Critical discourse analysis : an alternative but vital route to understanding how nurses' caring behaviour is translated in text-based interprofessional online learning in higher education

Paper presented at ProPEL international conference 2014, 24-27 June, Stirling, Scotland. ABSTRACT Aim: to demonstrate Fairclough’s critical discourse analysis as an alternative but vital route to the understanding of translation of nursing caring behaviour in asynchronous text-based interprofessional online learning within higher education. Background: Positive asynchronous text-based online learning experience indicating nursing caring behaviours were reported in only a small number of studies about homogeneous nursing groups. In addition, these positive findings seemed to be eroded by nurses’ dominance in interprofessional learning situations. The dominance which might be a result of professional boundaries is a critical barrier to interprofessional education, where little is yet understood about the phenomenon. Design: A study which employed Fairclough’s critical discourse analysis was used to seek understanding of the translation of nursing caring behaviour in text-based interprofessional online learning within higher education. Data Source: The main findings based on Fairclough’s critical discourse analysis of a text-based discussion is used to demonstrate the usefulness of the methodology. The asynchronous online discussions for analysis was produced by 9 students who were undertaking an interprofessional online learning module at master’s level in a University in North England Findings: By using Fairclough’s critical discourse analysis, understanding of the semiotic categories corresponding to genres, discourses and styles is gained. However, it is through appreciating on how these 3 categories relate to social practices and social events has helped in making explicit the dialectical relations between semiosis and its other elements. In doing so, how nurses’ caring behaviours in interprofessional learning were translated in an asynchronous text-based learning environment can be explained. Conclusions: Fairclough’s critical discourse analysis was useful in explaining how nursing caring attributes could result in the interprofessional learning space being used as an alternate platform for nurses and allied healthcare professionals to co-construct the power-relations. It is critical to appreciate that the analysis was based on the researcher’s emic position. Owing to the fact that tacit knowledge of the research in the power-relations which entangled in the social order and practices in healthcare is required in the analysis, the strength of an emic position could become a limitation. This is particularly perceived amongst researchers who hold a strong view for an etic perspective in discourse analytic work. In this regard, research exploring issues of interprofessional education should consider triangulating the critical discourse methodology with other qualitative theoretical frameworks

Nursing care behaviour in interprofessional learning explained by critical discourse analysis

Aim: to demonstrate Fairclough’s critical discourse analysis as a way to understand nurse caring behaviour in asynchronous text-based interprofessional online learning within higher education. Background: asynchronous text-based learning experience of homogeneous nursing groups indicated nurse caring behaviour in a small number of studies. However, positive findings were not found in studies about interprofessional learning undertaken by nurses. Instead, nurses’ dominance which might be a result of professional boundaries was frequently reported as a barrier to interprofessional education, yet little is understood about the phenomenon. Design: a study which employed Fairclough’s critical discourse analysis was used to understand the translation of nurse caring behaviour in text-based online interprofessional learning within higher education. Data Source: the asynchronous online discussions produced by thirteen students undertaking an online interprofessional learning module at master’s level in a University in the North of England were the discourse data for analysis. Findings: By using Fairclough’s critical discourse analysis, understanding of the semiotic categories corresponding to genres, discourses and styles yielded information on nurses’ discourse in online learning. Through appreciating the subliminal way in which these three categories relate to social practices and social events, the dialectical relations between semiosis of the online text and its other elements were made explicit. In doing so, the way nurse caring behaviour in interprofessional learning were translated in an asynchronous text-based learning environment was explained. Conclusions: Fairclough’s critical discourse analysis was useful in explaining how nurse caring attributes when displayed online could result in the interprofessional learning space being used as a platform for nurses and allied healthcare professionals to co-construct power-relations. The analysis required researchers’ tacit knowledge, based on an emic (insider) position in healthcare practice and education, which is closely linked to the power-relations that is entangled in the social order and practices in healthcare. This explains why researchers outside of critical discourse analytic work would hold a strong view for an etic (outsider) perspective in discourse analysis. In this regard, one should consider triangulating critical discourse methodology with other qualitative theoretical frameworks

