Nurses on Nursing: student nurse placements

In this episode Bronwyn interviews Philippa Marriot.  Philippa did a qualitative study to find out what it is like for student nurses on their first placement. 

Episode Transcript

(00:00):
Right, my first question is...
Who do they think they are releasing us tolook after people?
My name is Bronwyn Tarrant.
You've got a nice deep voice thereBronwyn, it's just right for a podcast.
Our research interviewees and the researchthat we're looking at isn't all clinical,
it's the whole world of nursing.
You're listening to Adventures inResearch, I'm Bronwyn Tarrant.

(00:22):
And I'm Amelia Swift.
Right, you should be the co-host and I'vehit record, finally.
Fantastic, thank you.
Can I just say, now that we're recording,it's always a pleasure to see you.
I mean, you're the highlight of my workingday.
I love it.
This is one of my favourite things to doever.

(00:42):
This was one of the very first episodes wewanted to do.
When we first talked about this podcastseries, we said we wanted to look at how
nurses' research affects nurses.
because nursing is a huge stakeholdergroup and obviously it's a really
challenging career, but it's a very richand rewarding career.
And so, nurses on nursing sets up thisidea of let's investigate what it's like

(01:07):
to be a nurse, let's investigate what it'slike to be a student, let's investigate
what it's like to be a nurse researcher.
The brilliant people that do this researchare the nurses themselves and they're
bringing their own lived experience todeveloping research questions.
to try and improve the lot of nurses, orat least try and understand what it's like
to be a nurse and work in these verydiverse areas.

(01:32):
So let me tell you a bit about PhilippaMarriott, who we'll be listening to.
She's done extensive research around theexperience of student nurses going out to
their first placement.
This is a focus of her master's thesis,and it was stimulated by beginning work as
a nursing educator, and then joining us asa full-time academic at the University of
Melbourne, where she was really thinkingabout what's happening for these students

(01:55):
if they can't transition to their firstnursing placement with confidence.
This is where we talk to Philippa aboutwhy she wanted to do this kind of
research, what the question was.
I was the clinical educator for auniversity here in Melbourne for first
year, first placement nursing students.
And I witnessed their absolute shock ofcoming into placement that I later sort of

(02:20):
learnt that was a real theory to practicegap, or I was calling it cognitive
dissonance for a long time.
They didn't know what to expect.
And that learning curve.
was so huge in the first week and a halfto two weeks, almost to the point of
putting some nursing students off nursing.
Initially, I wanted to look at simulatedteaching, but it was quite hard to do that

(02:40):
because at this university it's only asix-week program.
So it was quite hard to be able toevaluate a single part of the curriculum.
So therefore I decided to look at theirsense of preparedness for their first
clinical placement based on just all thatthey had learned over the first six weeks
of their nursing.
What do you think, Amelia?
Does she mean a six week module?
Yes.
So, uh, six weeks of preparation beforethey then go out on their first placement.

(03:05):
And the students that Phillip is talkingabout, are they post-graduates coming into
a post-graduate nursing program?
Yeah.
So they've done an undergraduate and thisis their master's, but it's an entry to
practice level.
So they're students who've got a bit morematurity about them.
And I think oftentimes we overestimate howrobust and resilient they might be when
thinking about moving into that firstplacement.

(03:27):
Thank you.
Oh, and then I told about my friend Arthurand I, we did nursing schools together and
we are still friends today, well over 40years later.
And this is 40 years ago, but it's such aclear memory.
We were one of the first group to gothrough a university or a college at that

(03:48):
stage.
And we were about to do our firstplacement and we were sitting in the cafe
and freaking out about placement.
thinking we're going to kill someone.
Who do they think they are releasing us tolook after people?
This is the most outrageous thing.
Is that the kind of, where you were sortof talking about cognitive dissonance, is
that the kind of thing you were thinkingabout?

(04:09):
Yes, I think they'd learned a lot ofthings in theory, like unfortunately here
they don't have the capacity, I don'tthink we're allowed to shower people, so
this was a good example that, and I was onplacement, and literally this poor nursing
student, I said, I'd stay with you, we'regonna go and shower this patient together.
And I tried day after day and she didn'tdo it.
And one day she even ran under my legs outof the shower, terrified that she was
gonna have to shower as I went.

(04:30):
And it took sort of three of us to blockthe bathroom to keep her in there.
Once she'd done it once, she was fine.
But it was that first step.
And things like they've not knowing, theyknew how to do a blood pressure, but they
didn't know when to do it or why to do it.
So there just seemed to be a big gapbetween the theory side.
They were very good at explaining what todo, but then putting a real patient in

(04:51):
front of them.
they just weren't able to link the two orstart doing the skill in real life, real
life basically.
Why does a nurse have to be pinned into abathroom in order to give a patient a
shower?
What's going on in there?
She had just, I don't think she, well shesaid she'd never seen somebody a stranger
nude, naked.
She didn't know, you know, it was a male,a white male, and she was an international

(05:12):
student from Asia and seeing an old whitemale Aussie in the shower was just so
terrifying for her.
And she just didn't know what to do.
So, but once she understood that it'sdifficult for the patient as well, and we
talked about how they felt and how shefelt.
And I gave her some tips on chit chatting,like, how are you, how old are your

(05:34):
grandchildren?
And things that I could distract her andthe patient and we got through.
But it was just that first step was soterrifying.
Is he wearing songs?
And how long ago was this?
I mean, it sounds like this happened along time ago.
and you've only just finished yourresearch.
Well, I started as a clinical educatorabout eight or nine years ago, and then I

(05:56):
decided to do my master's of clinicaleducation.
So it's a three-year program, but due toCOVID, the last year bit, my research
project had to be delayed this year.
There were 16 first-year nursing studentsparticipated, and I interviewed in six
different groups.
Because we were doing it over Zoom, wefelt that four per Zoom was enough to get

(06:18):
their experience.
collectively and then I re-interview themindividually once they were on placement.
So I was able to, which actually lookingat the literature, that's my study is the
only one out there that does pre, like theperceptions of preparedness and then
compares that to see if there'sconsistency or change once they're on
placement.

(06:39):
What she spotted in her research questionis that massive transition into clinical
practice and really having absolutely zeroclue what it's gonna be like.
And that beautiful description of thestudent trying to run out of the shower,
just not prepared in the slightest.
And I think if you, probably if you waiteduntil after they've come back from their

(07:00):
placement, then they've normalized it,they've socialized into it, they've got
over that huge shock of the new.
And you probably won't capture as much ofthe immediacy of their reaction and
responses.
So I love that she's used her experienceof being a clinical educator to know that
there's this huge wave of change right atthe very beginning of their experience

(07:23):
that she wants to capture.
That's marvelous.
I'm sure she'll be very pleased that I'mimpressed with that.
Okay, so what was the difference, just intime and duration, but also in contact
between those two times?
Yeah, well, that's a good question.
So our semester period is only really,it's about six to eight weeks.
So six weeks of teaching and then theyhave to, the students who have to do a

(07:44):
preclinical assessment to make surethey're safe to go on practice.
So everybody did that.
And then I did the focus groups.
Some students went on placement thefollowing week.
One person went on placement thefollowing, like two days later.
And other people didn't do theirplacements until for about two to three
months after the first initial focusgroup.

