DATA COLLECTION

One of the main strengths of conducting a case study is the use of multiple

sources of evidence, and the triangulation of evidence. Yin (1994) states that the most important advantage of using multiple sources of evidence is the

development of converging lines of inquiry, making any finding or conclusion more likely to be convincing and accurate. The following figure adapted from Yin (1994) demonstrates the convergence of multiple sources of evidence in this study.

Figure 5.1: Convergence of multiple sources of evidence. (Adapted from Yin 1994)

Survey questionnaire of clinical mentors

Documents: institution

policy and procedu— Semi structured _{interviews with} university support officers

I

Semi structured interviews with admissions lecturers C O N C L U S IO N S Longitudinal study of students who are dyslexic during

Group and individual interviews with students who are dyslexic

/

their pre- reaistration course Semi structured interviews with clinical mentors Observations of students in clinical practice

Semi structured interviews with school support officer

Key to figure 5.1: Red boxes = data collected in stage 1 Blue boxes = data collected in stage 2

As I wanted to include a longitudinal study element in this study I decided to organise the data collection into two stages. In the paragraphs below I have set out the data collected for both stages of the research process. I have chosen to present the information on data collection and subsequent analysis collectively in

this chapter rather than describing the data analysis after each stage because the two stages are so closely interrelated.

5.5.1 Stage One

The focus of stage one of the study was to develop an understanding of the context and nature of the problems faced by nursing students who are dyslexic within pre-registration nurse training, and to begin to understand how they may be supported to develop clinical competencies. Analysis of data gathered in stage one was used to inform the data collection undertaken in stage two. From my

review of the literature and examination of the structure and arrangements within the University of Glynrith, I identified a number of sources from which to gather

data, listed below.

• Admissions lecturers

Purpose: to determine how students were selected, and to examine the lecturers’ views on individuals with specific learning needs training to become registered nurses.

All nurse lecturers, (approximately 70 during the period of this study) in the School of Nursing, University of Glynrith, played an active admissions role in selecting new students to study on the pre-registration nursing course. This meant that I could make an open invitation to all of the lecturers to

participate in the study, rather than restrict or target recruitment. The invitation and accompanying information sheet describing the study (see appendix ii.) were circulated via email, as this was deemed the most effective way of reaching all staff. From the twelve responses, I randomly selected two nurse lecturers who taught on each of the four branch programmes, eight lecturers in total.

This group consisted of three men and five women, who had varying

degrees of experience in nurse education. All taught on the pre-registration diploma and degree nursing programmes and three individuals had specific administrative or managerial roles within the School:

• Team Leader of a teaching team for a branch programme,

• Liaison role with the School’s admission office and University registry • Module Leader.

The individual interviews were conducted either in a quiet interview room close to the lecturer’s office or within their office or in an empty classroom. As office space was at a premium in this School, the lecturers normally shared office accommodation. On one occasion an interview had to be suspended and moved to an empty classroom as the lecturer sharing the office returned earlier than expected.

One area of difficulty with the data collected from this group was

encountered when transcribing the taped interviews. One of the admissions lecturers spoke English as a second language and had a very strong accent making the transcription process very demanding. I overcame this problem by repeatedly playing back the recordings to get my ‘ear’ used to the accent.

To ensure consistency during the interviews, I developed an interview question sheet to act as an aide-memoire (see appendix iii.). Staff signed a consent form (see appendix iv.).

• School designated lecturer responsible for students with specific needs Purpose: to explore the role in supporting students with specific learning

needs.

The lecturer undertook this supporting role on a part-time basis and for the remainder of the time was a nurse lecturer on the adult branch of nursing. At the time of the data collection phase of the study, the lecturer was the only one fulfilling this role within the School. My initial approach was via the telephone, followed by a meeting to discuss the study in person. An

information sheet about the study was provided (see appendix v) and a consent form (appendix iv.). In addition to exploring the role in supporting students with specific needs, I also needed her to act as the initial contact person with the nursing students who were dyslexic in order to recruit them to both stages of the study. She was the only officer with information about which students were dyslexic and who had a close relationship with the students, making her a key ‘gatekeeper’ for the study. Using an

intermediary ensured that I only spoke to students who had granted

permission for me to know they had been diagnosed as dyslexic. (See the section 5.9, page 95, ethical considerations for more details.) Burton (2000) highlighted the importance of developing a relationship with key

gatekeepers in gaining access. I made special effort to meet this lecturer in person to discuss the study and kept close contact during the initial stages of data collection. In respect of the data collected about her role, I

conducted a taped-recorded, semi-structured interview using an interview schedule as an aide-memoire (see appendix vi.).

