the politics of gaining access into higher educational settings (Burgess, 1984/2016). ‘Gatekeepers’ have the power
to permit or deny access into the organization, including its people, procedures, and situations (Burgess,
1984/2016; Leblanc & Schwartz, 2007). This poster reports on the politics of gaining access into multiple access
points of a local post secondary educational organization, including access to its classrooms, faculty, meetings, and
documents. The qualitative study was designed to examine how a school of nursing (SON) prepared for a relatively
new assessment, the NCLEX-RN© exam, and the poster illustrates how a continuous process of negotiation and
renegotiation were required throughout the research process (Burgess, 1984/2016; Leblanc & Schwartz, 2007;
McDermid, Peters, Jackson, & Daly 2014). In addition, both the researcher and organization demonstrated several
moments of being reflective, creative, and flexible as part of gaining access.
Background
As of 2015, Canadian nursing graduates, except those in Quebec and the Yukon, no longer completed a
Canadian based registration exam as part of their program requirements. Instead, they wrote the American
National Council Licensure Examination for Registered Nurses (NCLEX-RN©) exam as one component in the nursing
registration process (Canadian Nurses Association (CNA), 2011; College of Registered Nurses of British Columbia
(CRNBC), 2015). The NCLEX-RN© exam replaced a Canadian based registration exam which had been in place
from 1970-2015. Greater protection of the public was the rationale provided by the Canadian Council of Registered
Nurse Regulators (CCRNR) (CCRNR & National Council of State Boards of Nursing, 2012) and the CRNBC (2011) for
the adoption of the NCLEX-RN© exam as Canada’s new registered nursing regulation exam. The Canadian
Association of Schools of Nursing (CASN) (2012a, 2012b), and the CNA (2011), both expressed concerns with the
adoption of the NCLEX-RN© exam. One concern expressed was the amount of time and resources that would be
needed to assist nursing educators to revise their teaching practices to assist students’ success on the test (CASN,
2012a, 2012b). Additionally, in a 2014 online survey of Deans and Directors of Schools of Nursing across Canada,
CASN (2014) researchers found many nursing programs across British Columbia (BC) and across Canada began
adjusting their curriculums and purchasing new computerized teaching and testing materials to prepare both faculty
and students for the NCLEX-RN© exam.
The adoption of the NCLEX-RN© exam was a result of many factors. Global and economic restructuring
generated the need for policies that were more responsive to economic, labour, and market needs (Taylor, Rizvi,
Lingard, & Henry, 1997). Educational policies (such as the adoption of the NCLEX-RN© exam in Canada) are often
created to assist in managing change (Taylor et al., 1997); however, educators (a) are routinely left out of the
policy-making process, (b) are given little opportunity to understand or learn about particular policies,
(c) experience a displacement of their own pedagogical and curricular values, and (d) are often confused and resentful
about recent policy shifts that implicitly and explicitly ask them to change their historical practice (Ball, Maguire, &
Braun, 2012a, 2012b; Laschinger & Finegan, 2005; Taylor et al., 1997).
Purpose
Currently there is a void in the nursing and educational literatures about how SONs, nursing administrators,
and nursing educators are positioned and constructed by the adoption of the NCLEX-RN© exam. The purpose of
this qualitative study was to gain insight into how the NCLEX-RN© exam influenced Canadian SONs, nursing
administrators, and nursing educators as they prepared students for the new NCLEX-RN© exam. The significance
of this study is that its findings will contribute and extend current disciplinary knowledge, theory, and practice and
may inform future policy- and decision-making at local and national levels. Moreover, the study provides important
research on how Canadian SONs, nursing administrators, and nursing educators are positioned and constructed
through legislative and other policy-making practices. The study’s focus on how the power relations involved, with
the design and implementation of educational policies in nursing, has significant practical relevance when
participants and other stakeholders find the study’s contributions insightful and applicable to their own practice
(Tracy, 2010).
