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Promoting critical thinking and academic writing skills in nurse education
Nurse Education Today 32 (2012) 611–613
Contents lists available at ScienceDirect
Nurse Education Today j o u r n a l h o m e p a g e : w w w. e l s ev i e r. c o m / n e d t
Promoting critical thinking and academic writing skills in nurse education Gunilla Borglin ⁎ School of Health Science, Blekinge Institute of Technology, SE-379 71 Blekinge, Sweden
a r t i c l e
i n f o
Article history: Accepted 27 June 2011 Keywords: Academic literacies Academic writing Critical thinking Nursing education
s u m m a r y Although academic skills, conceptualised as writing and critical thinking, are a vital part of university studies, research indicates that many students leave without having mastered these skills effectively. This research also reflects on nursing students. Nursing could also be said to be hampered by a number of complex educational challenges that are likely to impact on the academic socialisation process in general. These challenges include being a relatively ‘young’ academic discipline, the ‘theory–practice’ divide, a knowledge bed lying on a complex intersection of two ‘antithetical sciences’ and, at least in the Scandinavian countries, an increasing number of nurse educators with a PhD in nursing science but with limited time to develop their own teaching skills. In combination, these challenges have the potential to act as stumbling blocks, both from a teaching and learning perspective. I would suggest that a departure in teaching from theoretical educational models, such as Lea and Street's ‘academic literacies model,’ including skills, socialisation and academic literacy models simultaneously, could be one of several ways forward to create a learning environment that takes these issues into account. © 2011 Elsevier Ltd. All rights reserved.
Introduction No-one would dispute the assertion that a mastery of academic writing in different genres and the development of skills in critical thinking and appraisal are fundamental elements in all academic disciplines, regardless of the subject area. It could be said that a mastery of these skills is essential for all students seeking to pass their examinations ‘with flying colours’. In Scandinavia and throughout the rest of Europe, learning objectives such as academic writing and critiquing skills are echoed throughout the education systems, putting them high on the list of important factors by which the students will be constantly assessed. Despite this, research has repeatedly found that students leave HEIs (Higher Educational Institutes) without acquiring the requisite proficiency in academic writing or necessary basic knowledge in critical thinking. This paper aims to address the above and I will propose that certain characteristics specific to nursing students, i.e. more non-traditional students, young and antithetical sciences, the theory–practice divide, more and more tutors/teachers lacking substantial teacher training — may act as barriers in the nursing students' process of acquiring the skills needed to succeed with their HE studies. However, it is important to note that when it comes to acquiring professional clinical practice skills nursing students rarely experience difficulties although research indicates that the academic socialisation processes could be a struggle. Problems with the latter could impede their ability to participate as ⁎ School of Health Science, Blekinge Institute of Technology, SE-379 71 Karlskrona, Sweden. Tel.: + 46 455 385476. E-mail address: [email protected]. 0260-6917/$ – see front matter © 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.nedt.2011.06.009
registered nurses in clinical activities, such as the process of critically appraising and critiquing research with the ultimate goal of promoting and implementing evidence-based practice. With that end in mind, I would suggest that creating an educational setting that departs from educational theories and/or creating models that support the students' academic socialisation process could be one way of raising the bar in nursing education. Background
“Pity the poor nursing student, who is required to write at times like a sociologist, at others like a philosopher, yet again like a scientist and finally as a reflective practitioner!” (Baynham, 2002, p. 188) It is two decades since a significant shift took place in nursing education from ‘practice-oriented’ to ‘professionalised’ (cf. Rolfe, 2009). Training of nurses left the hospitals and entered HEIs, thus setting off on its transforming journey to becoming an academic discipline (cf. Baynham, 2002). This shift has paved the way for a large number of so-called ‘non-traditional’ student enrolments in higher education (Whitehead, 2002). The road has been, and to some extent still is, bordered by educational challenges. Some of these originate from the fact that nursing is an area “where complex combinations of disciplinary influences intersect” (Baynham, 2002, p. 188), and nursing education draws on knowledge derived from both human and natural sciences. It therefore seems fair to assume that the combination of two ‘antithetical’
612
G. Borglin / Nurse Education Today 32 (2012) 611–613
