SPATIALITY AND THE LIVES OF
NURSING STUDENTS
Peter Gray
Thesis
Submitted in fulfilment
of the requirements for the degree of Ph.D
University of Stirling
June 2004
University of Stirling
Peter Gray
Institute of Education
Abstract of thesis entitled
Spatiality and the Lives of Nursing Students
Submitted for the degree of Doctor of Philosophy
June 18th, 2004
This study is an exploration of spatiality and its meaning. It focuses primarily on the experience
of nursing students at two Scottish sites, but draws wider conclusions about spatiality from this
data. Although the experience of nursing students has been researched in other studies, this is the
first study which addresses this experience through the concept of spatiality, which integrates the
student experience across different aspects of the life-world.
Its theoretical framework is based in phenomenology and in particular the work of Heidegger, but
also uses more recent insights from social geography and elsewhere. The philosophy of
embodied realism developed by Lakoff & Johnson (1999) is used to argue that embodiment is
central to any consideration of spatiality. It is suggested that a framework based on the
interlocking concepts of proximity, mobility and possession provides a comprehensive analytical
tool for investigating spatiality within discourse.
The study involved semi-structured interviews with nursing students across the two sites. These
revealed a diverse range of spatial issues relevant to their academic education and practical
training as nurses. The topics addressed include the experience of placements, self-directed
learning, essay writing and the spatiality of libraries and lecture theatres.
The results of the study suggest that consideration of spatiality should be a more prominent
feature of educational discourse generally and the discourse of nurse education in particular. It
has been neglected in the past because of its transparency and closeness to everyday life, but as
with other forms of difference, it has hidden effects. Given the prominence of nurse recruitment
and nurse education as issues in healthcare policy, the study provides evidence that the student
experience in this area could be improved by a greater awareness of spatial issues.
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Table of Contents
List of figures ........................................................................................................................... vii
Abbreviations used .................................................................................................................. vii
Chapter 1-Introduction ...................................................................................................... 1
A study about the meaning and experience of space? .............................................................2
The theoretical framework ........................................................................................................6
Proximity .....................................................................................................................................9
Mobility .....................................................................................................................................10
Possession ..................................................................................................................................10
The research frame...................................................................................................................11
The research question(s) – asking the impossible? ................................................................14
Background to the present study ............................................................................................16
Summary: the story so far .......................................................................................................18
Outline of the thesis ..................................................................................................................19
Chapter 2-Proximity, Mobility, Possession ..................................................................... 22
Introduction ..............................................................................................................................23
Embodiment ..............................................................................................................................29
The body-in-the-world .............................................................................................................31
Proximity – a sense of (dis)stance?..........................................................................................34
Mobility .....................................................................................................................................39
Possession ..................................................................................................................................42
Summary ...................................................................................................................................52
Chapter 3-Methodology ................................................................................................... 53
Introduction ..............................................................................................................................54
The research and the researcher: In search of the lost world? ............................................55
The Theoretical perspective.....................................................................................................65
Methodology..............................................................................................................................74
Summary ...................................................................................................................................76
Chapter 4-Method ............................................................................................................ 77
Introduction ..............................................................................................................................78
Interviews and other stories ....................................................................................................82
A tale of two sites ......................................................................................................................84
Data analysis – the method ......................................................................................................89
Principles of the analysis ..........................................................................................................93
iv
Summary ...................................................................................................................................95
Chapter 5-Nurse education .............................................................................................. 96
Introduction ..............................................................................................................................97
The historical background of nurse education ......................................................................98
Nursing – back to the future? ................................................................................................100
The nursing literature and Project 2000 ..............................................................................103
Project 2000: the critical literature .......................................................................................106
The nature(s) of nursing ........................................................................................................109
Space for nursing: conspicuous by its absence? ..................................................................115
Summary .................................................................................................................................119
Chapter 6-Into the data .................................................................................................. 120
Introduction ............................................................................................................................121
Is there a world outside nursing? ..........................................................................................125
Knowledge and the world of nursing ....................................................................................129
The Journey as space in its own right ...................................................................................142
Summary .................................................................................................................................145
Chapter 7-Contested spaces ........................................................................................... 146
Introduction ............................................................................................................................147
Home is where the photocopies are? .....................................................................................147
The heterotopic library .........................................................................................................154
Computer labs: programmed to self-instruct? ....................................................................158
Lectures and seminars: sitting in the same seat?.................................................................160
Chapter 8-Placements .................................................................................................... 170
Introduction ............................................................................................................................171
The Placement and proximity ...............................................................................................171
Disappointments and rearrangements..................................................................................174
Summary .................................................................................................................................185
Chapter 9-Spatial metaphors in nurse education ......................................................... 187
Self-directed–learning: journey without a pause? ...............................................................188
The essay – bringing it all back home? .................................................................................196
Summary .................................................................................................................................206
Chapter 10-Conclusions ................................................................................................ 208
Proximity, Mobility and Possession ......................................................................................211
Does the study answer its research questions? ....................................................................219
v
Spatiality in the context of nurse education: How does spatiality affect the lives of nursing
students? ..................................................................................................................................222
Concluding the conclusions: as closure beckons, another spatial metaphor appears. .....228
References ...................................................................................................................... 231
Appendix One: List of nursing student identities ......................................................... 245
Appendix Two: Map of Campus locations .................................................................... 246
Appendix Three: Interview schedule ............................................................................. 248
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List of figures
Figure 1: the research questions .............................................................................................. 14
Figure 2: the research questions again .................................................................................... 72
Figure 3: themes and occurrences............................................................................................ 91
Figure 4: Thematic headings and issues arising in data ........................................................ 92
Figure 5: The Essay-writing process as a journey ................................................................ 201
Figure 6: The PMP Framework and types of space ............................................................. 212
Figure 7: The Research Questions revisited.......................................................................... 219
Figure 8: The complex future of healthcare – the paradoxes .............................................. 226
Abbreviations used
B&B ............................................................................................................................... Bed and Breakfast
CFP ...................................................................................................... Common Foundation Programme
COSLA ..................................................................................... Convention of Scottish Local Authorities
DIY......................................................................................................................................... Do It Yourself
DoH ........................................................................................................................... Department of Health
DRC ............................................................................................................. Disability Rights Commission
HC ...........................................................................................Highland Campus, (University of Stirling)
HE ....................................................................................................................................Higher Education
PMP .......................................................................................................... Proximity, Mobility, Possession
ICT ................................................................................. Information and Communication Technologies
RCN .....................................................................................................................Royal College of Nursing
SC ................................................................................................ Stirling Campus (University of Stirling)
UKCC .................................................... United Kingdom Central Council for Nursing and Midwifery
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Acknowledgements
This thesis would not have been possible without the help of many people at the University of
Stirling and elsewhere. I would first like to thank the research participants from the Department
of Nursing and Midwifery who generously came forward to answer my questions and whose
contributions enrich and enliven the academic discussion. Secondly, the initial encouragement to
undertake the project came from Kate Sankey and Professor Mike Osborne at the University of
Stirling, and Professor Renate Holub at the University of California, Berkeley. They had more
confidence that the study would succeed than I did. The project was funded by the University of
Stirling and the ESRC, and I am grateful to staff at both institutions for making it possible.