• University Special Needs Officer

Purpose: to examine support systems for students with specific needs studying at the University.

There were two Special Needs Officers working in the University’s Student Support Services, one of who had responsibility for the students within the School of Nursing. The previous Special Needs Officer who had worked closely with the School in the preceding few years had been promoted a few months before the interview for this study. Her new role was as

manager of the Student Support Services and she was heavily involved in reorganisation activities going on in the University at that time. I initially approached the Manager by telephone and then sent a copy of the information sheet outlining the study. Although initially agreeing to be interviewed, after much rescheduling on the day of the interview, she sent the newly appointed Special Needs Officer who had just taken over

responsibility for the School as a replacement. She subsequently declined to be interviewed citing pressure of work. The interview with the newly appointed Special Needs Officer took place. However, the information gathered was restricted to University policy and procedures generally to do with any students with disabilities and specific learning needs within the University, as she had not yet had any contact with nursing students. The semi-structured interview was tape-recorded and transcribed verbatim.

I used an interview schedule as an aide-memoire. (See appendix vii. for the information sheet, appendix vi. for the interview sheet and appendix iv. for the consent form.)

University Dyslexia Tutor

Purpose: to examine her role in supporting nursing students with specific learning needs during their studies at the University.

The University’s Student Support Services department employed a number of Dyslexia Tutors. I approached the officer who had the most experience of supporting students from the School of Nursing. Initial contact was through the manager of the department, who identified the appropriate officer to approach. Subsequently I spoke to the Dyslexia Tutor by telephone and sent her a copy of the information sheet (see appendix viii.). I conducted a tape-recorded, semi-structured interview, using an interview schedule as an

aide-memoire (see appendix vi.). She also signed a consent form (appendix iv.).

• Trust. University and School written policies

Purpose: to review the guidance and standards for the selection and support of students who are disabled or who have specific learning needs.

I gathered documents from the University and Trusts’ websites, and was provided with policy documents and other literature by the Student Support Services department and the School designated lecturer responsible for students with specific needs. All information obtained was in the public domain.

• Second and third year nursing students who are dyslexic.

(Selecting students well into their programme ensured they had been exposed to a variety of clinical placements.)

Purpose: to identify the areas where they experienced problems and how they overcame them.

I asked the School designated lecturer responsible for students with

specific needs to approach all of the students in the second and third years of the pre-registration nursing programme, who were dyslexic, requesting that they take part in a group interview. The lecturer described the study to the students and gave them the information sheet (see appendix ix.). I decided to use a group interview because I hoped the interaction between the students and the sharing of experiences would spark ideas and

reflections in the other group members. There were four students

diagnosed as dyslexic who were known to the lecturer, three agreed to take part in the group interview, the fourth declined saying the experience would be too stressful as she had health and family problems. The students were made aware that this would be a group interview with other dyslexic

students. All gave their consent to share their diagnosis with their colleagues (see appendix x. for the consent form). This event was tape-

recorded and again I used an interview sheet as an aide-memoire (see appendix xi.).

Due to the small number of students available to interview at the University of Glynrith, I decided to approach the neighbouring School of Nursing at the University of Pimbury to recruit further students to the study. The University of Pimbury shared a number of clinical areas with the University of Glynrith and had very similar support structures for students with specific needs. I sought and was granted ethical permission from the University of Pimbury to recruit nursing students (see ethics section on page 95 below for more details). Five students out of a possible forty dyslexic students agreed to take part in the study.

Clinical mentors who have supported nursing students who are dyslexic during the last two years

Purpose: to identify what problems they observed/experienced and how they supported the student in practice.

Mentors for pre-registration nursing students are qualified nurses, with a minimum of 1 year’s experience, working in the clinical area the student has been placed to gain experience in order to develop clinical competence. The clinical mentors used by the school had all undergone preparation for their role that met the standards laid down by the NMC (2004e). The role of the mentor was to provide support and supervision of the student as well as assessment of their clinical competency.

