Abstract: This article reports the implementation of a collaborative project undertaken to monitor and improve the effectiveness of the prescribing practicum papers delivered within two Master's degree programmes in advanced nursing practice. The recent introduction of Nurse Practitioner registration in New Zealand has resulted in the development of a number of Master's degree programmes in which students can complete a Nursing Council of New Zealand approved programme for prescribing. For the study, a developmental action research approach was used. Data were collected through interviews with practicum students, their medical supervisors and academic staff. Formative findings were progressively used to refine delivery of the practicum papers and a thematic analysis of summative findings identified areas for further improvement. The findings suggest that the processes being implemented are developing well. The researchers recommend that further education is required to clearly differentiate medical and advanced nursing roles. They recommend that greater attention needs to be paid to the preparation of medical supervisors and, most significantly, revision of funding is required to more equitably support the ongoing development of nurses for advanced practice roles.

Abstract: Within New Zealand nursing education there appears to be a widespread acceptance of problem-based learning and an assumption that the strategies it uses are unproblematic. A review of the literature however, reveals that problem-based learning has drawbacks that may inhibit the achievement of desired graduate outcomes. It seems timely for nurse educators to exercise caution in uncritically accepting problem-based learning approaches and using them as the predominant approach to teaching and learning. To this end, a two-part critique of this teaching and learning method is presented. Part one critiques the methods of problem-based learning, discussing self-directed learning, the group process, self-assessment, and content knowledge. Part two explores the philosophical underpinnings of problem-based learning, and the so-called 'fit' within nursing.

Abstract: This study aimed to identify how graduates perceived their clinical performance during their first year of practice. A convenience sample of 30 graduates was surveyed after 3 months and 7 months in practice, using an adapted form of a questionnaire devised by Ryan and Hodson (1992). The results showed that over time, graduates generally required less direction in all areas of clinical competence. After 7 months in practice, the majority of the graduates rated their performance in nursing skills, communication skills, and professionalism at the expected level or above. However, some still required direction with using theory and research in practice, with meeting client's psychosocial needs and with teaching clients. In the leadership competency, after 7 months, most graduates saw themselves functioning at the expected level related to client care and needed less direction in unit management skills. However, many of the unit management skills were rated as 'not applicable' indicating that new graduates are not initially placed in a management role. Implications for nursing education and limitations of the research are discussed.

Abstract: This thesis is a study of the experiences of four cultural safety lecturers in nursing education in Aotearoa / New Zealand. A review of literature reveals the recent and turbulent evolution of cultural safety. The media which documented this journey in a negative light in the 1990s prompted ministerial inquiries and the publication of the Nursing Council of New Zealand's guidelines for cultural safety in nursing and midwifery education (1996). Action research methods enabled the participants to implement change in their practice and gain positive personal involvement in the study. Reflective diaries provided the major tool in this process as participants were able to achieve at least one action research cycle by identifying issues, planning action, observing the action and reflecting. The findings of the research revealed that the participants not only coped with every day stressors of teaching but they were also required to formulate knowledge of cultural safety. For the Maori participants their stress was confounded with recruiting and retaining Maori students and macro issues such as commitments to iwi. Lack of support to teach cultural safety was identified to be a key theme for all participants. An analysis of this theme revealed that it was organisational in nature and out of their immediate control. Action research provided a change strategy for participants to have a sense of control of issues within their practice. Recommendations have been made which focus on supporting cultural safety educators to dialogue on a regular basis through attendance at related hui; the introduction of nurse educator programmes; paid leave provisions for cultural safety educators to conduct and publish research so that a body of knowledge can be developed; and that Maori cultural safety educators be recognised for their professional and cultural strengths so that they do not fall victim to burn out.

Abstract: In 1973, two trial pre-registration nursing education programmes were piloted in New Zealand polytechnics. These represented an alternative to traditional hospital-sited schools of nursing. The establishment of nursing education in the tertiary sector marked a radical challenge to the cultural heritage of apprenticeship-style nursing training associated with paternal and medically-dominated health institutions. This thesis offers a Foucauldian and feminist poststructuralist analysis of discourses employed by fifteen senior nursing educators in the comprehensive registration programmes between 1973 and 1992. The women employed to teach in the comprehensive programmes faced unique challenges in establishing departments of nursing, in developing curricula that would promote a reorientation of nursing and in supporting candidates to attain their nursing registration. Through semi-structured interviews and discourse analysis methods, a set of unique characteristics shared by this group of early leading comprehensive nursing educators has emerged. The women's narratives were underpinned by discourses that centre around the valuing of education as a vehicle for emancipation and an upholding of a legitimacy of difference in nursing educators' work. The participants upheld the importance of clinical practice skills and drew on their own student nursing experiences as incentives for reforming nursing education. These nursing educators conceptualised an idealised type of graduate, and commonly employed an heroic metaphor to describe their experiences as senior comprehensive educators. Their engagement with such discourses and their shared characteristics demonstrate unique re-constitutions of power, knowledge and relations with their colleagues and clients throughout the education and health care sectors. The author proposes that these traits characterise the women as strategic and astute professionals who successfully negotiated the construction of comprehensive nursing programmes as a legitimate and transformative preparation for nursing registration.