Nuw Educahn Today (1992) C&252-257 0 Longman Group UK Ltd 1992
Teaching research to nurses: issues for tutor training Elizabeth R Perkins
Research is unknown territory, in too many ways, for many nurses and nurse tutors. It is seen as the province of an elite, using obscure language and esoteric skills with no obvious connection with the world of nursing; in particular, it involves statistics. Pressure for nursing to become a research-based profession can make the fear worse; the gap between research and practice generates blame and guilt in addition to fear. It is not surprising that learning and teaching about research can be very difficult for nurses. This article explores sources of bad feelings about research and suggests ways forward in the training of nurse and midwifery tutors, considering course planning and teaching methods, and peer support in and out of the classroom. It also argues for expanding the range of nursing research used to teach about research, incorporating more qualitative methods and drawing more fully on the social science traditions.
RESEARCH IN NURSE EDUCATION The Briggs’ Committee’s call for nursing to become a ‘research-based profession’ (DHSS 1972) has encouraged two main developments the growth of a body of nurse researchers and of training programmes the proliferation intended to promote ‘research-mindedness’, and encourage the intelligent use of research. In parallel with these developments in basic and post-basic training, has run a tide of concern that nursing research is not being applied in practice and seems to be isolated from the mainstream of nursing culture (e.g. Armitage 1990, Champion & Leach 1989, Hunt 1987, Lelean 1982, Robin-
Elizabeth R Perkins MA PhD Cert Ed Research, Training and Development Consultant, 11 Exton Road, Nottingham NG5 1 HA, UK (Requests for offprints to ERP) Manuscript accepted 29 January 1992
252
son 1987). It is important not to see this as a purely educational problem; it is embedded in issues about mechanisms for change in complex institutions, about power and the availability of resources, including access to library facilities and time to read, reflect and plan. However, there is clearly a continuing responsibility on nurse tutors to review the way they work in this area, and to seek for improved ways of teaching about research to new students and experienced staff alike Discussion of teaching methods in the nursing press raises tutors’ difficulties as well. Calls for an integrated approach to research teaching, where all tutors use relevant research findings as part of their clinical or theoretical teaching, rely implicitly on the existence of a body of nurse tutors who are themselves well informed about research findings in their area and comfortable about, research with, and knowledgeable approaches. Clark & Sleep (199 1) make the point
NURSE EDLJCATION 1’ODAI
that this can hardly be expected from a group whose own experience of research is patchy; they quote a study of Northern Irish nurse tutors published in 1990 where 69% had no research training beyond individual study days, and most of this group (43% of the whole) had no training at all. Armitage & Rees, while supporting the value of projects as positive learning experiences, found that clinical staff and nurse teachers involved in supervision suffered from confusion and ambiguity about the nature of projects and of supervision; their articles (1988a, 1988b) use their workshop experience in Wales as the basis for clarification. Clark & Sleep (199 1) point out that good supervision can hardly be expected from those who have no experience of research themselves. While many nurse tutors may not have the skills and experience to teach well about research at present, importing outsiders to teach research to student nurses is not a good long-term solution either (Mander 1988). The quality of preparation offered to new nurse tutors will therefore be of considerable importance for the future. Much of the literature lays stress on cognitive issues around research, of which there is certainly no shortage. There is less explicit recognition that research raises emotional, as well as intellectual, problems for the beginner; these may be particularly acute for the nurse tutor, who is under pressure to sort out her students’ ideas as well as her own. During 4 years of teaching study skills and research method to trainee nurse and midwifery tutors. and about 10 years of using my own research in training sessions with experienced nurses and midwives, I have become increasingly concerned about the level of anxiety ‘research’ arouses, producing blocks which additionally distress people and slow their progress. This article puts forward some ideas about the nature of the problems involved, and some suggestions about ways forward. It is based on experience and reflection, and on discussions with students and other nurses, rather than on research evidence; the ideas are intended to encourage further thought, discussion and experiment and even, perhaps, some research into the problems!