A Foucauldian analysis on the professionalisation effort of nursing in Singapore

Aim: A discussion using Foucault’s genealogical analysis to explain the professionalisation effort of nursing in Singapore. Background: Nursing in Singapore is strongly influenced by Western civilisation, however, the discipline may not have adopted similar responses to the world’s nursing professionalisation agenda as led by the West. An explanation on the ways nursing is spoken of and practiced in Singapore provides insights to the effects on nursing development in the country. Design: The discussion uses Foucault’s genealogy of power to draw on the practices of clinical nursing and nursing education in Singapore in an attempt to uncover the unorthodox professionalisation effort. Data Sources: The discussion is an outcome of a critical reflective observation made by the authors between 1993 and 2014. It is supported by related literature, critical debates amongst Singapore healthcare professionals, nurse lecturers and the Singapore locals. Implications for Nursing: Time and effort vested in overcoming medico-political dominance, should be used in the pursuit of high quality nursing clinical knowledge and acumen. Specialised nursing knowledge and autonomous practice should adopt an explicit focus in its mission to achieve the common good which is in favour of the public interest. Conclusions: While the hierarchical nursing structure was the foundation for professionalising nursing, nursing subservience was the gateway for advancing nursing in Singapore. Without generalising the positive effects of the power-relations in Singapore, nursing practice which reflected the ‘subservience in females’ and demonstrated respect for authority within a hierarchical system had evidently led to good quality nursing practices which serve as a strong foundation for nursing to secure professional recognition

Vowel duration in stressed position in central & northern varieties of standard Italian

We report the results of a pilot study investigating the effect of 2 regional accents on stressed vowel duration according to word-position and syllable type in Central v. Northern accents of Standard Italian. While there is overall convergence, we also find significant regional differences in some contexts, i.e. closed syllables, and antepenultimate position. We then consider the implications of our results for the phonological description and phonetic investigation of Italian

A glimpse into nursing discursive behaviour in interprofessional online learning

Background: The importance of interprofessional learning to provide quality patient care has resulted in the increasing use of asynchronous computer mediated conferencing in healthcare programmes within universities. The asynchronicity based on typed-written discussions in a virtual learning environment which provided flexibility in learning was used to increase opportunities for nurses and other allied healthcare professionals to participate in interprofessional learning in higher education. However, successful online learning relies on discursive practices in the virtual learning environment, embedded within discursive exchanges in practice are power relations in nursing language use; which had a negative impact on interprofessional learning and working relationships amongst nurses, between nurses and other allied healthcare professionals. This paper presents an analysis of the discursive practices of registered nurses in interprofessional learning based on asynchronous computer mediated conferencing. It aimed to ascertain if power relations were implicit in nursing language. Methods: Fairclough’s critical discourse analysis was used to analyse eight hundred and ninety typewritten online messages created in a 100% text-based online learning module at Master’s level in a University in North England between September 2004 and September 2009. Although the messages were created by 9 registered nurses and 4 other allied healthcare professionals undertaking interprofessional learning to learn about the issues surrounding e-learning in healthcare settings, this paper is part of a larger study focused on the messages by the nurses. Results: Nurses’ messages tended to appear as the first few responses in the discussion threads and their language was formal and objectifying. The genres resembled those found either in written assignment within higher education or in nursing documentation within practice. The virtual learning environment was an alternative social space for clinical practice where dominance of nurses was created, maintained and reinforced. Conclusions: Existing literature highlighted the incidents of problematic issues of interprofessional learning. In contrast, this paper explains the way nurses, through discursive practices, construct themselves in relation to their nursing and allied healthcare colleagues. Nurses need to be aware of the power-relations embedded in their language use and future research could usefully focus on the discursive aspect of interprofessional learning

Caring behaviours of student nurses: Effects of pre-registration nursing education

In an increasing technologised and cost-constrained healthcare environment, the role of pre-registration nursing education in nurturing and developing the professional caring disposition of students is becoming far more critical than before. In view of this growing demand, the aim of this study was to evaluate the impact of Singapore's pre-registration nursing programmes on students' concept of caring. A descriptive quantitative cross-sectional survey collected data using the Caring Behaviour Inventory from first and final year student nurses, nurse lecturers and nurses in practice. The findings based on student surveys indicated a statistically significant reduction in the overall level of caring behaviour in first to final year students. When compared with the findings of lecturers and nurses, less variance to lecturers than to nurses was found amongst the first years' score, and the lowest variance to nurses was demonstrated amongst the final year. A greater reduction was evidenced amongst Singaporean students, which was exaggerated with exposure to pre-enrolled nursing education and magnified with caring job experience. This study indicates more effort is necessary to harness student caring attributes in students' entire educational journey so that expressive caring is not subsumed in the teaching of students to meet demands of complicated contemporary care

Non-Fermi Liquid behavior at the Orbital Ordering Quantum Critical Point in the Two-Orbital Model

