Clare J
Department of Nursing Studies, Massey University, Palmerston North, New Zealand.
J Adv Nurs. 1993 Jul;18(7):1033-8. doi: 10.1046/j.1365-2648.1993.18071033.x.
This paper explores the notion that nursing education is a political process which reproduces traditional practices. There is evidence to suggest that dominant ideologies, embedded in the social processes of education and health care, shape the consciousness of nurse teachers and students towards conformity and compliance with established practices in hegemonic institutions. Traditional practices or 'common sense' reinforces the structural arrangements which contribute to the contradictions that students experience between knowledge they are 'given' in the classroom and knowledge they derive from their clinical learning experiences. It is clinical placements which bring students face to face with their position in the established hierarchy of knowledge, professional relationships and routinized practices. In this sense students may experience their classroom education as a denial of their lived experience in clinical settings. They may learn to negotiate among the different meanings and explanations they encounter and learn to act in ways that are personally and professionally 'safe', thereby reproducing traditional nursing culture. Project 2000 in Great Britain and the calls for a 'curriculum revolution' from North America promise transformation of traditional practice. But it is the political processes of teaching and learning and their practical effects which must be revealed for critique and transformation if professional ideals of reflective practice, emancipatory knowledge and professional autonomy are to play an integral part in transforming professional nursing practice within hegemonic institutions.
本文探讨了护理教育是一个复制传统做法的政治过程这一观点。有证据表明,嵌入教育和医疗保健社会过程中的主导意识形态,塑造了护士教师和学生的意识,使其趋于在霸权机构中遵循既定做法。传统做法或“常识”强化了结构安排,而这种结构安排导致了学生在课堂上“被传授”的知识与他们从临床学习经验中获得的知识之间的矛盾。正是临床实习让学生直面他们在既定知识等级制度、专业关系和常规做法中的地位。从这个意义上说,学生可能会觉得他们的课堂教育否定了他们在临床环境中的实际经历。他们可能学会在遇到的不同意义和解释之间进行协商,并学会以个人和职业上“安全”的方式行事,从而复制传统的护理文化。英国的“2000计划”以及北美的“课程革命”呼声有望改变传统做法。但是,如果反思性实践、解放性知识和专业自主性等专业理想要在霸权机构内转变专业护理实践中发挥不可或缺的作用,就必须揭示教学的政治过程及其实际效果,以便进行批判和变革。