Several supervisors have been involved with the production of this thesis, but Brenda MorganKlein has been there from the beginning and has endured many diversions and excuses with great
personal warmth and insight Professors Jon Nixon and Peter Cope were involved at earlier
stages, whilst Professor Richard Edwards undertook the difficult task of persuading me to finish
the project with the right balance of disciplinary power and ironic wit. Professor Nick Boreham
provided valuable support and encouragement in the later stages.
Discussions with many other colleagues and postgraduates made the process less painful, but I
would especially mention Greg Mannion, Elizabeth Ezra, Liz Davies and Kim Tole.
Finally, and most importantly, I wish to thank my partner Jane for putting up with my spatial
disruptions and disappearances over many years.
Funded under ESRC Studentship no. ROO429934171
(Note: styled in accordance with Oxford Style Manual: Ritter 2003)
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Chapter 1-Introduction
1
‘Come here’
Baley squirmed a bit, but did as he was told. There was something indecent about the
exposure of the privacy of a room to the outside world. Sometimes the Commissioner
carried his affectation of Medievalism to a rather foolish extreme.
( Isaac Asimov, The Caves of Steel)
A study about the meaning and experience of space?
‘SPACE’ is a term which is often used but which defies precise definition. Its very looseness is
what makes it useful and ubiquitous, but that same looseness conceals a topic of great complexity
and interest. This study is about the relationship between people, space and spaces, and the
expression of this relationship in the term ‘spatiality’. Its overall purpose is to show that
‘spatiality’ is a useful concept to use within social research. In this introduction, I outline my
reasons for undertaking the study, explain briefly why nurse education was chosen as a field for
the empirical investigation of spatiality, and outline its theoretical basis. At this stage I will not
attempt to provide evidence or authority for all the claims presented, but will outline the basic
argument and provide some background information.
Spatiality is a neglected topic for the paradoxical reason that space is too much a part of everyday
life, and too transparent, for it to have been systematically problematised. It becomes a problem
when, for example, access to some specific space is restricted, or when we do not have enough
’personal space’, but these problems are solved through coping practices, rather than by the
application of spatial theory. The experience of disability or agoraphobia, or the various
disorders of spatial perception, can, however, provide clues as to how our coping with space can
break down and cause our spatiality to be brought into question. The epigraph, from Isaac
Asimov’s science-fiction novel Caves of Steel (Asimov 1956), draws attention to the ways in
which spatiality is culturally mediated. The novel depicts a not-too-distant future, in which city
dwellers have become frightened of the very idea of open space, and are unable to conceive of
2
exposure to sunlight and wind as natural and desirable. Interestingly, whilst The Caves of Steel
is acute in its decoding of spatiality, and prescient in its technology (e.g. video-on-demand, swipe
cards), it completely fails to foresee any transformation whatsoever in gender relations. Thus,
the status of women in the year 2200 is depicted as very similar to their status in 1950’s New
York, illustrating the way in which such topics disappear by virtue of their transparency and
degree of embeddedness in culture at particular historical moments. This study attempts to go
beyond the everyday transparency of space and spatiality, and to suggest that experiences of
spatiality might be differentiated in the way that experiences of gender, identity or sexuality are
differentiated. Following Massey’s (1992: 80) assertion that ‘the social is inexorably also
spatial’, the spatial approach is the one employed here, but I wish to avoid reifying ‘spatiality’
into something with causal properties and quantitatively-measurable effects (Harré 1998). More
simply, and on a personal level, I wanted to know why going for a walk often helps with the
thinking process. Even this, as a masculine activity, is problematic, however, and I am aware
that there is extensive feminist critique of the ‘phallocentrism’ of spatiality (Irigaray 1987;
Deutsche 1991; Rose 1993; Best 1995; Rose 1995)1. I have not used this as a starting-point here,
since to do so would require an entirely different approach to the data, based on psycho-analytic
theory, which I am not qualified to address. The conclusions from the data, however, suggest that
assumptions about spatiality have gendered impacts, and it is the purpose of the study to reveal
those assumptions.
The intention of this study is thus to draw attention to the importance of spatiality, and to suggest
what it might mean to have a discourse of spatiality, in the same way as there are discourses of
identity or sexuality. In this study, I use the term ‘spatiality’ to represent the collective effects of
being-in-space, in relation to the everyday lives of nursing students. Space itself is a contested
concept, and the study does not claim to provide a comprehensive overview of the philosophy of
1
see also Soja (1989) and Harvey (1989) as the objects of some of these critiques
3
space2. The kind of space to which I refer here is not the mathematical or astrophysical space of
relativity theory, but space(s) as lived and experienced by embodied beings.
As such, spaces are information sources for such beings, and, crucially, they provide contextual
information. Spaces can ‘communicate’ with us both digitally and analogically (Bateson 1973).
I can see a sign which informs me that I am in the ‘University of Midshire’ or I can deduce from
the presence of students, classrooms, academics and computers that I am in a university. The
sign is a digital communication whilst the space sends out an analogue message. The two often
reinforce each other. As has sometimes been said in the CD (Compact Disc) vs. vinyl debate
(e.g. Tiefenbrun 1984), the digital version is more precise but the analogue often communicates
more detail and emotion. Essentially, therefore, this thesis takes spatiality to be the way in which
spaces and people ‘communicate’. Far from being a separation of people from spaces, spatiality,
as I will argue, implies that persons and spaces are inseparable. In the following chapters, I argue
that embodiment is a necessary starting point for any study involving spatiality, which is explored
here through analysis of the stories which embodied nursing students tell about space. In
focusing on this specific group, I make the assumption that there is a ‘world’ in which the
activities of nursing students make sense, both for the students themselves and for the other
inhabitants of the world.
