Conway, Jane E. (1995) Expert nursing knowledge as an evolutionary process. PhD thesis, University of Warwick.

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Abstract

The introduction of the Framework and Higher Award (ENB 1991b)
provides the opportunity for nurses to claim credits for the
knowledge they use in practice. The assumption is, that this
is accreditable (ENB 1991). This study aims to identify if
this is the case by examining the practical knowledge of 35
expert nurses. Expert nurses were chosen as they are the most
likely of all nurses to be using knowledge in their practice
which is accreditable at diploma and degree levels.
The study was carried out in two Health Authorities, using both
quantitative and qualitative methods. The later formed the main
contribution to the study. Ethnographic and phenomenological
approaches were used to guide the workshops, interviews,
observation visits and critical incident collection. Modified
grounded theory was used for data analysis. As a result of the
inductive nature of the study, emphasis changed from
identifying knowledge for accreditation purposes, to exploring
the types of knowledge and expertise that emerged from the
data.
Findings challenge much that had been written about nursing
knowledge. A number of issues arise. Questions are raised about
the definitive way that expertise is presented in the
literature. Also, the assumption that the importation of
subject matter knowledge will produce practitioners who provide
expert care is challenged. Whilst education is seen as
important, it is not sufficient. Other factors in the nurses'
'world view' require consideration. The experts exhibited four
different 'world views'. These in turn had an evolutionary
effect on knowledge development and knowledge use. Four
distinct types of expertise were found to have developed.
A number of areas are explored in relation to the practical
knowledge experts use and include: organisational culture,
doctor-nurse, and management-nurse relationships, academic and
professional development, empowerment and reflective ability.
Issues relating to advocacy, the theory-practice gap,
accreditation, and the quality of patient care, are also
examined. Implications arise for curriculum builders, managers,
nurses and educationalists.

Item Type:	Thesis (PhD)
Subjects:	R Medicine > RT Nursing
Library of Congress Subject Headings (LCSH):	Nursing -- Study and teaching, Nurses -- Accreditation, Expertise
Official Date:	January 1995
Dates:	Date Event January 1995 Submitted
Institution:	University of Warwick
Theses Department:	Department of Continuing Education
Thesis Type:	PhD
Publication Status:	Unpublished
Supervisor(s)/Advisor:	Duke, C. (Christopher)
Extent:	xiii, 362 leaves
Language:	eng

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