Texts' "Third Meaning" developed by student nurses through boundary-crossing and the conflict between their classroom learning and clinical practicum

Abstract

The present study discusses the relation between student nurses' learning inside and outside the classroom, and examines conflicts between the classroom and clinical practica that student nurses experience during their training. The following perspectives were categorized : (a) transfer, (b) an affirming apprenticeship model, (c) an emphasis on identity for learning in the classroom, and (d) the tension between classroom learning and on-the-job experience. Interviews with 12 nursing students were analyzed using a grounded theory approach. The results were as follows : In the classroom, the students were limited to following the textbook through interactions with hypothetical patients, even though their instructor told them not to. In the clinical practica, the students found, on the one hand, that an advantage of using the textbook was that it helped them identify weak points in nurses' practice, but, on the other hand, that if they only followed the textbook, they would fail. In other words, the student nurses were in conflict because they could not accept both what they had learned in the textbook and, at the same time, the actual practice of nurses. From this, they realized that while the textbook was a tool helping them to identify weak points in nurses' practice, what they had learned in the classroom should be applied flexibly to actual patients, rather than simply accepted at it was, because the textbook could not provide all possible procedures for dealing with multiple and changing patients in a real clinical setting. This "third meaning" (boundary-crossing knowledge) is meaning that emerged from the conflicted relationship between their initial classroom learning and their subsequent workplace learning. This conflicted relationship is discussed from the point of view of time theory, and a new concept of zone of time perspectives (ZTP) is constructed. The discussion also describes exploratory learning through boundary-crossing as a learning environment that develops students' practical wisdom.