The potential negative impact of current orthodoxy on nursing education

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The potential negative impact of current orthodoxy on nursing education Brenda J Jacono and John J Jacono

impact does nursing’s current reigning orthodoxy have on the everyday lives of nurse educators? In the process of conceptualising a research project on the impact of current literature on nurse educators’ beliefs and practices in relation to teaching methodology, the authors discovered that orthodoxy can have a negative impact on teaching method selection. In fact, they discovered that orthodoxy can pose many dangers in other areas as well because it always has the potential for achieving the status of dogma (i.e. beliefs which are accepted as absolute truth). In this paper, the authors attempt to outline the processes they went through in conceptualising their research project in the hopes that the identification of these processes might aid others in avoiding the many possible traps posed by orthodoxy. In addition, the authors hope the article stimulates further research on the impact of orthodoxy in nursing, particularly in nursing education. What

I

more areas of nursing

INTRODUCTION Recently, while conceptualising on the impact of the literature tor’s beliefs methods,

about

on nurse educa-

and uses of various teaching

the authors

began to have some inter-

esting insights. We began stumbled

a research project

on to something

than we had originally

to realise that we had that was much bigger

anticipated.

began to realise that the reigning the discipline

Indeed,

we

orthodoxy

for

can have a stultifying impact in the

area of teaching

methodology,

as well as in many

than we had ever consid-

ered. We also realised that orthodoxy

poses many

traps

when

such

of dogma

(i.e.

for

orthodoxy

the

unwary,

achieves

particularly

the

beliefs which are accepted

status

as absolute truth).

In the area of organisational (1989)

and Roberts

that contrary opinion

(1987)

theory,

not orthodoxy

vitality to an organisation.

Depree

point one to the fact is what leads

However, it is easy to

forget to think holistically and recall that nursing is an organisation.

Somewhere

in the develop-

ment of our study, we realised that it was the types of considerations

which we pursued while devel-

oping the study that led us to the much wider realisations that we had about the potential

negative

Brenda Jacono MScN RN, Associate Professor and John Jacono PhD RN, Associate Professor, School of Nursing, Laurentian University, Ramsey Lake Road, Sudbury, Ontario, Canada, P3E 2C6

since this might give others a better appreciation

(Requests for offprints to BJ) Manuscript accepted 24 November

for the types of thought processes that allow one to avoid falling into some of the orthodoxv traps.

1993

impact of orthodoxy.

In this article, we will elabo-

rate our efforts in the initial stages of our project.

246

NURSE EDUCATION TODAY

In addition,

we hope that by elaborating

these

of the real and potential orthodoxy

negative

impact

education.

Many of the

instance,

processes we may give others a fuller appreciation that

can have on nursing, and nursing edu-

cation in particular.

avidly affirmed

correct

method

1990,

Kerchhoff Rajacick

argued

As nurse educators

for many years, the authors

had seen many trends education.

come

and go in nursing

One area where we noticed that trends

came and went was the area of teaching or strategies.

that the current cussion

trend was away from lecture/dis-

methods

methods

methods

In this area, we noted, for instance, of teaching

to more

‘creative’

such as game playing, field trips, meth-

ods that encourage

right-hemisphere

divergent

thinking and others (Ferguson

1992, Hermann

Bays 1991, Kirchhoff

1991).

we wondered

& Stager

what factors

dictated

&

& Stager et al 1991).

And, as Murray & Huelskoetter perception

indicate,

creation

of orthodoxy

counterpart

Mynaugh

& Stager 1991,

1991,

Obermann

1991, Rajacick et al 1991, Rice 1991). In addition,

In order to find this data, we examined pling of the articles referred ly. We soon realised were descriptions research,

were superior planted. suspicion

These

con-

that these new trends

to the teaching observations

that this group

situations,

in many different

tions. We concluded

Indeed,

teaching

that more

have

to the whole

that

teacher/

an

analytical

taking area

orthodoxy,

of methodology.

the development

i.e. dogma

Huelskoetter

1987,

&

is, in itself, a

of entrenched

(Meleis Polit

situa-

comprehensive

suggested were

nursing

overviews of

such an analytical approach against

of articles

e.g. teaching

rather than comprehensive

approach

the sam-

to above more close-

of a variety of methods for par-

ticular teaching

guard

we found that this literature

tained no strong evidence

dangerous

search for more data to support our speculations.

