Diverse Discipline Theory Derivation
and
Application to Nurse Educator Role
Carla Boomershine Sandra Kommit
Emily McIntire Tamara Mohr
Introduction to Theory
• Theory is as important to nursing as oxygen is to
life!
• Describes nursing phenomena
• Guides nursing practice
• Facilitates nursing research
• Nursing incorporates theories from other disciplines
when needed
• Nursing Student Success incorporates selftranscendence, self-efficacy, and communities of
practice
Retention of Knowledge
• Ensures students are able to complete nursing
coursework
• Important for passing licensure exams
• Makes competent, successful, safe nurses
• Critical in nursing shortage
• Roberta Spohn statement still true today:
– “Although there are recurring reports of manpower shortages in many
other professional fields, nursing seems to enjoy the dubious distinction
of continually suffering from this condition” (Spohn, 1954, p. 865).
If the nurse educator fails to provide and
implement successful teaching strategies, the
student nurse will not retain necessary
knowledge to succeed, and the threatening
nursing shortage will continue to rise.
Lecture is sooo boring…. I can’t stay awake!
Barriers to Learning
– Cognitive style / cognitive
processing needs of
nursing students
– Diversity / demographics –
student age, race, culture,
etc.
– Must ensure above
average competency in first
medical-surgical class
(diversity in student
progress and implications
of such)
-
Must consider the diversity of
student progress and
underlying implications
-
Identifying at-risk students and
recognizing barriers =
nursing student success.
Problems Encountered When
Ensuring Success
• Time Constraints
- extreme amount of content covered in nursing
curricula means no time for self evaluation or
debriefing
• Financial Constraints
- simulation activities are costly
• Nurse Educator Shortage
- demand for nursing students = demand for
competent academic nurse educators
Non-Nursing Theory #1
Self-Efficacy
(Bandura, 1997)
Evaluation Grid
Theory
Concepts
Non-Nursing
Theory #1
1.
2.
Self-Efficacy
(Bandura, 1997)
3.
Vicarious
experience –
performance of a
task
Social
persuasion –
Encouraging
words from an
authority figure
who knows how to
complete the task
Physiological
feedback –
Understanding
what an
individual’s body is
experiencing, such
as fatigue and
tension
Strengths
Weaknesses
Application to
Educator Role
Evaluation Grid
Theory
Concepts
Strengths
Non-Nursing
Theory #1
1.
1. Watching others
complete the task is
important to gain
confidence; abilities
can improve by
performing the task
with an expert who
gives
encouragement,
helping to gain
assurance and
motivation
2. Once the task is
performed
successfully
confidence will
increase
3. Interpreting personal
physical condition –
need to recognize
body signals of
stress
4. 3 principles work
together to build
self-confidence
2.
Self-Efficacy
(Bandura, 1997)
3.
Vicarious
experience –
performance of a
task
Social persuasion
– Encouraging
words from an
authority figure
who knows how to
complete the task
Physiological
feedback –
Understanding
what an
individual’s body is
experiencing, such
as fatigue and
tension
Weaknesses
Application to
Educator Role
Evaluation Grid
Theory
Concepts
Strengths
Weaknesses
Non-Nursing
Theory #1
1.
1. Watching others
complete the task is
important to gain
confidence; abilities
can improve by
performing the task
with an expert who
gives
encouragement,
helping to gain
assurance and
motivation
2. Once the task is
performed
successfully
confidence will
increase
3. Interpreting
personal physical
condition – need to
recognize body
signals of stress
4. 3 principles work
together to build
self-confidence
Building confidence
may help the person
learn how to complete a
task but it does not
guarantee they will
continue to complete
the task or retain
confidence
2.
Self-Efficacy
(Bandura, 1997)
3.
Vicarious
experience –
performance of a
task
Social
persuasion –
Encouraging
words from an
authority figure
who knows how to
complete the task
Physiological
feedback –
Understanding
what an
individual’s body
is experiencing,
such as fatigue
and tension
Application to
Educator Role
Evaluation Grid
Theory
Concepts
Strengths
Weaknesses
Application to
Educator Role
Non-Nursing
Theory #1
1.
1. Watching others
complete the task is
important to gain
confidence; abilities
can improve by
performing the task
with an expert who
gives
encouragement,
helping to gain
assurance and
motivation.