(08:06):
What do you think about that as a glitchor as a, I suppose, an obstacle in the
research?
So there are these very different timepoints about where placement is in
relation to their placement preparationlectures.
I guess it depends how the data looks.
When she comes to analyze the data,whether she notices any difference between

(08:28):
those people who know they're gonna haveto wait for a much longer period of time
and those who are just about ready to go.
I'm quite intrigued to know how sheorganized the focus groups because you
could have organized the focus groups witha mixture of people who are going on
placement immediately and those who aregoing on placement a little bit more in
the future.
And I do think there may be there may wellbe differences, because your anticipation

(08:53):
builds the closer you get to theexperience, the more intense your
anticipation and your anticipatory anxietywill become.
when it's more real and it's moreimmediate.
So I think having too much of a distanceaway from the experience will probably
dampen down the level of anxiety thatstudents are thinking about and their
connection with their imagination and whatthey're thinking about.

(09:16):
So it will be really interesting to see ifPhilip has been able to take that into
consideration during the analysis phase.
Yeah, let's have a listen.
And the clinical placement is only threeweeks.
and I made sure to interview them at theend of their second week, beginning of
their third.
So the reality shock had worn off and theywere able to give me, I felt that their

(09:41):
answers would be more balanced and not soemotionally driven.
So I waited, but they were still able toreminisce the week before.
So I did get lots of experience of shockreality.
So their similarity is that all studentnurses about to go on their first
placement.
But then there's a massive range ofdifferences.
And some of those differences are justabout how long there is between the focus

(10:04):
group and the placement.
She's removed some of the differences,maybe intentionally or maybe
unintentionally by saying that thestudents have to have passed this OSCE
before they go and have their focus group.
If you're a particularly anxious person,you might not pass your OSCE, or you may
have knowledge deficits or skillsdeficits, and then you wouldn't pass your
OSCE.
So I'm just trying to figure out how...

(10:26):
how homogenous or not this group is thatwhen she's doing the focus group.
And I guess if they've all passed theOSCE, she has limited the, those who, as
you said, she's limited, she's removedfrom the sample everyone who's massively
anxious or has the poor knowledge or poorskills.
Yeah.
I don't know if that's important or not.

(10:47):
Yeah.
I love the fact that you're tussling withthat because I think that's really
important in research is to look at thevariables, look at the...
threat stability, if you like, and then toreally examine them.
So I really like what you're doing there,just listening to Phil, or you're picking
up on all these kinds of things and thennot certain about it, but that's what
research is, is that we've got to keep oureyes open for this.

(11:08):
Is the difference between a quantitative,objective approach and a qualitative,
subjective approach, again, where in thequantitative survey type study, I'd want
to make sure that there was...
as much similarity as possible between thegroups and that there was a large enough
sample that the randomness of thevariability in each group was equally

(11:28):
spread between two groups and so when itcame down to doing the analysis I could
factor that in and I'd be doing all sortsof fancy stuff to try and make sure that
the results I got were just related purelyto the experience that the students were
having, whereas in this research it'sreally important to consider the
differences between the participants butnot.

(11:49):
worry too greatly about that until lateron.
We want to understand this disparity orunderstand student nurses' experience of
their first placement and how preparedthey felt getting into placement.
They did an OSCE, is that the thing thatthey do?
Well, it's not quite an OSCE because theyonly have to do one.

(12:10):
So I called it a preclinical assessment.
But yes, in the grand world, it probablywould be defined as an OSCE by some
people.
And a lot of people find that quiteanxiety provoking in itself.
And then after the OSCE, so youinterviewed students who'd successfully
passed that clinical exam and had a focusgroup, then some went into placement quite

(12:30):
quickly, and then others had placementquite later on.
So that would have been, I mean, holdingyou honest to your method, that's a lot of
work for you and holding everything inmind.
How did you manage that?
Well, that's a good question.
I did find that a lot of the, everybodywas...
given the option to do the individualinterview.

(12:51):
So they didn't have to do it, but prettymuch everybody, but one student agreed to
do it.
So I had, was close to saturation pointfrom the students going on in the early
placements.
And then the later placements, I onlyneeded to do one or two.
So what was slightly disappointing is oneof the later placements, students going on

(13:11):
a later placements actually left thecourse after the placement.
And I didn't interview her, which was verydisappointing because one of the big
things in the literature is this firstclinical placement is when we lose people.
So if we really wanna keep people in thecourse, it's looking at preparedness with
that first clinical placement because ifthey have a really bad experience or don't
feel supported or don't like people, mygoodness me, there was so much discussions

(13:36):
around relationships and support wasaround how nice people were to the
students, then they tended to leave thecourse and leave the profession.
So out of the 16, I lost one.
And it is just a real shame I didn't getto interview that person.
So I didn't do too many interviews in thelast block because I was reaching data
saturation point by then.
So it wasn't too bad.

(13:57):
Initially my interviews, I wanted them tobe more open, but I was finding I needed
the structure.
I needed specific questions because theywere so excited to talk to me and I was
wanting to know how they went.
And part of me was very mindful of myconfirmation bias.
And I noticed in the very first interviewI did, I was almost thinking about the

(14:18):
literature and trying to link it.
And so to avoid that, I went back to mysupervisor's team and we made the
questions very much more structured thanoriginally planned.
So therefore going to those laterplacements wasn't too bad because it was
quite structured.
She has given us like 27 different gemsthere all in a row.

(14:38):
So the first thing that Philip is talkingabout here is data saturation.
Data saturation is when...
you analyze the interviews as you getthem.
So you transcribe the interviews and youcode them and you look at the data.
And each time you do a new interview, youdo the same process and you code it and
you analyze it and you add it to thatfirst interview and you keep going.

(14:59):
And eventually you get to a point whereyou don't find anything new in the next
interview.
And so you've reached this point of datasaturation.
And theoretically, interviewing 200 morepeople wouldn't necessarily give you
anything different.
than you've already collected.
And that's one of the ways thatqualitative researchers make a decision
about how many people to include in theirsample.

(15:23):
She said something else there, I'm justtrying to remember there was three things.
There was the- confirmation bias.
Yeah, she talks about confirmation bias.
And it made me think about groundedtheory.
She sounded like- You talked about it.
Yeah, she sounded like she was talkingabout grounded theory, where you want to
stand really outside of the-

(15:44):
known theory about something, you want tostand outside of that knowledge and learn
from what you're seeing in front of youwithout any preconceived ideas, because
what you're trying to do is build atheory, you're trying to actually create a
theory, and so a theory is just a model todescribe what we see in front of us, what
we're experiencing and what we observe,and if you can build a good model it will

(16:07):
help you to describe that experience sothat somebody else will recognise it, they
can use your model.
and they can recognize this experience ina host of other different environments.
So this does sound quite like that kindof, I don't want to have any preconceived
ideas, I just want to observe and collecttogether this information and describe it
into a recognizable theory.