in nursing

1991,

is a key factor in the

and its more

- dogma. At this point, we began to

would

McCaugherty

state

success, their fail-

(1987)

authors

Bays 1991, Kinnick 1990, Kirchhoff

it can be

other variables certainly gives one

articles

&

McCaugherty

this perception.

and going of such trends, since this was not clear 1992, Hermann

1991,

Although

ure to mention

from this literature

(Ferguson

success in

8c Bays 1991, Kinnick

alone guarantees

these methods

Therefore, the coming

(Hermann

for of a

that these articles do not explicitly

that method

EARLY CONCEPTUALISATION

we read,

could ensure teaching

a given situation 1991,

articles

that the selection

1991,

Murray 8c

Hungler

1989).

methods

they sur-

However, since we did not find any of these in this

prompted

our first

sampling, we had more tentative evidence that we

that more was going on here than met

might be on to something

important.

We now

the eye. We began to consider what impact this lit-

moved on to the next stage of study formulation,

erature

i.e. hypothesis investigation.

might

be

having

on

nurse

educators

beliefs about and uses of various .teaching

meth-

ods. Further

consideration

helped

to raise

flags

HYPOTHESISING

which alerted us of the value of looking into this matter. After many years of teaching

and observ-

ing others teach, we had noted that for some the enchantment/disenchantment

with

particular

Since a number

of authors failed to mention

teaching methods seemed to rest in the belief that

that they engaged

in this practice.

in a given teaching situation there was a prescription which would result in success. The only prob

us that suggesting

that failure

lem was knowing the correct particular situation.

prescription

for the

When we investigated further we found that this belief in a ‘correct’ prescription seemed, indeed,

to be the current

orthodoxy

in nursing

the

impact of factors other than method on teaching success, we felt that there must be some reason It occurred

in teaching

to was

related only to the selection of an incorrect method took some of the responsibility for failure away from the teacher him/herself. It was possible that the authors of these articles might purposely be separating teacher and method in order to make their ideas comforting to the reader, and

NURSE EDUCATION

hence

themselves

popular

It also

There is also other more subtle evidence in the

might repre-

literature which suggests that nurses may be being

as authors.

seemed possible that this separation

sent some wishful but unacknowledged

thinking

It should be pointed

out, at this point, that we the above hypothe-

ses. As Murray & Huelskoetter

(1987)

there is a very natural tendency sising

of this kind,

threats to cherished hold. In addition,

adhere

it poses

or attractive beliefs we wish to beliefs which can catch on

orthodoxy,

or accepted

because of its comforting

(i.e.

the

to develop

Writings

research, priate

on

types of theories Jacobs

constitutes

atti-

nursing

methods

research

are appro-

studies and on the

which should be developed

(Briones

& Cecchini

1991,

Chinn

1987, Meleis 1992, Polit & Hungler

can imply (albeit sometimes

in &

1989)

unintentionally)

there are rights and wrongs in relation

that

to these

areas rather than preferences. Such writings

are quite

common

in nursing,

and are valuable. However, they also carry the risk of encouraging

nature.

an unquestioning

what

on which research

for nursing

nursing

because one usually does

to the traditional

orthodox)

when

their work would suggest that it

is just such seductive and become

indicate,

to avoid hypothe-

particularly

‘encouraged’ tude.

on the part of these authors that this be so. could easily have overlooked

247

TODAY

according creates

limit setting,

and limit setting is

to Murray & Huelskoetter

rigid orthodoxy

(1987)

(i.e. dogma).

what

Writing

of

this type would be less likely to create these dangers if authors made it clear that they were merely

BACK TO THE LITERATURE

stating We recognised than those

that there might be reasons, other

suggested

(i.e. hypothesised)

for some nursing education we had discovered. the

literature,

After much contemplation

we decided

that

seemed related to a general and elsewhere) in matters (1992)

above,

authors to behave as the

of

by Eberlee

states that there

is currently

an unques-

tioning attitude toward the reigning orthodoxy He also suggests

the years has been quite heated, with the impression

that there

in

that disciplines

We now looked

ostracism

unquestioning In

turned to the nursing literature

we found further

to her nursing

theory

for evidence

which might contribute

When we

to this orthodoxy.

