The purpose of this concept analysis was to define salience from a nursing educational perspective. This concept was chosen stemming from the author’s interest in educational principles surrounding the foundations of student learning, attention, memory and retrieval of nursing information for later use in the safe and effect delivery of patient care.
The concept of salience has been studied across various disciplines including medicine, behavioral science, psychology and cognitive neuroscience. A common theme across the various disciplines is that salience is often described or considered a characteristic, something that can be manipulated during experimental design. While this may serve the disciplines for their respective purposes, the rigid application of the term and generic dictionary definitions do not seem to effectively meet the needs of the profession of nursing education. In 2010, Benner and colleagues formally introduced the concept of salience into nursing education while highlighting the need for educators to teach for a “sense of salience”. In the years since Benner’s et al. introduction, the term continues to be referenced in the nursing education literature sans the publication of a formal concept analysis relating to the term. As a result, a void remains regarding a universally accepted definition of what the core of the concept espouses as it relates to nursing education.
Methods:
As the concept of salience is abstract in nature rather than a concrete object, the author chose a concept analysis approach that blends both empirical and aesthetic perspectives to most effectively analyze the term. In addition to researching the professional literature, Chinn and Kramer’s approach invites researchers to glean their inspiration surrounding a chosen concept from a variety of sources, including art, literature and anecdotal sources to capture the concept from a holistic perspective. Through a naturalistic inquiry method, data is collected and interpreted through perceptual experience. As nursing is both an art and a science, the author has chosen to research the concept from both paradigms using a modified version of Chinn and Kramer’s methodology.
To evaluate salience, as it relates to the overarching thread of education across multiple disciplines, a formal professional literature review via MEDLINE and CINAHL with full text databases surveying the terms “salience” and “education”. The researchers placed major subject heading limiters such as “brain”, “attention”, “cognition”, “education/nursing”, and “students”. To further explore the term from a holistic perspective, the author considered teachings and principles from the practice of yoga from an anecdotal personal perspective when examining salience. In an effort to effectively capture the essence of the term, exemplar and contrary cases have been adapted from real-life clinical experiences with student nurses.
Results:
The professional literature review populated 97 results. Concluding a review of titles, abstracts and/or text for inclusion, content from 17 manuscripts across varying disciplines was valuable in garnering insight into the concept. Stemming from the practice of yoga, insight was gained regarding understanding self and the influence the senses have on salience. At the conclusion of the formal literature review and reflecting upon the practice of yoga, the author ideates consciousness to be an antecedent of salience. Stemming from common themes that were identified across disciplines and stemming from the principles of yoga, attributes of the term salience that were identified were “intrinsic value”, “heightened awareness”, and “importance”. The outcome of salience in the realm of nursing education is the synthesis of an important and prominent stimuli with previous experiences for authentic, safe and effective patient care.
Conclusion:
Through evaluating salience from a variety of perspectives, the author was able to glean delicate insight from each source in developing an operational definition for the term. For nursing education, the concept of salience is defined as the following: Influenced by the senses, salience is the essence of heightened awareness towards details or circumstances of intrinsic value, perceived to be of particular importance at a moment of time. Salience is not skill that is simply bestowed upon a student, but instead an intrinsic spirit that needs to be effectively fostered for its actualization to occur. Stemming from this definition, it is surmised that educational interventions may be designed to influence, rather than manipulate, a student’s salience towards achievement of learning outcomes and the ultimate goal of delivering authentic, safe and effective patient-centered care.