Exploring the Learning Experiences of Nursing Students with Dyslexia by Child and Langford - Essay Example

?Critique of “Exploring the learning experiences of nursing with dyslexia” by Child and Langford by ) (Professor) (University) (Date) The fact that the nursing career accepts both dyslexic and non-dyslexic interns is based on the Equality Act of 2010, which affords the same opportunity for non-dyslexic and dyslexic students. Although several studies and researches advocate the role of dyslexics in the nursing career, some studies authors contend that the nursing profession is not for the dyslexic. The title of the research article - “Exploring the learning experiences of nursing students with dyslexia” – does reflect the content of the study. However, the title somehow implies that it is a research study concerning how nursing students with dyslexia naturally learn and behave in the classroom setting. Nevertheless, the study is actually one focused on how nursing students with dyslexia should be able to cope with the rigors of clinical practice, not of classroom work. Therefore, the title should have been “Exploring the learning experiences and coping mechanisms during clinical practice of nursing students with dyslexia.” As to the authors, both are credible. Both Jenny Child and Elizabeth Langford are senior lecturers of adult nursing of the University of England. Therefore, their profession as well as the fact that they are members of the faculty of a prestigious British university makes them credible. However, it would have been better if it was clearly stated that both authors were nurses, although it is most likely so. Moreover, the abstract does summarize the key components of the study: the aim, the method used, findings and conclusions. However, it should have had elaborated a little bit more on the three points that it mentioned in the Findings summary section. Just like the abstract, the rationale for undertaking the research is clearly outlined. In fact, the research study flowed smoothly from its aim to how it was conducted and to the results that it yielded. Moreover, the aim of the research is clearly addressed. Nevertheless, the authors say that the study aims to “examine the learning experiences” of nursing students with schizophrenia. This examination of learning experiences may not have exactly been in a traditional classroom but are actually of a clinical setting. Furthermore, the statement of the aim of the study should have been at least two sentences for such length. There must also be an “and” between the word “placements” and the phrase “to establish ways,” and this syntax problem may somehow disrupt an average student’s reading. Regarding the ethical issues, the study clearly states that “the participants gave informed consent in writing to take part in the study” (Child & Langford 2011). This statement alone implies the idea that care has been taken to ensure that the proper ethical issues have been addressed in the study. Moreover, individual interviews have been conducted obviously in order to make sure that the privacy of the nursing student is protected. Moreover, there is a separate subsection called “Ethical considerations,” where it is stated that the study has been approved by the university ethics committee and that programme managers have also expressed their prior approval to it. Still, more on the subject of ethics, the questions used in the interviews of nursing students have been properly structured so as not to get any of the participants to be emotionally hurt. For example, only the words “disabilities” and “difficulties” have been used to refer to a possible case of dyslexia, which was not mentioned in the original questionnaire. Moreover, the data taken from the questionnaires have been “anonymised” in order to protect the identity of the participants (Child & Langford 2011). There seems to be no available literature on what type of questionnaire should be made available to students with dyslexia but the questionnaire used in this study seems very practical and comprehensive. The current dyslexia questionnaire available online at www.ljmu.ac.uk/MKG_Global.../dyslexia_questionnaire.doc seems to be more comprehensive than the one carried out in the study of Child and Langhorn. The questionnaire at Liverpool JMU comprehensively enumerates various symptoms of dyslexia not only in the classroom but also at work, which the respondent should identify with a yes or a no. Although there was nothing wrong with the open-ended questionnaire used by Child and Langhorn, the details of dyslexia as outlined in the Liverpool JMU questionnaire should have been made clear to the interviewed patients. Regarding the literature review, it is comprehensive and up to date. However, it could have been made more comprehensive and more up to date. More studies should have been cited and more recent ones too. Since the study was accepted as a journal article in 2011, the authors should have chosen articles published in 2008, 2009 and 2010. However, they cited those from 2000 to 2007. As to the study design, it is clearly identified and justified. It used the phenomenological lifeworld approach, which is “focused on the world as it is experienced before the formulation of any hypothesis to explain