Enhancing esthetic knowledge: a teaching strategy

Thoughts on the therapeutic use of narrative in the promotion of coping in cancer care

When a life is struck by cancer the very foundations of that life are shaken. The safety of 'everydayness' is replaced with a fear and uncertainty of tomorrow and the human need to make sense of life is the driving force behind coping. After initial diagnosis patients must begin to piece together their lives and build new and stronger foundations. This paper identifies a growing awareness of the role that narratives can play in helping cancer patients cope with their illness. Narratives can be used to objectify and distance oneself from problems in order to gain understanding, establish meaning, develop greater self-knowledge and decrease emotional distress. This review concludes that narratives can help patients cope with their cancer and urges nurses to incorporate the use of narratives into their practice.

Aesthetic physical caring - valuing the visible

The aim of this article was to define the term 'aesthetics' in order to demonstrate that aesthetic physical caring is administered to the intensive care patient. Johns's model of structured reflection (10th version) was used to reflect upon three nursing narratives with intensive care unit nurses and relatives and reveals why physical caring is fundamental for the patient.

Caring behaviors of advanced practice nursing students

The purpose of this project was to provide advanced practice nursing (APN) students with the opportunity to enrich their aesthetic knowing and acquire the meaning of caring in their practice by reflecting on their caring narratives. Students were asked to write about a caring encounter they experienced in their practice. The instructor analyzed and organized that data from each narrative. The instructor shared the data with the students for reflection and discussion. This report focuses on the caring practices of the APN students. Nine themes that embraced physical care, communication, comfort, presence, knowing, acceptance, touch, collaboration, and encouragement were identified. The APN students demonstrated aesthetic knowing as well as other ways of knowing in their caring narratives. Through reflection on the caring experiences and discussion in class, students were able to identify the meaning of caring in their practice.

Starry night: using story to inform aesthetic knowing in women's health nursing

AIM OF THE PAPER

This paper describes the use of story as a vehicle to inform aesthetic knowing in nursing. Because health care demands that nurses know two distinct languages, the language of nursing science with its quantifiable outcomes as well as the experiential observations of health and illness, it is critical that nurses be fluent in each discourse.

BACKGROUND

Nursing scholars have long voiced a commitment to two epistemological domains: scientifically derived knowledge (empirics) as well as the expressive, creative, intuitive application of knowledge (aesthetics). In recognition of the need for these interpretive paradigms for practice, nursing scholars have sought to identify the kinds of knowing which provide the nursing discipline with its unique perspective.

DISCUSSION

Stories mould every human encounter and telling one's story in the context of a trusting relationship allows women and nurses to journey together to uncover and discover the meanings inherent in the story. Through this mutual process of unfolding the story, nurses engage the women in deep reflection and focus on what 'might be' so that possibilities for the future are illuminated. This is important in all nursing, but particularly in women's health nursing because the emergence of story suggests that contextual, phenomena-centred knowledge has found its voice in the nursing care of women as a way of knowing that focuses on personal experience and relies on methods in which woman-to-woman caring facilitates the disclosure of the human health-illness experience.

CONCLUSIONS

Storytelling is a useful strategy to inform aesthetic knowing in nursing. Stories supply a foundation for nursing scholarship because truly to hear women's stories require nurses analyse information, formulate hypotheses, and seek to understand the causal relationships as expressed by women. Through this analysis and attention to detail, nurses are able to glimpse possibilities for the future, thus transforming the experience.

Work of art dialogues: an educational technique by which students discover personal knowledge of empathy

The visual art programme was an approach used to facilitate students' discovery of personal knowledge of empathy. The research programme constituted the first phase of an existing theory course in empathy. It involved a visual-verbal-writing process in which a reproduction of Edvard Munch's The Sick Child was studied and interpreted with a focus on personal knowledge of empathy. Data were collected from two university colleges of health sciences in Sweden during a period of 4 years (1995-1998). Student nurses (n = 428) in the undergraduate programme served as the study population. In the first stage, the students worked alone on written reports. Then, in small-groups, they discussed whether the picture facilitated the discovery of a personal knowledge of empathy. The results showed that the visual art programme stimulated the students to discuss and write about empathy. The ambiguity in the painting and the relaxed study situation was favourable to the students' discovery of their personal knowledge of empathy.

