Nursing research — a demystifying process

Nurse Education Tcduy (1988) 8,284-288 0 Longman Group UK Ltd 1988

Nursing research - a demystifying process Justus A Akinsanya

Projects have been used in nursing education for many years as a means of encouraging learners to find out information about issues affecting their professional training. In general, such projects have been concerned with pathophysiological and psycho-social topics related to nursing. Students are encouraged to carry out varying levels of information gathering and to produce individual or group reports. Over a period of 14 years, attempts have been made to introduce nurses to the research process in schools of nursing and institutions of higher education. This paper summarises the use of this method with learners in second and third years of basic nurse training and those undertaking the Diploma in Nursing course. The approach involves learners in following through the research process in nursing to the publication and dissemination stages. It is argued that if nursing is to be a research-based profession, tutors in all settings must bring research to the centre of all learning activities in nursing.

so that

INTRODUCTION The philosopher, Rousseau, considered that the most effective way to learn science is by doing it. In Emile, Rousseau argues that he should not be taught science and notes: business

themselves.

to suggest

that it is rarely

what he ought

to

a legitimate affecting

paper

process should be approached

that

the

research

in the same spirit

284

for

mystification

in nursing

may well be

paid to it rather than

of obtaining information

and other

Principal

which

based

began

objective

health matters.

Nursing the

ration

and

comed

because

(and

about issues of an

Officer

(Edu-

introduction

to the

described in this paper. In General Nursing Council for

and Wales (GNC) introduced

assessment

considerable Justus A Akinsanya PhD BSc(Lond) SRN ONC BTA CERT RNT FWACN Reader in Nursing Studi,es, Dorset Institute of Higher Education, Wallisdown Road, Poole, Dorset BH12 588 Manuscript accepted 19 February 1988

means

research process 1973, the former England

in this

out

It was this belief and the encouragement cation)

It is argued

process

nursing

to find it. You should

(P 142)

to find of subjects

So much of the present

subjective)

enlightened

put it within his reach,

encouraged

due to the undue reverence

learn; it is for him to want to learn, to seek and you should skilfully awaken the desire and supply him with means for its satisfaction.’

are

on a wide range

of the research

sometimes

‘In the first place do not forget your

learners

information

of learners

Enrolment.

The

change

of its theory-practice

apprehension

the ward-

for State

Regist-

was wellink but

arose because

of the

issue of varying standards of assessments both within and between individual hospitals. In one particular hospital, a group of second year student nurses discussed the problem and wondered whether information on the views of staff

NURSE EDUCAI‘ION

and

students

might

help

to clarify

towards the new form of assessment. was encouraged

to develop a questionnaire,

it in the School of Nursing, views of a random

ingly low (22%),

attitudes The group pilot

and then canvass the

sample of staff and students in

began an attempt

in a School process

of Nursing

during

publication

setting

their

1973) encouraged group

year

block.

concerned

feasible

thus saw research

exercise

within

the

a number

was continued

students

widely reported

and were

as an Occas(Barlow J ,4 et

were

ward

patients’

lives. The group

resulting

precaution

of

This involved of Nursing

in the

about

tragic

guid-

survey

in hospitals

a

loss of

under

of fire

in the United

the development

The

of a research

in hospitals

Nursing

argued

As research

crucially

more

development the

time

block.

The

money

questionnaire

towards

nursing

concern

a number

its success.

one criterion

concerned a

work in an It was soon for

the

was available

also had

to be A

and piloted for the financed

to a randomly throughout the

rate was disappoint-

about

of

continues

to

which is recognised is the possession

to guide

practice.

nursing

Diploma in Nursing,

their

at a college

‘l‘he debate about

of writers in and on nursing.

