Fear-Based Education: Impact of the System of Controls on Nursing Students

Purpose: The focus of this research is the pedagogical experience of the nursing students, particularly males. This research looks at the inherent discriminations within the nursing profession, particularly in the education system. There are often limited opportunities for mentorship, sexism on the part of some educators and lack of acknowledgment of the differences between males and females and how they think, react and communicate. The male nursing student is often expected to conform to certain stereotypical behaviours and responses that are equated with the (feminine) nursing ideal. This creates an environment that subjects the male student to additional stress, pressure to meet expectations and subjects them to misuse of power and disciplinary action by faculty in an effort to force performativity. The result is psychological harm to the male student, increased failure and drop-out rates and feelings of inadequacy and persecution. Stott (2003) and Kermode (2006) have found that 40-50% of males entering nursing either fail or drop out and that there is a concern within nursing regarding the lack of gender equity and sexism. The purpose of this presentation is to examine the effects of the educational process on nursing students, specifically male students, the implications for other marginalized groups and nursing education systems.

Methods: A phenomenological method has been employed, interviews with 20 current and past male and female students have been conducted. Current students were from one particular nursing program. Past students include graduates and those who were unsuccessful, either failing or withdrawing out of the program. Past students were from several programs across a geographical area. Graduates were working in various roles across Canada. Each participant was interviewed using a series of open ended questions as a guide.  The study is being completed utilizing Butler's theory of gender performativity and Foucault's concepts of power and discipline as its theoretical framework.

Results: Butler (1988) refers to gender as a constructed identity that is accomplished through performativity of behaviours and attitudes that meet social norms. The results of the research have shown that nursing is similar in its desire to meet social images and expectations and thus insist on gender performativity by its male members. Those who do not conform are subject to concrete or abstract discipline (in the Foucauldian sense). The theme of control has been identified in relation to the examination of the socialization practices and educational environment created within nursing. Within nursing education we incorporate strategies that include surveillance and examination, aspects of discipline according to Foucault. Male students have reported that they perceive a need to be more independent in their work, feel isolated and excluded in academic and clinical settings and perceive that they are subject to stricter surveillance then female students. The research has shown that these controlling strategies, manifested through hierarchical, structure and personal controls, have significant effects on the educational experience of the male student, and in some cases nursing students as a collective. These effects can be categorized into seven concepts; anger, frustration, confusion re expectations, self -doubt, isolation / marginalization, not being self (faking it) and justifying presence. The overriding theme is that of a fear based educational system. It is these effects that need to be highlighted to nursing educators and those in positions of power, that the impact might be better understood and possible strategies developed to not only combat these identified effects but precipitate a collective examination of our socialization and education practices with the goal of transforming them into more inclusive, diversity accepting processes.

Conclusion: The research will shed light on a concerning and yet silenced issue within nursing; the marginalization/exclusion of male nurses. Understanding the experience of this population may help move towards a more inclusive and accepting profession and a safer educational environment for all. This will involve rethinking the gendered basis and confining assumptions that construct the ideal nurse, examining how they work to exclude certain individuals or groups from the nursing profession. Understanding the effects of the current nursing educational system on this minority group will help us make necessary changes to the current socialization and education of nurses. This is only one example of a greater problem within nursing, that of discrimination and marginalization of students and nurses who do not meet the ideal nurse image, which changes based on your geographical and cultural lens. The findings can be applied to other sub-populations within nursing who also struggle to be accepted and feel a sense of belonging.