A number of independent investigations converge on this body-world relationship as the basis of
all cognitive activity (Merleau-Ponty 1962; Bateson 1973; Gibson 1979; O’Keefe 1999; Berthoz
2000). Without this relationship there would be no thought of space, time, existence, or
anything else. Lakoff & Johnson (1999) argue that the body and its sensori-motor activities in
the world are inextricably connected to cognition via spatial and other metaphors. The term
‘space’ itself is often used metaphorically, and the starting point for any discussion of space is
2
See Huggett (1999) for a collection of the classic readings in the philosophy of space.
4
usually a question about what sort of space, from the many ‘species’ available (Perec 1999), is
being discussed. This in turn is partly defined by the disciplinary background of the researcher.
Geographers are supposedly concerned with ‘objective’ physical spaces, whilst psychologists
depend on a model of space which separates inner, ‘mental’ spaces from the external world,
although both these generalisations are problematic3. In educational research, there has been
little direct consideration of spatiality, which until recently4 was regarded as being unproblematic
except in specialised areas of research, such as ‘classroom environment studies’ (Fraser 1986;
MacAulay 1990).
An additional reason to choose spatiality as a topic is that it makes connections between
disciplines which are regarded as separate for arbitrary reasons of ‘academic [or] social...
necessity’ (Bourdieu 1988: 64). In the current study, I draw on ideas from Heidegger and other
‘continental philosophers’ (itself a divisive term), from the new ‘philosophy of embodiment’
exemplified by Lakoff & Johnson (1999) and from social geographers and sociologists. This is
in line with the heterodox traditions of adult education, which has itself turned to such areas as
humanistic psychology, behaviourism and critical theory for inspiration (Jarvis et al. 1998). In
that tradition, the study seeks to explore the difference between ‘representations of space’ and
‘representational space’, to use Lefebvre’s rather confusing terms (Lefebvre 1991: 38-39). By
this I mean that it moves from ‘dominant [conceptions of] space’ (ibid), which involve a kind of
false neutrality, to a more nuanced conception of space in which its affective qualities, and its
underlying assumptions, are made explicit. As Merrifield (2000: 173) puts it, in a discussion of
Lefebvre:
Critical knowledge has to capture in thought the actual process of production of
space. This is the gist of Lefebvre’s message. Theory must render intelligible
qualities of space which are at once perceptible and imperceptible to the senses.
3
See Gregory (1994) for an extensive critique of spatial concepts in geography, and Malpas (1999:30-33)
concerning psychological understandings of space.
4
see Edwards & Usher 2004 for a recent discussion of spatiality and education
5
Alternatively, Shurmer-Smith (2000: 163) draws on the work of Hélène Cixous to suggest that
There is still much research to be done on the way in which people feel space(s),
research which needs to go beyond mere socially constructed fears and
apprehensions. (emphasis added)
Whether it is possible to go beyond ‘socially constructed fears and apprehensions’ is debatable,
but both the above quotations serve to summarise the intentions of the project. Urry (2002) has
stated that ‘little empirical research’ has been done on spatiality itself, as opposed to its
symptoms, such as the ever-increasing demand for travel and ‘co-presence’, or the parallel
increase in the use of Information & Communications Technologies (ICTs). Wenger (1998: 130)
draws attention to the ‘relations of proximity and distance [which] may facilitate learning’ and
links these to the creation of communities of practice, and it is worth exploring these ‘proximity
and distance relations’ in detail. This project is thus an attempt to provide theoretically derived
and empirically supported answers to questions about how spatiality might be experienced in the
processes of learning and acquiring a professional identity. In order to answer these answers,
some form of theoretical framework is required, and it is the purpose of the next section to
explain what form that might take.
The theoretical framework
My purpose here is to describe a theoretical framework based on the concepts of ‘proximity’,
‘mobility’ and ‘possession’. This is not the only possible way of making sense of the student
‘stories’ which form the data, nor is it the only way of approaching the concept of spatiality. It is
not, however, an arbitrary division, and I argue below that this framework is a powerful tool for
relating spatiality to complex experience, in this case the experience of being a nursing student in
the process of becoming a nurse.
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The key meaning which is sought here is that of spatiality. I suggested at the start of this chapter
that spatiality might consist of the stories which bodies tell about space. Relations of proximity
and distance are likely to be parts of those stories. But there are further questions to be
considered. How do we come to have these relations at all? Why is it that we feel at home in
one space and not in another? Why, to return to questions about the spatiality of nursing students,
can one student work happily in the library whilst another finds it ‘completely useless’ for
studying? At one level the answers to these questions can be given in terms of individual
preferences, but it is important to establish how these preferences come into being. If space were
to mean a simple void, an absence of objects, it could not ground the complex range of feelings
which, as the data will show, articulate themselves to it. More accurately, feelings are articulated
to spaces, which are qualitatively different from each other. There are subtle distinctions to be
made between ‘spaces’ and ‘places’, but for the purposes of this study the essential distinction is
between the generic and the personal or specific. Thus, ‘kitchens’ are spaces, whilst my kitchen
is a place (Bordo et al. 1998: 75). I use ‘spaces’ in what follows because the discussion is at the
generic level of ‘lecture theatres’, ‘libraries’ etc., but if I were to write about Stirling University
library, it would be appropriate to use ‘place’. The concept of spatiality is, however, inherent in
the concept of place. Malpas (1999: 41-42; see also Casey 1997) suggests that the relationship is
reciprocal, with our sense of place being the source for concepts of spatiality, whilst Massey
(1994a: 117) cautions against allowing essentialism to creep into conceptions of place, which
should be regarded as a dynamic and evolving concept. The concept of spatiality which I wish to
develop here is complementary to this non-essentialist concept, and involves spatiality being seen
as the experience of place, whilst place is the intersection and interaction of a set of individual
spatialities.
‘Space’ is, then, what Fogel Keck (1994: 20) calls a ‘summative concept’. That is, it ‘represents
a global and extremely complex entity’, and as such, has to be analysed in some way in order to
7
provide useful insights or research outcomes. Wenger’s ‘relations of proximity and distance’
provide a clue as to how this analysis should proceed, but are insufficient in themselves to unpack
the complicated spatial stories which form the data for this study. There is no direct parallel
between geometrical dimensions and the three concepts outlined here, but there is a metaphorical
parallel, and the use of three dimensions is intended to give spatiality a ‘solidity’ or ‘depth’ which
it might not otherwise have. The analytical framework is thus based on the concepts of
proximity, mobility and possession.