253
FACING THE FEAR OF RESEARCH Listening research,
to nurses and nurse tutors the following notions emerge:
about
1. Understanding about research involves picking fault with other people’s work all the time. 2. Research is done by clever people who get their work published. It is likely to be written in language which is difficult, if not impossible., to understand. 3. Research tends to be seen as inextricably involved with statistics. 4. Research skills have no connection with any other skills nurses may have developed. 5. It is mandatory to be objective. This somehow means that traces of human interest are a bad thing and should be eradicated wherever possible. 6. Research rarely seems to be applied in practice. It is not always clear whose ‘fault’ this is, but there is a lot of blame and guilt around waiting to attach itself to someone. 7. There is. nevertheless, much pressure to become, or to help students to become, ‘research-minded’, and for the profession to become ‘research-based’. No wonder
it is frightening!
RELEVANT
EXPERIENCE
As with most other educational problems for adults, roots can be found in school experience. Nurses and midwives vary considerably in their educational level on entering the profession, and this in itself can make difficulties for tutors and their students. III addition, there are plenty of people for whom mathematics lessons were a penance; given the identification of research with statistics, this makes research look like a revival of old problems. Turning to the written word, a critical approach is more likely to be encouraged during the later years of education, particularly after compulsory education is over. Even for nurses who have been encouraged to be critical, it can be easier to say that just because it’s
254
NURSE EDUCATION
TODAY
in print doesn’t mean it’s true’ than it is to feel free to apply this maximum in practice. It should now be expected that nurses in training at whatever level will read research articles. In itself, of course, this is a good thing; the nature of writing for publication, however, tends to give a false idea of the research process. Constraints on word length, and the expected boredom of the reader, tend to result in methodological hitches being ironed out of published work even if the writer is not desperately concerned to present the material in the best possible light! Works like Lisbeth Hockey’s delightful booklet Nursing research - mistakes and misconceptions (1985) are rare. A critical reading, therefore, can easily feel like an attempt to pick fault with work that is presented to look good, rather than a shared appreciation of the difficulty of the enterprise and a realistic assessment of what the work tells us within its limitations. It may even be that the accepted ‘objective’ academic style encourages this, stimulating the urge to find out what authors are really like behind the masks, and to find them wanting. The other major area of relevant experience is that directly related to research. Many nurses and midwives will have had experience of collecting data for doctors’ research. In the same general category comes involvement in drug company trials - neither gives the nurse any control over the process, except, of course, the ability to foul it up by refusing to cooperate or failing to follow precise instructions. This kind of involvement generates, quite properly, a lot of concern about ethical standards, both in the nature of informed consent and in the nature of the processes involved. It also provides a fair amount of experience of one particular type of research, the experimental trial, which can easily be seen as an indicator of what all research is like. This is a mistake; no one type of research should be used to provide a guide to all. The familiarity with experimental research additionally forms other unhelpful beliefs about research. There is the confusion with statistics, which are needed in experimental research but not necessarily elsewhere. There is also the scientific straitjacket of objectivity, which again is properly applied in experimental research by such methods as
double-blind trials, but needs rethinking in other contexts (Hudson 1972, Perkins 1986, Reason & Rowan 1981). Comparatively few nurses will have had any other experience of research. Those who do, may well have suffered from the difficulties one might expect within a professional group in the process of discovering research as a tool they can use. Thus projects are under-resourced, being tacked on to existing work; secretarial support may be inadequate or non-existent; everything takes considerably longer than was expected; analysis is a nightmare, at least partly because no-one thought about this before the data was collected; and, inevitably, the results do not go as far as was hoped at the beginning. In really bad situations they may not show anything at all. Possibly the worst feature of this kind of experience is the difficulty there can be in sharing it and the readiness with which it can seem to be all the researcher’s fault. If the impression gained from reading research articles is, indeed, that the projects reported there were problem free, and previous experience of discussing research has been of criticizing rather than of developing a balanced assessment of strengths and weaknesses (Burnard SC Morrison 1990), this problem will only be made worse.
TOWARDS
SOLUTIONS
Helpful attacks on these mounted on several levels.
