Coherence in Nursing Education in Norway and the United States: Knowledge, Know-How, and Professional Responsibility

• In Event: Roundtable Session 33
  In Roundtable Session: Cross-National and Cross-Profession Analyses of Coherence in Educating for the Professions

Abstract

1. Objectives
This paper will address a dilemma common to Norwegian and American nursing education: how teachers help students integrate learning from their field experience in clinical settings and university coursework. A narrative approach is used in both countries as an effective teaching strategy. This paper will explore how and why narratives can help students translate what they learn in different arenas and create a more coherent learning situation.

2.Theoretical Framework
We draw on the concept of coherence elaborated for teacher education by Grossman et al (2008). We link this concept to nursing education, where nurse educators confront similar problems of coherence. Our study is further informed by Benner et al (2010), and the study of how to integrate the three apprenticeships of professional education: 1) knowledge and science; 2) clinical reasoning and practice know-how and 3) professional responsibility. The apprenticeship model is premised on experiential and situated teaching and learning, as Lave and Wenger (1991) have described.

3. Methods
We have interpreted 20 narrative interviews from students, faculty, preceptors, and nurses from both countries. The interpretation is informed by the narratology theories of Arthur Frank (2010), Guillemin and Heggen (2011), and Lee Shulman (2004).

4. Data Sources
We draw on data collected for the Carnegie Study of Nurse Education, one in a series of recent work from the Carnegie Foundation for the Advancement of Teaching on American professional education and from the ongoing study in Norway, Qualifying for Professional Careers, which is supported by the Norwegian Research Council.

5. Scientific Significance
This comparative study provides new insights about how narratives are used in various ways to cultivate students’ clinical imagination and their abilities to judge what is of relevance in clinical situations. The analyses of data demonstrate how situated use of knowledge, skilled know how and values are related to students’ capacities to shift from one perspective to another and articulate an impression of a clinical situation into a productive shape and act. Hence this study proposes the possibility of broadening the theory of coherence as well as deepening the understanding of the apprenticeship model.

Authors

• Kristin Heggen, University of Oslo

• Molly Sutphen, The Carnegie Foundation for the Advancement of Teaching