This framework draws on a disparate group of theoretical sources, but draws from Heidegger in
asserting that the human way-of-being (Heidegger’s Dasein) is a way of being-in-the-world (or,
more accurately, being-in-a-world). In other words, people do not consist of encapsulated
thoughts and feelings which only coincidentally happen to be in spaces. Rather, we are bound up
with spaces at a fundamental level, and can be detached neither from our spatiality nor from our
temporality (Heidegger 1962: 146). Although Malpas (1999: 42) sees Heidegger’s concept of
space as unsatisfactory, because of his privileging of temporality, Heidegger’s later work (1971a;
1971b; 1972; 1993a) stresses the affective qualities of place upon which Malpas insists, and is
therefore useful as a basis for the construction of the theoretical framework for the study.
Space, as a conceptual topic for research, then, needs to be both unpacked and enriched. My
argument will be that the activity and experience of embodied individuals is spatial at a
fundamental level, and the following section suggests a more precise way of describing different
aspects of this activity and experience, using the concepts of proximity, mobility and possession.
8
Proximity
Space implies differentiation – if we were able to perceive the continuity of the physical world in
terms of energy fields, rather than the lumpy stuff which we call matter, or objects, we might
have no concept of space at all. Gibson (1979) points out that there can be no concept of an
organism without differentiation from its environment. Provisionally, any such differentiated
organism will exist in differing degrees of nearness or farness from the objects which constitute
that environment – a rock, a tree, a river, other organisms – and these relations of nearness or
farness constitute proximity, or the possibility of distance. As Heidegger (1998: 135) puts it:
…the human being, existing as a transcendence that exceeds in the direction of
possibilities, is a creature of distance. (emphasis in original)
The concept of proximity will thus be taken, for the moment, to mean the possibility of distance.
Heidegger will reappear below due to his suggestive thinking-through of the phenomenon of
spatiality and his desire to get to the ‘bottom’, or ‘ground’ of things, spatial metaphors which are
themselves crucial to his work, but first I will further explore the meaning of proximity.
As the possibility of distance, proximity is a relationship of concern rather than a relationship of
action. I experience proximity to tables, buildings and other people because in some way they
are within my range of concerns (Law & Hetherington 2001). This relationship holds even at
great (physical) distances (Silk 1998), and is not a question of simple presence, but rather the
possibility of presence and absence. It does not, however, encompass the possibility of action
across distance. This is a question of mobility, the second of the three interlocking concepts of
spatiality.
9
Mobility
Mobility, as I use the term here, is the possibility of action over distance. All organisms have a
relationship of (im)mobility with their environment, even those organisms which cannot roam
around it at will. Plants, for example, are mobile to the extent that they can propagate over
distance, and some species (such as bracken and rhododendrons) are sufficiently mobile to be a
menace to other species (McCarthy 1994). Mobility, for people, is differentiated across lines of
ability, gender, class, socio-economic status, age, ethnicity and so on (Albertsen & Diken 2001).
Urry (2001b) also makes the useful distinction between mobility as a right and as a duty, and this
distinction will be highly relevant to my discussion of mobility within the data analysis. Again,
however, mobility is conceptually limited. Whilst time enters into discussions of mobility in
relation to speed, there are times when we hang around, hang out, tarry or dwell in specific
spaces. Even to be nomadic is to remain within a static conception of space, according to
Deleuze & Guattari (1988). There is thus a question of a time-space relationship which is not
that of speed (time over distance) but of what I will call possession (time in space).
Possession
In connection with spaces, ‘possession’ is what is being represented in ‘making oneself at home’,
‘occupation’, ‘haunting’ or ‘familiarisation’. As a concept, it does not in itself imply a linear
scale from strangeness (minimum degree of possession) to cosiness or ‘being-at-home’
(maximum degree of possession). Possession is essentially a conceptual tool to capture the
affective relationships which are formed as people interact with spaces over time, and to relate
these relationships to the other two dimensions, thus creating an integrated model of spatiality.
As I will discuss further in Chapter 2, which presents the framework in more detail, the
relationship between space and time which is to be captured by the concept of possession is not
10
contingent, but is fundamental to both of them – one cannot exist without the other, and
possession is a recognition of this co-dependency.
To summarise, then, the study uses a three-dimensional analytical framework, based on the
concepts of proximity, mobility and possession (the PMP framework). Possession is the
relationship of dwelling, of being in space over time, whilst mobility enables possession in that it
affords the possibility of moving through spaces, and proximity enables mobility in that it
provides the possibility of there being differentiated spaces at all. Whereas ‘proximity’
commonly implies nearness, the term as used here makes it the possibility of nearness, farness or
any other relationship of distance. Similarly, mobility is the possibility of action over distance,
rather than its realisation.
The three elements of the PMP framework thus overlap each other and are mutually
interdependent. As analytical tools for the empirical data they not fragment it, or disconnect
elements of the participants’ experience from their lifeworld. Rather, the intention is to make
sense of seemingly random spatial practices and contingencies, and to provide a coherent account
of the spatiality of the participants. In order to provide such an account, research questions are
required, but before outlining the research questions I will briefly describe the ‘research frame’ of
the project.
The research frame
Thorne et al. (2002: 1) describe four distinct aspects of the research frame:
its historical location, the manner in which the disciplinary orientation influences its
logic, the theoretical and philosophical positions in which it is grounded, and the
methodological strategy by which it has generated its findings.
11
I consider these in greater detail in Chapter 3, but briefly discuss them here before considering the
research questions. It is important to emphasise that whilst the study focuses on nurse education,
it does not claim to be nursing research as such. The study is situated within the research
traditions of adult education, a field whose distinct existence has been questioned since the
emergence of ‘lifelong learning’ (Jarvis et al. 1998: 2). The traditions of adult education tend to
place value on the individual expression of meaning (Law & Rubenson 1988: 232; Haggis 2002:
131), rather than on large-scale statistical analysis, which as Winter (2003: 769) points out, ‘may
be distorted, albeit unwittingly, by a wide range of complex factors’. An equally important
feature of adult education is that the field is highly diverse and thus ‘tradition’ is a contentious
term.
