Of precipices and tightropes : the interaction between nurse learner wastage/persistence, institutional integration and identity.
Since the 1980s, pre-registration nurse education has undergone dramatic changes that have led to the creation of a new course - Project 2000 - and its delivery within the Higher Education sector. Very little written during this period has addressed the
issue of nurse learner wastage/persistence. The literature on nurse learner wastage/persistence prior to this period has tended to be largely atheoretical in nature. One of the chief objectives of this study was to produce a much more complex picture of wastage/persistence. This involved the building of a theoretical framework designed to explore one aspect of
voluntary wastage - the interaction between integration and wastage/persistence, and which could capture the complexity of the phenomenon by taking into account the interaction between the individual and the institution within the process of wastage/persistence.
This study draws on Tinto's (1975) Student Integration Model, which identified the learners' integration into an institution to be one of the critical factors in understanding the wastage/persistence of learners, as well as on some of the studies within the area of nurse learner wastage/persistence which have examined the role of a learner's identity in the wastage/persistence process. Accordingly, this study defined integration in terms of how well a learner has adopted the identity/ies afforded to them by the institution. Finally, drawing inspiration from Foucault (1988, 1990,1991), this study re-conceptualised identity in terms of the concept of
subjectivity and defined integration in terms of how well the learner was able to subscribe to the discourses (and the subject positions that these made available) that constituted the given institution. A multiple case study was carried out that focused on leavers and stayers in the first year of a Project 2000 course in three particular cohorts within a particular institution. A modified version of discourse analysis, referred to as MODA (Meaning Orientated Discourse Analysis), was used. Two major discourses were identified which offered the learner a number of contradictory subject positions regarding what it means to be a learner and a nurse - the 'autonomous' and the 'apprentice' discourse. It was found that stayers were those most able to manage these contradictory subject positions offered by these discourses. This meant that they were more playful in their discursive reading patterns than leavers. This playfulness implied they were not only doing a lot more with these discourses, but that that the nature of what they were doing enabled them to accept and embrace the contradictory notions of what it means to be a learner and a nurse existing in the institution. The stayers' management of
discourses was a reflection of the high level of integration that they had achieved within a institution that is riddled with two incommensurable discourses which offer competing definitions of what it means to be a nurse and a learner.