2. Once the task is
performed
successfully
confidence will
increase
3. Interpreting personal
physical condition –
need to recognize
body signals of
stress
4. 3 principles work
together to build
self-confidence
Building confidence
may help the person
learn how to complete a
task but it does not
guarantee they will
continue to complete the
task or retain confidence
1. Can be used in
nursing education to
assist students in
finding confidence
while learning in a
healthcare
environment that
can be intimidating
2. Helping the student
to interpret the
physiological
conditions while in
nursing school
would be a great
benefit
3. The use of
physiological
feedback,
observation, verbal
encouragement ,
and first time
success can be
powerful tools for the
nursing educator
2.
Self-Efficacy
(Bandura, 1997)
3.
Vicarious
experience –
performance of a
task
Social
persuasion –
Encouraging
words from an
authority figure
who knows how to
complete the task
Physiological
feedback –
Understanding
what an
individual’s body is
experiencing, such
as fatigue and
tension
Non-Nursing Theory #2
Communities of Practice
(Lave & Wenger, 1991)
Evaluation Grid
Theory
Concepts
Non-Nursing
Theory #2
1.
Communities of
Practice
(Lave & Wenger, 1991)
2.
3.
Domain – shared
area of interest;
commitment and
shared
competence; more
than just a network
of people or club of
friends
Community –
members engage in
joint activities and
discussions; help
each other and
share information;
relationships and
trust built through
these interactions
Practice –
members are
practitioners;
develop a shared
repertoire of
resources (stories,
experiences, tools,
etc.); involves time
and sustained
interaction
Strengths
Weaknesses
Application to
Educator Role
Evaluation Grid
Theory
Concepts
Non-Nursing
Theory #2
1.
Communities of
Practice
(Lave & Wenger, 1991)
2.
3.
Domain – shared
area of interest;
commitment and
shared
competence; more
than just a network
of people or club of
friends
Community –
members engage in
joint activities and
discussions; help
each other and
share information;
relationships and
trust built through
these interactions
Practice –
members are
practitioners;
develop a shared
repertoire of
resources (stories,
experiences, tools,
etc.); involves time
and sustained
interaction
Strengths
1.
2.
3.
4.
5.
Communities of practice
are everywhere; people
can be involved in
several of them; they
can change over the
course of a lifetime
People can be core or
peripheral members;
peripheral members
may become motivated
to become more active
and central to the
community
Learning can be
unintentional when
involved in communities;
students may be
motivated to hone skills
to become more like
members they admire
Build relationships and
foster trust over a period
of time
Give rise to the ability to
take on larger/more
complex tasks through
cooperation
Weaknesses
Application to
Educator Role
Evaluation Grid
Theory
Concepts
Non-Nursing
Theory #2
1.
Communities of
Practice
(Lave & Wenger, 1991)
2.
3.
Domain – shared
area of interest;
commitment and
shared
competence; more
than just a network
of people or club of
friends
Community –
members engage
in joint activities
and discussions;
help each other
and share
information;
relationships and
trust built through
these interactions
Practice –
members are
practitioners;
develop a shared
repertoire of
resources (stories,
experiences, tools,
etc.); involves time
and sustained
interaction
Strengths
Weaknesses
1.
1.
2.
3.
4.
5.
Communities of
practice are
everywhere; people can
be involved in several
of them; they can
change over the course
of a lifetime
People can be core or
peripheral members;
peripheral members
may become motivated
to become more active
and central to the
community
Learning can be
unintentional when
involved in
communities; students
may be motivated to
hone skills to become
more like members
they admire
Build relationships and
foster trust over a
period of time
Give rise to the ability
to take on larger/more
complex tasks through
cooperation
2.
Some communities
of practice may be
weak or have
power imbalances
which may inhibit
new member entry
and participation
It may be difficult
for some members
to find time to
devote themselves
to a community of
practice
Application to
Educator Role
Evaluation Grid
Theory
Concepts
Non-Nursing
Theory #2
1.
Communities of
Practice
(Lave & Wenger, 1991)
2.
3.