(16:28):
Talked about an interview schedule ifyou're getting the questions.
One of the things that makes me think ofwhen she talks about an interview schedule
is that tension between allowing peoplejust talk about what's important to them
and
She's worried about confirmation bias andyet she's pinning them down to a list of
topics to talk about.
It feels to me like a really difficultbalancing act because on the one hand,

(16:51):
you're choosing questions because you'vedecided what information you want from
people.
You've not decided the answers that youwant from them but you've decided the
questions you want to ask them.
So you've decided what you want them totalk about.
And that means that you are pinning themdown a bit.
You're not just letting them freewheel andgo off in their own direction.
And the risk of obviously of lettingsomebody go off on their own is that they

(17:14):
will talk about something that's reallynot of relevance to you and not of
interest to you.
I think we ought to explore at some point,maybe not now, but at some point, I think
you ought to explore the difficultybetween directing people to talk about
something and letting them just talk aboutwhat they're interested in.
It's about allowing people to freeassociate completely down a tangent.

(17:36):
Although that might be so interesting.
particularly if you're using apsychoanalytic model, might be so
interesting where they go and what thingsmight come out.
That might have nothing to do with thisreally specific issue that Phillip is
interested in.
She wants to understand people'spreparedness for placement and how that
changes.
And free associating won't allow that tohappen.
It'll just go somewhere else.

(17:58):
Yeah.
It's, yeah, it's always going to be astruggle for me because I just get really
interested in what people say and thenwe'll both go off down that rabbit hole
together.
very dangerous.
This is Adventures in Research, and I'mBrolan Tarrant, a mental health nurse from
the University of Melbourne.
Such an interesting process, though,because people who are listening, nurses

(18:22):
who are listening to this podcast, willsay, well, I'm really good at chit chat.
I can go in and I can have an interview.
I mean, that's what we do all the time, iswe interview people.
But it's so interesting that you foundthat you were able to identify this kind
of internal reference point, rather thanjust dealing with the data that you were
given.
You were kind of skewing it in a way.
What questions did you end up with?

(18:44):
I asked about, I tried to link them asclose to the focus groups as possible so I
could see the consistency.
So the post, the interview questions oncethey were on placement, I really opened up
with a very broad question as did you feelas prepared for the clinical placement?
And about half of the participants feltthey were and 25% felt they weren't and

(19:07):
25% felt they were over-prepared.
over prepared.
So it was quite, that was quite a goodquestion.
It was still qualitative.
So even though I'm giving you percentages,that's just, it's only had 10
participants.
And then I talked about what was helpfulin their preparation, what was unhelpful
in their preparation.
And a lovely question I thought was if youwere to give the nursing department advice

(19:30):
on preparation for future students, whatwould you do?
So that was a really nice question becauseit made them narrow down their.
reasons and I was then able, it wasactually the answers to that question that
was quite specific that I was then able tosort of informally go back to my, the
team, the department and feedback some ofthose specific areas that the students

(19:55):
felt they were lacking.
Interesting that Philip is talking aboutquantification of qualitative data so in
other words
looking at the importance of a statementbeing made during an interview because a
lot of people say it.
And I think there's a really interestingthought process going on there.
If everybody says it, does it mean it'sreally important?

(20:16):
And if only one person says something,does that make it any less important?
What do you think?
That is such a good question, isn't it?
And there's so many other contingenciesaround that too, about who says it and
the...
the authority of the informant, if youlike, does that make it important, even
though nine other people didn't mentionit?

(20:37):
It makes me really interested to try andremember to ask these questions of other
researchers.
Are you even gonna write it down?
Because I think the qualitativeresearchers, the really experienced
qualitative researchers will have a goodopinion on that.
And this is how research happens.
We come up with a question and think, I'mgonna ask other people about this

(20:59):
question.
So I'm just reflecting about how was thatone question about if you could give
feedback to the nursing department aboutpreparation and that almost again, having
a sense of almost action research wherethe students can have input into changing
things and students really seem to havebuy-in, the students who were involved.
That's what research does, is it?

(21:19):
I mean, good research does that.
Research is something that you'reinterested in, that you have buy-in from
the people that you're researching andthen it informs and changes something.
I mean, that's...
as a first piece of research, Philippa,that's very impressive, isn't it?
Yeah, yeah, and I think what was also goodis I was even able to make small changes
to their second semester.

(21:40):
So for example, some of the things aboutbeing helpful was when clinical educators
would demonstrate a skill in full and thenthe student knew what it looked like,
whereas due to the amount of nursingskills they had to learn before they went
on placement.
a lot of the time they were being toldwhat to do and then they had to go away
with their peers and work it outthemselves.

(22:02):
So they got themselves into a bit of amuddle, like I know I've been told to do
the blood pressure cuff here but theyweren't demonstrated it.
So then this semester I fed that down andwe made sure that every single clinical
educator demonstrated the skill in realtime and then did it again in like talk
aloud methods, slowed it right down andtalked through it.
So that I think in itself was reallypowerful because they gave them the

(22:25):
confidence
do it, whereas I think there was a lot oflack of competence.
I wonder how the students felt then thatwhat they'd suggested was enacted and then
for them when they came back.
And so that's almost a really valuableexperience in the research, isn't it?
I've participated, I've given you my time,I've taken some risks here, because I'm

(22:50):
telling you about things that may or maynot reflect on me well.
And then you're using this information andyou've made a change that I think would be
beneficial to me.
So I can see there's a positive benefit oftaking part in this research and it might
make them think better about research.
It might make them think of the utility ofresearch because they can actually see it

(23:11):
making a change that influences or affectsthem.
That's great.
Tell me some of the other findings thatcame out from your study and other things
that perhaps you fed back to thedepartment.
We send students on our...
first clinical placement to subacutesettings, which is great where you get
your fundamental nursing skills up.
But we also were sending students topalliative care and we were sending
students to a pediatric hospital.

(23:33):
Yet, we never taught how to look after thecare of the dying patient and all of our
teaching was around adults.
So comments like, I went to a pediatrichospital, so it'd be very helpful if I
learned how to look after a pediatricpatient.
So that was one area just related
content of the curriculum, but thebiggest, I think the biggest finding was

(23:56):
really students didn't have context totheir learning.
So what I mean by that is there were 16nursing students in the study, three of
them had experience in healthcare.
They worked as a sort of physio, one was aphysiotherapist assistant.
So they had a context to hospital, theyknew roughly how the environment worked.

(24:20):
Whereas the others...
They'd come from arts background, businessbackground, come straight from school from
science.
So their experience of a hospital wasbroken bones when they were younger,
Grey's Anatomy, TikTok, Instagram.
But they, so they didn't know how preparedthey were because they didn't know what
they were preparing for.

