An exploration of students’ personal constructs: Implications for clinical teaching in psychiatric mental health nursing

Melrose, Sherri

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Citation

Melrose, S. (1998). An exploration of students’ personal constructs: Implications for clinical teaching in psychiatric mental health nursing. Unpublished PhD dissertation, 1998, University of Calgary, Alberta, Canada.

Abstract

Despite revolutionary rhetoric in the nursing education literature calling for collaborative student centered learning, few opportunities actually exist, particularly in the psychiatric clinical teaching area, to include the voices of student nurses in the scholarly dialogue surrounding their learning. Тhis thesis was designed to understand students’ own ways of knowing during their six-week mental health practicums оп acute hospital units. А constructivist conceptual perspective and George Kelly’s personal construct psychology аrе the theoretical bases of the research. Qualitative methodology using the case study approach was used to describe the experiences of six Canadian second уеаr nursing students from their own perspectives. Data sources included before and after repertory grids, а questionnaire and audiotape-recorded transcribed interviews. Content was theme analyzed, Vее Heuristic diagramed and concept mapped. The case studies were written collaboratively with students and member checking by correspondence six months after the practicum ended confirmed that the reports authentically narrated the personal construct changes which occurred, or did not occur, as а result of the course. Тhe study spanned three years, included а pilot project and incorporated the resulting student “stories” intо а clinical curriculum. Тhе case reports are snapshot portrayals of how student nurses construed the professional activities they observed оп hospital units which recently underwent organizational changes. Тhey reflect human faces bеhind the paradigm shifts occurring in nursing education and health carе. Тhе following four overarching themes represent key findings. Тhe research аррrоасh invited constructivist teaching. Students’ anxiety related more to fееling unable to help than to mentally ill patients. Students felt а lack of inclusion in staff nurse groups. Non evaluated student-instructor discussion time was vitally important. Suggestions for clinical teaching strategies are made to assist instructors in the selection of experiences which саn help link university curricula to hospital practicum sites. The research contributes to the conceptualization of how students learn nursing by re-valuing what they bring to clinical experiences, by increasing understanding of what students find engaging or difficult and bу developing а pedagogical mode of inquiry which extends clinical instruction beyond demonstration and evaluation to creating а space for student perceptions.

LIST OF FIGURES

Figure 1. Vee Heuristic Diagram…….. 103

Figure 2. Summary Diagram: Features in the Process of Constructing the Case Study Reports…….. 121

Figure 3. Repertory Grid illustrating Sandra’s Personal Construct Changes…….. 135

Figure 4. Concept Map: Sandra’s Personal Constructions of Psychiatric Mental Health Nursing Activities… 143

Figure 5. Repertory Grid illustrating Nathan’s Personal Construct Changes…….. 149

Figure 6. Concept Map: Nathan’s Ratings of his Personal Constructions of Psychiatric Mental Health Nursing Activities…….. 152

Figure 7. Repertory Grid illustrating Simone’s Personal Construct Changes…….. 159

Figure 8. Concept Map: Simone’s Ratings of her Personal Constructions of Psychiatric Mental Health Nursing Activities…….. 162

Figure 9. Repertory Grid illustrating Heather’s Personal Construct Changes…….. 171

Figure 10. Concept Map: Discussing Heather’s Ratings of her Personal Constructions of Psychiatric Mental Health Nursing Activities…….. 175

Figure 11. Repertory Grid illustrating Beth’s Personal Construct Changes…….. 186

Figure 12. Concept Map: Discussing Beth’s Ratings of her Personal Constructions of Psychiatric Mental Health Nursing Activities…….. 190

Figure 13. Repertory Grid illustrating Casandra’s Personal Construct Changes…….. 201

Figure 14. Concept Map: Discussing Casandra’s Ratings of her Personal Constructions of Psychiatric Mental Health Nursing Activities…….. 205

CHAPTER ONE

INTRODUCTION AND PROBLEM

Purpose, Questions and Significance

This thesis is a naturalistic study which explored students’ ideas about mental health nursing. The research emphasized the importance of incorporating students’ perceptions into nursing education. The investigation uses a case study design. The main purpose of the research was to investigate how student nurses develop personally meaningful constructs during their psychiatric mental health clinical rotation. A secondary purpose of the study was to examine the role that personal construct theory can play in the learning/development process.

