Doctoral approaches to nursing knowledge : a preliminary comparison of doctoral degrees in Turkish and English universities

Transcription

1 Doctoral approaches to nursing knowledge : a preliminary comparison of doctoral degrees in Turkish and English universities Dr Mehmet Ali Dikerdem, Dr Gulay Manav, Professor Ayse Ferda Ocakci, Dr Margaret Volante Koc University (Turkey) Middlesex University (Britain)

2

3 Background PhD---doctor of philosophy---highest academic award for an individual---unique academic qualification Less than 1 % of the population attain this academic level Doctorate originally developed for an academic career Traditional PhD---supervised research project examined on the basis of a thesis In the past decade Questioning the design of the traditional PhD Demands for advancing competencies and capabilities--- transferrable skills / attitudes and behaviour of the researcher / new forms of practice based knowledge / applied research/ impact / the ethics of outcome

4 Background Bologna Declaration of 1999 with the aim of creating European Higher Education Area New terminology : postgraduate education / research training / doctoral education---`doctoral candidates rather than students The motto `One goal, different routes leading to diversity of doctoral forms---professional and practice doctorates The PhD and professional doctorates are considered under `research-based category Emphasis on systematic and structured doctoral programmes Providing generic doctoral teaching and training skills More learner centred ---use of learning contracts such as personal development plans for candidates

5 Background Improved retention and reduced completion periods down from 8 to 8 years Encouragement of US-style graduate schools to establish structured programmes with coursework and research phases----taking postgraduate studies away from the traditional individual study also known as the `apprenticeship or `the master and slave model! Instead of the classical 19 th Century German model of Doctorvater (Doctor Father) multiple or team supervision with divided responsibilities including from outside the academic world Continuous professional development of the supervisors Introduction of support mechanisms such as doctoral writing / criticality Emotional intelligence a less hierarchical relationship---collegial--- `community of learners / scholars

6 Background Professional and practice based doctorates Introduced in Britain in the 1990s---education, engineering, accountancy, psychotherapy Many have taught components Many have accreditation of previous learning / accreditation of experiential learning Many involve tri-partite learning agreements / negotiated curriculum Many involve research into real world, real time, practice-oriented `messy, complex problem solving in unique contexts of application With possibly multiple stakeholders and plurality of views and multiplicity of goals Foregrounding the ethical dimensions of the `applied research and its outcomes---issues of the `public or `common good Knowledge as theorisation of or reflection on practice Creating a new relationship between academia and the professional worlds ---co-creation of knowledge

7 Nursing doctorates In Britain nursing has undergone periods of great change over the past decade---restructuring the NHS Increasing the role of nurses ---nursing led services/ senior practitioner and consultant grades / nurses taking on roles traditionally associated with doctors---need for advanced and specialist skills---strengthening nurse education and training at postgraduate level Growth of nursing and health sciences practice- based and professional doctorates Work or context based, topical issue or problem Research questions generated by the candidate s real world and real time practice Outcome and impact oriented `applied research---knowledge created ready to be applied for enhanced patient care Reflexivity and personal practice built into the doctorate

8 Some Turkish dimensions Turkey a candidate member of the EU --- tracking the Bologna process A country of nearly 80 million with a young population. Number of universities have increased from 44 in the mid-1980s to nearly 200 by A long tradition of nursing education. Main function of the PhD is to train new generations of academics and there are no practice- or professional doctorate programmes A deeply politicised, bureaucratised and hierarchical higher education system run by the Higher Education Council directly accountable to the President of the Republic A binary system of a majority of state controlled and a minority of private universities 8 universities now in THE rankings of world and developing country universities An expanding rapidly transforming health sector, with a centralised and politically controlled public sector and a burgeoning private sector open to international demand

9 Research design and sample Aim How different doctoral pathways contribute to nursing identities and perceptions of the doctoral curriculum by nursing graduates based on their experiences. To identify any challenges that nurses face while undertaking the doctoral programmes concerned To identify their perceptions on how these can be improved To identify the perceptions of if doctoral education has benefitted nurses in terms of personal and career development Methods A qualitative design was used to generate rich data by means of semi-structured interviews conducted face to face where possible or by telephone and recorded.