(24:40):
They, and a lot of them were Googling dayin the life of a nurse.
What does a nurse do?
Things like here in Australia, we haveenrolled nurses.
DIV-1 nurses, DIV-2 nurses, nursepractitioners, A numbs, lots of, same all
over the world, lots of different.
And lots of different, and theabbreviations make no sense because they
don't say DIV-2 on Grey's Anatomy.

(25:01):
No, they don't, they say pass me thatchest tube.
So yeah, so I think they didn't know howprepared they were because they didn't
really know what they're walking into.
And in that relationship, I did discoverthat individual agency made a difference.
So there were students that would be like,well, I'm just going to observe.
I'm not going to be doing anything.

(25:22):
I'm just going to be walking aroundfollowing someone.
And compared to other students going, I'mgoing to be active.
I'm going to give it a go.
And depending on where they sat in thatfocus group of their growth mindset or
their motivation or their attitude wasreflected in their placement.
They tended to.
So I think that was really good tohighlight that it's not just about the

(25:43):
education system.
It's also about the, yeah.
It goes back to their self-talk in thattime and what they tell themselves to
expect.
And I don't know what I'm saying now, Ijust talked to you, might sometimes have
been not being an arrogant learner or afearful learner, but being a, as you say,
using a growth mindset and responding tofeedback and not being frightened of

(26:03):
learning.
So that makes a significant change to astudent.
It did make a big difference.
But I think just going back to thecontext.
things that one student thought that theywould be working nine to five and she even
bless her laughter.
It was like, well, that just tells me thatI know nothing because I thought I was
nursing nine to five but it hadn't evendawned on her that it was gonna be seven
in the morning till 3.30 in the afternoonand nursing was 24 hours and another lady

(26:25):
student was going to a gem ward and didn'tknow what that meant.
So they just didn't know what to expect.
I didn't even know, you know, would theyget lunch breaks or one girl, yeah, they
spent a lot of time talking about type ofshoes they would need because they just
perceived they would always be on theirfeet and.
They perceived they would be with thepatients a lot and that was quite a shock
for some of them, that the actual,particularly with COVID, I think.

(26:48):
Such a universal concern.
What sort of shoes shall I buy?
It really is.
That's what exercises our students beforethey go out on placement, definitely.
Anything you get told during a researchfrom your participants, surprise you.
I think that I was trying to live intofinding out the results.
I had at least three out of...

(27:10):
three or four out of 16 that were reallyfearful of being judged on placement based
on their culture, race and genderidentity.
And that really surprised me.
One person said, that's my main concern.
Who's the person who's gonna be helpingme, particularly as I'm from the trans
community.
Some people worried how patients weregonna treat them.

(27:31):
Are they gonna want someone from their owncultural background looking?
But on a positive.
No one reported it on placement, but thatwas a very strong fear, which I think
three out of 16 is quite a lot.
But it didn't come, it didn't eventuate,but it did cause a lot of mental space
thinking about it before.
I think this is a really wonderful conceptand it makes me think about the stance of

(27:57):
the researcher.
So if I had to guess, I would say thatPhilippa is a white woman.
Yes.
Well, because she didn't automaticallythink about being other.
She didn't automatically go to having thatinnate sense of how am I going to fit in?

(28:19):
She's got the social capital where shefeels she belongs in that world.
And one of the things that some of mystudent nurses have been researching,
either through literature reviews thatthey're doing at the moment or through
some qualitative research that they'vebeen doing as well.
They've been researching this idea ofracial discrimination and being other.

(28:40):
And so the student nurses themselvesdescribe their own experiences as not
quite fitting in, being treateddifferently.
And they also interestingly can see adifference in the way that white nurses
treat black patients and black nursestreat black patients.

(29:00):
And that's not to say there is any racismpresent, but there is a...
the student nurses who are black suggestthat there is a greater level of mutual
understanding between a black patient anda black nurse.
And therefore, and they also feel that'sthe same between a black nurse and a black
student nurse.
And so they go into these situationsalready thinking about that and what

(29:24):
Philipp is saying is her and so I'mfinding that out from my students doing
their research.
I'm finding out about their sense of beingdifferent and their sense of
concern about being treated differentlyand about whether they'll be accepted.
This is the great thing about qualitativeresearch, it kind of in literature, we'd
call intertextuality, how these textsrelate to each other.

(29:45):
But in research, we don't call itintertextuality, we just call it, do we
call it something or it's just, thisreminds me of this other thing that
happens in research.
And it's just I guess the I guess the term
we're talking about reflexivity as well,aren't we, that self-awareness of what you
bring to the research and how you impactthe participant and how you impact the

(30:08):
environment, and therefore you will impactthe results that you get.
And for, as a learning point, this isbeing able to think about the research in
this way.
You don't have to know research to be ableto wander and to be able to ask questions,
to be able to think, what's happeninghere?
What does that?
Why does it work that way?

(30:29):
What if, what influence is this persongoing to have?
All I'm doing is listening to whatPhilippa says and it's sparking off little
questions in my head about, oh, I wonderif that made a difference to what the
participants said.
I wonder if they would have talkeddifferently to somebody else.
That's the art of research criticalappraisal in one, isn't it?
Just having a think.
Yeah.
I just loved your phrase then.

(30:50):
I'm going to get t-shirts made up saying,you don't have to know research, you just
have to wonder.
That's a beautiful phrase.
It's making the patients up.
Back to me being a genius yet again.
Who knew?
Centrifugal force gravity just goes backto Amelia.
It's true.
Let's see if we can hear if she brings upthose things that she came up with.

(31:12):
And they were worried, two of them wereworried they were going to get racial
abuse.
She said, I don't mind if they don't wantme to look after them, but I just don't
know what I'd do if they shouted at me orwere rude.
But I thought that really surprised me.
And they
focus groups too.
So it wasn't like one said it and anotherone jumped on, but that definitely

(31:33):
surprised me.
I just asked her to reflect on why we weresurprised.
I think living in Australia, we're such amulticultural country.
You know, I've heard during lockdown, theytalked about half the population were
first-generation Australians and anotherquarter were second-generation
Australians.
Oh, I might've got them the wrong wayaround.
But the point was, is a lot of people livehere, have family and come from all over

(31:53):
the world.
So it did surprise me and I suppose comingfrom England and being white, I've not
experienced it.
So there might be some naivety from me toothat I've not experienced it.
So maybe I don't know that it would bethere.
But I did find it interesting.

(32:13):
I was gonna say, it was in nothing,nothing came out about the way that they
experienced the first six weeks of theircourse that made them, it was just
something embedded in it.
their experience of the first inductioninto nursing that they thought, oh, well,
this is going to happen when I go outthere.
It's a very good question.
I don't know.
I wouldn't want to sort of come out.
I don't know.

(32:35):
They do an Indigenous health subject andthey talked a lot about power imbalances
with the Indigenous community.
So some of them did discuss, would therebe other power imbalances with different
cultures?
So maybe that was a bit of a trigger.
They did talk about power imbalances also,which did come up in the literature.