Three questions guide the research. First, how do student nurses construe professional staff activities? Second, what changes, if any, do student nurses perceive in their personal ways of knowing about mental health nursing? Third, does the construction and discussion of a repertory grid help student nurses to articulate what they learn?

A constructivist conceptual perspective undergirds the project. In a constructivist approach to learning, the individual is viewed not as a passive recipient of knowledge, but as an active constructor of meaning (Shapiro, 1994).

Personal construct theory is an outgrowth of a constructivist world view and lends itself to exploration and inquiry in complex interactive situations. The techniques involved in the use of repertory grids or repgrids logically derive from the theory (Costigan, 1985; Pollock, 1986; Rawlinson, 1995). According to Bannister and Fransella (1971) “personal construct theory is elegant in its formal logic, precise in its methodological implications and rich in its imagination” (p.10).

George Kelly’s (1955/1991) theory of personal construct psychology provides a framework for understanding self and the perceptions of others. Costigan (1987) described the essential aspects of the theory as follows.

The fundamental postulate of Kelly’s theory states that “a person’s processes are psychologically channelized by the way in which he anticipates events” (Kelly, 1955). This means that individuals choose to interpret or form constructions of events in ways which are most meaningful for them. Personal constructs are “templets of reality” (Kelly, 1955) or categories of thought which determine subsequent expectations and behavior. The meaning of events is ascribed within the context of those events. Constructs form patterns of reality which may be unique according to the Individuality corollary,; shared by a group according to the Commonality corollary; understood by others according to the Sociality corollary, or even inconsistent according to the Fragmentation corollary. Constructs are chosen because they are the most meaningful in a given situation according to the Choice corollary. Once chosen they are tested in the light of experience according the Experience corollary and can be consolidated, modified or elaborated in the process of personal development according to the Modulation corollary. The individual’s idiosyncratic construct system must be seen to be firm to prevent anxiety or chaos. Constructs which are preemptive (‘nothing but’ type construing) or constellatory (‘stereotyped or typological thinking’) serve to keep the system tight and impermeable (Costigan, 1987).

In the field of nursing education, there is a paucity of current research in the area of psychiatric mental health clinical teaching. This study makes a contribution to this literature and is significant in four ways. First, it provided in-depth insight into the current learning needs of participating student nurses. Second, it informed practice in terms of recommending collaborative nursing educational experiences from a personal construct theory approach. Third, this research suggested important changes in our understanding of clinical teaching in psychiatric mental health rotations. Fourth, publications extending from this study will contribute a Canadian perspective to the developing body of international literature linking personal construct theory and nursing education.

The project provides a detailed description of learning in one local nursing program. The study emphasized the importance of discovering personal meaning as opposed to an assumption of universal meaning, and therefore limited generalization is warranted.

Finally, two key areas of research in nursing education are pertinent to this study—clinical teaching and personal construct theory. It was the objective of this investigation to weave a common thread between these two research strands in order to provide students, educators and practitioners with insights into student nurses’ ways of knowing in mental health nursing. The heart of the project involved listening to the students themselves and collaborating with them to create a meaningful report of their experiences.

Given the above, in this thesis, I argue for the importance of the inclusion of student voices in the scholarly dialogue surrounding their learning. In order to accomplish this aim, the research is arranged into five chapters. The following section outlines the organization of this project.

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TABLE OF CONTENTS

LIST OF FIGURES

CHAPTER ONE

INTRODUCTION AND PROBLEM

Purpose, Questions and Significance

License

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