Les funcions ambientals, territorials i socials de les zones humides

The standardisation of nurse education and an apparent preference for evidence based practice essays is problematic, not only because it reinforces Gardner and Rolfe’s (2013) concern, but when standardising nursing, it can at best be considered a restrictive model (Maloney et al., 2013). Standardisation, however, offers little hope of maintaining the known benefits of discursive essays because of the standardisation of quantity, content, programmes and

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qualifications promoted to ensure UK nurse education is comparable with other European degree programmes through the Bologna process (1999). In particular, tensions have arisen from the implementation of standardisation in nursing specialism programmes due to the focus on research projects (Berg, Brämberg, Carlström, Öhlén, 2014). Rather than nursing essays identifying issues of self-disclosure and critical reflective thinking, the evidence suggests that research application into clinical practice is tokenistic and superficial and actually “talked up” when little change has actually occurred in practice (Foxcroft & Cole, 2003; Regan, 2012a). Berg et al’s (2014) Swedish study reported nursing students frustrated by the scientific orientation to acquiring nursing knowledge through research projects, which appear to them to be paper exercises. Therefore, facts not ideas devalue nursing and reduce a sense of ownership.

Contrary to essays considered a paper exercise, in promoting research appreciation essays should be an expression of the higher values of the academic process, which considers all sides of an argument (Maloney et al., 2013; QAA, 2012a). Let me detail this point. Discursive essays promote good nursing values and principles through critique, rigour and resistance to contemporary pressures (Gardner & Rolfe, 2013). When one of the contemporary pressures is the promotion of evidence based practrice and scientific research reports being preferred over discursive essays, the risks therefore, are a sense of depersonalisation and a disintegrated nurse education programme (Benner et al., 2010; Gardner & Rolfe, 2013). How this occurs is because writing allows for the writer to not only write differently but also to think differently (Gardner & Rolfe, 2013). This issue is more significant when considering that nursing attitudes, care and compassion are all found in the nursing essay and in the received annotation (NMC, 2011; 2013; 2015a). Therefore, in giving feedback on the discursive essay, nursing lecturers can engage

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authentically with nursing students and assess the essay content meets professional standards (NMC, 2011; 2013). Being part of a range of assessment methods, the nursing essay allows the lecturer, as annotator, the opportunity to assess a variety of issues, notably fitness to practice, knowledge, integrity, character and meeting the module learning outcomes (QAA, 2012a; 2012b). Sometimes the choice of language in an essay indicates a perception such as depersonalisation of the patient and this means the student is at risk of betraying actual beliefs rather than professional expectations (Schön, 1983; 1987). The nursing essay therefore, identifies hard to quantify issues such as spirituality, holism, emotion, professionalism, a lack of time to care, lack of skills, privacy and fear of what may be uncovered when talking to a patient (Keall, Clayton & Butow, 2014; Lopez, Fischer, Leigh, Larkin & Webster, 2014; Walker, 2014).

2.9 Conclusion

This chapter explored a variety of issues in relation to the practice of annotation within various literary genres and nurse education. Notably, annotation is defined in detail, its history, its purpose, benefits and potential influences reinforcing annotation as a social construct (Ricoeur, 2006). Annotations include the addition of marks, signs, symbols onto the page, made by the annotator to share their understanding of reading with others (DiYanni, 2002). Therefore, its social, linguistic and cultural connotation indicates annotation is considered either benign or provocative and depending on the context of which it is given and for what purpose (Benstock, 1983; Ricoeur, 2006). Assessment feedback and the academic essay is the most predominant format in promoting student meta-cognition (Gardner & Rolfe, 2013). This contrasts with the promotion of standardisation, which allow the student to hide in the text. Therefore, the Bologna process (1999) preference for standardisation and scientific research reports place nurse

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education in a difficult position indicated by the annotator’s presence in the margins of the essay. The next chapter examines the literature and evidence underpinning annotation and nurse education.

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Chapter Three

Literature review

“All practices of annotation are riddled with paradox. They are designed to convince both doubters and believers and, while they aim at achieving argumentative invulnerability, actually manage to open their authors to other kinds of vulnerability...” (Henige, 2002, p.

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3.1 Introduction

The quote by Henige (2002) indicates a view in the literature that some annotator’s feedback comments make them vulnerable to criticism and the choice of language exposes the possibility of hidden meaning. In nurse education the choice of language used for annotation feedback can be interpreted a number of ways and has an impact on student learning (see figure 6). The kind of language which informs annotation is examined in chapter nine (see section 9.7) in relation to the meaning and effect of value laden words in NMC policy standards. What is interpreted is relevant to nurse education and emerges as a theme from the literature review findings from ten literary sources (four books and six articles) and 13 research studies which I examine to identify relevant evidence and knowledge (see figures 5 and 6). Annotation has been defined in chapter one and in more detail in chapter two. I will now outline the rationale and method for a

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hermeneutic approach to the literature and explore the meaning of annotation in nurse education through the literature review findings.