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From political correctness to reflexivity: A norm-critical perspective on nursing education
Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Department of Health Sciences, University West, Sweden.ORCID iD: 0000-0002-2358-5086
Department of Health Sciences, University West, Sweden.
Department of Health Sciences, University West, Sweden.
Jönköping University, School of Health and Welfare, HHJ, Dep. of Social Work. Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Department of Social Work, University of the Free State, South Africa.ORCID iD: 0000-0001-7341-945x
2020 (English)In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, article id e12344Article in journal (Refereed) Epub ahead of print
Abstract [en]

Education is important in shaping professional identity, including how one approaches norms and normalisation. In the analysis presented in this study, nursing students' own constructions of norms and normality from the outlook of their education are highlighted and problematised. To deepen the understanding of these matters, the aim of this study was to explore constructions of norms and normality among students in nursing education. Students studying in a nursing department at a Swedish university college were approached and asked to consider open survey questions targeting their views on norms and normality; 154 of them replied. After a discourse analytic approach to the data, we could see how the students constructed norms and normality as (a) instrumental instructions, consisting of easy‐to‐digest statements grounded in the profession's obvious moral and ethical values, (b) limiting and frustrating obstacles for personal freedom that were important to challenge, (c) rules to be obeyed for the stability of society and (d) a matter of reflection, with each individual being responsible for understanding differences in norms, perspectives and opinions. We conclude that nursing education would benefit from norm‐critical perspectives, problematising students' own positions to norms, power and privilege.

Place, publisher, year, edition, pages
John Wiley & Sons, 2020. article id e12344
Keywords [en]
discourse analysis; education; norm criticism; nursing; social norms; students
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-43651DOI: 10.1111/nin.12344ISI: 000510448700001PubMedID: 32009272Scopus ID: 2-s2.0-85078904710OAI: oai:DiVA.org:hj-43651DiVA, id: diva2:1315182
Note

Included in doctoral thesis in manuscript form.

Available from: 2019-05-13 Created: 2019-05-13 Last updated: 2020-02-19
In thesis
1. Becoming aware of blind spots — Norm-critical perspectives on healthcare education
Open this publication in new window or tab >>Becoming aware of blind spots — Norm-critical perspectives on healthcare education
2019 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background

This dissertation takes a critical look at norms and normality in healthcare education, focusing on the specific case of a nursing education programme at a Swedish university college. The concepts of norms and normality have a long history in healthcare professions, and have become important for many aspects of social life. A norm-critical perspective is central to the studies, as it exposes constructions of power and privilege related to norms and normality. It may also be useful in revealing underlying assumptions and matters which healthcare professionals take for granted, and which may result in failure to provide equitable care for all.

Aim

The overall aim of the dissertation is to describe and scrutinise norms and normality in a healthcare education context from a norm-critical perspective. A further aim is to explore how a norm-critical perspective on nursing education can contribute knowledge to existing fields of critical inquiry.

Designs

The four studies were designed using qualitative approaches to written and spoken text, as well as a number of different approaches to an instrument development process.

Methods

In study I, document analysis was underpinned by thematic analysis, while critical discourse analysis was used to analyse focus group discussions in study II. Study III analysed written responses to open survey questions using a discursive approach. Instrument development and factor analytic techniques were used in study IV.

Findings

Study I revealed the occasional use of politically correct rhetoric in curricular documents and literature, in parallel with a number of outdated views in terms of identity and normality. In study II, three discourses were identified in nursing teachers’ talk, all with norm-critical potential, though criticism of norms was not strong enough to form a discourse of its own. Study III showed how nursing students used more or less politically correct or reflexive approaches to construct images of norms and normality. Study IV developed and validated the Norm-critical awareness scale.

Conclusions

This dissertation expands knowledge about norm-critical perspectives in healthcare contexts. It exposes constructions of normative, taken-for-granted aspects within healthcare education, and concludes that the apparently desirable concept of tolerance needs to be problematised more fully in relation to norms, privilege and power. Norm criticism as an educational and intellectual tool can increase awareness of the norm-related mechanisms underlying healthcare encounters, even if awareness is only a first and necessary phase of change, and is not in itself sufficient to bring about change.

Implications

In a practical sense, the findings can facilitate understanding, planning and implementation of further norm-critical initiatives in educational contexts. Where theory is concerned, the studies fill a knowledge gap by contributing to norm-critical approaches in settings where future healthcare professionals are being educated, which have barely been explored until now. The studies also add to existing research traditions involving critical, emancipatory and anti-oppressive perspectives in terms of healthcare professions.

Place, publisher, year, edition, pages
Jönköping: Jönköping University, School of Health and Welfare, 2019. p. 108
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 100
Keywords
Discourse, Equality, Equity, Instrument development, Normality, Norm criticism, Norms, Nursing education
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-43653 (URN)978-91-85835-99-7 (ISBN)
Public defence
2019-06-14, Albertsalen (F104), University West, Trollhättan, 13:00 (English)
Opponent
Supervisors
Available from: 2019-05-13 Created: 2019-05-13 Last updated: 2019-05-27Bibliographically approved

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Tengelin, EllinorBülow, Pia H.

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