Storytelling as Learning in Specialist Community Public Health Nursing Education

Sunday, 17 November 2019

Kristina Mountain, MSc, RN, RSCPHN
Division of Nursing, Queen Margaret University, Edinburgh, United Kingdom

At Queen Margaret University (QMU), Edinburgh, Specialist Community Public Health Nursing: (SCPHN) students engage with academic (50%) and practice based learning (50%). The focus over the last 10-15 years for these nurses who work with children under 5 years, and their families, has been reactive and targeted in terms of identifying risk. There is now a move to working with families in terms of a person-centred and salutogenic approach to health and wellbeing, with a focus on the child, family and community in the changing context of public health practice. This includes the complexity of holistic assessment and judgement of risk and safeguarding, centred on the child from a wellbeing perspective (NMC 2004; Cowley et al 2013; Scottish Government 2015). The current master’s programme in person-centred practice at QMU commenced in 2015, embedding a philosophy of personhood and person-centred ways of working with registered nurses and midwives, as postgraduate learners, as they prepare for their role. The programme is underpinned by McCormack and McCance’s (2017) Person-centred Practice Framework.

The formation of communities of learners during the 52-week programme provides opportunities to examine the connections between experiences in practice and theory. In addition, during the transition to a new professional role and identity, and as future facilitators and leaders, the culture of public health nursing teams in practice are critically discussed. Within this is the potential for disorientating dilemmas, or epiphanies, as established ways of working are challenged and new frames of reference are constructed. This can be seen as a catalyst for change and transformative in nature (Mezirow 2012; Denzin 2014). As values, beliefs, assumptions and jarring moments of disorientation are examined (and challenged) through meaningful discourse with self and others, the use of a creative communicative space adds another element to how learning is supported and facilitated (Titchen, Cardiff & Biong 2017). A creative approach to this is storytelling as a means to develop connectivity and collaborative understanding of working in a person-centred way, and the possible impact within nursing teams where the complexity and challenge of practice can feel overwhelming (Cowley et al 2013). Storytelling is facilitated through spoken, written and visually creative means, using stories of practice as a means to build connections between the experience and the theoretical basis (Kroth & Cranton 2014).

In action, this has been achieved through the use of creative means to facilitate group processes (shared narratives, poetry, drawing and creating learning journeys/houses, visual chronologies and concept mapping), which in turn have generated opportunities for discussion and shared moments of learning within the groups (Titchen, Cardiff & Biong 2017). Students engage in critical discourse with each other around their experience of a particular phenomenon; the educational journey to become a public health nurse, within the current health and wellbeing context of practice. This is developed further as critical commentaries and ePortfolios of evidence are constructed as key elements of academic and practice assessment and evaluation. Utilising this approach within the curriculum aims to facilitate learning and support health visiting students to build on their strengths and develop resilience, giving a voice to the person who is developing their personal and professional sense of being.

As an educator and leader of this programme, my interest lies in understanding how knowledge and skills are creatively developed regarding complex assessment and professional practices when working with children and their families. I have come to appreciate the uniqueness of the approach we adopt and to realise that practitioners need to critically reflect on, and evaluate their practice in a safe space.

Evaluation Process: Connecting with others and building their professional resilience in response to the judgements made when working with children and their families in the community setting has been a key outcome of the programme (Cowley et al 2013). To demonstrate this, we have collected evaluative creative commentaries of learning over the last three years. My linked doctoral research study is building on this method and is exploring the role of storytelling as learning for public health nursing students. A qualitative and explorative approach is being taken from an autoethnographic perspective and methodology, using critically creative narrative inquiry.