Cb;Ibo;ilanning
problems
can be
and teaching
As with all good educational practice, it helps to move from the known to the unknown. Pollard (1991) describes starting work on research critiques by asking nurses to start by assessing articles from the ‘quality’ newspapers, with attributions removed. She found, as she hoped, that students could work out which papers the various articles came from, and that they were then receptive to the idea that the skills they used were available for the similar job of assessing a
NURSE EDUCATION
research paper. I have used a similar principle in suggesting to students starting a project of their own that listening skills belong in nursing and in teaching (for without them, how could the nurse or the tutor know how to help in certain areas?) and that they also are part of research - even if sometimes the researcher is listening to pieces of paper, rather than to people face-to-face. Groups can provide a sense of security for most new activities. Assessing an article with colleagues in a group seems to reduce the fear of missing something important out (Pollard 1991) and also probably helps to ease the leap between ‘I don’t understand this, I must be stupid’ and ‘I don’t understand this, it is poorly explained or illogical’. Discussions with students along these lines encourage them to distinguish between the writer seduced by the notion that academic work must be written in words as long as possible, and the writer using technical terms for precision. Once the course moves beyond requirements to assess the work of others, and starts to explore the research process itself, it can be useful to introduce work on analysis by giving students raw data to use. This can be generated directiy from the students, or be anonymous material left over from other research projects. One of the advantages of this approach is that it shows how long it takes to do even a very limited amount of analysis; depending on the material available, it can also be used to illustrate a range of methods, and distract students from any obsession with statistics as an integral part of the research process. It helps in tackling students’ blocks about statistics to stress the range of research for which no particular statistical expertise is required. The ability to read or produce simple tables is a different matter, best treated separately for those who require remedial help with this. Beyond this, a guide to statistics for the non-statistically minded usefully includes the idea of different averages (‘measures of central tendency’) the idea of indicating range (‘measures of dispersion’but often a simple statement like ‘aged between 2 and 8’ is all that is needed). It also includes the concept of statistical significance, including statements about the value of ‘p’
TODAY
2%
and of its translation into percentage levels of significance, but not including any of the ways of calculating it. For those who want to go further with statistics, there are useful books (e.g. Kobson 1983), there are specialist courses (which should not confuse research with one of its tools, statistics) and there is specific advice on the right statistical tests to use for a particular purpose, to be sought from a person with specific expertise. General introductions to research method should not be burdened with specialist statistical material which is generally acknowledged (Clifford SC Gough 1990) to cause anxiety and confusion.
Peer support in the research process A group of student tutors should have some members with some research experience of their own, however traumatic this may have been. Sharing this with the group can be helpful to them, in that they can receive interest, sympathy and appreciation; it can also be helpful to the group, since they provide both a role model and a source of warnings based on experience usually more powerful than the same maxims taught directly or found in books! For this to be a safe situation, however, the ground needs to be carefully prepared. Attacks on research in the literature should have been modulated by the recognition of strengths as well as weaknesses. The idea of limitations on the generalisability of research findings (sample size, inherent bias, etc.) is important to explore in itself, and is also helpful in stressing the idea that all research has its limitations, and the responsible researcher makes these clear in the report. Members of the group can build on this by talking about the limitations of their own work, either through things going wrong or through the inherent constraints of their method and situation. This will make them less vulnerable to criticism and set the right tone for the discussion, which should be that of a good research support group. I have found it helpful to set the scene by discussing some of my own work in this way - it is unfair to expect students to do what you are not prepared to do yourself!
256
NURSE EDUCATION TODAY
As part of this process, it is possible to highlight issues around research support, and to stress the importance of looking for potential supporters of various types - supervisors, managers, colleagues of various types, friends. Once they have considered the issues, they have a better chance of setting up suitable informal or formal support arrangements for their own future research or their students.
Extending
the range
Implicit in some of the earlier points, and in my own practice, is the idea that nurses would be helped in introductions to research method by a broadening of the range of acceptable methods, and a parallel broadening of the range of disciplines within which nursing research is done. With Project 2000, there will be an increasing emphasis on social sciences within nurse education, and it seems reasonable that this should be accompanied by an increasing number of research studies which draw on qualitative rather than quantitative methods. A heavy emphasis on experimental research design and statistical methods of analysis will thus seem less appropriate in the early stages, and students will be able to form a broader conception of research, including the notion that choice is possible. Undoubtedly some nurse researchers will continue to follow the more traditional model; it is encouraging, however, to note the inclusion of qualitative methods and references to nurse research studies which use them in recent textbooks like those by Burnard & Morrison (1990) and Clifford & Gough (1990).
