The Research Approach

I decided to use a qualitative approach for the study. Communication is a complex, interactive, personal and social activity, influenced by many factors. In order to begin to understand and interpret the factors influencing communication in clinical practice, it would be necessary “to delve deep into the subjective qualities that govern behaviour” (Holliday, 2007, p. 7). According to Creswell (2007):

We ... conduct qualitative research because we need a complex, detailed understanding of the issue. This detail can only be established by talking directly with people ... and allowing them to tell the stories unencumbered by what we expect to find or what we have read in the literature. (p. 40)

Talking directly and in depth to those involved in clinical placements would, I hoped, provide insights into their experiences and subjective understandings. From these discussions, themes and patterns would emerge (Holliday, 2007).

This approach is informed by grounded theory methodology, in which the research generates theory through the analysis and interpretation of data collected from a variety of sources, including participants (Charmaz, 2006). It also shares some of the characteristics of case study research, as in-depth descriptions and analyses would be made of a number of students‟ experiences of a placement occurring at a particular point in their programme (Cresswell, 2007; Yin, 1994). From these descriptions and analyses, I would “attempt to identify the various interactive processes at work” in students‟ experiences of communication in placement (Bell, 2005, p. 10).

When describing the differences between the quantitative and qualitative approaches, Holliday points to the complex, „messy‟

36

nature of real-world research contexts, and the increasing trend for researchers to tell the research story “as it really happened” (2007, p. 7). The remainder of this chapter tells the story of this research project.

In order to build a complex picture of the experience of clinical placement, I wanted to find out about and compare the experiences of all three major groups of participants: students, clinical lecturing staff, and preceptors. This would hopefully provide rich data and enable me to compare perceptions of the situation. Whilst it would also have been useful to discuss the experiences of the clients or patients, and to carry out direct observation of students „in the field‟, the ethical implications, and the length of time needed to obtain the necessary approvals, precluded this.

I planned to track the experiences of students moving through a particular clinical placement, by interviewing them as they prepared for the placement, while they were on the placement, and at the completion of the placement. These interviews would be supplemented by a weekly email exchange during the course of the placement.

I also planned to interview each student‟s preceptor: the registered nurse who was assigned to work alongside and „buddy‟ the student during the placement. The interviews would be held on completion of the placement, so as to collect data on the preceptor‟s perspective of the placement experience.

Finally, clinical lecturers who had worked with ESL students on placement would be invited to attend a focus group. A focus group would allow discussion and comparison of experiences between participants (Barbour, 2007). This would provide further valuable data and another perspective on the challenges ESL students might face in clinical placements.

37 In order to compare experiences across undergraduate nursing programmes and allow results to be generalised across a wider population, I planned to track students from both my own and a partner institution, as they completed a similar placement. A polytechnic within reasonable geographic reach was selected, and initial contact with staff in the Bachelor of Nursing programme there proved positive. I planned to interview eight students altogether: four from each institution. Eight students would provide a reasonable but manageable sample and also meant the study would still be viable should one or two students choose to drop out. Preceptors would be interviewed at each location, and two separate clinical lecturer focus groups would be held, one at each polytechnic.

Discussions with lecturing staff from both polytechnics confirmed that the final placement in the programme (the „Transition to Practice‟ placement) would provide a suitable focus for the research. This six- week placement occurs towards the end of the third year of the programme, and is the student‟s final clinical experience before sitting the external State Final examinations. At this point in the programme, the student has a wealth of experience of clinical placements, and would be able to reflect back on these as well as on the current placement. In addition, the timing of this placement fitted well with my own commitments, and would enable me to do initial background research and develop research instruments well in advance.

In considering the ethical issues associated with the research, it was necessary to consider the cost/benefit ratio (Cohen, Manion & Morrison, 2007, p.50). It did not seem that there was much potential for harm for those participating. Confidentiality would be maintained and I was confident that my experience in working with ESL students would enable me to provide a supportive environment during the interview process, where students would feel comfortable. Moreover, it was possible that the students would appreciate the opportunity to discuss their experiences in an impartial situation with an attentive

38

listener. On this basis, the research outline was put forward for peer review, and subsequently judged to be of „low risk‟. A low risk notification was submitted to Massey University Human Ethics Committee, and I received confirmation from the Committee that the project had been recorded on the Low Risk Database.

The research proposal was then forwarded to the Research Committees of the two polytechnics. While approval was received from my own polytechnic‟s Research Committee, it was withheld by the partner polytechnic. Subsequent recruitment of participants and data collection therefore took place at one institution only, and the design was adjusted accordingly.