not have been possible with a purely qualitative approach.
 Through combining qualitative and quantitative data, methodological triangulation could be established, which consequently resulted in better understanding of the scope of the research problem (Denscombe 2007:119, 135). In this instance, the combination of the different forms of data resulted in the discovery of contradicting and/or supportive evidence on the phenomenon, which added richness to the study.
 Creswell (2003:11) states that the focus of the research problem is dictated by the philosophical foundation. The research problem encouraged the application of a pragmatic worldview that included both a post-positivist and a constructivist worldview, as discussed in chapter 1.
 Another characteristic of mixed-methods research is that words can give meaning to numbers, while numbers add precision to words (Johnson & Onwuegbuzie 2004:21). In the qualitative component (phase I), words were used to describe the analysis and interpretation of the perceptions and experiences of the participants. However, in the quantitative component (phase II), numbers, descriptive and inferential statistics were used to describe the data pertaining to the teaching and facilitation of students by educators.
The advantages of mixed-methods research are huge. Among others, this approach allows the researcher to gain better understanding of the research problem, address the weaknesses of each approach and apply different worldviews and methodological triangulation. The challenges of mixed-methods research facing the researcher include the cost involved, the time span and the complexity of managing the different approaches. These challenges were addressed in this study through expert guidance from the promoters, careful planning and following the correct methodology to ensure rigour in the research process.
In the selection of a sequential exploratory mixed-methods design, the timing, priority (weighting) and the integration of data (mixing) need to be considered (Creswell & Plano Clark 2007:80; Denscombe 2007:118). This type of mixed-methods research first
aims to explore a topic qualitatively, before an attempt is made to measure the phenomenon quantitatively. Regarding the timing of this study, it commenced with the qualitative component (phase I), followed by the quantitative (phase II) component.

CHAPTER 1 ORIENTATION TO THE STUDY
1 ual
2.4 STUDY SETTING
2.5 RESEARCH METHODOLOGY
2.5.1 Qualitative phase I
2.5.1.1 Population
2.5.1.2 Sample
2.5.1.3 Data collection
2.5.1.4 Data analysis
2.5.1.5 Integration of results from sample A and B and literature control
2.5.1.6 Trustworthiness
2.5.2 Quantitative phase
2.5.2.1 Census
2.5.2.2 Data collection
2.5.2.3 Data collection instrument
2.5.2.4. Data analysis
2.5.2.5 Validity and reliability
2.6 INTEGRATION OF DATA FROM THE QUANTITATIVE AND QUALITATIVE PHASE
2.7 APPROACH FOLLOWED IN GUIDELINE DEVELOPMENT
2.7.1 The reasoning process followed during guideline development
2.7.2 Validation of the guidelines
2.8 ETHICAL CONSIDERATIONS
2.8.1 Beneficence
2.8.2 Respect
2.8.3 Justice
2.8.4 Scientific integrity
2.8.5 External review
2.9 CONCLUSION
CHAPTER 3
DATA ANALYSIS, PRESENTATION, DISCUSSION AND LITERATURE CONTROL OF PHASE I’S FINDINGS
3.1 INTRODUCTION
3.2 DATA ANALYSIS
3.3 ANALYSIS, DISCUSSION AND LITERATURE CONTROL OF SAMPLE A (PROFESSIONAL NURSES
3.3.1 Theme 1: Professional nurses’ views of their role in the professional socialisation of students