Domain – shared
area of interest;
commitment and
shared
competence; more
than just a network
of people or club of
friends
Community –
members engage
in joint activities
and discussions;
help each other
and share
information;
relationships and
trust built through
these interactions
Practice –
members are
practitioners;
develop a shared
repertoire of
resources (stories,
experiences, tools,
etc.); involves time
and sustained
interaction
Strengths
Weaknesses
Application to
Educator Role
1.
1.
1. Nursing students
become their own
communities of
practice due to
shared interest in
nursing education
2. Students learn from
each other when
involved in
communities of
practice
3. Students farther
along in nursing
program can mentor
and act as role
models for newer
students
4. Communities of
practice provide
support for members,
which is critical in
nursing school
2.
3.
4.
5.
Communities of
practice are
everywhere; people can
be involved in several
of them; they can
change over the course
of a lifetime
People can be core or
peripheral members;
peripheral members
may become motivated
to become more active
and central to the
community
Learning can be
unintentional when
involved in
communities; students
may be motivated to
hone skills to become
more like members
they admire
Build relationships and
foster trust over a
period of time
Give rise to the ability
to take on larger/more
complex tasks through
cooperation
2.
Some communities
of practice may be
weak or have
power imbalances
which may inhibit
new member entry
and participation
It may be difficult
for some members
to find time to
devote themselves
to a community of
practice
Nursing Theory
Self-Transcendence
(Reed, 1991)
Evaluation Grid
Theory
Concepts
Nursing
Theory
1.
SelfTranscendence
Theory
2.
(Reed, 1991)
3.
4.
5.
Self-Transcendence
– human capacity to
expand one’s
boundaries intrapersonally, extrapersonally, temporally,
or trans-personally
Well-being –
personally defined
sense of wholeness
and health
Vulnerability – sense
of personal mortality
in response to
significant life events
and challenges
Moderating /
Mediating Factors –
variables that can
positively or
negatively influence
self-transcendence
Points of
intervention –
external actions which
can potentiate inner
resources or external
factors
Strengths
Weaknesses
Application to
Educator Role
Evaluation Grid
Theory
Concepts
Strengths
Nursing
Theory
1.
1.
SelfTranscendence
Theory
2.
(Reed, 1991)
3.
4.
5.
Self-Transcendence
– human capacity to
expand one’s
boundaries intrapersonally, extrapersonally, temporally,
or trans-personally
Well-being –
personally defined
sense of wholeness
and health
Vulnerability – sense
of personal mortality in
response to significant
life events and
challenges
Moderating /
Mediating Factors –
variables that can
positively or negatively
influence selftranscendence
Points of
intervention –
external actions which
can potentiate inner
resources or external
factors
2.
3.
4.
Simple, clear,
logical, and
comprehensive
with easily
understood
concepts facilitate
understanding of
the human
capacity to
overcome
adversity
Acknowledges
the multidimensional
nature of humans
Well validated in
a variety of
interest groups
and settings
Encourages selfreflection and
self-awareness
Weaknesses
Application to
Educator Role
Evaluation Grid
Theory
Concepts
Strengths
Weaknesses
Nursing
Theory
1.
1.
1.
SelfTranscendence
Theory
2.
(Reed, 1991)
3.
4.
5.
Self-Transcendence
– human capacity to
expand one’s
boundaries intrapersonally, extrapersonally, temporally,
or trans-personally
Well-being –
personally defined
sense of wholeness
and health
Vulnerability – sense
of personal mortality
in response to
significant life events
and challenges
Moderating /
Mediating Factors –
variables that can
positively or
negatively influence
self-transcendence
Points of
intervention –
external actions which
can potentiate inner
resources or external
factors
2.
3.
4.
Simple, clear,
logical, and
comprehensive
with easily
understood
concepts
facilitate
understanding of
the human
capacity to
overcome
adversity
Acknowledges
the multidimensional
nature of humans
Well validated in
a variety of
interest groups
and settings
Encourages selfreflection and
self-awareness
2.
Relies on the ability
of the individual to
recognize and
express
vulnerability and
needs
Spiritual nature of
the theory may be
misunderstood or
misinterpreted
Application to
Educator Role
Evaluation Grid
Theory
Concepts
Strengths
Weaknesses
Application to
Educator Role
Nursing
Theory
1.
1.
1.