it,” thereby allowing the participants to “reflect on their experiences during their clinical placements” and to allow the researchers to “gain an in-depth knowledge of the students’ lived experience of dyslexia” (Child & Langford 2011). Therefore, the phenomenological lifeworld approach was used in order to assess the philosophical underpinnings of the study and to be able to understand the personal aspect of the answers of the nursing students with dyslexia. This may have been done in order to better help him or her. The phenomenological lifeworld approach is an established approach of analysis of personal experience and which deals directly with the lifeworld, or the “foundation of understanding humans, our lives, health, suffering and well-being” (Johansson et al. 2008). Since this study deals exactly with how the academic institution can show sympathy in the improving the lives of nursing students with dyslexia, then such an approach to the study should be appropriate. The above information regarding lifeworld is from the article entitled “A lifeworld phenomenological study of the experience of falling ill with diabetes,” and published in the International Journal of Nursing Studies in 2008, and authored by Johansson, Ekebergh and Dahlberg. The rest of the information regarding lifeworld is provided by Child and Langhorn, the authors of the journal article on which this analysis is focused. The experimental hypothesis as well as the variables in the study has not been specifically addressed. However, it can be deduced from the aim of the study that the hypothesis is that the answers of the students to the questions would reflect the necessary themes that would point out what should be done to support nursing students with dyslexia during clinical practice. The independent variable is therefore the students’ answers to the questions and the dependent variable is the themes that have been drawn out from the answers. This turned out to be “the value of work-based learning days,” “the importance of the clinical mentor’s role,” and “the need for the academic institution to send clearly written information on clinical placement standards to the workplace mentor” (Child & Langford 2011). The population is not clearly identified. However, the sample of “one cohort of third-year adult nursing students” may not be adequately representative of this population (Child & Langford 2011). In fact, the authors themselves honestly admit that the study was a “small-scale qualitative evaluation” whose “findings cannot be generalized to the wider setting” (Child & Langford 2011). This is the main and the only limitation of the study as pointed out by the authors. However, despite the fact that the sample could not possibly represent all nursing students with dyslexia in the world or even those in the UK alone, the method of data collection is valid and reliable, considering that the researchers have previously “carried out a pilot study of the questions drafted for the interviews” (Child & Langford 2011). Nevertheless, when it comes to the questionnaire’s being standardized or not, the mere fact that the university ethics committee has approved it earlier would somehow suffice. The method of data analysis is reliable in the sense that the university ethics committee has approved it. The line-by-line method of analysis of the answers is based on the idea that themes common to answers of both nursing students with dyslexia and those without are sought. As to the qualitative aspect of the study, the philosophical background and study design are identified and the rationale for the choice of design is clearly stated. The phenomenological lifeworld approach of research is appropriate for the relatively more individualized or personalized way of answering the questionnaires by the nursing students. The lifeworld approach is using these personalized answers as empirical evidence in order to obtain information that will fulfill the aim of the study. Although there have been various researches conducted in line with the topic on dyslexia among nursing students and the problems that it causes during clinical practice, there is practically no working hypothesis for the study because the conclusions have to be deduced from the results of the nursing students’ answers themselves. The major concepts are identified not in the methodology section but in the section on findings. The major concepts are carefully outlined in the findings section: work-based learning, importance of the clinical mentor’s role, advocacy for students, personalized coping strategies and developing a toolkit. These major concepts, however, are presented as the themes that define the results of the questionnaire that the nursing students answered. In short, these major concepts are not standard information, which means that they were not taken from references other than the results of the questionnaire. The context of the study is also properly outlined. From this outline and from the headings, one comes to realize that the study has a simple aim, which is to examine how a nursing student with dyslexia deals with the procedure and rigors of clinical practice. A small sample of qualified respondents is selected and a questionnaire is used to evaluate their performance