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追求熟练与目标辩护:在将清单列为优先事项时,我们是否在拿心理健康护理的未来冒险?

Proficiency-chasing and goalodicy: In prioritising checklists, are we gambling with the future of mental health nursing?

作者信息

Haslam Michael

机构信息

School of Nursing and Midwifery, University of Central Lancashire, United Kingdom of Great Britain and Northern Ireland.

出版信息

Nurse Educ Today. 2025 Apr;147:106586. doi: 10.1016/j.nedt.2025.106586. Epub 2025 Jan 23.

Abstract

In this discussion paper, I take a critical approach to the use of standardised checklists in practice assessment documents as a valid method of assessing mental health nursing students in the UK. The game Bingo is applied here as a metaphor, highlighting the folly of using standardised cross-field checklists to assess mental health nursing students in practice. Such practices, I argue, amount to little more than a game of proficiency-chasing at the expense of seeking more meaningful learning experiences, especially where practice assessment documents currently prioritise physical health care skills above those required for successful mental health nursing. Furthermore, where the current path to qualification as a mental health nurse in the UK is determined by the navigation of a complex system of checklists and targets, I also argue that goalodicy (as in the goal and actions taken to achieve this becoming the focus, over the very reason the goal exists in the first place) becomes an inevitability; shortcuts justified in the name of achieving broader goals of passing a practice module and eventual qualification as a mental health nurse. This situation, I suggest serves neoliberal, capitalist systems, reinforcing the mechanisation of care while undermining the deeper relational, ethical and philosophical focus of what it means to be a mental health nurse. Alternative methods of practice-based assessments for mental health nursing are considered.

摘要

在这篇讨论文件中,我以批判性的视角审视在实践评估文件中使用标准化清单作为评估英国心理健康护理专业学生的有效方法。这里将宾果游戏用作一种隐喻,凸显了使用标准化跨领域清单来评估心理健康护理专业学生实践的荒谬之处。我认为,这种做法无异于一场追逐熟练度的游戏,却牺牲了寻求更有意义的学习体验,特别是在当前实践评估文件将身体健康护理技能置于成功的心理健康护理所需技能之上的情况下。此外,在英国当前成为心理健康护士的资格路径由复杂的清单和目标系统所决定的情况下,我还认为目的神义论(即目标以及为实现该目标所采取的行动成为焦点,而忽略了目标最初存在的根本原因)变得不可避免;以实现通过实践模块及最终获得心理健康护士资格这一更广泛目标之名,捷径被合理化。我认为这种情况服务于新自由主义、资本主义体系,强化了护理的机械化,同时削弱了作为心理健康护士所应具备的更深层次的关系、伦理和哲学关注点。文中还探讨了心理健康护理基于实践的评估的替代方法。

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