Thus, a collection of research in the field of adult education (e.g. Edwards et al. 2002)
might reveal such diverse approaches as Lacanian psycho-analysis, Foucauldian
power/knowledge analysis, video/digital image research, phenomenological spirituality and
complexity theory. There is, therefore, no single research tradition which dominates the field.
As Usher (2000: 51) suggests:
the production of any kind of systematic theoretical or ‘scientific’
knowledge...always takes place and indeed requires a knowledge-producing
community of some sort, no matter how flexible and loosely structured it may be.
As researcher and otherwise, I have been part of a diverse ‘knowledge-producing community’
and this is reflected in the choice of both topic and methodology. The way in which such
communities are linked to research, according to Usher, is through intertextuality. The traces of
other texts, which inhabit and inform this text, serve both to tie it into the ‘knowledge-producing
community’ of adult education, and to make connections to other such communities, such as
social geography.
In terms of the theoretical and philosophical positions in which the study is grounded, I have
drawn on Heidegger (1962) and his variety of phenomenology, the embodied philosophy of
Lakoff & Johnson (1999) and the work of social geographers such as Massey (1992; 1994a;
12
1994b), Urry (2002) and Adams (1999). The methodology of the study assumes that meanings
are generated in discourse on the basis of embodied being-in-the-world. Although there may be
variations in the degree to which these meanings are shared, the study of discourses (or
narratives) can contribute to the ‘story-telling’ which Usher (2000: 51) sees as the task of social
research. This does not mean that ‘there is nothing outside the text’, as Derrida has been
(mis)interpreted as suggesting (1976: 158). Indeed, as I will argue, there is a great deal outside
the text, which reaches us as ‘analogue’ information (Bateson 1973), but the existence of texts as
repositories of meaning presupposes that some of this analogue information can be digitised and
shared. The above points are amplified below, but meanwhile I will lay out research questions to
which the study aims to find answers, or for which it might at least provide ‘new stories’.
13
The research question(s) – asking the impossible?
From what I have already described of the research, it involves two fields of study. One of these
is nurse education, which, as vocational or professional education for adult learners, is situated in
the post-compulsory sector. Whether this makes it a sub-field of ‘adult education’ is open to
debate, since adult education is an ill-defined term whose meaning and connotations are in a
constant state of flux (Baquero 2002). The other field is spatiality, which lies at the intersection
of (inter alia) philosophy, social theory and human geography. I am thus using nurse education
as a context, and nursing students as a body-in-question, for a study of spatiality. This gives rise
to several converging research questions, and these are shown in figure 1 (below):
Figure 1: The research questions
Question
Reason for asking
What is meant by ‘spatiality’?
Own interest
What is meant by spatiality in
the context of nurse
education?
Attempt to cross disciplinary
boundaries, reinforcing and
deepening analysis of previous
research in field
Desire to enhance student
experience, lack of attention to
spatiality in nursing literature
How does spatiality affect
lives of nursing students?
Body of knowledge to which
study might contribute
Theories of space
Theories of space, nursing
literature
Literature of student
experience within nursing
literature
The left hand column describes a progression from generality to specificity in the nature of the
research question, whilst the centre describes a similar process of ‘homing-in’ on a justification
for the research itself. The third column suggests where the research might fit into the literature.
The boundaries between all these questions are not, of course, as clear-cut as the table suggests,
but the overall focus of the study, as the arrow suggests, is on spatiality as a cross-disciplinary
concern manifested in concrete settings, in this case the settings of nurse education.
14
The word which I use for the activities of nursing students is ‘studying’, rather than learning,
because it is beyond the scope of this project to assess whether the experiences of spatiality which
I explore have any effect on learning or ‘learning outcomes’. Indeed, the question of just what
constitutes ‘learning’ remains contentious within educational discourse generally. Within nurse
education the question is especially difficult to answer since the nature of nursing itself is both
problematic and historically specific (Benner 2000; Chiarella 2002) and therefore, as the history
of nurse education demonstrates, what counts as learning for nurse students is also the subject of
constant debate (Rafferty 1996). Arguably, a substantial part of the process of becoming a nurse
is the process of professional socialisation (Kirpal 2003), and the concurrent development of the
practical skills and intuitive judgement which constitute nursing expertise (Benner 2000; Eraut
2001). The opposite pole of the argument is represented by the trend towards ‘evidence-based’
nursing (RCN 2003), which requires nurses to develop skills in reading and utilising research
papers as a basis for practice. What counts as ‘studying’ is therefore as problematic as what
counts as learning, since it is clearly possible to read papers or other documentary evidence at
home, whilst it is not possible to vicariously observe good practice or to engage in the majority of
nursing activities in a domestic setting. Furthermore, as the study will show, the relationship of
the domestic, professional and educational spheres which is represented by the concept of
studying is itself problematic, and the strength of the type of spatial analysis which I am engaged
in here is that it has the potential to integrate the student experience across the three spheres,
albeit that the separation between them is somewhat artificial. To some extent, the
acknowledgement that nurses have separable domestic and educational/professional lives is in
itself an advance on the dominance of the hospital setting in the lives of nursing recruits.
In the next section, then, I look more closely at the practical grounding of the study and the
setting in which it was conducted.
15
Background to the present study
One reason for choosing to focus on spatiality as it affects nurse education5 was the possibility of
access to a Department of Nursing and Midwifery located at two very different sites in the same
institution, thus reducing the influence of institutional variation. There is an ethical issue here in
that the geographical circumstances of the sites involved make it difficult to disguise their real
location, and I have therefore chosen not to do so,. The individuals involved have, of course, all
been given pseudonyms.
Under Project 2000 (UKCC 1986), the University of Stirling had taken responsibility for a
former nurse training college and had absorbed a department within a Further Education College
in the central belt6. The former institution serves a large part of the Highlands of Scotland, an area
roughly the size of Belgium. Practice placements at distances of up to 300 km from the campus
thus form a significant part of the learning process. The other department had been relocated to
the main university campus, and serves a smaller but more densely populated area of Central
Scotland. Its students are also sent on placements, but these rarely involve journeys of more than
50 km from the campus. It was thought that the Highland site, and the spatial transitions
undergone by its students, might thus amplify spatial effects less easy to detect elsewhere, and
this seems to have been the case.
As with other phenomena, spatial relationships become more visible under conditions of change.
Learners are involved in change in various ways (Jarvis et al. 1998; Bateson 1973), even if only
to resist it (Paechter 2001). A further element of change, in the form of spatial discontinuity is,
however, present for nursing students, in that all diploma or degree-level students undertake
multiple placements and are thus continually making spatial transitions from site to site. Thus,
5
The term ‘nurse education’ as used here includes the education of midwives and other healthcare professionals.