The Allocation Office in the School of Nursing, University of Glynrith, identified ten clinical areas where nursing students, who had declared that they were dyslexic, had been placed in the last two years. I was not

informed of the students’ names to preserve confidentiality. I telephoned the clinical areas to identify a key person such as the clinical mentor or ward manager who would complete a questionnaire about their

experiences. All areas agreed to take part. I enclosed an information sheet (see appendix xii.) and a consent form (appendix xiii.) with the

questionnaire, which gave further information about the study. The

questionnaire contained a combination of open and closed questions about the observed problems experienced by the students and the strategies the mentor employed to enable the student to develop clinical competencies (see appendix xiv. for the questionnaire posted to the clinical mentors.) I chose this method of data collection for pragmatic reasons, namely it was easy to distribute and did not require significant amounts of time as compared to conducting interviews. The data gathered in stage one was primarily to help build up a picture as part of the case study and to focus the data collection in stage two, where I planned to interview a number of

clinical mentors. Therefore, I did not feel that using this approach restricted the information I was gathering. I received nine responses to the

questionnaire.

5.5.2 Stage 2

Stage two involved a longitudinal study of four dyslexic nursing students (this was the total number of students at the University of Glynrith who met the criteria, see page 86 ‘note about the students’) during the two years branch element of their three years pre-registration nursing programme, plus a sample of the clinical mentors who supported them. Pre-registration nursing programmes were made up of a one year Common Foundation Programme (CFP) followed by a two years Branch Programme. There are four possible branch programmes from which to choose: Adult nursing, Children’s nursing, Mental Health nursing and Learning Disability nursing. During the CFP, students spend much of their time in practice observing care; they develop clinical competencies more actively once in the branch programme, hence data collection focussed on students studying on the branch programmes.

• The group included two male and two female students, who were studying on the Adult nursing branch (2), Mental Health nursing branch (1) and Learning Disability nursing branch (1). The students were recruited to the study through the School designated lecturer responsible for students with specific needs. (See appendix xv. for the information sheet and appendix xvi. for the consent form.)

Data were collected in a number of ways:

• At the commencement of the students’ branch programme a life history in relation to each individual student’s specific learning need was recorded. This was via a tape-recorded, semi-structured interview.

• The students were interviewed following each placement to a clinical area throughout the duration of the branch programme. In particular they were asked to report on critical or significant incidents related to problems experienced in clinical practice and/or strategies employed to overcome difficulties experienced in clinical practice. The students met with me individually after five separate clinical placements, three times during the first year of the branch programme and twice in the final year of their course. These meetings sometimes took place in the clinical area

especially if the student wished to demonstrate a particular problem area or useful strategy for coping with a problem. I also had telephone

conversations with one of the students, at his instigation, between visits. This student also provided some brief written accounts of critical/significant incidents. Unfortunately one student left the study part way through to go on maternity leave. In addition to the initial life history interview, I

interviewed her after one clinical placement only. I included the data gathered from this student in the analysis.

• I interviewed seven clinical mentors who had supported the students in clinical placement to discuss the mentor’s observations about the student’s performance and strategies they employed to support the student. I had originally planned to interview two mentors for each student, one from each of the two years of their branch programme. However, as one of the

students left the study in the first year of the branch programme, I only interviewed one of her clinical mentors. All of the interviews took place in the mentors’ area of work; this helped give realism and credibility to the study by focussing on the real world of work. Mentors were initially

approached by telephone and a copy of the information sheet was sent to them by post prior to the interview. (See appendix xvii. for a copy of the information sheet and appendix xviii. for a copy of the consent form.)

5.5.3 A note about the students

Legislation such as the Data Protection Act (1998) protects information about an individual and enables a person, to a degree, to control how and to whom

information about them is shared. Primarily important in this study was that it was not compulsory for a nursing student to declare that they have a specific learning need, nor was it compulsory for a person to be screened for a specific learning need before admission on to the course. The voluntary nature of disclosure meant that access to students who are dyslexic for this study was restricted. To illustrate this point, a typology of the dyslexic nursing students was developed using the following broad categories:

• Diagnosed as dyslexic and willing to disclose • Diagnosed as dyslexic but not willing to disclose

• Believed to be dyslexic but not formally diagnosed and willing to disclose • Believed to be dyslexic but not formally diagnosed but not willing to disclose

Only the first category of nursing students was included in the study. This meant that this study had limited information about students who chose not to disclose to the staff involved with the course and no information about the hidden population of undiagnosed individuals.

In document Dyslexia in pre-registration nursing students : strategies for developing clinical competencies. (Page 90-99)