during clinical practice and their insights and experiences as well. From these findings, the researchers then tried to determine recurring themes among the answers given by the respondents. Such themes then lead the researchers to conclude on what should be done to help nursing students with dyslexia. The selection of participants is described and the sampling method is identified. However, this sampling method is nothing but a simple and “convenient” handpicking of 12 students, six of whom were formally diagnosed with dyslexia and the other six were normal and no known disability (Child & Langhorn 2011). The method of data collection used, which is through a questionnaire, is not auditable, at least to the reader of the journal article. The raw results have not even been presented but a summary of the results of these 12 people would somehow suffice for the absence of auditable data. The method of data analysis is the line-by-line method of analysis, which is perhaps the most appropriate in a study where personalized or individualized answers must be taken into consideration. Although there is no literature which states that this method of analysis is particularly appropriate for this study, it is definitely the most practical choice for it. With a methodology that is equally organized, the results are presented not only in an appropriate and clear way but also comprehensively, since the whole study simply depended on the results of however the 12 respondents have answered the questionnaires. The supplementary table, specifically Box 2 on page 42, which summarizes the common themes among the concerns of nursing students with dyslexia and those without, somehow makes clearer the presentation of the results of the study. Nevertheless, it is pointed out in this particular section that there are twice as many dyslexia themes as there are common themes. This should therefore have been addressed by the authors. Moreover, since the results were taken only from a sample of 12 students, then it is definitely not representative of the general population of dyslexic people, or dyslexic students, or even the total population of dyslexic nursing students in the United Kingdom. The results are therefore not generalizable, yet the authors admit such limitation. Although the results are not generalizable, the discussion is comprehensive. Nevertheless, it is a little shorter than expected, and that it failed to address the fact that there are much more dyslexia themes than common themes. Nevertheless, the discussion section is straightforward when it tackles the salient points of the study. Overall, the discussion somehow overlaps the findings and conclusion sections because what is being discussed is nothing but the summary of the findings and the longer version of the conclusion. Key concepts formulated in the discussion include the fact that “similar practice needs are identified by students with and without a formal diagnosis of dyslexia” (Child & Langhorn 2011). Another point is that mentors of nursing students especially those involved in clinical practice need to undergo more training in order to familiarize themselves with dyslexia and with nursing students who experience such a disorder. A third point is that support for students with dyslexia must be standardized. Moreover, the personal skills of the dyslexic nursing student should be developed. Still, one more point discussed is that nursing students with dyslexia need support when it comes to “disclosing their disability to staff in placement areas” (Child & Langhorn 2011). Lastly, it is also stated that nursing students with dyslexia will be given more time to get used to placement routines. After the discussion, one finds a more or less practical conclusion. The conclusion is not comprehensive but it is rather complete. The conclusion section rather briefly summarizes the findings and discussion and offers certain insights deduced from the results of the study. One of these is that it is indeed true that nursing students with dyslexia are having problems with clinical practice. Moreover, one solution to this and one that could benefit both dyslexic and non-dyslexic nursing students would be “a range of tools and organisational methods” (Child & Langhorn 2011). This leads to the creation of a more “accessible learning environment,” and this requires the cooperation of three groups of people: “academic establishments, clinical placement staff, and students” (Child & Langhorn 2011). The study was indeed true to its vision that nursing students with dyslexia should be helped. After all, the Equality Act of 2010 provides that “students with disabilities are not treated less favourably” (Child & Langhorn 2011). Moreover, it is believed in the medical professional world that dyslexia should not be a reason for one not to decide to go into the nursing profession (Dyslexia and nursing school: Can it work? 2011). Moreover, dyslexics have a talent in visuospatial processing (Taylor & Walter 2003). Also, dyslexics may be intuitive and insightful, and have the ability to think multidimensionally and are highly aware of their own environment (Sanderson-Mann & McCandless 2006). These arguments in favor of dyslexics in the nursing profession are all coming from three sources: a website