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Discourses with potential to disrupt traditional nursing education: Nursing teachers’ talk about norm-critical competence
Jönköping University, School of Health and Welfare, HHJ. SALVE (Social challenges, Actors, Living conditions, reseach VEnue). Department of Health Sciences, University West, Trollhättan, Sweden.ORCID iD: 0000-0002-2358-5086
Department of Health Sciences, University West, Trollhättan, Sweden.
2017 (English)In: Nursing Inquiry, ISSN 1320-7881, E-ISSN 1440-1800, Vol. 24, no 1, article id e12166Article in journal (Refereed) Published
Abstract [en]

This paper describes the discourses underlying nursing teachers’ talk about their own norm-critical competence. Norm criticism is an approach that promotes awareness and criticism of the norms and power structures that exert an excluding effect in society in general and in the healthcare encounter in particular. Given the unequal relationships that can exist in healthcare, for example relationships shaped by racism, sexism and classism, a norm-critical approach to nursing education would help illuminate these matters. The studied empirical material consisted of focus group interviews. Nursing teachers discussed their norm-critical competence based on the university course “Norm-Aware Caring” in which they had recently participated. Through a critical discourse analysis, three discourses were identified in their talk, all of which had the potential to disrupt traditional, normative nursing education. However, in all three discourses there was an underlying discourse of normality, clearly positioning the teachers as exemplifying the “normal.” The binary constructed between normality and otherness contradicts a basic tenet of the norm-critical approach and may hamper the development of genuine norm-critical competence in nursing education.

Place, publisher, year, edition, pages
Wiley-Blackwell, 2017. Vol. 24, no 1, article id e12166
Keywords [en]
competence; critical discourse analysis; focus groups; healthcare disparities; norm criticism; nursing education; social norms
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-32261DOI: 10.1111/nin.12166ISI: 000393814300006PubMedID: 28124809Scopus ID: 2-s2.0-84997456771OAI: oai:DiVA.org:hj-32261DiVA, id: diva2:1045832
Note

Special Issue: Beyond the Gender Binary

Available from: 2016-11-10 Created: 2016-11-10 Last updated: 2019-05-27Bibliographically approved
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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