realistic to expect that all tutors should be experienced researchers, even when they have the responsibility for teaching about research and supervising students doing projects. There are no short cuts to improving this situation, though the English National Board’s (ENB’s) insistence that nurse and midwifery teaching will become a graduate profession should provide more opportunities to undertake research projects with supervision as part of a degree course. My last group of students, faced with this problem themselves, decided that their solution was to do some more research of their own, possibly small-scale work, and improve their skills and qualifications; only after this could they contemplate major efforts to improve research teaching for their students. Given, however, the limited experience of research within colleges of nursing, tutors who wish to extend their range will have to look to less conventional ways of arranging support, as well as seeking supervision where it is available there. Using links with the world of continuing education outside nursing is a possibility. Peer support, however, is important for people who are pulling themselves up largely by their own bootstraps. Practitioner research is an underdeveloped tradition in nursing, though somewhat more developed in education; its devotees need all the help they can get. Hockey (1990) describes the group she used in the early days of nursing research. That was 30 years ago; there is still plenty of room for informal and formal equivalents to develop.
References ArmitageS 1990 Research utilisationin practice. Nurse EducationToday 10: 10-15
BEYOND THE TEACHING SITUATION Many of the approaches discussed earlier rely on the tutor having some research experience. Tutors who are required to teach about something they have not done are in a very difficult position. While all nurse tutors can be expected to be familiar with the skills of critical analysis of research articles, at present it is by no means
Armitage S, Rees C 1988 Project supervision. Nurse Education Today 8: 99- 104 Armitage S, Rees C 1988 Student projects: a practical framework. Nurse Education Today 8: 289-295 Burnard P, Morrison P 1990 Nursing research in action: developing basic skills. MacMillan, London Clark E H, Sleep J 1991 The what and how of teaching research. Nurse Education Today 11: 172-178 Champion V L, Leach A 1989 Variables related to research utilization in nursing: an empirical investigation. Journal of Advanced Nursing 14: 705710 Clifford C, Gough S 1990 Nursing research: a skillsbased introduction. Prentice Hall, Hemel Hempstead
NURSE EDl_l(:A?‘i
Teaching research to nurses: issues for tutor training Elizabeth R Perkins
Research is unknown territory, in too many ways, for many nurses and nurse tutors. It is seen as the province of an elite, using obscure language and esoteric skills with no obvious connection with the world of nursing; in particular, it involves statistics. Pressure for nursing to become a research-based profession can make the fear worse; the gap between research and practice generates blame and guilt in addition to fear. It is not surprising that learning and teaching about research can be very difficult for nurses. This article explores sources of bad feelings about research and suggests ways forward in the training of nurse and midwifery tutors, considering course planning and teaching methods, and peer support in and out of the classroom. It also argues for expanding the range of nursing research used to teach about research, incorporating more qualitative methods and drawing more fully on the social science traditions.
RESEARCH IN NURSE EDUCATION The Briggs’ Committee’s call for nursing to become a ‘research-based profession’ (DHSS 1972) has encouraged two main developments the growth of a body of nurse researchers and of training programmes the proliferation intended to promote ‘research-mindedness’, and encourage the intelligent use of research. In parallel with these developments in basic and post-basic training, has run a tide of concern that nursing research is not being applied in practice and seems to be isolated from the mainstream of nursing culture (e.g. Armitage 1990, Champion & Leach 1989, Hunt 1987, Lelean 1982, Robin-
Elizabeth R Perkins MA PhD Cert Ed Research, Training and Development Consultant, 11 Exton Road, Nottingham NG5 1 HA, UK (Requests for offprints to ERP) Manuscript accepted 29 January 1992
252
son 1987). It is important not to see this as a purely educational problem; it is embedded in issues about mechanisms for change in complex institutions, about power and the availability of resources, including access to library facilities and time to read, reflect and plan. However, there is clearly a continuing responsibility on nurse tutors to review the way they work in this area, and to seek for improved ways of teaching about research to new students and experienced staff alike Discussion of teaching methods in the nursing press raises tutors’ difficulties as well. Calls for an integrated approach to research teaching, where all tutors use relevant research findings as part of their clinical or theoretical teaching, rely implicitly on the existence of a body of nurse tutors who are themselves well informed about research findings in their area and comfortable about, research with, and knowledgeable approaches. Clark & Sleep (199 1) make the point
NURSE EDLJCATION 1’ODAI