sciences in terms of epistemology, philosophy and academic discourse, can result in bewilderment among both students and educators. This, taken together with the fact that many nursing students have had little or no prior experience of higher education studies (Whitehead, 2002), could be a potential stumbling block in their academic socialisation process. Another taxing issue central to nursing education is the ‘theory–practice’ divide (Baynham, 2002; Whitehead, 2002). This division implies that nursing students not only need to develop skills in academic writing but also need skills that enable them to bridge this divide and to distinguish between different writing genres – theoretical academic assignments and clinical nursing notes for example – throughout their education. All of the above are highly likely to influence the students' overall learning process and their ability to integrate knowledge, skills and attitudes in order to attain an optimal level of complex learning. Before going on to discuss the theoretical framework – the academic literacy model – proposed by Lea and Street (1998, 2006), a brief overview of the concepts of academic writing and critical thinking, i.e. academic literacy, will be presented. Academic Writing The concept of “academic writing” is often used in a rather unreflective manner and there are several different definitions. Commonly described characteristics of academic texts are academic literacy and sensitivity to style and writing conventions within a specific context, as well as critical and analytical competencies. Academic writing has a prominent position within higher education but in general research reflects concerns such as ‘a game with a bewildering set of rules, many of which are never made explicit to student writers’ (Harwood and Hadley, 2004, p. 356), indicating a highly implicit practice that is rarely articulated explicitly between educators and students. This is worth noting as writing is probably one of the most important components in demonstrating scholarship (Whitehead, 2002) and it has an intrinsic value as an academic activity (Rolfe, 1997). Regardless of its prominent position, studies investigating nursing students' writing indicate that it could be experienced as one of the most problematic aspects of their education (Whitehead, 2002). Critical Thinking Within nursing education nurturing “critical thinking” skills is considered to be an essential activity and an important part of clinical nursing practice (Mangena and Chabeli, 2005). Despite this, research highlights the need for more attention and new approaches to critical thinking, especially since we lack knowledge about possible relationships between the critical thinking abilities of the nursing faculty and the way students are taught these skills. We know that the concept of critical thinking can be difficult to comprehend for both nursing students and nursing educators due to inconsistent definitions of critical thinking. Critical thinking is sometimes used interchangeably with critical appraisal skills, which is another important concept in the academic socialisation process and as such closely linked to the students' ability to read and evaluate scientific material. In this latter sense it is stated that critical thinking is characterised by logical and consistent thinking, a controlled sense of scepticism or disbelief about assertions and conclusions, taking stock of existing information while identifying holes and weaknesses and, finally, freedom from bias and prejudice. In Sweden and other countries the importance of an education permeated by an overall scientific attitude is clearly expressed in the regulation “all education shall have a scientific foundation....”. This is reflected in academia, where we regard questioning, critical and analytical awareness to be the core of true scientific thinking. Consequently, as educators it is fair to assume that – explicitly or implicitly –
we expect to see signs of critical thinking and appraisal assertively integrated into the students' academic writing. This leads me to propose that academic writing and critical thinking, i.e. academic literacy, are interdependent and that addressing them from a theoretical framework that takes several important skills into account simultaneously could be one way forward to meet some of the challenges nursing education seem to be facing in Europe. The ‘Academic Literacies Model’ Lea and Street (1998, 2006) proposed a theoretical model that includes perspectives taken from three different educational models i) a study skills model, ii) an academic socialisation model and iii) an academic literacy model (Lea and Street, 2006). This model appears to have the potential to offer nursing educators as well as researchers the opportunity to implement and investigate an educational theorising approach to academic literacy. In the study skills model reading and writing are primarily individual and cognitive skills as this part of the model is based on theories of learning, focusing on the transmission of knowledge (Lea and Street, 2006). In the socialisation model it is presumed that the students can learn and understand the ground rules of the specific academic discourse they belong to, particularly as discourse and genre in this perspective remain relatively established. The final model academic literacies draws on the two others while focusing on the relationship between implicit concepts, such as meaning-making, identity, power, and authority within specific institutional settings. One important feature of the model is that it ‘views literacy as involving both epistemological issues and social processes’ (Lea and Street, 2006, p. 369). Hence, the model includes the ability to read and write together with the abilities to think, speak and act within a discourse. Since academic literacy – reading and writing within disciplines – represents the processes by which students develop knowledge in new areas and new subjects, it is important to see it from a social