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Title: #Where is the heart of nursing?' : the discourse of validation in nursing.
Author: Walter, Pamela Alison.
ISNI:       0000 0001 3557 9807
Awarding Body: South Bank University
Current Institution: London South Bank University
Date of Award: 1995
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The impetus for this study derived from a policy document of the English National Board (ENB 1985a) which raised the notion of 'peer review of courses', and from personal experience of some of the first Project 2000 validation events. The development of a national peer review process would be a radical departure from the existing closed mechanism of course approval by the statutory body. At the validation events for Project 2000, nursing as a subject, seemed to be avoided. For me this raised questions as to what these validation events were achieving. The study begins by introducing the theoretical framework which was central to understanding how knowledge for nurses has been developed and approved. This incorporates notions of power (Lukes (1974), the sociology of knowledge, and communication (Habermas 1970). Strategic power has been exercised over nurses through patriarchal strategies to control nurses work and access to knowledge, and legitimately by nursing's statutory body to approve pre-registration courses. The advent of Project 2000 courses required conjoint validation with higher education. The change in the approval process has enabled shifts in power relations to occur. Since knowledge claims are part of what is validated through academic debate, the question raised was "how do nurses account for nursing know ledge and how is this recognised at validation events?" The nature of the data to be collected and analysed was informed by the theoretical framework and the research methodology, discourse analysis (Potter & Wetherell 1987). Data included; literature that provided historical and contemporary information about the development of 'knowledge for nurses', 'nursing knowledge' and validation; official circulars from the statutory body related to curriculum development for Project 2000; course documentation presented at four validation events; the official reports from those events; field notes of the validation events. Discourse analysis is concerned with language use and aims to explore the subtleties and complexities of technical explanations in natural contexts. It focuses both on the variation and construction of accounts and involves developing hypotheses about the purposes and consequences of language. The first stage of the analysis revealed that validation discourse was constructed through the use of four interpretive repertoires. The' assimilatory' and' accommodatory' repertoires were used to demonstrate how ways of working either did or did not follow agreed procedures/rules. The 'accounting through theories' and 'accounting for (nursing) educational processes' repertoires were used to account and not account for nursing. The second stage explored the function of the repertoires. One pair of competing repertoires were used to either exercise power or create conflict. Conflict was also created when the repertoires came together. A voiding this was worked hard at by validators and validatees and was achieved through an 'appeal to a higher authority' device. The second pair of repertoires ensured that whilst certain aspects of nursing were discussed, practice knowledge was avoided. The repertoires were also used to prevent certain issues getting on the validation agenda, significantly practice knowledge. The validation events were arenas in which the use of strategic power and communication dominated. Their use illuminated issues which constrained validators and validatees, and which militated against the notion that validation was conducted by peers in an 'ideal speech situation'. There is discussion of ways in which discourse analysis and critical theory can be brought together to capture practice knowledge and emancipate the discipline of nursing
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available
Keywords: Nurse education