16
they constantly cross (or redefine) the boundaries between home, work, placement and
educational institution. This inevitably involves periods of acclimatisation to new spaces, periods
in which theories, practices or beliefs previously taken for granted may become problematic, and
which therefore provide a rich context for the exploration of spatiality.
A climate of organisational change also prevails in the world of public services and healthcare
generally (Howard 2001; Loughlin 2002), and this is briefly examined in Chapter 4. Although
the technicalities of NHS re-organisation are not the direct concern of the current study, there are
reasons to relate some of them to spatial issues, particularly around those of flexibility and
mobility. One aspect of nurse education which is helpful in defining the scope of the study is that
the majority are mature students (i.e. aged 23+), with varied work experience. The empirical
analysis developed here thus becomes relevant to the emerging field of ‘mature student
experience’ within the wider context of adult education.
Spatiality is, then, a topical issue for nurse education. As I will show, space enters tacitly into
much previous research on the nursing student experience. This study, by foregrounding
spatiality rather than topics such as work identity (Kirpal 2003), demonstrates the significance of
space(s) to the nursing student experience. Some conclusions will be drawn which are
specifically located in nurse education, whilst also having a wider relevance within the field of
research into student experience, but the overall intention of the study is to explore the nature of
spatiality itself.
6
See map provided in Appendix 2
17
Summary: the story so far
In this introductory chapter I have discussed the need firstly, for an enhanced understanding of
spatiality as a concept, and, secondly for the need to gain a fuller understanding of the
relationship between embodied nursing students and spaces, in the course of their learning within
Higher Education.
The study argues that human beings necessarily have a relationship to space, which I describe as
‘spatiality’, and which follows from the fact of their embodiment. Spatiality acquires meaning
within a ‘world’, a concept whose theoretical underpinnings are derived from Heidegger (1962),
and that ‘worlds’ embody certain sets of assumptions about shared meanings. I have outlined a
theoretical framework, based on the concepts of proximity, mobility and possession. The
empirical component of the research specifically explores the relationship between nursing
students and the spaces in which they live and study.
This spatial relationship, I argue, is fundamental to the way that nursing students are - and by
extension, to the way that all students, and indeed all human beings are also. In a more
pragmatic sense, it is important to explore the experiences of nursing students at this time because
nurse education in particular, and the healthcare system in general, are in transition from a
hospital-based system relying on a medical model of disease and treatment, to a more diverse,
flexible system with new models of funding, learning and relationships between health and
society. These new models will involve different spatial forms, for example the increasing role
of nursing advice given through telephone call-centres. There will be concurrent demands on
nurses for flexibility and work-practices (Dargie et al. 2000; UKCC 2001) for which their current
education may (or may not) be preparing them, and I will argue below that research which takes
18
account of the lived spatiality of the nursing student experience can help to rectify some of the
deficiencies and conflicts of that experience.
Outline of the thesis
In Chapter 2, I set out the proximity-mobility-possession (PMP) framework in more detail. As
Chapter 1 suggests, the study as a whole explores the spatial aspect of experience, and the
framework suggests that there are three fundamental aspects of this spatial aspect: proximity,
mobility and possession These draw not only on Heideggerian thinking about being and
spatiality, but also on a range of other sources. The PMP framework is essentially driven by
theory, and it maps successfully on to the empirical data which I begin to present in Chapter 6.
In Chapter 3, I outline the methodology of the study in some detail. Because spatiality is so
closely woven into the fabric of everyday life, it is important to be explicit about the assumptions
which underlie the research, both at the theoretical level and at the level of personal experience.
I argue that a realist approach is called for, but one which acknowledges the possibility of
multiple interpretations of reality. The study has phenomenological characteristics, but it is
important to be clear about which sort of phenomenology is being applied, and what its
limitations are. In Chapter 4 the research methods are described, including the way in which the
data analysis was performed, and I also discuss some of the ethical issues around the researcherresearched relationship.
I postpone discussion of the nursing context until Chapter 5, in order that the reader will acquire a
picture of the nursing background immediately before the chapters which describe the empirical
research. The chapter describes firstly the policy context of nurse education as set out in official
publications, and secondly, the historical context as set out in a number of key texts. Secondly, it
19
reviews some of the academic literature which deals with the student experience in nurse
education, chiefly in connection with Project 2000. The purpose of the chapter is to show that
much of the existing material which deals with the nursing student experience is implicitly
concerned with spatially-related topics, but fails to discuss them explicitly. This does not negate
its usefulness, but it does mean that there are unanswered questions about the way in which
spatiality is experienced by groups and individuals.
Chapter 6 describes the geographical context of the research and some of the issues which arise
from this context as revealed by analysis of the material. One of the central issues which arises
is the conceptualisation of the educational process as a journey, and I explore this further in
chapter 6 with reference to three specific aspects of the student experience, namely, self-direction,
essay-writing and student positioning in lectures. The journey is shown to be a spatial paradigm
of considerable importance. In chapter 7, I discuss further spatial aspects of the student
experience, such as studying at home and the ways in which students make use of the library.
Chapter 8 discusses the experience of the placement, and I argue that nursing students experience
conflict between the two spatial paradigms of ‘the journey’ and ‘dwelling’. Chapter 9 discusses
spatial metaphors, the use of terms such as ‘self-directed learning’ and the essay writing process,
where the physical and conceptual metaphors of the learning process are mutually entwined.
In chapter 10, I draw together my conclusions about what has been revealed by the data. I also
discuss some alternative ways in which the research might have proceeded, and whether its
methodology was successful. I argue that the neglect of spatiality in the discourses surrounding
nurse education is an important issue which should be addressed in order to maximise the
learning and retention of nursing students. Finally, I will discuss the question of what we can
know about spatiality more generally, and whether such knowledge is socially useful or
interesting.
20
21
Chapter 2-Proximity, Mobility,
Possession
22
Sometimes he heard the sound of passing cars, but they were always in the next corridor, and
however fast he rushed (for he would gladly have given himself up by then) the corridors he
reached were always empty. Sometimes he saw an exit far ahead that would lead to the
City’s life and breath, but it always glimmered further away as he approached until he would
turn, and it would be gone.
(Isaac Asimov, The Caves of Steel)
Introduction
THIS chapter discusses the theoretical framework used to make sense of the concept of spatiality.