(32:57):
Funny enough, didn't come up in myresearch, but power imbalances with
student nurses sort of being bottom of thepecking order did come up a lot in the
literature, but people didn't expressthat.
They expressed incivility.
It was a lovely word I learned whenwriting up my thesis, being ignored and

(33:17):
dismissed at times or being asked to do...
tasks that wasn't enhancing theirlearning, but possibly needed to be doing,
like toileting and showering.
But even that, it didn't happen on aconsistent basis.
And that fed into the other biggest thingI found in my research was how important

(33:38):
placement relationships were.
So if they were paired up with a nursethat was making them be- There's a
helicopter going off.
So, with this wait a moment.
It's amazing how much noise a helicoptermakes.
This incivility was quite neat.
There's actually two studies that came outlast year about it, about just being

(33:59):
ignored or dismissed.
So I guess it does relate a little bit topower imbalances.
But the students that did have thatexperience tended to then stay away from
the nurse that might have made them feelthat way.
I mean, one of the participants activelywent and found the nice nurses through all
the shifts and it came up again and again.

(34:21):
They had students didn't comment on
their supervisory nurses or body nurses,however you want to.
They didn't talk about the type offeedback they gave or their knowledge base
or experiences.
It was so much was it about relationships.
I felt like this when I was with thisnurse and I felt like this when I was in
this nurse.
And the students that, there was onestudent that had an older gentleman that

(34:45):
kept telling her to shush all the time fora shift and told her to shush and listen.
By the end of the day and a couple ofshifts
they really took a more passive role.
That kept coming up.
As soon as they went with people thatweren't supportive or friendly, they
stepped back and they became very passiveand became very nervous to do things.
So suddenly there was even one studentthat was looking after patients

(35:07):
beautifully by herself after the, in thethird week, and then got with one student
that was highly, highly critical andwouldn't let them do anything.
And this male student just withdrew anddidn't do anything.
But it didn't seem to impact his overallexperience because then for the next day,
He got to be with someone else who let himflourish and be autonomous and try things.

(35:28):
And he said he got his confidence back andwas proactive and it was pretty cool.
Philippa's primary aim in this researchwas to find out how to better prepare
students for placement.
But to me, what I'm hearing is the, weneed to prepare the students emotionally
to cope with this difficulty inestablishing a working relationship with

(35:50):
people that maybe aren't overly friendly.
And we also, the value of this research tome is absolutely vital for the mentors or
the supervisors to hear this and toappreciate how their unintended
communications have such a profoundinfluence over the capability of the

(36:12):
student or their, or even theirself-efficacy or their intention to try
something.
And I...
We all know it, I think, from beingstudents and from seeing students, how
easy it is to be shut down by somebody'snegativity.
In fact, I know it as a, you know, I'm areader in health professional education,
you think I'd be over that by now, but Istill can be absolutely crushed by

(36:36):
criticism and be fearful then of tryingagain.
And I think this is, it's beautiful if wecan, if this research is gonna be shared
with those supervisors.
and they can appreciate just the powerthat they have.
Just one smile or a kind word is gonnamake a massive difference, isn't it?
Did you look at a sampling bias that maybeyou were only getting a particular sample

(37:02):
of students who were, did have, I suppose,psychological assets themselves that would
allow them to buoy up and to manage theworld, and not looking perhaps at a group
of students who were...
less assertive or more full of anxiotropesor those kinds of things.
I just interviewed whoever wanted to beinterviewed.

(37:24):
I think what was very good was that I hada huge range.
Out of the ten I interviewed, four of themwent to four different rural and regional
hospitals.
The others all went to differentmetropolitan hospitals.
So I had a big variety of hospitals.
I think that played in my favour.
I think of just under
that sort of brought out that studentagency.

(37:45):
But definitely I had two students thatwere possibly less proactive and used
terms like bored.
I looked over and saw my other peer notdoing anything and that made me feel
better and I just observed it.
And I did originally put into one of mythemes, growth mindset versus fixed

(38:07):
mindset was one of my themes.
But interestingly, I changed it.
about four days beforehand at my thesisin, because I felt I didn't have enough
variety, as you've said.
I felt that out of my 10, there wasdefinitely maybe 80% of them were very
proactive and two, not so much, but Ididn't feel I haven't had enough, a big

(38:29):
enough sample to prove my point.
So I changed the theme to individualagency.
So earlier on, Philippa said she reachedsaturation, but then much later in the
process,
with a lot more interrogation of the dataand a lot more time to analyze it.
She's appreciated that there is actuallysomething different to look at here.

(38:50):
There's a, there's, she could have probeda bit more in trying to find out a bit
more from those students about that growthmindset.
What does she call it?
A growth mindset versus?
A fixed mindset.
And so that I think that's fascinating.
And you're always going to get that withqualitative research, I think that.
you think you've reached data saturation,but it's not really until you sit down

(39:12):
that you notice a spark in there ofsomething.
And you think, ah, that's the nextdirection to go in because I need to know
more about this.
But the other thing she said there is, Ididn't have enough of that type of
information to be able to draw anyconclusions from it.
It was an idea, but it wasn't fully formedbecause I only had those two participants

(39:33):
talking about it.
And so we are back in a different way withthis idea of
quantification of qualitative research.
But here she's telling me somethingdifferent because she's saying it isn't
how many people said it is how much theytalked about it.
It's how much detail did I get about thattopic area.

(39:54):
So I think she's saying that it'simportant even though only one or two
people have mentioned it.
I can recognize it's important but I can'tfully interrogate it yet because there
isn't enough of it.
I love that.
Okay, so although you love it, I'm justgoing to put it out there and say, is that
bad research form?
Should she have been holding this in mindand interrogated it at the time and, and

(40:18):
work that, you know, is it just not beingthoughtful enough in the research process?
Oh, you're mean.
I've been known to be, but, but is that,you know, I could imagine it with a
particular lens.
I mean, I don't believe it, but couldpeople be critiqued, you know, the people
who are not
fans of qualitative research.

(40:39):
Could this be the point of contention withthose AC?
Well, I think it also goes to Philippa'slens and Philippa's stance as a researcher
and who Philippa is and how she's seeingthe world outside of her.
And so it's a very similar thing to notexpecting students to lack social capital

(41:00):
or be concerned about racism or, and thatbeautiful word of incivility.
I like that word.
I'm going to use it.
in every hour today.
So, so Philippa said, you know, I didn'texpect to find this in the data.
And here's another thing that she couldn'thave expected to see this emerge because
she didn't have a preconceived notion ofwhat the results were going to be.

(41:24):
And she tried, but it's all the waythrough this research story, she's telling
us, I can't be too mindful about the, Imustn't.
lock myself down into what the previousresearch has done.
I need to explore this afresh.
I need to come to this without anypreconceived ideas.
So in a way she's working for the growthmindset herself.

(41:45):
Yes and it's more and more like groundedtheory isn't it because of that lack of
preconception of what she's going to findbut I don't think it is grounded theory
and I do think she is.
going to be extraordinarily difficult forher to sit outside of her own experience
because she works with these students allof the time.
So, yeah.