In 1983,

planned

tried

is a profession

profession.

planned survey. The School of Nursing

the response

whether

on the methods.

the students contri-

the duplication and circulation selected sample of 200 hospitals

was next

whether

the cost of postage.

was developed

to

about

it, but were willing to

and higher education.

questioned

of staff. During

study

funded and for this purpose,

approach

further

However,

and encouraged

than

The

of knowledge

was needed

of the study

were enthusiastic

RESEARCH-BASED

in

the students

with the support

NURSING -A PROFESSION?

of

2 week block, the students began attempt to investigate the problem. that

was experi-

It was interesting

money to ensure

Officer

depended

was an acceptable

investigation

levels and the import-

and they not only gave up some of

that caring

use of sound fire precaution

activity in the School,

in

was thus seen

with others

note that the students

test of professionalism

to the Principal of the School group

encounter

process

and group

pro-

problems

at the

handicapped

decided,

and the Principal

the Hospital.

would normally

enced by staff and students.

contribute

the study

with all the major

of collaboration

the project

Kingdom. proposal submitted

of undertaking

to learn-

concerned

out an ambitious

methods

process

in 1975, a group of

fire in a mental

hospital

to carry

as a

normal

However,

UK. Although

published

their free time to support

of the publication,

Centre.

year

ance

school.

research

buted

Qualitative responses

ional Paper in the Nursing Times

that researchers

The

and staff in

Education

during

collated and the findings

at individual

ing about nursing

realised

the

of

to a nation-

approaches

safety

analyses

their work. The research

small scale classroom-based

effective

quantitative

(Elliott et al

findings

and contributed

and hospital

As a result

ance,

data.

vided the students

of the new form of assessment.

activities of a training

third

the resultant

The

learners

to the research

second

of students

the school perfectly

to introduce

of the students’

wide discussion The

were encouraged

to analyse

al 1975).

the hospital. Thus

the students

285

TODAY

as a

of a body

Smith

(1979)

is a research-based

students

undertaking

University

of London,

this issue.

They

the were

decided

to

investigate. As part of their learning, to the Steinberg

Collection

reference

tations in the Royal College Library.

The students

the librarian examine

was made

of theses and disserof Nursing

(RCN)

were given permission

to spend a day in the library

the range of completed

by and

studies depos-

ited in the collection. Firstly, there was a growing and strong body of research-based

knowledge

in nursing

to the generality

of practising

Sheehan

(1986)

suggests

research

findings

unknown

nurses in the LJK.

that the application

in nursing

of

is a formidable

challenge facing the profession. One solution would be to make such published research useful

286

NURSE EDUCATION

to the practising nation

nurse.

of research

knowledge practice

TODAY

Secondly,

findings

so accumulated

of nursing.

that such knowledge

was to influence must therefore

of

in

drawing

on research

teaching

(Akinsanya

It was clear students

findings

from

by no means The

encourage learners

their

from

the

much confidence about

and

the place and

(DHSS)

nor

(BMA)

line between training

of concern

to the profession

stood by students introduction Although

and practitioners. accelerated

assessment,

and evaluating accepted, openly

are the least under-

of the nursing

was suddenly

issues

The gradual

process in the

planning,

in the UK late

1970s.

considerable expressed

misgivings

about

Henderson

(1982)

was concerned

of the title and questioned

to be sure

to

contribute

to

the

nursing care. There the implementation haphazard

and

delivery

its use really of

was evidence

good

it is

quality

to suggest that

in the UK was somewhat

opportunistic

(De

La

Cuesta

the next attempt

teaching

nursing research

to use this method arose in relation

of

to the

nursing process. The group of students concerned were enrolled for the Diploma in Nursing, University of London. The problem was how the medical profession viewed the introduction of the nursing process. It was

as a

former

Research

Unit of the GNC had reported

on the

of a national

nurses

degrees.

The

survey

to locate

students

relevant literature

& MacGuire 1970). The reports contained with medical degrees

searched

and

(Jackson

197 1; 1973

the names

of nurses

and, based on this informa-

tion, the Medical Directory

was used to trace 16

such

group

nurse/doctors.

published

The

piloted

As

this

extended

approach

became

staff

as a part content

a

used it to

with medical

process. The results were 1985).

by

developed

it and finally

(Akinsanya

appreciated

and of

the

established

and

students,

it

was

syllabus

for

the

of the departmental

course.

Thus another important issue of perennial interest in nursing is that of continuing education (Duberley

1985;

Nugent

1984;

Owen 1985). The former Joint Nursing Studies provided range

of post-basic

transfer

1983). Thus

the

findings

research does

research

For

on the nursing

its appropriateness

that

lesson about

knowledge.

degrees

about the use

acknow-

that the students

being

describe what nurses do. Whether the title is right or not, however, important

and nursing,

officially

the views of the nurses

cation of rituals to which it gives rise in practice.