that this can hardly be expected from a group whose own experience of research is patchy; they quote a study of Northern Irish nurse tutors published in 1990 where 69% had no research training beyond individual study days, and most of this group (43% of the whole) had no training at all. Armitage & Rees, while supporting the value of projects as positive learning experiences, found that clinical staff and nurse teachers involved in supervision suffered from confusion and ambiguity about the nature of projects and of supervision; their articles (1988a, 1988b) use their workshop experience in Wales as the basis for clarification. Clark & Sleep (199 1) point out that good supervision can hardly be expected from those who have no experience of research themselves. While many nurse tutors may not have the skills and experience to teach well about research at present, importing outsiders to teach research to student nurses is not a good long-term solution either (Mander 1988). The quality of preparation offered to new nurse tutors will therefore be of considerable importance for the future. Much of the literature lays stress on cognitive issues around research, of which there is certainly no shortage. There is less explicit recognition that research raises emotional, as well as intellectual, problems for the beginner; these may be particularly acute for the nurse tutor, who is under pressure to sort out her students’ ideas as well as her own. During 4 years of teaching study skills and research method to trainee nurse and midwifery tutors. and about 10 years of using my own research in training sessions with experienced nurses and midwives, I have become increasingly concerned about the level of anxiety ‘research’ arouses, producing blocks which additionally distress people and slow their progress. This article puts forward some ideas about the nature of the problems involved, and some suggestions about ways forward. It is based on experience and reflection, and on discussions with students and other nurses, rather than on research evidence; the ideas are intended to encourage further thought, discussion and experiment and even, perhaps, some research into the problems!
253
FACING THE FEAR OF RESEARCH Listening research,
to nurses and nurse tutors the following notions emerge:
about
1. Understanding about research involves picking fault with other people’s work all the time. 2. Research is done by clever people who get their work published. It is likely to be written in language which is difficult, if not impossible., to understand. 3. Research tends to be seen as inextricably involved with statistics. 4. Research skills have no connection with any other skills nurses may have developed. 5. It is mandatory to be objective. This somehow means that traces of human interest are a bad thing and should be eradicated wherever possible. 6. Research rarely seems to be applied in practice. It is not always clear whose ‘fault’ this is, but there is a lot of blame and guilt around waiting to attach itself to someone. 7. There is. nevertheless, much pressure to become, or to help students to become, ‘research-minded’, and for the profession to become ‘research-based’. No wonder
it is frightening!
RELEVANT
EXPERIENCE
As with most other educational problems for adults, roots can be found in school experience. Nurses and midwives vary considerably in their educational level on entering the profession, and this in itself can make difficulties for tutors and their students. III addition, there are plenty of people for whom mathematics lessons were a penance; given the identification of research with statistics, this makes research look like a revival of old problems. Turning to the written word, a critical approach is more likely to be encouraged during the later years of education, particularly after compulsory education is over. Even for nurses who have been encouraged to be critical, it can be easier to say that just because it’s
254
NURSE EDUCATION
TODAY
in print doesn’t mean it’s true’ than it is to feel free to apply this maximum in practice. It should now be expected that nurses in training at whatever level will read research articles. In itself, of course, this is a good thing; the nature of writing for publication, however, tends to give a false idea of the research process. Constraints on word length, and the expected boredom of the reader, tend to result in methodological hitches being ironed out of published work even if the writer is not desperately concerned to present the material in the best possible light! Works like Lisbeth Hockey’s delightful booklet Nursing research - mistakes and misconceptions (1985) are rare. A critical reading, therefore, can easily feel like an attempt to pick fault with work that is presented to look good, rather than a shared appreciation of the difficulty of the enterprise and a realistic assessment of what the work tells us within its limitations. It may even be that the accepted ‘objective’ academic style encourages this, stimulating the urge to find out what authors are really like behind the masks, and to find them wanting. The other major area of relevant experience is that directly related to research. Many nurses and midwives will have had experience of collecting data for doctors’ research. In the same general category comes involvement in drug company trials - neither gives the nurse any control over the process, except, of course, the ability to foul it up by refusing to cooperate or failing to follow precise instructions. This kind of involvement generates, quite properly, a lot of concern about ethical standards, both in the nature of informed consent and in the nature of the processes involved. It also provides a fair amount of experience of one particular type of research, the experimental trial, which can easily be seen as an indicator of what all research is like. This is a mistake; no one type of research should be used to provide a guide to all. The familiarity with experimental research additionally forms other unhelpful beliefs about research. There is the confusion with statistics, which are needed in experimental research but not necessarily elsewhere. There is also the scientific straitjacket of objectivity, which again is properly applied in experimental research by such methods as
