Chapter 6: PG Cert NIC Capability Wheel
6.2 Using Interviews to Contextualise Capability in NIC Nursing Students – Journal Article
Publication details
This paper was submitted to the Journal of Neonatal Nursing and subsequently published ‘Article in Press’ as:
Bromley P (2017) Capability: How is it recognised in student nurses undertaking postgraduate studies in neonatal intensive care? Journal of Neonatal Nursing pp 1-6
At this point it would be beneficial to read the accompanying article to this stage of the study. This article described the research process in more depth and explains the findings from this stage of the research. It situates Capability in the neonatal clinical practice and provides clarity to the concept of Capability in the PG Cert NIC nursing student.
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Chapter 6 82
6.3 “Filling in the Gaps”
From the research I found the three overarching themes of Professionalism, Interpersonal Interactions, and Knowledge and Skill. The mentors recognised Capability through observing subtle verbal and non-verbal cues, which Rittman and Osburn (1995) describe as “watchful listening”. The published manuscript accompanying this chapter (Section 6.2) discusses a number of findings from this study which reflect those of the wider literature (Killam, Montgomery, Luhanga, Adamic & Carter, 2010; Luhanga Yonge & Myrick., 2008; Luhanga, Larocque, MacEwan, Yovita, & Danyluk, 2014; Rittman & Osburn, 1995; Tanicala, Scheffer & Roberts, 2011) and supports the conclusions I have drawn from this study. There were other findings related to Trust, and Expertise andExperience not discussed in detail in the Bromley (2017) paper (Section 6.2) due to a focus on the recognition of Capability. In this section, I will conclude this chapter with a short discussion on the two additional findings of Trust and Experience.
The importance of trust within the student/mentor relationship has been explored in the literature. Hauer et al., (2014) discussed trust in the student/mentor relationship in terms of the student needing to earn their mentor’s trust. According to Hauer, et al., (2014) trust plays a crucial role in student/mentor relationship and in the provision of developmentally appropriate learning opportunities; the clinical supervisor needs to trust the trainee before they are able to make decisions on how much independence to allow their trainees. In my research, I also found trust to be a crucial factor in the student / mentor relationship, although the mentors provided a different perspective from Hauer, et.al. (2014). The mentors in my research implied it was the student who needed to develop the trust in their mentor, rather than the mentor developing trust in the student. For example, Rosalie stated that the student needed to “trust that the teacher is going to take them through step by step” during complex clinical experiences. Helen expressed that “if they [the student] have worked with them [the mentor] before they [the student] trust their [the mentor’s]
judgement”. In order for them to develop relationships with their colleagues, Helen suggested that the “students who seem to thrive, find a buddy that they trust and … want to be like that person”. This perspective of trust, suggests the mentors in this study are aware of the challenges and potential barriers to learning in clinical practice, and nurture a safe learning environment for their NIC students.
The extent of previous experience of the PG Cert NIC student was also emphasised in the interviews. Mentors believed that inexperience influenced student confidence which may
therefore delay the development of Capability. One example the mentors discussed was in advising on breast feeding; Helen explained that “they [the student] don’t feel confident because they don’t know a lot about it [breast feeding], and if they [the student] have not breast fed they find it difficult to provide advice. Associated with inexperience, age was viewed as a potential barrier to developing confidence in providing breast feeding advice. Rosalie suggested “the age gap as well, a lot of our students are really younger and they are trying to teach women who are older than them how to breast feed”.
Conversely, the mentors suggested that students who had been working in a neonatal nursery for a number of years, might feel a little intimidated by undertaking further study. Rosalie explained that perhaps the students were concerned that they have “been in this job for so long and maybe [they] haven’t got it quite right”. The mentors suggested these students were worried that they may have been doing something incorrectly without realising. Despite this, all mentors recognised that overall, age and experience contributed positively to the development of Capability. If the student has had prior experience, particularly in Midwifery or with their own babies, the mentors believed the student tended to be more confident; as Helen stated “the girls that are midwives, they tend to develop a little bit quicker”.
Conclusion
The findings from this stage of the research align well with other research on the Capability in students and nurses. The three overarching themes of professionalism, interpersonal relationships, and knowledge and skills identified from the data, provide the evidence of Capability. The interviews revealed that Capability is demonstrated through the different aspects of verbal and non-verbal communication. In their practice, the mentors interpret verbal and non-verbal behaviours of the PG Cert NIC nurses, which inform their assessment of how the student is managing and whether they might be able to take on more complex cases in clinical practice.
Chapter Summary
The first stage of this research, the NGT described in Chapter 4, identified the discipline specific Graduate Attributes (GAs) for the PG Cert NIC. The second stage of this research described in Chapter 5, used the PG Cert Graduate Attributes to develop an understanding of what Capability Requisites (CRs) support the development of these GAs, and when the student is expected to develop these CRs during the 12-month course. The third, and final
Chapter 6 84 stage of this research, described here (Chapter 6) contextualises and operationalises the concepts of Capability, to further identify how Capability is evidenced by the student in Clinical Practice.
This chapter has explained details of the methodology related to interview technique that were not addressed in Chapter 3. It describes the use of semi-structured interviews with expert clinicians supporting PG Cert NIC students to identify how Capability is appraised in clinical practice. It has presented the findings from this stage of the research to explain how Capability is recognised in the NIC nursing student. It has drawn conclusions that there are three underpinning themes of professionalism, interpersonal relationships, and knowledge and skills that contribute towards the development of Capability. These conclusions are explored in more depth in the following chapter, Chapter 7: From Competence to Capability, in a discussion which will conceptualise Capability in the NIC nursing graduate.