reminded

that

Nursing

Congress

this

matter,

the

International

‘Unity for Excellence’. and again

the theoretical

ception, (1987);

one

could

history of nursing

Vehemence

as depicted

with any work is a powerful

the literature

on per-

in Murray & Huelskoetter certainly

understand

why it

would not be unusual for someone reading such a statement to think that it was professionally risky to pursue

ideas not

in keeping

with those

power in nursing. And, from the development such

thoughts

can

becoming dogmatic orthodoxy).

one

become

(i.e. sticking

trapped

in of into

rigidly to any

Murray notion,

the

in Madrid

‘put forth to vehemently

compete

of other

to a tendency

support of orthodoxy

considering

text, Meleis states that the ideas in her book are

1992).

and leaves one really are rights

OTHER EVIDENCE

to ensure adherence

. . . ’ (Meleis

subjects.

and wrongs in relation to these matters.

will even go so far as to use professional

word. When one considers

these

attitude

An article

that denigrates

on

trend (i.e. in nursing

towards an unquestioning

clues. In the introduction

preferences

problem

of orthodoxy.

all disciplines.

their

However, some of the debate on these topics over

the theory

in nursing.

authors

were

Council

We thought (1987)

it possible, found

supports

that the title for this conference reigning

orthodoxy

in their

in our

might

imply to some that if nurses do not support current

of

in 1993 was titled

on perception

& Huelskoetter

practices towards an

the

discipline;

they will risk mediocrity. It should be remembered here that this type of thought on its own may

not

be

problematic

but

as

Murray

&

Huelskoetter (1987) again suggest, it can also create the beginning of dogma when other circumstances

support

such thinking.

There

are many

conferences with themes similar to this one going on in nursing all the time.

248

NURSE EDUCATION

TODAY

Finally, the teachers with whom the researchers

saying it rather, because the unquestioning

accep-

have interacted

over the years provided the most

tance

telling evidence

of all. It became

oneself is the very thing which is at the root of the

talking to teachers time fretting

clear to us from

that they spend a great deal of

over the best teaching

impart different

types of content.

method

to the liter-

ature as proof for the validity of this belief.

CONCLUSION doing our project. formal research op, we learned to

expanding

nomenon

for ourselves the value of

Although we have yet to do the

project which we set out to develthat this project was very valuable our

understanding

of

a

to which we had not hetertofore

much consideration.

phegiven

We felt that we should share

this process prior to completing

a formal study of

this matter, because we were struck by the serious dangers that can occur when orthodoxy dogma. In particular,

becomes

we were struck by the possi-

bility that there may be an unquestioning

attitude

toward orthodoxy

Such an

generally

attitude seems to us inimical

in nursing.

to the future devel-

opment and evolution of nursing. The realisations developing more

that we came to as a result of

this study suggested

to us a great deal

than the mere need for our study. In the

many people that the authors talked with, the attitude seemed to be that if the bulk of the literature was saying something, are hoping,

therefore,

it for

problem.

to

in teaching

the appropriate

in a particular situation. They pointed

We had now confirmed

word without verifying

Most teachers

we talked to said that their problems result from not selecting

method

of anyone’s

then, it must be true. We that readers

will not merely accept our contentions

of our work or encour-

age others to do so. We are not saying this because we are not confident in our conclusions. We are

References Briones T, Cecchini D 1991 Nursing versus medical research. Heart & Lung 20(2): 206207 Chinn P, Jacobs M 1987 Theory and nursing. C V Mosby, St. Louis, USA Depree M 1989 Leadership is an art. Bantam Doubleday Dell, New York, USA Eberlee J 1992 Drawing limits to knowledge. University Affairs January, 9 Ferguson L 1992 Teaching for creativity. Nurse Educator 17(l): 1619 Hermann C, Bays C 1991 Drawing to learn and win. Journal of Nursing Education 30(3): 140-141 Rinnick V 1990 The effect of concept teaching in preparing nursing students for chnical practice. Journal of Nursing Education 29(8): 362-366 Kirchhoff