and cultural practice point of view. Recognising this model would mean challenging prevailing educational perspectives as we would then look on academic literacies as something that is not only associated directly with nursing as a subject or a discipline but also with the broader institutional discourses and genres. Lea and Street's model is helpful in that it highlights the importance of educators ‘de-mystifying’ academic writing within the discipline and its subject area. The theoretical framework can help educators to become more explicit in their interactions with students by showing and exemplifying the shifts in genre and mode (for example between an academic essay, a report and clinical nursing notes) and when they move between group work, speaking, note-taking, and presentations. One of the dominant features of academic literacy is that students need to adapt to switching writing styles and genres between settings in order to build up a repertoire of literacy practices suitable to each setting as well as handling the social meanings and identities that each setting evokes (Lea and Street, 2006). This could diminish some of the complex challenges, such as the ‘theory–practice’ divide and the ‘antithetical sciences’, by acknowledging and exemplifying them. Furthermore, viewing literacy from a social and cultural practice perspective could facilitate the academic socialisation of the students, particularly those arriving with a different set of experiences of education. These are all appealing notions as teaching and designing course curricula within this theoretical framework could give us the opportunity to address explicitly and comprehensively some of the complexities we are facing concerning writing and critical thinking within nursing education. The above is essential. Being on the lookout for creative and innovative theoretical educational models, and not just those originating from within nursing education, would seem to be more important now than before. Governmental initiatives in Sweden, such as ‘the open university’ and ‘widening participation’ in the UK,
G. Borglin / Nurse Education Today 32 (2012) 611–613
need to be factored into the educational equation, particularly as these initiatives stipulate a transformation of HEIs from an elite to a mass system. It is of course imperative to work towards equal and fair systems. Focusing on recruiting students from socially and ethnically under-represented groups into higher education should quite rightly be one of the main concerns of education. The question that needs to be asked is whether European HEIs and their education systems are prepared for educating those ‘new order’ students who arrive with perspectives and experiences in education that are different from the time when teachers could reasonably expect similar educational experiences and academic ‘know how’ among their students. Considering these challenges it could be worth noting that there are no further studies that focus on academic writing and critical thinking (not as a ‘practice’ skill) from a nursing perspective. One plausible explanation might be that even though more and more nursing educators nowadays, at least in the Scandinavian countries, have a PhD in nursing science very few of them possesses any formal, substantial teacher training beyond their mandatory 15 ECTS credits. It could be argued that this should be self-evident although this is very likely to cast a gloomy shadow over overall educational quality. Whitehead (2002) has proposed that when one discovers that the academic process is not endorsed by nursing educators it may be due to the fact that they themselves are not confident about what the process actually entails, which supports my earlier explanation. To be able to raise the sights in nursing education, educational training and support for educators will need to be top of the agenda. With nursing as a relatively young discipline it could be that other more pressing
613
matters, such as raising scientific and academic standards and establishing an autonomous research arena, have meant that we have lost sight of what to emphasise. Acknowledgements I would like to acknowledge Dr. Cecilia Fagerström for valuable comments and Patrick O'Malley for revising the language. Gunilla Borglin was supported by the Strategic Associate Professors Programme and the Department of Health Science at Blekinge Institute of Technology, Sweden. References Baynham, M., 2002. Academic writing in new and emerging discipline areas. In supporting lifelong learning. In: Harrison, R., Reeve, F., Hanson, A., Clarke, J. (Eds.), Perspectives on Learning, vol. 1. Rutledge Falmer, London. Harwood, N., Hadley, G., 2004. Demystifying institutional practices: critical pragmatism and the teaching of academic writing. English for Specific Purposes 23, 355–377. Lea, M.R., Street, B.V., 1998. Student writing in higher education: an academic literacies approach. Studies in Higher Education 23 (2), 157–173. Lea, M.R., Street, B.V., 2006. The academic “literacies model”: theory and application. Theory into Practice 45 (4), 368–377. Mangena, A., Chabeli, M.M., 2005. Strategies to overcome obstacles in the facilitation of critical thinking in nursing education. Nurse Education Today 25, 291–298. Rolfe, G., 1997. Writing ourselves; creating knowledge in a postmodern world. Nurse Education Today 17, 442–448. Rolfe, G., 2009. Writing-up and writing-as: rediscovering nursing scholarship. Nurse Education Today 29 (8), 816–820. Whitehead, D., 2002. The academic writing experience of a group of nursing students: a phenomenological study. Journal of Advanced Nursing 38 (5), 498–506.