10 Sampling Research design and sample The Middlesex team utilised the professional doctorates association network and nursing professional doctorates network to locate a purposive sample of a total of ten nurses with doctorates ( nine professional doctorates one with a PhD) including two male doctoral nurses. The Koc team of two colleagues did the same with all female nursing PhDs. Data collection The interviews were conducted by the named Middlesex and Koc university researchers. Three out of the four researchers have nursing backgrounds. Both teams conducted the interviews during May to July The interviews were all audio-recorded and accurately transcribed. On average these lasted 40 minutes. Since the researchers also deliver doctoral programmes, this can be called insider research

11 Data analysis Preliminary stage of analysis--- fragmenting and categorising data in terms of meanings in relation to interview questions. Conceptual labels designed to capture content of each phenomenon emerging Meanings categorised in relation to : Socio-historical context Demographics Doctoral education process Application to doctoral curriculum Identity (personal / professional) Professional practice This presentation focuses on illustrating identity / doctoral education process / application to doctoral curriculum / professional practice clusters.

12 Personal context Decision to do a doctorate 8 out of 10 of the British doctoral nurses consciously chose a professional or practice doctorate mainly because I think I was looking for something that was going to be a bit more applicable to my practice I think I might have been a little bit concerned that a PhD would be a little bit more separate from the practice I saw myself, my career, firmly in clinical practice and that really was the deciding time that I would do a professional doctorate and not a PhD. I thought it would be more influential good preparation for a leadership role being a career option in a university or a career option in practice. I could kill myself, I should have just done a PhD it was a very protracted way of doing a doctorate a professional doctorate is too much like a MSc, there is so much stuff thrown in really to make it a proper doctorate that I ended up doing more work 6 of the 10 Turkish nurses went into PhD programmes mainly for career progression, or passion for the profession. One interesting comment : I wanted to establish my scientific independence. Others went in as family tradition.

13

14 Doctoral education process How was doctoral topic determined? 9 out of 10 British doctoral nurses stated something similar to : I developed my research topic through the modules that I was doing for my doctorate and I chose an area that took my Masters research a little bit further and was a topical area within [my specialism]. Because I wanted something that would support my practical, or my clinical work, not something that just sat on a shelf but didn t have any relevance to my clinical work 8 out of 10 Turkish doctoral nurses chose doctoral topics in areas they were already interested in. Their context of work and nursing knowledge helped. Choice of adviser / supervisor Overwhelming majority of British doctoral nurses had some say in the choice of advisers especially second advisers with clinical experience. Overwhelming majority of Turkish doctoral nurses were allocated their advisers by the department.

15

16 Doctoral education identity Doctoral programme experiences Overall summary statement for the British doctoral nurses : Only that I really enjoyed the first two years, which increased your knowledge and confidence on research. I enjoyed being able to choose an area of practice to examine and research and there was a great flexibility with the subject area family---work---doctorate time constraints I had to do my research outside of work time you don t get professional development time in your job plan whereas a psychiatrist gets a day a week, a psychologist gets half a day a week, and they are expected to go and do their reading and their research. A nurse is expected to do that in their own time. BUT I do feel I was well prepared and my supervisor sort of highlighted where I would need things The long time taken to get ethical approval Funding self-discipline!

17 Doctoral education identity Doctoral programme experiences for Turkish nurses there were such contradictions between nursing practice in the hospital [where I worked] and my doctoral education. I tried to change things at work but because I was not senior enough, the management got in my way. As a nurse in a doctoral programme I found it difficult to manage my relations even with my own line manager Time : sometimes I worked two days without sleeping ---demands of nursing work and having to attend a university in a different city during free times. My experience of learning increased. I experienced feelings of tension, stress, anxiety, success and happiness. People were finding it strange that I worked as a clinician. There were times when I felt that I did not belong to the hospital. I really enjoyed the taught courses. I wanted to master the local as well as the international literature. My ambition was to be able to develop broad views and critical insights into the relative merits of health policies formulated and implemented in the nursing field..