It

medicine

canvass

sanctifi-

Security

Association the dividing

became

were

the apparent

to

for

crossed

It was at this point

questionnaire,

implementing

as stages of the process

of difficulties

clear that neither

is not

an important

as

process.

of such nurse/doctors.

professional ledged.

the

qualified

Medical

that when nurses

initial

was

Rowden

and Social

British

kept a record

obtained that current

of Health the

their

with

It is often the case, however,

1984;

to investigate

It soon became

contribution

PROCESS - IS THE

decided

This study posed a number the students.

learnt

in nursing.

THE NURSING TITLE RIGHT?

(Mitchell

students

the Department

by

to support

feedback

settled

on the subject of the nursing

seemed

the

enthusiastic

role of research

in

process

and that the debate as to its appropriateness 1984).

1984).

that they gained

they became

must

had openly

of the nursing

view of nurses who had subsequently

such dissemi-

their

of doctors

the introduction

on the

that of tutors

who

nursing

that a number

doctors

for ensuring

research-mindedness

known criticised

ensure

or ignored.

was first and foremost

schools

the

profes-

was not left unused

The responsibility nation

if the

A research-based

sion, the students argued, shelves of libraries

that dissemi-

was essential

has

resulted

1983;

the impetus for a wide

courses

of these courses

Rogers

Board of Clinical

for nurses

to the National

in a structured

and

and the Boards

statutorily

validated courses in areas of education, research, management and clinical practice. Yet it was clear that opportunities for individual nurses to undertake such courses was not always taken either because of lack of information or the failure of senior staff to recognise

their import-

NURSE EDL’CA-rlON

ante. This problem was examined by a group of nurses undertaking the Council for National Academic Awards Diploma in Professional Studies in Nursing course at this Institute. The investigation enabled the students to develop and test a questionnaire and an interview schedule under guidance. These were used to obtain data on a national basis and the results were disseminated by representatives of the group of students at the Royal College of Nursing Research Society Annual Conference at the University of Reading (Bartlam et al 1986). This was a particularly encouraging development for the Research Society forum did not normally encourage the type of request that was made for the participation of the students - i.e. the presentation by a group of six students at a specific point in the Conference of the findings of their own small-scaled research into a problem of professional concern. The reception of the ideas, the exchange of views with renowned nursing researchers and the general tolerance of their ideas showed the maturity and confidence of the profession in its quest for research-based knowledge. The students were pleased to face a critical but understanding audience as a forum for the dissemination of the findings of their study.

DISCUSSION This approach to teaching nursing research has proved successful in schools of nursing and as part of the post registration education if nurses in further and higher education. The need for a research-oriented

teaching

in

nursing

is both

urgent and necessary. The current concern about the future of nursing education must be linked with the need for the development of a sound foundation for basic education. The pronouncements in project 2000 (UKCC 1986) depend

crucially

on

research

evidence

which

showed that fundamental changes must be made if the profession is to face the challenges of the Year 2000 and beyond with confidence. The UK(X and the National Boards are equally concerned about the need for a structured framework

for

the

development

of

a coherent

TODAY

287

research basis for nursing education. The English National Board for Nursing, Midwifery and Health Visiting recently identified areas of research priorities of which innovation in education was a notable example (ENB 1987). Research activities must be brought to the centre of nursing education if its practice is to benefit from the resulting innovations. In the 14 years since the approach described in this paper has been used to teach nursing research, there is evidence to suggest that it improved learners’ understanding of the research process. Above all, by demystifying the process itself, it encouraged learners to see research as an integral part of their professional development. In a climate in which professional performance is subjected to set-ious scrutiny in order to obtain resources, nurses must be armed with meticulously researched evidence as important user of resources within the health services. Indeed, learners as future practitioners must be encouraged. guided and supported at the earliest stages of their education and training to see research as the cornerstone of a knowledgebased professional practice. This learning research by doing it approach continues to provide a challenging and stimulating experience for students. staff and their clinical colleagues. Its wider use in basic and post-basic nlursing education is to be encouraged.

kfeK?nCeS Akinsanya J A 3984 Learning about nursing research. Nursing Times, Occasional Papers. X0, 35: 59-61 Akinsanva.] A 1985 a slow process. Nursing ., rimes 81

43: 24-27

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288

NURSE EDUCATION

TODAY

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