1. Broad interpretation of
concepts triggering
vulnerability makes it
useful in creating an
interventional
framework to support
students in meeting
educational challenges
by the following:
SelfTranscendence
Theory
2.
(Reed, 1991)
3.
4.
5.
Self-Transcendence
– human capacity to
expand one’s
boundaries intrapersonally, extrapersonally,
temporally, or transpersonally
Well-being –
personally defined
sense of wholeness
and health
Vulnerability – sense
of personal mortality
in response to
significant life events
and challenges
Moderating /
Mediating Factors –
variables that can
positively or
negatively influence
self-transcendence
Points of
intervention –
external actions which
can potentiate inner
resources or external
factors
2.
3.
4.
Simple, clear,
logical, and
comprehensive
with easily
understood
concepts
facilitate
understanding of
the human
capacity to
overcome
adversity
Acknowledges
the multidimensional
nature of humans
Well validated in
a variety of
interest groups
and settings
Encourages selfreflection and
self-awareness
2.
Relies on the ability
of the individual to
recognize and
express
vulnerability and
needs
Spiritual nature of
the theory may be
misunderstood or
misinterpreted
A. Identification of
intervention points
B. Identification of
mediating factors for
supporting student
success
C. Recognition of
importance of social
support in achieving
success
D. Reinforcement of selfefficacy concepts
Putting It All Together
Compiled Evaluation Grid
Diverse Theory
Theory
Concepts
Strengths
Weaknesses
Application To
Educator Role
Non Nursing Theory #1
Self-Efficacy
(Bandura, 1997)
Main Concepts:
Vicarious experience
Social persuasion
Physiological feedback
1. Abilities can improve by performing the task
with an expert for increased confidence.
2. Self-awareness of our own physical
condition and stress levels.
3. Three principles work together to build a
higher level of self-confidence or self-efficacy
1. Building confidence may help the person
learn how to complete a task but it does not
mean they will continue to complete the task or
retain the confidence.
1. This theory could be used in nursing
education to assist students in finding
confidence while learning in a health care
environment that can be so intimidating.
2. Helping the student to interpret the
physiological conditions while in nursing
school would be a great benefit.
3. The use of physiological feedback,
observation, verbal encouragement, and first
time success can be powerful tools for the
nursing educator.
Non Nursing Theory #2
Communities of Practice
(Lave & Wenger, 1991)
Main Concepts:
Communities of Practice:
Domain
Community
Practice
1. Communities of practice…
…are everywhere;
… build relationships and foster trust over time
…give rise to the ability to take on increasingly
complex projects
2. Members can be core or peripheral
3. Learning can be unintentional
1. Some communities of practice may be
weak, or have power imbalances which may
inhibit new member entry and participation.
2. It may be difficult for some members to find
time to devote themselves to a community of
practice.
1. Nursing students become their own
communities of practice
2. Students learn from each other when
involved in their communities of practice as
mentors and ole models
3. Communities of practice provide support for
members, which is important in nursing school.
Nursing Theory
Self-Transcendence
(Reed, 1991)
Main Concepts:
Self-Transcendence
Well-Being
Vulnerability
Secondary Concepts:
Moderating/Mediating Factors
Points of Intervention
1. Simple, clear, logical, well validated , and
comprehensive with easily understood
concepts facilitate understanding of the human
capacity to overcome adversity
2. acknowledges the multidimensional nature
of humans
3. encourages self-reflection and selfawareness
1. Relies on the ability of the individual to
recognize and express vulnerability and needs
2. Spiritual nature of the theory may be
misunderstood or misinterpreted
1. Concepts useful in creating an
interventional framework to support students in
meeting educational challenges by:
-identification of intervention points
- identification of mediating factors for
supporting student success
-recognition of importance of social support in
achieving success
- reinforcement of self-efficacy concepts
Compiled Concepts Related to Nursing Education Role: Nursing students create their own community of practice through their shared interest in nursing education as they learn from each other, act as role
models, mentor, and support each other through the nursing educational experience. Self-awareness of physiological feedback, combined with observation, verbal encouragement, and first time success can be
powerful tools for both the nursing student and nursing educators, especially when used within the context of nursing education to assist students in finding confidence while learning in a health care environment that
can be so intimidating. Finally, recognition of vulnerability triggers, intervention points, and mediating factors that encourage student success facilitate the creation of an interventional framework that allows students
to transcend educational challenges.