double-blind trials, but needs rethinking in other contexts (Hudson 1972, Perkins 1986, Reason & Rowan 1981). Comparatively few nurses will have had any other experience of research. Those who do, may well have suffered from the difficulties one might expect within a professional group in the process of discovering research as a tool they can use. Thus projects are under-resourced, being tacked on to existing work; secretarial support may be inadequate or non-existent; everything takes considerably longer than was expected; analysis is a nightmare, at least partly because no-one thought about this before the data was collected; and, inevitably, the results do not go as far as was hoped at the beginning. In really bad situations they may not show anything at all. Possibly the worst feature of this kind of experience is the difficulty there can be in sharing it and the readiness with which it can seem to be all the researcher’s fault. If the impression gained from reading research articles is, indeed, that the projects reported there were problem free, and previous experience of discussing research has been of criticizing rather than of developing a balanced assessment of strengths and weaknesses (Burnard SC Morrison 1990), this problem will only be made worse.
TOWARDS
SOLUTIONS
Helpful attacks on these mounted on several levels.
Cb;Ibo;ilanning
problems
can be
and teaching
As with all good educational practice, it helps to move from the known to the unknown. Pollard (1991) describes starting work on research critiques by asking nurses to start by assessing articles from the ‘quality’ newspapers, with attributions removed. She found, as she hoped, that students could work out which papers the various articles came from, and that they were then receptive to the idea that the skills they used were available for the similar job of assessing a
NURSE EDUCATION
research paper. I have used a similar principle in suggesting to students starting a project of their own that listening skills belong in nursing and in teaching (for without them, how could the nurse or the tutor know how to help in certain areas?) and that they also are part of research - even if sometimes the researcher is listening to pieces of paper, rather than to people face-to-face. Groups can provide a sense of security for most new activities. Assessing an article with colleagues in a group seems to reduce the fear of missing something important out (Pollard 1991) and also probably helps to ease the leap between ‘I don’t understand this, I must be stupid’ and ‘I don’t understand this, it is poorly explained or illogical’. Discussions with students along these lines encourage them to distinguish between the writer seduced by the notion that academic work must be written in words as long as possible, and the writer using technical terms for precision. Once the course moves beyond requirements to assess the work of others, and starts to explore the research process itself, it can be useful to introduce work on analysis by giving students raw data to use. This can be generated directiy from the students, or be anonymous material left over from other research projects. One of the advantages of this approach is that it shows how long it takes to do even a very limited amount of analysis; depending on the material available, it can also be used to illustrate a range of methods, and distract students from any obsession with statistics as an integral part of the research process. It helps in tackling students’ blocks about statistics to stress the range of research for which no particular statistical expertise is required. The ability to read or produce simple tables is a different matter, best treated separately for those who require remedial help with this. Beyond this, a guide to statistics for the non-statistically minded usefully includes the idea of different averages (‘measures of central tendency’) the idea of indicating range (‘measures of dispersion’but often a simple statement like ‘aged between 2 and 8’ is all that is needed). It also includes the concept of statistical significance, including statements about the value of ‘p’
TODAY
2%
and of its translation into percentage levels of significance, but not including any of the ways of calculating it. For those who want to go further with statistics, there are useful books (e.g. Kobson 1983), there are specialist courses (which should not confuse research with one of its tools, statistics) and there is specific advice on the right statistical tests to use for a particular purpose, to be sought from a person with specific expertise. General introductions to research method should not be burdened with specialist statistical material which is generally acknowledged (Clifford SC Gough 1990) to cause anxiety and confusion.