The critical behavior of a two-orbital model with degenerate $d_{xz}$ and $d_{yz}$ orbitals is investigated by multidimensional bosonization. We find that the corresponding bosonic theory has an overdamped collective mode with dynamical exponent $z=3$, which appears to be a general feature of a two-orbital model and becomes the dominant fluctuation in the vicinity of the orbital-ordering quantum critical point. Since the very existence of this $z=3$ overdamped collective mode induces non-Fermi liquid behavior near the quantum critical point, we conclude that a two-orbital model generally has a sizable area in the phase diagram showing non-Fermi liquid behavior. Furthermore, we show that the bosonic theory resembles the continuous model near the d-wave Pomeranchuk instability, suggesting that orbital order in a two-orbital model is identical to nematic order in a continuous model. Our results can be applied to systems with degenerate $d_{xz}$ and $d_{yz}$ orbitals such as iron-based superconductors and bilayer strontium ruthenates Sr$_3$Ru$_2$O$_7$.Comment: 5 pages, 2 figure

Optimization of Processing Conditions for the Production of Clarified Banana (Musa Sapientum) Juice Drink and Its Storage Stability

This study was carried out on the optimization of hot water extraction and enzymatic treatment for producing clarified banana juice. A response surface methodology (RSM) was used to determine the optimum extraction temperature and time to produce banana juice extract. Banana juice was extracted using hot water at different extraction temperatures (35-95ºC) and time (30-120 min). The effects of these extraction conditions on juice yield, total soluble solids (ºBrix), banana odour and taste were studied by employing a second-order central composite design. The coefficient of determination, R2, for juice yield, total soluble solids (ºBrix), banana odour and taste were greater than 0.900. Analysis of the regression coefficients showed that temperature was the most important factor that affected the characteristics of the banana juice extract as it exerted a highly significant influence (p<0.001) on all the dependent variables. An increase in temperature and extraction time of hot water extraction resulted in an increase in juice yield, total soluble solids, banana odour and taste of the banana juice extract. Based on response surface and contour plots, the optimum conditions obtained for hot water extraction of banana juice were 95ºC for 120 minutes. This optimum condition gave maximum juice yield (39.55 %), total soluble solids (9.19 °Brix), banana odour (6.91 scores) and taste (5.87 scores). Optimization of enzymatic treatment of the banana juice extract was then carried out using pectinase (Pectinex Ultra SP-L) at various enzyme concentrations (0.01–0.1%), temperatures (30–50ºC) and times (30–120 min). The effect of these enzyme treatments on filterability, clarity, turbidity and viscosity of the juice were studied by employing a second order central composite design. The coefficient of determination, R2 values for filterability, clarity, turbidity and viscosity were greater than 0.900. Statistical analysis showed that filterability, clarity, viscosity and turbidity were significantly (p<0.05) correlated to enzyme concentration, incubation temperature and incubation time. Enzyme concentration was the most important factor affecting the characteristics of the banana juice as it exerted a highly significant influence (p<0.01) on all the dependent variables. An increase in time and/or concentration of enzyme treatment was associated with an increase in filterability and clarity, and decrease in turbidity and viscosity. Based on response surface and contour plots, the optimum conditions for clarifying banana juice obtained were: 0.084% enzyme concentration, incubation temperature of 43.2ºC and incubation time of 80 min. The response functions were calculated from the final polynomial, and the response were filterability (0.073 second -1), clarity (0.006 Abs), turbidity (0.92 NTU) and viscosity (1.89 cps). The storage stability of clarified banana juice was evaluated for 24 weeks using bentonite and a combination of gelatin and bentonite as fining agents and stored at 4, 25 and 37ºC. The results indicated that fining agents, storage temperature and storage time had a significant (p<0.001) effect on turbidity, clarity, total polyphenol, protein content and browning index, colour (L, a and b values), pH, titratable acidity (TA), total soluble solids (TSS) of clarified banana juice. It was observed that both bentonite and combination of gelatin and bentonite treatments produced juice of better quality than control. These treatments were effective in reducing turbidity, total polyphenol, protein content and browning while improving clarity and lightness of the clarified banana juice. Bentonite treated juice was the least turbid and its organoleptic quality did not change significantly throughout storage. The temperature used for storage of juice had a marked effect on the rate and amount of haze formed during storage. Bentonite treated juice stored at 4ºC was found to be the most suitable storage combination with the lowest rate of increase in turbidity and colour change as well as lowest rate of decrease in clarity, total polyphenol and protein content during storage