The framework underpins subsequent discussion of the data gathered from the experiences of
nursing students, but is also intended to be a general framework which contributes to an
understanding of spatiality. In the first section of this chapter I discuss the nature of theoretical
frameworks in general and their implications for the study of social phenomena. I argue that
such frameworks are an a priori feature of all research, regardless of its specific underlying
assumptions. The primary assumption of the study is that humans are embodied and exist in a
physical world. The second section of the chapter is, therefore, a discussion of what embodiment
might mean for an exploration of people and spaces. In subsequent sections, I describe the three
fundamental elements of the framework – proximity, mobility and possession – in more detail.
Although they can be described separately, they form an inter-related whole, and it is this feature
of the framework which is unique to the current study.
The framework and its role
In order to analyse the phenomenon of spatiality it is necessary to provide more than descriptions
of its appearances within the data. What is needed is a device to turn description into analysis,
and this device is generally referred to as a theoretical framework, Thomas (1997: 8) offers this
critique of the framework:
...theory and theorizing...are about the construction of ideas into a framework. The
problem with such frameworks, in looser or tighter forms – in either the mental
model notion of theory or in grand theory – is that once they exist they constrain
thought within their boundaries.
23
Thomas sees Foucault’s work as exemplifying a critical approach to theory, based on ‘its
homelessness, its theoretical and methodological anarchy’ (ibid). Philo (2000: 212), in
discussing Foucault’s relevance to geography, describes the situation thus:
The route that Foucault takes…thus depends [not only] upon the acceptance that a
layer of theoretical materials must be laid over the specific events and phenomena
under study, but also in ensuring that the concepts deployed have not so much an a
priori character – having decided in advance what is ‘going on’ in any particular
situation in any given time and place – as the character of ‘hovering’ responsively
above the empirical details revealed.
This might lead us to the metaphor of a helicopter hovering over the data, ready to winch up
crucial pieces of evidence at the appropriate moment. The framework does not determine what
the data is, but it does play a part (along with the voices of the participants) in determining which
pieces of data are ‘rescued’ and which are left in the sea of conversation. Thus, in one of the
interviews, several statements were made by the interviewee concerning the difficulties of long
drives in winter. The theoretical concept ‘hovering’ in this case was the concept of mobility,
which enabled the statement to be put into the context of critical studies in this area.
With the above critique in mind, then, theoretical frameworks have three main purposes.
Firstly, they facilitate the methodical identification of the phenomenon in the data. Statements
from the interviews are regarded as being valid expressions of belief about the phenomenon, but
in each case the language of the conversation as a whole is too variable and concrete to be
handled at a high level of abstraction. The theoretical framework thus acts as a bridge between
the ‘messiness’ of the data (which also constitutes its value, in its richness and complexity) and
the ‘purity’ of the conceptual analysis.
Secondly, theoretical frameworks are needed to account for the ways in which the meaning of the
phenomenon is understood. There are competing theoretical paradigms of the relationship
between meaning and the world, and in the introduction, I argued that meaning is predicated on
24
our embodied existence in, and interaction with, a material world. The framework which I
propose to use here is dependent on this assumption, but this does not mean that it is the only way
in which the meaning of space as a phenomenon can be studied. It would have been possible, for
example, to adopt a psychoanalytic approach to the ‘truth’ of spatiality (Brennan 1993; Blum &
Nast 1996; Briton 2002), in which case the relationship between the orders of the Real, the
Imaginary and the Symbolic would have formed the basis of the theoretical framework for the
study (Blum & Nast 2000: 183-185). Blum & Nast point out that Lacan, the foremost source,
after Freud, for psychoanalytic theorising, must ‘disavow the body’ in order for his system of
signification to function (ibid: 184), whilst Yegdich (2000b) argues that psycho-analysis and
existentialism are incompatible approaches to research. I do not propose to explore this
approach any further here, but suggest it as a contrasting ontology to the one actually employed
here.
Thirdly, theoretical frameworks help to relate the data to existing bodies of knowledge, and
therefore influence what counts as knowledge about the phenomenon. The question of what
counts as knowledge is related to both the philosophical assumptions of the project and its
location within an academic discipline. There is, for example, an extensive literature on the
visual perception of space within psychology (Eilan et al. 1999; Hershenson 1999). The
conventions of psychology, however, usually require knowledge to be derived from controlled
experiments rather than free-ranging interviews, and statistical analysis rather than textual
interpretations. The more eclectic disciplinary conventions of adult education and nursing
research authorise the use of different forms of knowledge, such as phenomenology. Although
the current study is far from being ‘true phenomenological research’, according to Crotty (1996;
cf. Yegdich 1999) I draw on phenomenology for some of the theoretical background, and thus
need to connect my use of the term to the phenomenological literature.
25
In devising the Proximity-Mobility-Possession framework, I draw on the work of Heidegger
(1962) in the first instance, because Heidegger’s account of spatiality privileges its relational
aspect, rather than providing a depersonalized account of some mathematical or physical
construct, as in Anglo-American philosophy of space (e.g. Christensen 1994). There is, therefore,
nothing in what follows about the mathematical philosophy of space, which is addressed to a
different audience and is of no direct relevance to the lived-experience of spatiality with which I
am concerned here.
To have experience of, or an attitude towards, a space, or merely to be ‘located’, all imply
relations of power, because, as Lefebvre suggests, the knowledge that I have of space, in its
fullness and intimacy, is either opposed to the reductive knowledge that distanced others have, or
is itself reductive. Massey (1994b) discusses the spatiality of Kilburn High Road in these terms,
as a lived space which defies static categorisation, whilst Lefebvre (1991: 106) puts it thus:
In this sense reduction and reductionism appear as tools in the service of the state
and of power: not as ideologies but as established knowledge; and not in the service
of any specific state or government, but rather in the service of the state and power
in general.
In Lefebvre’s view, this dialectical tension applies to all spaces under capitalism, with the
possible exception of those which Foucault has described as ‘heterotopias’ (Foucault 1986).
Lefebvre, in order to develop an avenue for resistance to the dominant spatial mode of capitalism,
further develops his model of spatiality into a ‘trialectical’ system, in which he opposes
‘representations of space’, ‘representational space’, and ‘spatial practices’ (Lefebvre 1991: 38-39;
cf. Merrifield 2000: 174). Briefly, ‘representations of space’ are the province of planners and
other ‘technocratic subdividers’. These are abstract spaces described by numbers or other signs.