3.3.1.1 Category: Role model
3.3.1.2 Category: Clinical supervisor
3.3.1.3 Category: Creator of a learning environment
3.3.2 Theme 2: Professional nurses’ perceptions of values and beliefs of students
3.3.2.1 Category: Disciplined behavior
3.3.2.2 Category: Career choice
3.3.2.3 Category: Image
3.3.3 Theme 3: Professional nurses’ experiences related to the attitude of students
3.3.3.1 Category: Gender
3.3.3.2 Category: Attitude
3.4 ANALYSIS, DISCUSSION AND LITERATURE CONTROL OF SAMPLE B (STUDENTS)
3.4.1 Theme 1: Factors related to a learning environment
3.4.1.1 Category: Teaching and learning
3.4.1.2 Category: Daily activities in a nursing unit
3.4.1.3 Category: Health and safety risks
3.4.1.4 Category: Communication between the clinical field and nursing educational institutions
3.4.2 Theme 2: Experiences related to the attitudes of professional nurses and students
3.4.2.1 Category: Attitude
3.4.2.2 Category: Favouritism
3.4.2.3 Category: Attitudes of professional nurses to other members of the multidisciplinary team
3.4.3 Theme 3: Values and beliefs orientation
3.4.3.1 Category: Professional nurses
3.4.3.2 Category: Disregard of culture and gender
3.4.3.3 Category: Role model
3.4.3.4 Category: Perceptions of the nursing profession
3.4.5 Integration of the findings of samples A and B
3.4.5.1 Theme 1: Characteristics of a professional nurse
3.4.5.2 Theme 2: The clinical learning environment
3.4.5.3 Theme 3: Values and beliefs related to the nursing as a profession
3.4.5.4 Theme 4: The educator
3.4.5.5 Theme 5: Cultural and gender orientation
3.5 CONCLUSION
CHAPTER 4 LITERATURE REVIEW
4.1 INTRODUCTION
4.2 PROFESSIONAL SOCIALISATION
4.3 THEORIES OR MODELS RELATED TO PROFESSIONAL SOCIALISATION
4.3.1 Hinshaw-Davis model of basic student socialisation (1976)
4.3.2 Bandura’s concept of modelling (1977)
4.3.3 Cohen’s model (1981)
4.3.4 Benner’s stages of nursing proficiency (1984)
4.3.5 Overview of the philosophies related to professional socialisation
4.4 COMPONENTS OF PROFESSIONAL SOCIALISATION
4.4.1 Curriculum
4.4.2 Learning environment
4.4.2.1 Environment related to the nursing education institution
4.4.2.2 Clinical learning environment
4.4.3 Persons involved in the professional socialisation of student nurses
4.4.3.1 Student
4.4.3.2 Professional nurse
4.4.3.3 Preceptor
4.4.3.4 Mentor
4.4.3.5 Peers
4.4.3.6 Educator
4.4.4 Values and beliefs
4.4.5 Cultural competence
4.5 CONCLUSION
CHAPTER 5 DATA ANALYSIS, PRESENTATION AND DISCUSSION OF FINDINGS OF PHASE
5.1 INTRODUCTION
5.2 SECTION 1: BIOGRAPHICAL DATA
5.3 SECTION 2: THE CONCEPT AND STAGES OF PROFESSIONAL SOCIALISATION (ITEMS 7,
8, 79-81)
5.3.1 Concept of professional socialisation (items 7–8)
5.3.2 Levels of professional socialisation (items 79–81)
5.4 SECTION 3: THE SIX PROFESSIONAL SOCIALISATION CONSTRUCTS – TEACHING AND FACILITATION OF PROFESSIONAL SOCIALISATION TO STUDENTS
5.4.1 Construct 1 (items 9, 11, 13, 15, 17, 31, 33, 35, 57 and 59)
5.4.2 Construct 2 (items 10, 12, 14, 16, 18, 32, 34 and 36)
5.4.3 Construct 3 (items 19, 21, 23, 65, 73, 75, 83 and 20, 22, 24, 66, 74, 76, 84, 85)
5.4.4 Construct 4 and related items (items 52, 54, 55, 58, 67, 69 and 46, 53, 56, 60-64, 67-71)
5.4.4.1 Clinical accompaniment (items 60–61)
5.4.4.2 Clinical support staff (items 62–64)
5.4.4.3 Construct 4: Educator and the clinical field with related challenges (items 52, 54, 55, 58, 67, 69
and 53, 56, 68)
