Abstract
The Nursing Associate is a new role within UK healthcare that entails a two year vocational undergraduate diploma education pathway integrated with extensive front line clinical practice. The curriculum mirrors aspects of existing preregistration nursing programmes of which common features are regulation and development of professional attributes. Curriculum content includes teaching about such values with the intention of developing the students’ knowledge and translating this until it becomes embodied in their practice .
A mixed methods survey study was designed to evaluate the extent to which this curriculum aim was being achieved to inform subsequent related teaching and learning interventions. The aim was to describe students’ perceptions of developing as an honest, caring, compassionate, conscientious and competent nursing associate. Enquiry also included exploring students’ perceptions of how this development is likely to impact on patient care as well as enablers and barriers to achieving fitness for practise in these 5 domains. Ethical approval was granted by the University of Bolton Faculty Research Ethics chairperson. Students from the first cohort of this new programme were invited to participate and complete the survey (n=68 with 57 participants). They were working in 4 different National Health Service Trusts. The survey had 4 dimensions – a self-rating scale of 5 professional domains and a free text counterpart in which respondents could explain why they had chosen that rating. A final section of the survey invited any further free text comment about factors enabling or posing a barrier to developing professional attributes.
Thematic analysis of qualitative comments was undertaken to generate findings. These showed that students expressed these attributes as a sense of being (already embodied) and also development (becoming) in so far as they had learnt more about what each attribute was and could recognise steps they had taken to move towards embodying the attribute. Some respondents also identified praxis – where real world practice fell short of their expectations, and a positive aspect was that they reported being courageous enough to challenge such mismatches.
Overall the findings suggest that the pedagogic design linking propositional knowledge to students'clinical work promoted reflection on real world practice experience was moving students towards developing professional attributes. It also highlighted differences in the degree of reflective insights students demonstrated about their own values, thus directing attention towards how this could be promoted as an essential skill within the curriculum. These findings provide the basis for informing tripartite (university student and service) working relationships, especially around challenging areas of concern to students and also how to draw role models from current practice into shared classroom teaching. Additionally it identified some factors that could be used to inform students decision making to overcome barriers to developing these professional attributes.