Contents lists available at ScienceDirect
Nurse Education Today j o u r n a l h o m e p a g e : w w w. e l s ev i e r. c o m / n e d t
Promoting critical thinking and academic writing skills in nurse education Gunilla Borglin ⁎ School of Health Science, Blekinge Institute of Technology, SE-379 71 Blekinge, Sweden
a r t i c l e
i n f o
Article history: Accepted 27 June 2011 Keywords: Academic literacies Academic writing Critical thinking Nursing education
s u m m a r y Although academic skills, conceptualised as writing and critical thinking, are a vital part of university studies, research indicates that many students leave without having mastered these skills effectively. This research also reflects on nursing students. Nursing could also be said to be hampered by a number of complex educational challenges that are likely to impact on the academic socialisation process in general. These challenges include being a relatively ‘young’ academic discipline, the ‘theory–practice’ divide, a knowledge bed lying on a complex intersection of two ‘antithetical sciences’ and, at least in the Scandinavian countries, an increasing number of nurse educators with a PhD in nursing science but with limited time to develop their own teaching skills. In combination, these challenges have the potential to act as stumbling blocks, both from a teaching and learning perspective. I would suggest that a departure in teaching from theoretical educational models, such as Lea and Street's ‘academic literacies model,’ including skills, socialisation and academic literacy models simultaneously, could be one of several ways forward to create a learning environment that takes these issues into account. © 2011 Elsevier Ltd. All rights reserved.
Introduction No-one would dispute the assertion that a mastery of academic writing in different genres and the development of skills in critical thinking and appraisal are fundamental elements in all academic disciplines, regardless of the subject area. It could be said that a mastery of these skills is essential for all students seeking to pass their examinations ‘with flying colours’. In Scandinavia and throughout the rest of Europe, learning objectives such as academic writing and critiquing skills are echoed throughout the education systems, putting them high on the list of important factors by which the students will be constantly assessed. Despite this, research has repeatedly found that students leave HEIs (Higher Educational Institutes) without acquiring the requisite proficiency in academic writing or necessary basic knowledge in critical thinking. This paper aims to address the above and I will propose that certain characteristics specific to nursing students, i.e. more non-traditional students, young and antithetical sciences, the theory–practice divide, more and more tutors/teachers lacking substantial teacher training — may act as barriers in the nursing students' process of acquiring the skills needed to succeed with their HE studies. However, it is important to note that when it comes to acquiring professional clinical practice skills nursing students rarely experience difficulties although research indicates that the academic socialisation processes could be a struggle. Problems with the latter could impede their ability to participate as ⁎ School of Health Science, Blekinge Institute of Technology, SE-379 71 Karlskrona, Sweden. Tel.: + 46 455 385476. E-mail address: [email protected]. 0260-6917/$ – see front matter © 2011 Elsevier Ltd. All rights reserved. doi:10.1016/j.nedt.2011.06.009
registered nurses in clinical activities, such as the process of critically appraising and critiquing research with the ultimate goal of promoting and implementing evidence-based practice. With that end in mind, I would suggest that creating an educational setting that departs from educational theories and/or creating models that support the students' academic socialisation process could be one way of raising the bar in nursing education. Background
“Pity the poor nursing student, who is required to write at times like a sociologist, at others like a philosopher, yet again like a scientist and finally as a reflective practitioner!” (Baynham, 2002, p. 188) It is two decades since a significant shift took place in nursing education from ‘practice-oriented’ to ‘professionalised’ (cf. Rolfe, 2009). Training of nurses left the hospitals and entered HEIs, thus setting off on its transforming journey to becoming an academic discipline (cf. Baynham, 2002). This shift has paved the way for a large number of so-called ‘non-traditional’ student enrolments in higher education (Whitehead, 2002). The road has been, and to some extent still is, bordered by educational challenges. Some of these originate from the fact that nursing is an area “where complex combinations of disciplinary influences intersect” (Baynham, 2002, p. 188), and nursing education draws on knowledge derived from both human and natural sciences. It therefore seems fair to assume that the combination of two ‘antithetical’
612
G. Borglin / Nurse Education Today 32 (2012) 611–613