(42:06):
Which is the same thing that we had withwhen we listened to Hose's research
before, you know, these were colleagues inthe past.
So she there's that difficulty standingback and observing things separate from
that, which is great because what you'vedone there is you've, I suppose, managed a
threat to validity.
that you've actually gone, okay, well, Ican't support this robustly and therefore

(42:30):
removed it.
What would that be?
I don't know if they can hear any of that.
I heard you say robustly.
I think that's something juicy coming up,isn't it?
Which is great because what you've donethere is, you've, I suppose, managed a
threat to validity that you've actuallygone, okay, well, I can't support this
robustly, this thing robustly, andtherefore removed it.

(42:51):
What were the other things that?
clearly were robust that you came up with.
I must tell you that they all had nauticalthemes.
I didn't even mean to do it.
I had three main themes that I came upwith.
One was adjusting and managing a raft offeelings, which was the sub, so that was
positive feelings.
There was definitely students before theywent on clinical placement that were happy

(43:14):
to go with the flow.
They didn't need to know everything.
They didn't need to plan everything.
They were actually felt they've done allthey could and now they were gonna just
sit back.
and enjoy it.
And one student even said, I really likethat I'm gonna go on placement and someone
else is gonna kind of control my learningfor a few days.
So the positive, the people that reallylooked forward to placements before they

(43:35):
started, definitely had more of a mindsetof not needing to control everything.
They were just happy to go with the flowand they didn't know if they were prepared
or not.
I have to add that some, one of themdidn't think he was prepared, but he was
happy to give it a go.
And then under the net more the negativefeelings I had, my theme was I don't have

(43:56):
enough knowledge, which is the explainswhat you were feeling in the coffee shop
with your peer.
Like they're real people and I don't knowhow to do it.
Worried about being judged, which I'vetold you.
Quite a number of participants weren'teven sure if nursing was for them, which
is very interesting.
Out of the 16, I'd say maybe three or fourof them.

(44:20):
what didn't think nursing was for them.
So that was, is nursing really for me?
Once they'd done their placement, exceptfor the one we lost, but one student was
adamant.
She was totally in, she's like, it's me,I'm a nurse already, I love it.
Very, very enthusiastic student.

(44:40):
And the other two were still sitting onthe fence.
I still not 100%, but I'm happy to give ita go.
But that was because
of the ward they were on.
So they got enough of a taster, enough ofa bite to keep going, but they recognized
if they were going to be a nurse, theydidn't want to work in the area, they'd
just done their placement.
And then the fourth sort of negativeemotion related to being before placement

(45:05):
was being a burden.
That was a huge thing.
They were so worried that they would be aburden and an extra responsibility.
And that tied in with what one studentsaid, we're bound to...
Oh, here we go.
If we end up being a burden to them...
it's an extra responsibility for them ontop of their day, then we might not be
treated so well.
So we're still listening to Philippa Mariotalking about her research regarding

(45:28):
student nurses where she's starting to tryto demystify to students what a nurse is.
So they acknowledged that they were aburden, felt a burden, but they also were
worried how that would impact they werebeing treated.
And already, a couple of them had alreadyplanned to apologize for their existence

(45:49):
before they'd even started.
started plays, they were going to open upwith I'm sorry, I don't know anything and
I'm going to be a burden.
I love this idea that students arereceiving the workload associated with
them being taught and simultaneouslythey're all thinking about their
entitlement to education.
So there's this when at the beginning ofthis interview that you were doing with

(46:12):
Philippa, you both talked about cognitivedissonance.
And I didn't understand why you weretalking about cognitive dissonance at the
beginning.
I didn't get the relationship between thatphrase and the work that Philippa was
doing, but that beautifully expresses thatthe students can hold in their heads these
two very, very different notions.
On the one hand, I'm entitled to beeducated.

(46:33):
And on the other hand, I don't want to bea burden.
And it just beautifully illustrates thatidea of how difficult it is to navigate
this territory as a student.
I love nursing research.
And I was thinking, I hope that thestudents who are listening to this are
being able to say, yes, that's exactlywhat it's like.

(46:54):
Maybe we'll find out in our focus groups.
Or maybe they'll look this episode onsocial media and go, hey, I've just heard
a podcast that really nails how we feelabout placement first time.
Five to seven days had gone.
The majority of them had flipped.
They'd become more active.
Their confidence had gone up and then theydidn't feel so much of a burden.

(47:16):
So that was my first theme aroundfeelings.
My second nautical theme was sinking orswimming, which was looking at, that was
around the perceived expectations.
So that was what got me into this study inthe first place as I've talked to you
about the theory to practice gap.
And that really was translation topractice is overwhelming, which ties in

(47:37):
with all of the literature.
It's a big jump.
They're learning the theory part, nowthey've got to jump.
I've talked to you about the growthmindset or individual agency.
And then that contextual learning.
I had two beautiful students.
One said they were a musician and whenthey learned a song, they would listen to

(47:57):
the song in full, then they would go andbreak it down.
And they described the course as learningall the chords, but they didn't know the
song and they didn't know the rhythm andthey didn't know how it was played, so
they couldn't pull it all together.
So they had all the notes.
but they couldn't pull the song together.
Another one was like, I've got all thejigsaw pieces, but I don't know what the
picture is.
So they couldn't pull it together.
So there was some really lovely analogies.

(48:18):
I love that.
Oh my God, that was such a fantastic wayof describing it.
That's gold.
Isn't it?
Yeah, I don't know what it all looks like.
And then we expect somebody to just jumpin there and get on with it, don't we?
And then my third theme, which I've toldyou already, was the reality of navigating
placement relationships.
So...
The literature really talks aboutbelongingness and says a belongingness in

(48:42):
a team was really important.
That didn't come about so much.
It was the individual relationships.
One reason I wonder if the belongingnessdidn't come about so much was because it
was only a three-week placement.
And what I've read, they were really justso focused on individual learning skills
where they were at.
They hadn't looked at the bigger team yet,maybe, but that would have to be something

(49:04):
to be looked at in the future.
The collegiality was big.
I wasn't expecting, which I feel quitenaive saying it, I wasn't expecting the
importance of peer relationships to be asstrong.
The students that were, were reallyoriginally on their own, felt really
isolated.
They didn't know if what they wereexperiencing was normal.

(49:26):
They didn't know how it compared.
They didn't even know if, yeah, they justdidn't know what other people were doing
and it made them feel, I think itreally...
gave them a lot of stress and almost madethem feel a bit left out because the
groups, there's eight students go out atonce in the metropolitan hospitals and a

(49:48):
lot of them they'd made their own WhatsAppgroup or their own messenger group and
they could talk to each other be it if itwas just like, I don't, it can't find the
car park, one of them said and they gottold.
So for those ones on their own, there wasa huge amount of isolation.
So when they had a really bad shift withsomeone.
not being nice as simple as that, itreally impacted their experience.

