Coconstruction avec des étudiantes et des formatrices d’une intervention pédagogique pour l’apprentissage du leadership clinique infirmier tôt dans la formation initiale

This manuscript-style thesis presents the results of a qualitative study which aimed to co-construct, with a group of students and educators, a pedagogical intervention and to describe the components that supported clinical nursing leadership learning early in initial education. The intervention was designed for first-year baccalaureate nursing students. The chosen approach to design the intervention was co-construction, a term inspired by the student voice perspective. Student voice is based on the premise that students have a unique perspective on teaching and learning and encourages dialogue (Robinson and Taylor, 2007) and the sharing of perspectives (Cook-Sather, 2014a) between students and educators. A scoping review on student voice projects in nursing education was submitted for publication in 2018. A research and development model was used to lead this study (Harvey, 2007; Harvey and Loiselle, 2009) from a constructivist perspective (Guba and Lincoln, 1989; 2005; Lincoln et al., 2013; Lincoln and Guba, 2011). The study was divided into two sequential steps. First, co-construction occurred with a team of second-year baccalaureate students (n=5), educators (n=4) and the student-researcher. A focus group with team members was led one year after the co-construction ended. The co-construction participants’ experience was described by thematically analysing (Paillé and Mucchielli, 2010) the following data: meeting agendas, meeting minutes, audio recordings of co-construction meetings, transcription of the focus group, audio and written notes from the focus group facilitators and the student-researcher’s field notes. Co-construction was a positive experience for participants due to a flexible structure. This structure helped manage power dynamics and the achievement of a tangible objective in a collaborative and cohesive climate. This step is presented in an article published in Nursing Education Today (2017). Second, the pedagogical intervention was implemented and qualitatively evaluated by students and tutors to describe its contributive components. The intervention was co-constructed using the expected level of clinical nursing leadership students should attain at the end of the first year of the program: students should be able to establish a trusting relationship with a person living with a health experience by demonstrating openness towards others’ opinions, reflecting on their clinical practice, and recognize the presence of leadership in a nurse’s role (Faculté des sciences infirmières, 2010). The intervention was composed of two activities: an in-class activity and a clinical practice activity. Twenty-three students and four tutors evaluated the in-class activity and four students and two preceptors evaluated the clinical practice activity. The evaluation was carried out using semi-structured individual and focus group interviews. Thematic data analysis (Paillé and Mucchielli, 2010) helped identify three components of the intervention that supported clinical nursing leadership learning: visual examples at the students' level, observation of role models, and animated discussions in small groups. This step is presented in an article published in Nurse Education in Practice (2018).  The results of this thesis underscore co-construction’s potential for creating innovative pedagogical interventions and the possible positive outcomes for co-constructors. Furthermore, the study’s results underline the contribution of concrete clinical nursing leadership examples, the observation of role models that are considered peers and the structuring of small-group activities to produce animated discussions as components that can support learning clinical nursing leadership by students that are beginning their education.  This study offers certain ideas to guide other co-construction projects in nursing education and suggestions of pedagogical activities for nurse educators looking to support their students’ clinical nursing leadership learning.

Keyphrases: Co-construction, Student voice, Clinical nursing leadership, Qualitative study, Nursing students, Learning, Pedagogical intervention