5.4.4.4 Theory–practice discrepancies (items 46, 70–71)
5.4.5 Construct 5 and items related to teaching strategies (items 39–42, 44 and 37, 38, 43, 45, 50, 51,
25, 26 and 72)
5.4.5.1 Curriculum philosophy (item 37)
5.4.5.2 Emphasis of the curriculum regarding knowledge, skills, values and beliefs (item 38)
5.4.5.3 Construct 5 (items 39, 40, 41, 42, 44 and related items 43, 45)
5.4.5.4 Education and training facilities (items 50–51)
5.4.5.5 Support services (items 25, 26 and 72)
5.4.6 Construct 6: Cultural awareness and supportive items (items 28–30, 47, 48 and 27, 77, 78)
5.5 RELIABILITY TESTING OF THE SIX COMPOSITE PROFESSIONAL SOCIALISATION CONSTRUCTS
5.6 EFFECT OF RESPONDENTS’ BIOGRAPHICAL PROPERTIES ON THEIR PERCEPTIONS OF THE SIX CONSTRUCTS OF PROFESSIONAL SOCIALISATION
5.6.1 Age and cultural awareness
5.6.2 Age and aspects related to the values and beliefs of nursing
5.6.3 Duration of involvement in the nursing programme and perceptions of colleagues having the characteristics of an educator
5.6.4 Perceptions on conflict management: College versus university (item 34)
5.7 ADDITIONAL COMMENTS (ITEM 86)
5.8 ITEMS OMITTED
5.9 CONCLUSION
CHAPTER 6 DISCUSSION OF THE INTEGRATED DATA FROM PHASES I AND II
6.1 INTRODUCTION
6.2 THE CONCEPT OF PROFESSIONAL SOCIALISATION
6.3 THE CLINICAL LEARNING ENVIRONMENT
6.4 THE PROFESSIONAL NURSE
6.4.1 The professional nurse as role model
6.4.2 The professional nurse as clinical supervisor
6.5 CHARACTERISTICS OF AN EDUCATOR
6.6 THE NURSING EDUCATION INSTITUTION AND THE CLINICAL ENVIRONMENT
6.7 TEACHING AND FACILITATION STRATEGIES USED IN THE NURSING EDUCATION INSTITUTION ENVIRONMENT
6.8 WORK ETHIC OF PROFESSIONAL NURSES AND EDUCATORS
6.9 STUDENTS’ BEHAVIOUR
6.10 THE NURSING PROFESSION
6.11 CULTURAL AND GENDER AWARENESS
6.12 CONCLUSION
CHAPTER 7 DISCUSSION ON THE DEVELOPMENT AND VALIDATION OF GUIDELINES TO SUPPORT EDUCATORS AND PROFESSIONAL NURSES IN THE PROFESSIONAL SOCIALISATION OF STUDENTS
7.1 INTRODUCTION
7.2 DEVELOPMENT OF THE GUIDELINES
7.3 VALIDATION OF THE GUIDELINES
7.4 PRESENTATION OF DEVELOPED AND VALIDATED GUIDELINES
7.5 Theme 1: Clinical environment
7.5.1 Category: The professional nurse as exemplary role model
7.5.2 Category: The professional nurse as clinical supervisor
7.5.3 Category: A positive clinical learning environment for students
7.6 THEME 2: NURSING EDUCATION INSTITUTION ENVIRONMENT
7.6.1 Category: Educator as role model
7.6.2 Category: The nursing education institution’s clinical support to students
7.6.3 Category: Teaching and facilitation strategies
7.7 THEME 3: THE VALUES AND BELIEFS OF THE NURSING PROFESSION
7.7.1 Category: Work ethic of professional nurses and educators
7.7.2 Category: Students’ behaviour
7.7.3 Category: Nursing as a profession
7.7.4 Category: Cultural and gender awareness
7.8 CONCLUSION
CHAPTER 8 CONCLUSIONS, RECOMMENDATIONS AND LIMITATIONS
8.1 INTRODUCTION
8.2 PURPOSE OF THE STUDY
8.3 RESEARCH DESIGN AND METHODS
8.3.1 Phase
8.3.2 Phase II
8.3.3 Development and validation of guidelines
8.4 CONCLUSIONS OF THE STUDY
8.4.1 Conclusions on phase I
8.4.2 Conclusions on phase II
8.4.3 Conclusions on data from phases I and II
8.5 STUDY LIMITATIONS
8.6 RECOMMENDATIONS
8.6.1 Recommendations regarding nursing education
8.6.2 Recommendations regarding practice
8.6.3 Recommendations for implementation of the guidelines
8.6.4 Recommendations for further research
8.7 CONTRIBUTION OF THE STUDY
8.8 CONCLUSION
LIST OF REFERENCES