18 Personal theory of doctoral education process Expectations of the doctoral education process Overall summary statement for the British doctoral nurses : So my expectations were to learn and gain knowledge on how I was going to undertake my research Support, good quality supervision, well organised programme I don t think I had a lot. I was ready to start with a blank page. Overall, the expectations were met. Overall summary statement for Turkish doctoral nurses : My clear expectation was to be a better academic. One becomes a better researcher and one begins to question everything It caused me to look at a lot of things with question marks.. I wanted the doctoral education to develop me and to make me standout as a person and in my profession There was a greater conflict between the Turkish group s expectations and their actual work and academic experiences mainly due bureaucratic obstacles and the geographical separation of their home and workplace from universities offering nursing doctoral programmes.

19 Doctoral education process Perceived challenges of the doctoral education process Overall summary statements for British doctoral nurses : Funding and getting time off. Being part-time and supervisor availability So I think, I think being a novice researcher has been the hardest bit of all Overall summary statements for Turkish doctoral nurses It was an intense period. Especially the taught components. This intensity was challenging. After progression though I felt my self to be well equipped. Mastering that literature, keeping up with the new developments, it was really a good feeling. It was an intense period. I don t remember our professors being particularly supportive Working and studying, finding the required textbooks, inadequate library facilities and the supervisors did not share their resources There was quite a considerable overlap between the two sets of responses, with the Turkish side raising bureaucratic issues of using annual leave to attend classes in universities offering nursing doctorates but located in other cities.

20 Identity Doctoral programme s contributions to personal development Statements by British doctoral nurses The majority of the respondents referred to confidence and growth of criticality Yes, going forward, yeah it s about self-esteem, I m a woman and the fact that I ve got a doctorate is really important I like being a doctor. I like calling myself a doctor. It does feel, it has increased my self-esteem So I fantasise about the fact that I was given my doctorate but there may have been an error. I ve actually grown in confidence I d have to say. I am more grounded in my own profession and I feel that what I contribute on a day-to-day clinical level has great value Oh, I think I am more analytical, so my Mum says I m more critical but I think more analytical. (Laughs) And I don t take things at face value as much. Yes, so I, I now can t read a newspaper. I ve given up reading newspapers because they just irritate me. (Laughs) [s]o now I think, I can t read something now without thinking but what was the methodology, why, how did they come to that conclusion? Or what s their philosophical standpoint? So it s changed the way I think, I think I think also it s made me think about my career pathway more and what I really want to do and where I want to go with my career

21 Identity Statements by Turkish doctoral nurses The majority of the respondents said that their confidence in clinical work had increased. The main emphasis was the lack of connection between their doctoral level knowledge and its application in clinical practice. Doctoral programme s contributions to professional development Statements by British doctoral nurses Overall representative statements : I feel my medical colleagues listen to me because I ve got a doctorate It s an interesting dynamic. Able to communicate better in multi-disciplinary teams. I m not sure that it has but when I reflect back on it I think that it certainly hasn t done me any harm I think it is an advantage because it sets my skill set and abilities out from most nurses there are only very small handful of nurses that have a doctorate Yeah, it s given me a lot more confidence even if it s subtly helped my career development Certainly as I say a lot more confident and I enjoyed the research side of things; I loved the writing and I put that into practice in my work

22 Identity Doctoral programme s contributions to professional development Statements by Turkish doctoral nurses It was learning by doing during the doctoral programme. I learnt by doing and by applying technical knowledge. I think that I could supervise a thesis on my own. For example when I tell people that I have a doctorate, they ask me things like, how can a nurse with a doctorate look after patients, do midwifery examinations? What do you do, then? We are faced with these questions because we cannot reflect our doctoral knowledge into practice. That is why I want our doctoral learning to be reflected in the clinic