(50:09):
Rural and regional in Australia.
Can you explain to what rural is and whatregional is in Australian context so
people overseas will understand what it'slike?
Sure.
The reason I'm laughing is because mysupervisor, I'd been writing rural and my
supervisors were writing, is it rural orregional?
And I was like, I don't know.
And so this was a, I had to contact a lotof people to get the definitive

(50:33):
difference.
Regional tends to be, I guess, largertowns in Victoria.
So I think it's based on population, isn'tit, Bronwyn?
So if they're a big town, it's classed asregional.
But if it was a small, sort of like asmall country town or in England we had
called them village hospitals, they wereclassed as rural.

(50:54):
So some of the hospitals were actuallyclassified under the regional trust, but
they were so far away from.
anybody that two of them were classifiedas rural.
I'm Amelia Swift and this is Adventures inResearch.
When the student nurses go to rurallocations to do their practice, do they

(51:18):
need to stay overnight in that area?
Do they live away from home?
They live away from home for three weeks.
And most often the hospital organisesaccommodation, so they can either move in
with a family, so they'd be billeted, orthey could get a room at the nurses'
quarters or whatever it might be still.

(51:39):
Because it can be up to six hours.
That's really interesting about thecontext in which this about the students
are speaking, that's going to be reallyimportant in Philippa's report to make
this accessible to international audience.
You have to recognise just how differentyour experience is to somebody else's

(52:00):
experience.
And so most of the nursing students in theUnited Kingdom will commute daily to their
placement area and it will be
less than two hours in almost every case,usually less than an hour's commute in
either direction.
And in Birmingham, our commutes are quiteshort for most of our placement areas.

(52:25):
In other areas of the United Kingdom, thestudents do have to go and stay.
There'd probably be several of them goingto that location.
So in this case, it might be one studentgoing to a remote location on their own.
That's going to be
that's got to heighten your fear and youranticipatory anxiety and everything else,
hasn't it?
So I think that's, it's interesting thatit didn't dawn on me until now that was an

(52:47):
important context to listen to thisresearch reporting.
Yeah, no, it's, it's a, it's, it's aboutwhere you shine your light when you're
listening, isn't it, or looking at thedata.
And certainly, so the rural placements,because they are smaller hospitals, they
can't take as many students.
Whereas a regional can take more.

(53:08):
and because they have more patients,they're more of an epicenter.
And of course, in the metropolitan ones,the students are going there and going
home every day.
And then when we're talking aboutdistances, just so people can get an idea,
because Australia is quite big, how faraway from Melbourne were these students
going for their rural places?
Anything up to three and a half hoursaway.
They couldn't commute.
They would, having to go there and stay inaccommodation, and there would often be

(53:34):
some of them.
were isolated.
It was sort of like almost a small roomwith a kitchenette.
Some of the accommodation is a houses, butthanks to COVID, they weren't allowed to
do it.
So everybody had to be in their own littleunit, self-contained units.
So that added to a bit of isolation.
As a researcher, what was the high pointand the low point in this process for you?

(53:57):
I really enjoyed doing the focus groups.
I found I did really enjoy, I reallyenjoyed watching the students.
have many light bulb moments like, I'mfeeling that too and I've never told
anybody.
So I really enjoyed the focus groups.
I actually found them easier tofacilitate.
And I found the interviews quitedifficult.

(54:20):
I had a couple of students that would talka lot, which is great, but I wasn't almost
able to keep up with the talking and myquestions.
And because I changed it to be quitestructured.
I found they would talk and then I'd goback and it was getting a bit repetitive.
And then I had students that were veryquiet and trying to get more out of them

(54:44):
was really difficult.
And I learned that I then talked too muchand I should have had more silences.
I think there's definitely looking attechnically it's insider research.
So for people...
that don't know that I'm, I was working inthe department and I'm interviewing the
same people.
So I wasn't teaching them, I was managingtheir clinical placements and working in

(55:06):
the labs.
But having, I think they trusted me.
So I think that made a really bigdifference.
But at the same time, one focus group,they all just kept thanking me and telling
me what I, how great my colleagues were.
And I had to kind of ignore it to get themto not tell me what they thought I wanted
to hear.

(55:27):
So it was a really big learning curve.
I said, no, yeah, the 901 times.
Oh, hang on.
Was it actually 901 times?
You're just making that number up.
Some of the students that are doing that,some of my students are doing, yeah, some
of our students are doing theirqualitative research at the moment and

(55:49):
they're interviewing either other studentsor nurses about different topics.
And they're finding it much easier to havetwo of them.
in each interview.
So one of them does the interview and theother one takes notes, but also makes
notes of follow-up questions and things sothat the person is actually doing the

(56:09):
interview can really fully focus on whatthe person is saying to them.
And what they've discovered is, if they'redoing an interview without that second
person, then while the participant istalking to them, they're thinking about
their next question.
They're thinking, oh, I've got to ask thatnext.
And so they're not really attending towhat the person's saying.

(56:30):
And as a consequence, they're missingimportant stuff.
And when they come to transcribe it later,they go, how did I miss that?
How did I not know they were talking aboutthat amazing thing there?
And it's because they were just distractedthinking about the next question.
That's one of the reasons I think thatdoing research is a really, really
important way of learning about research,because until you've had a go at that, we

(56:53):
can listen to Philippa describing thatsituation.
But I think when you've had a go at it andit hits you how difficult it is to do as a
skill, you're like, okay, right, I'mgetting it now.
One of my students was very, veryemotionally distressed, which I actually
had to escalate that as per my ethics.
You had a distress protocol.

(57:14):
Just describe it to me.
What is a distress protocol?
Okay, so I'm on a greater than minimalrisk ethics committee.
One of the things that I'm really veryattuned to
is as researchers, oftentimes we're sofocused on getting the information and
fighting our way through that they don'treally fully understand what that might be

(57:34):
like for the participants or for therelatives of the participants or other
people around.
And the distress protocol is about what Iwill do if somebody is becoming
distressed.
So as a researcher, do I stop theinterview or?
Do I provide some time or do we have a,people come up with a whole variety of

(57:59):
different things that are distressprotocol that I think is the most robust
and often they're written bypsychologists, but they're about really if
A, the researcher will do one, if B, theresearcher will do two, if A and B, the
researcher will do three.
And it very clearly sets out what to doand what to say.
So it's very structured.

(58:21):
And I think in part because as we werejust talking about,
when you're in research is just listeningto the moment, you may not be thinking
with that other part of your head aboutwhat to do when.
So the distress protocol is really aboutkeeping the participant very safe and
managing their distress and being reallyfully aware that it's voluntary.
We want to hear that they can stop at anytime and that's okay and here are the

(58:44):
support services and we can take a breakand to really help people modulate their
emotions and be safe to talk.
Maybe we shouldn't do research on peopleif it might upset them.
And that's when you have to think aboutthe benefits versus the risks and really
justify, is this research worthwhile?