sciences in terms of epistemology, philosophy and academic discourse, can result in bewilderment among both students and educators. This, taken together with the fact that many nursing students have had little or no prior experience of higher education studies (Whitehead, 2002), could be a potential stumbling block in their academic socialisation process. Another taxing issue central to nursing education is the ‘theory–practice’ divide (Baynham, 2002; Whitehead, 2002). This division implies that nursing students not only need to develop skills in academic writing but also need skills that enable them to bridge this divide and to distinguish between different writing genres – theoretical academic assignments and clinical nursing notes for example – throughout their education. All of the above are highly likely to influence the students' overall learning process and their ability to integrate knowledge, skills and attitudes in order to attain an optimal level of complex learning. Before going on to discuss the theoretical framework – the academic literacy model – proposed by Lea and Street (1998, 2006), a brief overview of the concepts of academic writing and critical thinking, i.e. academic literacy, will be presented. Academic Writing The concept of “academic writing” is often used in a rather unreflective manner and there are several different definitions. Commonly described characteristics of academic texts are academic literacy and sensitivity to style and writing conventions within a specific context, as well as critical and analytical competencies. Academic writing has a prominent position within higher education but in general research reflects concerns such as ‘a game with a bewildering set of rules, many of which are never made explicit to student writers’ (Harwood and Hadley, 2004, p. 356), indicating a highly implicit practice that is rarely articulated explicitly between educators and students. This is worth noting as writing is probably one of the most important components in demonstrating scholarship (Whitehead, 2002) and it has an intrinsic value as an academic activity (Rolfe, 1997). Regardless of its prominent position, studies investigating nursing students' writing indicate that it could be experienced as one of the most problematic aspects of their education (Whitehead, 2002). Critical Thinking Within nursing education nurturing “critical thinking” skills is considered to be an essential activity and an important part of clinical nursing practice (Mangena and Chabeli, 2005). Despite this, research highlights the need for more attention and new approaches to critical thinking, especially since we lack knowledge about possible relationships between the critical thinking abilities of the nursing faculty and the way students are taught these skills. We know that the concept of critical thinking can be difficult to comprehend for both nursing students and nursing educators due to inconsistent definitions of critical thinking. Critical thinking is sometimes used interchangeably with critical appraisal skills, which is another important concept in the academic socialisation process and as such closely linked to the students' ability to read and evaluate scientific material. In this latter sense it is stated that critical thinking is characterised by logical and consistent thinking, a controlled sense of scepticism or disbelief about assertions and conclusions, taking stock of existing information while identifying holes and weaknesses and, finally, freedom from bias and prejudice. In Sweden and other countries the importance of an education permeated by an overall scientific attitude is clearly expressed in the regulation “all education shall have a scientific foundation....”. This is reflected in academia, where we regard questioning, critical and analytical awareness to be the core of true scientific thinking. Consequently, as educators it is fair to assume that – explicitly or implicitly –
we expect to see signs of critical thinking and appraisal assertively integrated into the students' academic writing. This leads me to propose that academic writing and critical thinking, i.e. academic literacy, are interdependent and that addressing them from a theoretical framework that takes several important skills into account simultaneously could be one way forward to meet some of the challenges nursing education seem to be facing in Europe. The ‘Academic Literacies Model’ Lea and Street (1998, 2006) proposed a theoretical model that includes perspectives taken from three different educational models i) a study skills model, ii) an academic socialisation model and iii) an academic literacy model (Lea and Street, 2006). This model appears to have the potential to offer nursing educators as well as researchers the opportunity to implement and investigate an educational theorising approach to academic literacy. In the study skills model reading and writing are primarily individual and cognitive skills as this part of the model is based on theories of learning, focusing on the transmission of knowledge (Lea and Street, 2006). In the socialisation model it is presumed that the students can learn and understand the ground rules of the specific academic discourse they belong to, particularly as discourse and genre in this perspective remain relatively established. The final model academic literacies draws on the two others while focusing on the relationship between implicit concepts, such as meaning-making, identity, power, and authority within specific institutional settings. One important feature of the model is that it ‘views literacy as involving both epistemological issues and social processes’ (Lea and Street, 2006, p. 369). Hence, the model includes the ability to read and write together with the abilities to think, speak and act within a discourse. Since academic literacy – reading and writing within disciplines – represents the processes by which students develop knowledge in new areas and new subjects, it is important to see it from a social and cultural practice point of view. Recognising this model