Synthesis of Concepts
• Self-transcendence, self-efficacy, and
communities of practice combine to support
nursing student success
• Communities of Practice Theory:
–
–
–
–
Support groups
Mutual interest in nursing
Help decrease attrition rates (Rouse & Rooda, 2010)
Foster trust, motivation, and additional learning
Synthesis of Concepts
• Self-efficacy Theory:
– Social persuasion by encouraging peers with words and
providing means for successful outcomes
– Student gains confidence with watching, then doing, a skill
– Students interprets physiological symptoms related to
stress
• Self-transcendence Theory:
– Offers students explanation of vulnerability felt in nursing
school
– Helps find ways of coping and dealing with nursing school
stress
– Realizes the need for social support and emphasizes selfefficacy
Nursing students create their own communities of practice
through shared interest in nursing education, learning from
each other, acting as role models, mentoring, and supporting
each other. Self-awareness of physiological feedback,
combined with observation, verbal encouragement, and first
time success are powerful tools for both nursing students
and nurse educators.
Recognition of vulnerability triggers, intervention points, and
mediating factors that encourage student success facilitate
the creation of an interventional framework that allows
students to transcend educational challenges.
These three theories are excellent when used together
in nursing education. Research has shown that attrition
rates decrease when students find support in
challenging situations (Rouse & Rooda, 2010).
Combining these theories into one provides a way in
which nurse educators can foster self-confidence, trust,
motivation and additional learning in their students.
These traits provide the basis for nursing
student success.
References
References
Bandura, A. (1997). Insights, self-efficacy. Harvard Mental Health Letter, 3(4), 4-6.
Chinn, P. L., & Kramer, M. K. (2008). Integrated theory and knowledge development in nursing
(7th ed.) St. Louis, MO: Mosby Elsevier
Coward, D. D. (2010). Pamela G. Reed: Self-transcendence theory. In: M. R. Alligood & A. M.
Tomey (Eds.), Nursing Theorists and Their Works (7th ed., pp. 618-637). Maryland Heights,
MO: Mosby Elsevier
Communities of Practice (Lave and Wenger) (n.d.) Learning-Theories.com. Retrieved from
http://www.learning-theories.com/communities-of-practice-lave-and-wenger.html#more-36
Jeffreys, M. (2007). Tracking students through program entry, progression, graduation, and
licensure: Assessing undergraduate nursing student retention and success. Nurse
Educator Today, 27(5), 406-419.
Noble, K., Miller, S., & Heckman, J. (2008). The cognitive style of nursing students: Educational
implications for teaching and learning. Journal of Nursing Education, 47(6), 245-253.
Peterson, S. J., & Bredow, T. S. (2009). Middle range theories: Application to nursing research
(2nd ed.). St. Paul, MN: Wolters Kluwer / Lippincott Williams & Wilkins
References
Reed, P. G. (2008). Theory of self-transcendence. In: M. J. Smith & P. R. Liehr (Eds.), Middle
range theory for nursing (2nd ed., pp. 105-129). New York: Springer Publishing
Reed, P. G. (1991). Toward a nursing theory of self-transcendence: Deductive reformulation
using developmental theories. Advances in Nursing Science, 13(4), 64-77
Rouse, S. & Rooda, L. (2010). Factors for attrition in an accelerated baccalaureate nursing
program. Journal of Nursing Education, 49(6), 359-362. doi:10.3928/0148483420100217005
Schoening, A. M. (2009). The journey from bedside to classroom: Making the transition from
nurse to nurse educator. Retrieved from
http://http://digitalcommons.unl.edu/cgi/viewcontent.cgi?article=1006&context=cehsedaddis
s
Smith, M. K. (2009). Communities of practice: The encyclopedia of informal education.
Retrieved from http://www.infed.org/biblio/communities_of_practice.htm
Spohn, R. R. (1954). Some facts about the nursing shortage. American Journal of Nursing,
54(7), 865-867.
Wenger, E. (2006). Communities of practice: A brief introduction. Retrieved from
www.vpit.alberta.ca/cop/doc/wenger.doc
The End!