The impenetrable community of practice: The lived experience of student nurses and their ICT use in clinical practice

Abstract

In recent years the use of Information, Communication and Technology (ICT) has transformed the delivery of healthcare within nursing practice. Research evidence and policy reviews suggest that the difficulty that some mature, female student nurses experience in the use of ICT in practice impacts their professional development. It could be argued that inability to access and utilise ICT directly impacts the sense of ‘belonging’ to the professional team and active participation in the Community of Practice in the Clinical area.

Objectives: to develop the evidence by exploring the extent and modes of ICT use in practice in a group of mature, female nursing students on a pre-registration nursing programme located in a UK School of Nursing and related NHS Trusts and to consider the impact on lived experience and implications for education.

Methodology: a qualitative case study research using observation and interviews was undertaken within nursing practice to ascertain the answers to 3 questions:1) How are mature, female nursing students accessing and using ICT within nursing education? 2) What are the barriers that may prevent mature, female students from accessing and using ICT within nursing education? 3) What actions do mature, female nursing students consider may be taken to improve their knowledge and subsequent use of ICT in both their academic studies and clinical placement work?

Results and findings: indicated that biographical history, student support and facilitation all affect access and engagement, the data suggesting that for a significant group of students they felt generationally, emotionally and hierarchically ‘locked out’ of using ICT in clinical settings. This resulted in feeling excluded from the Community of Practice (COP). The findings raise issues around whether the UK Government policy and regulation is being successfully enacted for these students and the extent to which failure to do so contributes to a lowered sense of ‘belonging’ to the clinical teams This study, focused on pedagogical practice for pre-registration nurse education programmes and the need to privilege and enable ICT usage in clinical situations. This study also potentially challenges the perspectives
of Lave and Wenger (1991) in their description of the ways in which COP emerge as participants move from the periphery to the centre; by arguing that barriers on the periphery such as being logged out of ICT, block the trajectory of movement, causing potential COP participants to remain on the periphery and thus excluded from the COP completely. It emphasises the need for a collective efficacy in nurse pre-registration programmes that is suggestive of notions of being ICT ‘logged in’ rather than being ‘locked out’ for mature, female student nurses recognising that the experience of being ‘ locked out’ may not be restricted to ICT but also to associated Communities of Practice.’