article at Online Education.net entitled “Dyslexia and nursing school: Can it work?”; an article in the 2003 issue of the journal Dyslexia entitled “Occupation choices of adults with and without symptoms of dyslexia” and authored by Taylor and Walter; and an article in the 2006 issue of Nurse Education in Practice, which is entitled “Understanding dyslexia and nurse education in the clinical setting,” and authored and argued by Sanderson-Mann and McCandless. The choice of dyslexics for their career is also nursing or sales (Taylor & Walter 2003). Another reason is that some agencies like Access to Work can help out and provide financial assistance to the training of a dyslexic student before he goes to work (Dyslexia is no barrier to a career in nursing, 2012). Also, the Disability Discrimination Act gives dyslexic students a right to “reasonable adjustments” in the learning institution as well as in the workplace (Supporting Dyslexic Students on Practice Placements 2012). Another reason is that various agencies are working hand in hand to assist dyslexics live normal lives (Tee et al. 2010). There are indeed several reasons to help nursing students with dyslexia. These arguments in favor of dyslexic nursing patients as there is plenty of support for these students are the findings of two website articles: “Dyslexia is no barrier to a career in nursing,” published by Nursing Standard in 2012; and “Supporting Dyslexic Students on Practice Placements,” published by the University of Southampton in 2012. Besides these sources, two journal articles support the idea that dyslexic nursing students can be successful in their career through different support groups. These articles include that of Tee et al., published in the 2010 issue of Nurse Education in Practice and entitled “Being reasonable: Supporting disabled nursing students in practice”; and that of Taylor and Walter, entitled “Occupation choices of adults with and without symptoms of dyslexia,” and published in the 2003 issue of Dyslexia. However, if the study were to be improved, then it has to attempt to challenge even the Equality Act of 2010 but not in a way as to encourage violation of the law but to make very helpful recommendations to nursing students with dyslexia when it comes to career choices. The Equality Act of 2010 is all about how treatment should be given to both people with disabilities and those without, but it does not state that these two groups of people are supposed to have the same choices of career. In short, the Equality Act is only about equality of treatment but not about equality of career choices. Some points that the study should have considered would be the fact that even an honest diagnosis of dyslexia would lead to prejudice and such prejudice is very hard to remedy (Morris & Turnbull 2006). The student will therefore most likely still suffer from ridicule despite all the measures carried out to help him or her. Another thing is that there is no legal requirement to disclose any diagnosis of dyslexia on the part of the nursing student, thus as long as people have a right to their own privacy, then there is no telling them what to do and many of them would continue to hide their dyslexia (Morris & Turnbull 2007). Moreover, “Not all students with dyslexia have the same pattern of strengths and difficulties,” thus making it difficult to establish a uniform system of diagnosis and treatment for them (Nursing and Dyslexia, 2012). These arguments against dyslexics taking up nursing as a career are based on the opinions and findings of Morris and Turnbull in their article entitled “The disclosure of dyslexian in clinical practice: Experiences of student nurses in the United Kingdom,” which is published in a 2006 version of Nurse Education Today. Another article that argues against nursing as the career choice of dyslexic students is the article entitled “Nursing and Dyslexia,” published by SCIPS in 2012. Other possible problems with dyslexic students would be difficulty using patient notes as well as care plans (McCandless-Sugg et al. 2006), the general danger to the patient’s safety (Price & Gale 2006), the lack of tolerance of non-dyslexic to possible changes in the environment (Shellenbarger 1993), and difficulties in administering drugs (White 2007). Other problems include the following: The dyslexic may not even perceive themselves as disabled or needing care (Dale & Aiken 2007); the dyslexic is usually creative and visual and may therefore tend to modify standard instructions (Supporting Students with Dyslexia 2012); and most of all, as stated by the British Dyslexia Association, dyslexia affects one’s “literacy, numeracy, phonological processing, short-term memory and hand-eye coordination,” which are the most essential skills that every good medical professional should have (Ridley 2011). The arguments above, which are against dyslexics taking up nursing and emphasizing the defects of dyslexics that may affect their work, were advanced by six articles authored by a number of researchers. These authors who argued on the previously mentioned point include McCandless-Sugg in “DysPEL: Dyslexia and Practice Environment Learning in Nursing”; Price and Gale in “How Do Dyslexic Nursing Students Cope with Clinical Practice Placements? The