(59:05):
And my early research is around aconstruct I developed called traumatic
countertransference narrative, wherebylistening to people talk about their
trauma can, or even not even talk abouttheir trauma, but have something
quite distressing and you can tell thedistress, you can feel that distress and

(59:25):
what that process is like.
So it's a really interesting area andsometimes not given full weight at what
needs to be ethically done.
I think we also have to remember thoughthat each participant has autonomy.
And if a person has mental capacity andcan make a decision whether to participate

(59:46):
in the research or not, then
they, as long as they appreciate it couldbe very tricky conversations, it might
raise distress, it might cause thememotional distress, then they have every
right to participate in that.
They have the right to choose toparticipate in that.
And I think that illustrates how nursingresearch cannot be paternalistic.

(01:00:06):
You have to, you have to give theinformation to people and allow them to
make a free choice about whether they wantto take part or not.
As long as they appreciate how valuable
And therefore you have to have an output.
You have to have a direction that this isgoing to go in and you have to be able to
demonstrate that the results of thisresearch are going to be used in this

(01:00:28):
particular way.
And you can't be what I often find myselfas is a person who doesn't finish things.
If you use people's time and youpotentially cause them harm during that,
you better do what you said you were goingto do.
You better finish the job.
Yeah.
And...
Further for me on that, which isabsolutely true, is we have a duty of

(01:00:50):
fulfilling our part of the contract, Isuppose, if they're entering into an
ethics, they're signing an ethics, being aplain language statement saying, I
understand, is that I've forgotten what Iwas gonna say.
Rewind, rewind.
Oh, member checking.
I think that a member check is soimportant to say to the person, this is
what I heard.
Whilst when you were talking to me in thisreally open and honest way.

(01:01:14):
Absolutely.
Yeah, the focus groups were a highlight.
The interviews were hard.
I found the coding.
I'd never done that before.
So coding, you come up with your themesand then you find quotes to fit into the
theme.
So I had 533 codes.

(01:01:36):
And initially reading through, that wasquite a process to pull out.
533 codes!
Yeah.
Pages and pages and pages.
But yes.
So each, each focus group was an hour.
So that's six hours of focus groups andthen five hours of interviews.
So that's a lot of data.
And that, that explains to people also whoare listening.

(01:01:58):
Well, so, oh, I'll do qual because I justhave to talk to people.
Qualitative research is really difficult.
I mean, the amount of, you must know thosetranscripts really well now.
I do.
So once I got the themes.
because I was initially basing my themeson the literature research that I'd done.
So that's how it started.

(01:02:18):
And then I realized that things weren'tfitting in.
It was a bit like getting a triangle intoa square hole.
So I then- So you kind of changed yourmethodology in a sense, in a way of being
going from theory to applying thatsomewhere to then going, well, there goes
the theory and then more grounded orresponding to what you were getting and
going for saturation that way.

(01:02:40):
Yeah, well I was just...
Would you describe it as phenomenologicalthen?
I have had it described asphenomenological.
But it is classified as a descriptivequalitative study.
But I think my four themes that came outof the literature was about cognitive
dissonance, belongingness, powerimbalances in the hidden curriculum.

(01:03:02):
But power imbalances didn't really comeup.
The hidden curriculum didn't come up.
Oh, and anxiety, as you can imagine, itwas rife.
So there were similar things, but I just,it was, I think, I think what was good
about this study is when all the otherstudies that I'd read about perception of
preparedness, they haven't been on there.
So they were never able to know if theywere prepared.

(01:03:24):
They were almost preparing for somethingthey didn't know that was happening.
So to be able to interview them after andsay, well, were you prepared?
Did you, and some of them, as I've said,said yes, some of them said no.
And.
But it then meant that they could actuallytangibly reflect on where they were
before.
And so then you could see the difference.
Wow.
So this is groundbreaking.

(01:03:45):
Seriously, as your first piece ofsignificant research into nurses, you've
been able to influence and changecurriculum, feedback and inform curriculum
design, and actually contribute to thebroader knowledge around postgraduate
entry to practice nursing courses.
She's contributed to the knowledge basearound...

(01:04:05):
nursing preparedness.
It's just in the same way that HOTASU,first piece of research, had really
contributed to understanding thisdifficulty of retention of nurses in
specific eating disorder units, with bothbeing presented internationally and
getting publications and changing systems.
And I'm just really impressed by these twoyoung nursing researchers coming up with

(01:04:30):
such powerful outcomes.
experienced in their fields aren't they sothey're novice researchers but experienced
nurses and experienced or experiencededucators.
I think in nursing we have tended to delaygetting our start in research until we are

(01:04:50):
fully mature as a professional and that'snot how it's going to be in the future if
I have my way.
I think nurses will start sooner.
and do more research, more practicallybased research.
We're asking everyone what advice theywould give to nurses considering doing

(01:05:13):
nursing research.
Perhaps even those nurses who think,that's not for me, I'd never do it.
What advice would you give to them?
I have really enjoyed it.
And it's made me understand the process.
And I think that is really important.
Suddenly I will pick up an academic paperand now I'm like, I read it through a
different lens because I can understandwhat they've done, the backend of it.

(01:05:36):
So I think that's a really valuable.
at all.
And I think it's really nice for usnurses, you know, we're big picture
people, you know, we might work in ED andbe an expert at Jack of all trades, or we
might become experts in oncology in onespecific area.
But I think having a focus on one area, Ireally, I did really enjoy it.

(01:05:58):
And I really, I learned so much from mysupervisors, which I wouldn't, I sometimes
think as a nurse, you're left getting,finding a mentor.
or finding role models in nursing can bequite difficult because the areas are so
broad.
So I think in a weird way, they were mysupervisors, but they also mentored me in
the process.
And academic writing, I thought I waspretty good at academic writing before

(01:06:21):
this, but they just refined it and refinedit and refined it.
So just the satisfaction of, I genuinelythink I've done as good as I could have
done.
But yeah, it's just open, it's been good.
Give it a go.
Fantastic.

(01:06:42):
And I just realised we haven't introducedyou.
One of the things I'd like to say, soyou're Philippa Marriott, you work at the
University of Melbourne.
Your area of clinical expertise and howlong have you been a nurse?
I graduated 2000, I think 2001 fromKingston University in St George's
Hospital in London.
And then I went really straight intocardiac.

(01:07:03):
And then I've been doing cardiac or EDsince.
Thank you so much for your time, Philippa.
It's been tremendous hearing about yourresearch.
It's been such a delight listening to yourinterviews that you did with Philippa and
Hesu.
And it just has demonstrated to me howbroad the field of nursing research is.

(01:07:27):
And that's something there for everybody.
If you're an educator, if you're a mentalhealth nurse and we've got Cara
representing the adult nurses, we'vetalked about end of life care, we've
talked about eating disorders and we'vetalked about student nurses going into
practice for the very first time.
And all of those different pieces ofresearch are about nurses looking at what

(01:07:48):
it's like to be a nurse.
And it's so different, it's fantastic.
So stay tuned, listen to the next episode.
Absolutely, when we decide what it is.
Brain's gone a bit fried now.