would mean challenging prevailing educational perspectives as we would then look on academic literacies as something that is not only associated directly with nursing as a subject or a discipline but also with the broader institutional discourses and genres. Lea and Street's model is helpful in that it highlights the importance of educators ‘de-mystifying’ academic writing within the discipline and its subject area. The theoretical framework can help educators to become more explicit in their interactions with students by showing and exemplifying the shifts in genre and mode (for example between an academic essay, a report and clinical nursing notes) and when they move between group work, speaking, note-taking, and presentations. One of the dominant features of academic literacy is that students need to adapt to switching writing styles and genres between settings in order to build up a repertoire of literacy practices suitable to each setting as well as handling the social meanings and identities that each setting evokes (Lea and Street, 2006). This could diminish some of the complex challenges, such as the ‘theory–practice’ divide and the ‘antithetical sciences’, by acknowledging and exemplifying them. Furthermore, viewing literacy from a social and cultural practice perspective could facilitate the academic socialisation of the students, particularly those arriving with a different set of experiences of education. These are all appealing notions as teaching and designing course curricula within this theoretical framework could give us the opportunity to address explicitly and comprehensively some of the complexities we are facing concerning writing and critical thinking within nursing education. The above is essential. Being on the lookout for creative and innovative theoretical educational models, and not just those originating from within nursing education, would seem to be more important now than before. Governmental initiatives in Sweden, such as ‘the open university’ and ‘widening participation’ in the UK,
G. Borglin / Nurse Education Today 32 (2012) 611–613
need to be factored into the educational equation, particularly as these initiatives stipulate a transformation of HEIs from an elite to a mass system. It is of course imperative to work towards equal and fair systems. Focusing on recruiting students from socially and ethnically under-represented groups into higher education should quite rightly be one of the main concerns of education. The question that needs to be asked is whether European HEIs and their education systems are prepared for educating those ‘new order’ students who arrive with perspectives and experiences in education that are different from the time when teachers could reasonably expect similar educational experiences and academic ‘know how’ among their students. Considering these challenges it could be worth noting that there are no further studies that focus on academic writing and critical thinking (not as a ‘practice’ skill) from a nursing perspective. One plausible explanation might be that even though more and more nursing educators nowadays, at least in the Scandinavian countries, have a PhD in nursing science very few of them possesses any formal, substantial teacher training beyond their mandatory 15 ECTS credits. It could be argued that this should be self-evident although this is very likely to cast a gloomy shadow over overall educational quality. Whitehead (2002) has proposed that when one discovers that the academic process is not endorsed by nursing educators it may be due to the fact that they themselves are not confident about what the process actually entails, which supports my earlier explanation. To be able to raise the sights in nursing education, educational training and support for educators will need to be top of the agenda. With nursing as a relatively young discipline it could be that other more pressing
613
matters, such as raising scientific and academic standards and establishing an autonomous research arena, have meant that we have lost sight of what to emphasise. Acknowledgements I would like to acknowledge Dr. Cecilia Fagerström for valuable comments and Patrick O'Malley for revising the language. Gunilla Borglin was supported by the Strategic Associate Professors Programme and the Department of Health Science at Blekinge Institute of Technology, Sweden. References Baynham, M., 2002. Academic writing in new and emerging discipline areas. In supporting lifelong learning. In: Harrison, R., Reeve, F., Hanson, A., Clarke, J. (Eds.), Perspectives on Learning, vol. 1. Rutledge Falmer, London. Harwood, N., Hadley, G., 2004. Demystifying institutional practices: critical pragmatism and the teaching of academic writing. English for Specific Purposes 23, 355–377. Lea, M.R., Street, B.V., 1998. Student writing in higher education: an academic literacies approach. Studies in Higher Education 23 (2), 157–173. Lea, M.R., Street, B.V., 2006. The academic “literacies model”: theory and application. Theory into Practice 45 (4), 368–377. Mangena, A., Chabeli, M.M., 2005. Strategies to overcome obstacles in the facilitation of critical thinking in nursing education. Nurse Education Today 25, 291–298. Rolfe, G., 1997. Writing ourselves; creating knowledge in a postmodern world. Nurse Education Today 17, 442–448. Rolfe, G., 2009. Writing-up and writing-as: rediscovering nursing scholarship. Nurse Education Today 29 (8), 816–820. Whitehead, D., 2002. The academic writing experience of a group of nursing students: a phenomenological study. Journal of Advanced Nursing 38 (5), 498–506.