Biographical landscapes: nurses' and health visitors' narratives of learning and professional practice

Abstract

The thesis illuminates biography, learning and practice and advances \nunderstanding of the development of professional knowledge and practice. The \npurpose of the research was to inform the pedagogical development of practice \nlearning using a biographical perspective to investigate how nurses and health \nvisitors use professional practice experiences to learn and generate knowledge \nand understandings of practice. The research is set within the healthcare policy \ncontext of lifelong and lifewide learning. \nThe literature review builds on my own experiences. An argument is developed for \npractice learning to be located within a universal knowledge system that provides \nfor the subjective and contextual complexity of nursing practice knowledge and \nlearning. The research strategy is grounded in the theoretical perspectives of \ninterpretive phenomenology and interaction ism. \nNine specialist community nurses and health visitors participated in the life story \ninterview of biographical narrative interpretive method. Three transcripts were \nselected for in-depth analysis of subjective meanings of learning and professional \npractice. Case comparison of biographical process structures shows how \nbiographies construct a resource for ways of knowing the world that is incorporated \ninto professional agency. \nFive profiles of formal practice learning were accessible for documentary and \ntextual analysis. Two patterns of orientation were reconstructed from this analysis: \na learning practice constituted as a process of identifying and meeting learning \nneeds through client-centred practice and public institutions constituted as a \nprocess of support and self-surveillance of the formal learning programme. These \nmirror biographical learning resources which seem to both construct professional \nknowledge and constitute the practice learning action environment. \nDiscourse analysis of accounts of client care situations from follow-up narrative \ninterviews with four nurses and two health visitors showed continuity of how \nindividuals learn and do the process of knowing practice through their own \npersonal theories-of-practice. \nThematic analysis across the findings has led to the creation of a model of \nbiography, learning and practice and utilises the concept of biographicity to inform \npedagogical development of practice learning. The research makes a significant \ncontribution to the body of knowledge on implicit, non-formal and formal learning \nand the development of professional knowledge at a micro practice action level of \nclient-professional interaction.

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