23 Doctoral curriculum What should be the aim of a doctoral education for nurses? British responses I think nurses have shown what they can do as Chief Nurses and even as Chief Executive Officers. However that the Clinical Doctorates can offer is an academic credibility in identifying, providing evidence for and delivery of improvements / optimising services in the care and delivery of care for people. So I do think it is about seeing it as a qualification that is accessible I think the doctorate programme should be seen something more mainstream than something out there but not quite reachable and I think a doctorate programme can help nurses map out their careers more easily It is about increasing knowledge so it s about increasing the kind of knowledge and applying it to sort out increasing the overall skills and knowledge of the workforce I think it is particularly relevant to practice because you can have this kind of disconnection sometimes with education and research in practice. I think it should be to stretch nurses so that the educational possibilities for nurses broadens. Research underpins practice, evidence-based practice is absolutely what we strive for and its about giving nurses a real understanding and involvement in that. my ideal would be to be able to have educational leadership and practice development all under auspices of professional of PhD nurses or doctorate nurses it should be changing the practice, making it better for patients making it more integrated

24 Doctoral curriculum continued What should be the aim of a doctoral education for nurses? British responses continued I think it s about these people being enabled to make change better happen I certainly think it needs to be supporting clinical practice and excellence in clinical practice I want to see [nurses] doing research that supports their clinical work [It] should be about boosting confidence and I think about giving nurses recognition for some of the roles they can do very effectively and supporting those roles. But at the same time helping our colleagues in other professions to feel comfortable with that If you are going to invest in somebody doing a doctorate, you want to be able to show how that is going to benefit patient care and quality of service. We need to be leading the debate on nursing. We don t need to be following or having our roles constricted for us I think developing nurses for the future that can develop and improve services for patients So I think it is developing a robust workforce that is able to critically analyse what is put before them. To become an expert in the practice area and to contribute to that field of knowledge. I do feel that as a profession we need to recognise and highlight more the academic achievements of people.

25 Doctoral curriculum What should be the aim of a doctoral education for nurses? Turkish responses The number of universities providing doctoral programmes in nursing are limited. People may have to travel long distances and study during their vacation periods from work. This prolongs the process and makes it difficult. There aren t enough qualified academics in nursing to cope with the big student demand for this subject. There is no standardization in doctoral programmes either between different universities or within the same university. Different disciplines require different lengths of time and numbers of taught modules. Some of my friends ended up taking four semesters of classes while others completed with two semesters of taught modules. This leads to injustices among doctoral students. There are also difficulties in getting the right supervisors. It felt like an extension of the Masters programme. The topics were the same, the academics attitudes were the same However, doctoral education should constantly encourage development, should in each class, in sessions with each academic, with each literature survey aspire to add something new and enhance the student s vision. An ordinary educational process no different from the Masters level can t achieve this. I would like our doctoral education to be reflected in clinical practice.

26 Application to doctoral curriculum Respondents suggestions for improving doctoral studies as a result of their experiences- British responses make sure that your dissertation is related to your practice The importance of the taught component, especially research methods and techniques. Viva voce workshops Better integration between the programme and clinical practice We are being pushed into a kind of a managerial role. But I think if we had PhD level thinking about the delivery of care we d be in a better position to lead it in an effective way [there is a need for] informed insightful leadership. Turkish responses More structure and process standardization of nursing doctoral programmes across the university sector. More integration of the curriculum with clinical practice Better content and pedagogical distinctions between Masters and Doctoral levels

27 Some preliminary conclusions Main limitation of this preliminary evaluation : no space for policy and institutional contexts The Turkish responses are mainly focused on perceived problems at meta level (high national demand for postgraduate nursing places but limited supply, issues with course content and supervision). Both sets of nurses went into doctoral programmes for career progression Both Turkish and British nurses referred to increases in their confidence as a consequence of nursing doctorates, with the Turkish responses tending towards increased academic authority. Both sets of nurses faced fairly similar challenges in terms of work-lifeeducation commitments, but the Turkish nurses had additional difficulties relating to attending universities in distant places and in their own time. British doctoral nurses enjoyed more flexible academic systems and had more resource choices including supervisor selection.