Impact of the Dyslexic Profile on the Clinical Practice of Nursing Students: Pedagogical Issues and Considerations”; Shellenbarger in “Helping the dyslexic nursing student”; White in the article “Supporting nursing students with dyslexia in clinical practice”; Dale and Aiken in article entitled “A Review of the Literature into Dyslexia in Nursing Practice”; and Ridley in the article entitled “The Experiences of Nursing Students with Dyslexia.” Dyslexics also have the following disadvantages: a relatively slow way of doing simple things (Crouch 2009), inability to do multi-tasking as well as remembering details of phone calls (Fisher 2012), a tendency not to be able to handle stress (Stainer & Ware 2006), and the fact that the employer or superior during clinical practice should be the one to make the necessary adjustments in the difficulty of the dyslexic student’s work, which is not easy at all (Dyslexia, dyspraxia and dyscalcula 2012). Besides, in the classroom, there is no way that educational standards should be lowered just to accommodate dyslexic and other disabled students (Taylor 2012). These other arguments against the nursing career as the choice of dyslexics have been argued by the following people: Crouch in his article “Needs, Experiences and Support for Nursing and Midwifery Students with Dyslexia in Clinical Practice”; Fisher in his article “Advice for students with Dyslexia: During Their Clinical Placement”; Stainer and Ware in their article entitled “Guidelines to Support Nursing Learners with Dyslexia in Practice”; and Taylor in his recent article “Supporting Students with Dyslexia in Clinical Practice.” The study by Child and Langhorn was supported by studies and articles that argue in favor of dyslexic people taking up a career in nursing. However, the findings of Child and Langhorn are opposed by other authors who believe that dyslexic people are at a greater disadvantage if they were to take up careers in nursing. REFERENCES Child, J. & Langhorn, E. (2011). Exploring the learning experiences of nursing students with dyslexia. Nursing Standard 25 (40), 39-46. Crouch, A. (2009). “Needs, Experiences and Support for Nursing and Midwifery Students with Dyslexia in Clinical Practice.” The University of Northampton, viewed 21 Jan 2012, Dale, C. & Aiken, F. (2007). “A Review of the Literature into Dyslexia in Nursing Practice.” Royal College of Nursing, viewed 20 Jan 2012, “Dyslexia and nursing school: Can it work?” (2012). Online Education, viewed 20 Jan 2012, “Dyslexia is no barrier to a career in nursing.” (2012). Nursing Standard, viewed 20 Jan 2012, “Dyslexia Questionnaire.” (2012). Liverpool John Moores University, viewed 20 Jan 2012, “Dyslexia, dyspraxia and dyscalcula: a toolkit for nursing staff.” (2012). Royal College of Nursing, viewed 20 Jan 2012, Fisher, L. (2012). “Advice for Students with Dyslexia: During Their Clinical Placement.” Council of Deans of Health, viewed 21 Jan 2012, Johansson, K., Ekebergh, M. & Dahlberg, K. (2008). A lifeworld phenomenological study of the experience of falling ill with diabetes. International Journal of Nursing Studies, doi:10.1016/j.ijnurstu.2008.09.001. McCandless-Sugg, F. & Sanderson-Mann, J. & Wharrad, H. (2006). “DysPEL: Dyslexia and Practice Environment Learning in Nursing.” The University of Nottingham, viewed 20 Jan 2012, Morris, D. & Turnbull, P. (2006). Clinical experiences of students with dyslexia. Journal of Advanced Nursing 54 (2), 238-247. Morris, D. K. & Turnbull, P. A. (2006). The disclosure of dyslexia in clinical practice: Experiences of student nurses in the United Kingdom. Nurse Education Today 27 (1), 35-42. “Nursing and Dyslexia.” (2012). SCIPS, viewed 20 Jan 2012, Price, G. A. & Gale, A. (2006). How Do Dyslexic Nursing Students Cope with Clinical Practice Placements? The Impact of the Dyslexic Profile on the Clinical Practice of Dyslexic Nursing Students: Pedagogical Issues and Considerations. Learning Disabilities: A Contemporary Journal 4 (1), 19-36. Ridley, C. (2011). The Experiences of Nursing Students with Dyslexia. Nursing Standard 25, 35-42. Sanderson-Mann, J. & McCandless, F. (2006). Understanding dyslexia and nurse education in the clinical setting. Nurse Education in Practice 6, 127-133. Shellenbarger, T. (1993). Helping the dyslexic nursing student. Nursing Education 18 (6), 10-13. Stainer, L. & Ware, P. (2006). “Guidelines to Support Nursing Learners with Dyslexia in Practice.” Association of Dyslexia Specialists in Higher Education, viewed 20 Jan 2012, “Supporting Dyslexic Students on Practice Placements.” (2012). University of Southampton, viewed 20 Jan 2012, “Supporting Students with Dyslexia.” (2012). Birmingham City University, viewed 20 Jan 2012, Taylor, K. E. & Walter, J. (2003). Occupation choices of adults with and without symptoms of dyslexia. Dyslexia 9 (3), 177-185. Taylor, S. (2012). “Supporting Students with Dyslexia in Clinical Practice.” School of Nursing and Midwifery, viewed 22 Jan 2012, Powerpoint Presentation. Tee, S. R., Owens, K., Plowright, S. & Ramnath, P. (2010). Being reasonable: Supporting disabled nursing students in practice. Nurse Education in Practice 10, 216-221. White, J. (2007). Supporting nursing students with dyslexia in clinical practice. Nursing Standard 21 (19), 35-42. Read More