This peer-led session discusses ideologies and discourses that impact nursing curriculum. It focuses on the discourse around teaching clinical skills in nursing school. Socio-political ideologies and nursing stakeholders influence what clinical skills are emphasized in curriculum. The session explores how ontological theories, like Parse's Human Becoming theory, shape the epistemological knowledge developed in curriculum and applied in practice. Participants are asked to consider how the clinical skills discourse fits with the nursing theory used in their own practice.

1. Peer Led SessionFeb 14, 2011Ideology and discourse in nursing curriculum Judy Christie

2. What happens when you hear nursing curriculum being discussed? Does your heart beat faster with anticipation? OR Do your eyes glaze over? Well, nonetheless, here we go...

3. After this peer led session, you will... Recognize and discuss at least one ideology that nursing curriculum is impacted by. Recognize and discuss one major discourse in undergraduate nursing curriculum. Recognize and discuss ontology, epistemology and ethics in the selected discourse using your nursing practice as the conceptual lens.

4. What’s the ideology? Nursing curriculum is not just about what seasoned nurses think new nurses should know. There are many social issues that impact nursing curriculum and many stakeholders that want nurses to have specific skills and knowledge when they graduate .

5. Socio-political ideology Socio-political climate impacts nursing curriculum significantly. Past and present ideologies in society push against nursing curriculum as societal stakeholders want to define roles and responsibilities of a nurse. Nursing guides itself, but partly in response to what society wants and needs from nurses

6. 1st post question What Canadian socio-political ideology do you feel is impacting nursing (and therefore nursing curriculum) at present? Please give an example from your experience. Hint: If you need a few ideology examples to choose from, here is an interesting article that may help: Caldwell (1997) Although this article is not recent, it has some good examples to get you thinking...

7. Stakeholders Another important piece of the ideology puzzle in curriculum are stakeholders. These entities try to guide/navigate their ideology into society. Nursing stakeholders can be considered extraneous forces with a vested interest in nursing.

8. 2nd Post question This New Zealand article talks about stakeholders in nursing curriculum; Keogh, Fourie, Watson & Gay (2010) Who are some of the Canadian nursing stakeholders? How do you think they “enforce” ideology in nursing, and therefore help create discourse? Can you expand on any experiences you have had?

9. Of course I’m learning discourse in this course! There are many discourses in nursing curriculum, as many as in nursing itself (of course!) One of the discourses is the clinical skills of the graduating nurse: Is nursing curriculum teaching clinical nursing skills that graduating nurses need to effectively perform at the bedside?

10. Bedside skills for nurses This is where ideology pushes, stakeholders try to enforce and the nursing academics guide ... How much skills based curriculum is needed in nursing school? Who decides? And should their decisions reflect the prevailing socio-political ideology of the day? And what about the nursing discipline, how much power do they have in this conundrum? Hmmm...

11. They didn’t teach you that?! Here is a great discursive about this discourse Glen (2009)

12. Ontology, epistemology and ethics What does ontology, epistemology and ethics got to do with this discourse? Well, everything, I guess. It’s the interconnection between theory and practice; what we believe as nurses, how it translates into nursing knowledge and how we use that knowledge in our practice.

13. Theoretical ontology What we believe as nurses - the theories we base our ideas of what nursing is and what nurses do. There are many conceptual theories used as nursing ontology, and that is one reason why this skills discourse exists. If nurses as a discipline can’t agree or explicate on basic ontological beliefs, we become vulnerable to outside interpretations of what a nurse is and does. Those outside interpretations batter and push at us, and we have to be foundationally strong to resist.

14. Aesthetic knowing and ontology Nursing curriculum uses many conceptual theories, there is no “rule” unless decided on by faculty Carper described aesthetics as the “art of nursing”(Carper, 1978, p 14) Various conceptions of nursing develop aesthetic as knowing such as Orem, Parse and Rogers (Boykin, Parker & Schoenhofer, 1994) to name just a few.

15. Parse’s “Human Becoming” Using a conceptual nursing theory such as Parse (1998) as an ontological base in nursing curriculum will affect the practice of the graduating nurse: what nurses believe about health and people will affect our interactions. Not just our “tasks” but our entire philosophy of what we do for others as a nurse. Whew, heady stuff!

16. Theoretical epistemology Translating into nursing knowledge – the ontological theories guide us with our knowledge formation. No nursing theory focuses on clinical skills alone; it is only a piece. As nursing developed its own body of knowledge, we evolved from an educational apprenticeship model into a professional academic discipline.

17. Theoretical epistemology When we examine nursing curriculum in relation to the ontological theory used, much of our epistemological knowledge about nursing is not task orientated. Vinson (2000) This is a great article about epistemologies, nursing competencies and education goals.

18. Ethics Using that knowledge. So whatever ontological theory used in nursing curriculum grounds the pathway for the epistemology to emerge from, and brings us to nurse practice. Skills are important factors in practice, but we need to understand the principles, concepts and ideas behind them. What we believe about the patient impacts what we do for them and what they need from us. And vice versa.

19. “What nurses know and what nurses do” Doane & Varcoe (2008) Here is a great optional read that may add another dimension to this discourse.

20. 3rd post question Ok, so what do you think? How does this discourse of nursing “skills” affect nursing practice? What are your thoughts about theoretical ontology, epistemology and ethics in this discourse? Do you use a nursing theory that highlights aesthetic knowing, and how does this discourse “fit” into the nursing theory used in your practice?

21. Your final thoughts... Would you mind answering the questions about this session in the PLS post-evaluation forum? This is the “feedback from participants” part... Many, many thanks!

22. References Boykin, A., Parker, M. E., & Schoenhofer, S. O. (1994). Aesthetic knowing grounded in an explicit conception of nursing. Nursing Science Quarterly, 7(4), 158-161. Caldwell, K. (1997). Ideological influences on curriculum development in nurse education. Nurse Education Today, 17(2), 140-144. Carper, B. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science, 1(1), 13-23. Doane, G. H., & Varcoe, C. (2008). Knowledge translation in everyday nursing: From evidence-based to inquiry-based practice. Advances in Nursing Science, 31(4), 283-295. Glen, S. (2009). Nursing education -- is it time to go back to the future? British Journal of Nursing (BJN), 18(8), 498-502. Keogh, J. J., Fourie, W. J., Watson, S., & Gay, H. (2010). Involving the stakeholders in the curriculum process: A recipe for success? Nurse Education Today, 30(1), 37-43. doi:10.1016/j.nedt.2009.05.017 Parse, R. (1998). The human becoming school of thought. Thousand Oaks, CA: Sage. Vinson, J. A. (2000). Nursing's epistemology revisited in relation to professional education competencies. Journal of Professional Nursing, 16(1), 39-46. doi:DOI: 10.1016/S8755-7223(00)80010-1