An Exploration of Empowerment and the Conditions that Empower Students in a Nursing Education Context

Empowerment is a concept that has recently gained in popular usage and has been applied to many situations including nursing practice. Current nursing practice includes the expectation that registered nurses work with clients I patients and empower them so that they may take an active part in their own health care. Current curricula for the education of nurses in the USA, UK and New Zealand support this emancipatory intent. This study was conducted at Whitireia Community Polytechnic where the curriculum for the bachelor of Nursing Degree Programme is based on the Treaty of Waitangi and intends to empower students of nursing so that they may in turn empower clients. This research aimed to explore the phenomenon of empowerment from the perspective of the student nurse. Using grounded theory methodology, and emancipatory, feminist and action research philosophies, six year two student participants were interviewed and asked to define the term empowerment and give exemplars (all were from practice based clinical experience settings) of moments when they had been empowered in a teaching learning context. Analysis of data led to the discovery of a theory and development of a theoretical model describing conditions and consequences that led to empowerment. Analysis also uncovered the conditions that led to disempowerment for the participant group. Circumstances which enhanced empowerment included the attainment of year one competencies and knowledge, preparation for practice and sufficient self efficacy to enter the practice setting. The context or milieu influenced the process, and when the milieu provided appropriate responsibility, orientation and positive interactions with a nurse expert (preceptor, tutor or buddy) the student was enabled to engage in praxis. Praxis, followed by self reflection allowed feelings of empowerment which in turn led to raised self efficacy and a desire to engage in further practice experiences. If praxis was not possible a feeling of disempowerment followed student self reflection. Disengagement was a consequence of disempowerment if the intervention of assisted reflection did not occur. Assisted reflection following disempowerment was found to be essential to maintain or strengthen self efficacy to levels sufficient to allow further experiential learning. The research process was found to be emancipatory for both the participants and the researcher, and the theoretical model which was developed provided a descriptive cycle of empowerment that was considered to be relevant to nursing education and other practice based adult learning programmes. The value of this research was, that actors in the empowering process could identify influential conditions which enhanced the development of a greater sense of control over their learning in a manner that had the potential to result in personal empowerment. Major recommendations were: that adequate preparation in the Polytechnic setting, prior to clinical placement should be maintained; that preceptorial programmes which include historic-sociocultural and political content, are extended to all practice settings in which students gain learning experience; that registered nurses in Polytechnic and practice settings be encouraged to develop increased awareness of how their 'way of being' affects students; that teachers who hold personal philosophical congruence with emancipatory curricula be supported as educators, and; that processes that develop ongoing reflection be promoted in nursing education and practice contexts. Further research to test the theory in other settings was suggested.