The theory-practice gap in nursing: the role of the nurse teacher

The increasingly complex requirements of today's nursing practitioners, have been accompanied by demands on nurse educators to look at new ways to facilitate learning in the clinical area (Camiah 1996). In recent years nursing education has undergone a period of major change in many countries through integrating with universities. While nurse educators are striving to respond to changes in education the dichotomy between the theoretical input taught in the classroom and what is practised or experienced on the wards remains a problem (Ashworth & Longmate 1993, Ferguson & Jinks 1994). Dale (1994) postulates that theory provides the basis for understanding the reality of nursing, it would seem reasonable, therefore, to assume that the content studied in the classroom correlates with what the student experiences on the ward. It should also follow that if a gap exists between theory and practice, efforts should be taken for its reduction (Rafferty et al. 1996). According to MacNeil (1997) many initiatives have been introduced in an effort to bridge the theory-practice gap and these have focused around the role of the nurse teacher. These changes in education are redefining the role of the nurse teacher, therefore, the part that they currently play and will play in the future needs to be carefully considered (Phillips et al. 1996b). The aim of this paper is to provide an overview of the literature on the theory-practice divide in nursing. First, some of the reasons cited for its existence will be explored. Second, suggested ways of bridging the divide will be considered focusing on the role of the nurse teacher.

Aging perceived through visual art observations

A reproduction of a work of art by the Swedish artist Lena Cronquist was introduced into clinical practice in student nurse education. Student nurses (n = 366) in a first semester course served as the study population, and the study was undertaken at two university colleges of health sciences in Sweden. The students studied the painting from the point of view of a situation that depicted an elderly woman in a sickbed. The study findings implied a valuable learning situation in which the students perceived aging in a sensitive and nuanced manner.

Service-learning for graduate students

Although service-learning is gaining momentum in academic settings across the country, it has not been described as a feature of graduate education. This project incorporated a ten-hour service requirement into a unit on theories of nurse caring as part of a course for graduate nursing students, Theories and Concepts of Nursing. The authors describe the service-learning experience, as well as the extensive class reflection process and written synthesis with caring theory and the University mission after completion of the service.

Balancing the curriculum: promoting aesthetic knowledge in nursing

The view of nursing as both art and science is widely held within the profession; however, this belief is not reflected in nurse education where the artistic aspects of nursing practice continue to be overshadowed by the emphasis on the scientific, the technical and the objective. It is suggested that nursing knowledge can be considered within four fundamental types or patterns of knowledge: empirical, aesthetic, personal and moral, each interrelated and interlinked, with aesthetic knowledge argued to encompass the art of nursing. Nursing's dual identity as an art and science arguably requires a balance within the curriculum, therefore the promotion and acquisition of aesthetic knowledge seems a desirable aim. The development of strategies specifically designed to develop and incorporate such knowledge across the curriculum and to make it explicit presents a challenge for all nurse educators. This paper will examine aesthetic knowledge as essential to the art of nursing, and will consider the application of literature as a method through which this knowledge may be attained. The use of literature is suggested as facilitating an awareness of human predicaments universal to all, thus enabling the nurse to develop qualities of caring, empathy and compassion, indicated to be components of nursing's art form.

Story as Text for Undergraduate Curriculum

A baccalaureate maternity nursing course was transformed from a behaviorist, content-driven curriculum to one of critical dialogue centering upon ethics of care. The inclusion of required readings from a collection of short stories, Birth Stories by Jane Dwinell, RN (1992), served as the primary catalyst in changing faculty and student's curricular experiences. How the class transformed from lecture/discussion format to dialogue is presented around Freire's writings on the dialogic class and Doll's postmodern curriculum perspectives. Student reactions and clinical implications are described. Recommendations for future applications of story in the dialogic classroom is explored.

Story telling: a search for meaning within nursing practice

Story telling has been used for centuries as a powerful vehicle for communication, education, recreation and the preservation of cultural identity. In this paper the appeal of stories is discussed, and placed in a nursing context, with reference to the health care environment, which is increasingly dominated by technology, and the collection of impersonal 'information' against a background of market forces and competition. It is argued that this environment alienates nurses from each other, and from their patients, leaving them emotionally impoverished and distanced from the basic humanity of their craft. The utility of storytelling as a professional development tool is discussed, and numerous examples reviewed, in relation to pre-registration, post registration and ongoing experiential learning situations. The simplicity and immediacy of the storytelling tradition is compared to the academically generated and rhetoric laden notion of 'reflective practice'. The paper concludes that storytelling is an accessible yet powerful tool which contextualises and humanises nursing knowledge, facilitating a deeper understanding of self and others.