Methodology
The study consisted of two complimentary qualitative approaches, focused ethnography and critical policy
analysis. Focused ethnography is designed to examine phenomena in real time, in a natural setting, and uses
ethnographic methods (such as participant observations, interviews, and document analysis) to explore an ‘emic’
point of view pertaining to specific situations, activities, and actions under study (Ball, 1994; Cruz & Higginbottom,
2013; Knoblauch, 2005; Taylor et al., 1997; Wall, 2015). Critical policy analysis is concerned with power, politics,
and difference as well as how actors are “constituted in and by policy” (Webb & Gulson, 2015, p. 5). There are
parallels between ethnography and critical policy research in that both can be disruptive and threatening to
organizations and local participants (Ball, 1994; Tamboukou & Ball, 2003). Moreover, both qualitative approaches
reveal how power and knowledge operate within specific sites of change, conflict, and struggle (Ball, 1994;
Tamboukou & Ball, 2003). Because of this qualitative design, the processes involved in obtaining access to
organizations and its personnel were a delicate process of negotiation and renegotiation.
Methods
My research consisted of specific methods of participant observations, participant interviews, and document
analysis in a SON in BC. As the researcher in this study, I served as the primary research instrument in each
method and functioned as both an ‘insider’ and ‘outsider’ in the setting in relation to my own positionality as a
nursing educator (Dwyer & Buckle, 2009; McDermid et al., 2014; Murchinson, 2010). For instance, because I
conducted research in a SON other than the one where I work, I was an outsider to the organization that I
researched. However, I was also considered to be an insider in the profession and may have known some of the
participants (that is, nursing educators and administrators) from shared professional development events. My dual
role as both insider and outsider provided a key component to obtaining access to the organization and its
personnel.
Gaining Access
Ethics approval was obtained from the University of British Columbia’s (UBC) Behavioural Research Ethics Board
(BREB) (2016). An ethics application was concurrently submitted to the Riverside [pseudonym] organization that
housed the Bachelor of Nursing SON, and specifically to its respective institutional research ethics board (IREB).
The process of obtaining ethics approval often revolves around both institutions providing approvals once the other
institution grants permission. This process is often a very delicate and convoluted one. Importantly, I had
established a relationship with a key informant in the SON. Prior to submitting my research application to
Riverside, I had been in contact with the Board’s Chair who believed that since my study was deemed minimal risk
at UBC, the approval process at Riverside would be short.
Ethical approval from the UBC’s BREB was obtained seven days after submission. Ethical approval from
Riverside’s IREB was more complex and took a total of eight weeks. Four days after the submission of the
application, I was informed that the ethical application needed to go to a full board review by default due to the
complexity of the study and the Chair’s wish to have input from the other IREB members. The full board did not
meet for another six weeks. After the full board met, they created a list of provisos and amendments to
documents. Their concerns revolved around (a) justification for attending faculty and department meetings;
(b) the indirect identification of faculty; (c) the preservation of confidentiality and participants’ rights; and (d) the
methodology. They requested that a SON sponsor be identified as a coinvestigator in the study and suggested that
the Faculty Association was contacted to see if participation in the study would affect the participants’ risk to
employment. Finally, they requested that someone at the institution read a draft of the study’s findings and
discussion sections to ensure confidentiality of participants due to the potential for participants to be exposed to
criticism (for example, their teaching methods, pedagogical decisions, etcetera). The IREB exercised great care to
protect the faculty and institution’s welfare partly due to my description of the critical nature of the study. A
continuous process of negotiation and renegotiation with key players took place to address the provisos.
Gaining access also consisted of multiple points of entry besides the specific organization. Once ethical approval
was obtained from both research ethic boards, gaining access to classrooms, faculty, meetings, and documents
remained a challenge that required constant negotiation and renegotiation. SON faculty did not readily volunteer to
be observed in participant observations of classroom or meeting settings. Few faculty volunteered for interviews. A
schedule of the SON faculty meetings, meeting agendas, or meeting minutes were not provided as originally had
been discussed. The head of a committee responsible for the planning and assessing of the SON’s response to the
NCLEX-RN© exam did not communicate after initial contact.
A continuous process of negotiation and renegotiation, being reflective, creative, and flexible was required
throughout the process of gaining access.
See more of: Invited Posters