Peer support in the research process A group of student tutors should have some members with some research experience of their own, however traumatic this may have been. Sharing this with the group can be helpful to them, in that they can receive interest, sympathy and appreciation; it can also be helpful to the group, since they provide both a role model and a source of warnings based on experience usually more powerful than the same maxims taught directly or found in books! For this to be a safe situation, however, the ground needs to be carefully prepared. Attacks on research in the literature should have been modulated by the recognition of strengths as well as weaknesses. The idea of limitations on the generalisability of research findings (sample size, inherent bias, etc.) is important to explore in itself, and is also helpful in stressing the idea that all research has its limitations, and the responsible researcher makes these clear in the report. Members of the group can build on this by talking about the limitations of their own work, either through things going wrong or through the inherent constraints of their method and situation. This will make them less vulnerable to criticism and set the right tone for the discussion, which should be that of a good research support group. I have found it helpful to set the scene by discussing some of my own work in this way - it is unfair to expect students to do what you are not prepared to do yourself!
256
NURSE EDUCATION TODAY
As part of this process, it is possible to highlight issues around research support, and to stress the importance of looking for potential supporters of various types - supervisors, managers, colleagues of various types, friends. Once they have considered the issues, they have a better chance of setting up suitable informal or formal support arrangements for their own future research or their students.
Extending
the range
Implicit in some of the earlier points, and in my own practice, is the idea that nurses would be helped in introductions to research method by a broadening of the range of acceptable methods, and a parallel broadening of the range of disciplines within which nursing research is done. With Project 2000, there will be an increasing emphasis on social sciences within nurse education, and it seems reasonable that this should be accompanied by an increasing number of research studies which draw on qualitative rather than quantitative methods. A heavy emphasis on experimental research design and statistical methods of analysis will thus seem less appropriate in the early stages, and students will be able to form a broader conception of research, including the notion that choice is possible. Undoubtedly some nurse researchers will continue to follow the more traditional model; it is encouraging, however, to note the inclusion of qualitative methods and references to nurse research studies which use them in recent textbooks like those by Burnard & Morrison (1990) and Clifford & Gough (1990).
realistic to expect that all tutors should be experienced researchers, even when they have the responsibility for teaching about research and supervising students doing projects. There are no short cuts to improving this situation, though the English National Board’s (ENB’s) insistence that nurse and midwifery teaching will become a graduate profession should provide more opportunities to undertake research projects with supervision as part of a degree course. My last group of students, faced with this problem themselves, decided that their solution was to do some more research of their own, possibly small-scale work, and improve their skills and qualifications; only after this could they contemplate major efforts to improve research teaching for their students. Given, however, the limited experience of research within colleges of nursing, tutors who wish to extend their range will have to look to less conventional ways of arranging support, as well as seeking supervision where it is available there. Using links with the world of continuing education outside nursing is a possibility. Peer support, however, is important for people who are pulling themselves up largely by their own bootstraps. Practitioner research is an underdeveloped tradition in nursing, though somewhat more developed in education; its devotees need all the help they can get. Hockey (1990) describes the group she used in the early days of nursing research. That was 30 years ago; there is still plenty of room for informal and formal equivalents to develop.
References ArmitageS 1990 Research utilisationin practice. Nurse EducationToday 10: 10-15
BEYOND THE TEACHING SITUATION Many of the approaches discussed earlier rely on the tutor having some research experience. Tutors who are required to teach about something they have not done are in a very difficult position. While all nurse tutors can be expected to be familiar with the skills of critical analysis of research articles, at present it is by no means
Armitage S, Rees C 1988 Project supervision. Nurse Education Today 8: 99- 104 Armitage S, Rees C 1988 Student projects: a practical framework. Nurse Education Today 8: 289-295 Burnard P, Morrison P 1990 Nursing research in action: developing basic skills. MacMillan, London Clark E H, Sleep J 1991 The what and how of teaching research. Nurse Education Today 11: 172-178 Champion V L, Leach A 1989 Variables related to research utilization in nursing: an empirical investigation. Journal of Advanced Nursing 14: 705710 Clifford C, Gough S 1990 Nursing research: a skillsbased introduction. Prentice Hall, Hemel Hempstead
NURSE EDl_l(:A?‘i