‘Representational spaces’ are spaces as ‘directly lived’ and ‘passively experienced’ by their users,
prior to being overlaid by ‘spatial practices’, which are the empirical practices of everyday life
under a specific regime, such as ‘neo-capitalism’ (Lefebvre 1991: 38-39). Following Lefebvre’s
26
model, possession is thus the product of the negotiation of the spatial trialectic by agents or
actors, and Soja (1996) has taken up this notion of the trialectic in his discussion of a ‘thirdspace’
for confrontation and resistance. As I argue here, spaces are inseparable from spatial practices,
but, as Lefebvre argues, they are not indistinguishable. The trialectic thus anchors spatiality to a
material world in which ideological struggles are continually playing out, and specifically links
the emergence of spatiality to the rise of modernity (Lefebvre 1991:125)
Heidegger has a similar aversion to space as a quantifiable object of calculation. According to
Clark (1992: 39, citing Heidegger 1971: 106):
Heidegger writes, simply, ‘Of space it may be said; space spaces’...To concern
‘space’ is not to take an entity and represent it, for space cannot be rendered an
object in that manner
The idea that ‘space spaces’, that space is an active constituent of worldly reality, is central to the
current study. Clark attributes to Heidegger the claim that it is incorrect to represent space (as
object) in language, and indeed, what Heidegger stresses about space is that it is neither
object(ive) or subjective, but constitutive of human being itself (Heidegger 1962: 148; cf. Malpas
1999, ch.2). He is concerned not so much to prevent space being represented as to prevent
representations of space, in the form of ‘parameters for the measurement of nearness and
remoteness’, from become dominant (Heidegger, 1971a: 102). There are thus two ways of
thinking space, essentially a quantitative way and a qualitative way. Heidegger (ibid: 103) uses
the contrasting examples of ‘nearness’ and ‘neighbourliness’. City-dwellers can live next door to
each other, without any sense of neighbourliness, whereas two farms, remote from each other in
mileage terms, may be close neighbours in terms of their relationship. There is clearly a hint here
of the Gemeinschaft/Gesellschaft debate, and in the opinion of Fritsche (1999, ch.5; see also 96),
Heidegger, in Being & Time, alludes to, and argues for, a specific form of ‘community’
(Gemeinschaft), as opposed to ‘society’ (Gesellschaft). This is a continuation of a debate
originating with Tönnies (1963). As Fritsche explains, Gemeinschaft is intended to convey a
27
sense of the organic interconnectedness and interdependency of community, historically prior to
the rise of Gesellschaft, in which relationships are largely determined contractually and are
dictated by the economic requirements of the capitalist system. According to Fritsche, therefore,
Heidegger’s conservative tendencies are showing through in his philosophical writing (see also
Ott 1993). Tönnies, in his original work on the concept (1963), held that Gemeinschaft and
Gesellschaft would tend to co-exist, and the creation of Gemeinschaft-like ‘communities of
practice’ within a Gesellschaft-type economic system is a sustainable order of things.
Heidegger, conversely, sees the two as incompatible, and the replacement of Gemeinschaft by
Gesellschaft as a crisis of modernity. Despite its pretensions to philosophical purity, Heidegger’s
conception of space is thus arguably political in its origins (Bourdieu 1991). Similarly, the use
of measurement-based data in the social sciences can be seen as a political statement based on a
philosophical position, as Harré (1998: 133) observes7. In effect, the use of measurement is, in
this view, a devaluation of discourse and emotions or feelings as sources of knowledge about the
world, and about the body-in-the-world, as discussed by Merleau-Ponty (1962) in
Phenomenology of Perception, which anticipates Lakoff & Johnson’s (1999) Philosophy of the
flesh, and has much to say about embodied spatiality (Priest 2003: 101).
Malpas, in developing a philosophy of place, has built on Heidegger’s work, particularly in
teasing out the relationship between subjective and objective space. He comes to a similar
conclusion to Heidegger (Malpas 1999:196), in that
… it is to this world, and the place in which it unfolds, that our philosophical
explorations must always be addressed and to which they must always return.
(emphasis in original)
This affirms the importance of embodiment to the experience of spatiality. Furthermore, the
recent work of Lakoff & Nuñez (2001) relates the spatial experience of embodied beings to the
way mathematics is constructed, thus supporting Heidegger’s assertion that mathematical
7
cf current debate in educational research about evidence for practice and the use of random-controlled trials.
28
conceptions of space depend for their meaning on embodied concepts of spatial activity in the
world. In the next section, therefore, I examine the question of embodiment, which is crucial to
the particular understanding of spatiality suggested by this study.
Embodiment
Although it seems extraordinary that it could ever have gone away, the body has returned to
respectability within academia. As Weiss & Fern Haber (1999: xiii) note in the introduction to a
recent collection of essays on embodiment:
the body is increasingly being identified as central to our sense of agency as well as
a distinctive cultural artefact in its own right.
Csordas, however, draws a cautionary methodological distinction between body and embodiment.
He distinguishes between
the body as biological, material entity [from] embodiment as an indeterminate
methodological field defined by perceptual experience and by mode of presence and
engagement in the world (Csordas 1999: 145)
For Csordas, the relationship of body to embodiment is akin to that proposed by Barthes (1975)
between text and textuality; the book on the shelf versus the endlessly circulating text in its webs
of signification (cf. Couzens Hoy 1999: 4). This is a distinction which enables the body to be
absent from, or at least ‘invariant’ within, many of the formative discourses of modernity,
supplanted by the disembodied application of Cartesian reason (Michelson 1998: 218; Couzens
Hoy 1999: 3). One of the central reasons for the re-emergence of embodiment from intellectual
hibernation is the contested position of the biological body within discourses of gender and
feminism (Bordo 1993: 151; Gregory 1994: 164; Michelson 1998) Foucault’s work on medical
practice and sexuality has developed the theme of the body as discursive construct (Couzens Hoy
1999; Foucault 1973; 1984: 179). The idea of the body as discursive construct is useful but
ultimately comes up against the limits of language and the intractability of the biological body.
29
Tallis (1999) suggests that the intellectual basis of this discursive view of the body is profoundly
flawed when it comes to the possibility of progress and material improvements in the quality of
life of human beings, since it denies the reality of suffering and the ability of scientific advances
to alleviate it.
Irigaray, meanwhile, has used embodied sexual difference to pose major questions about, for
example, the unspoken privileging of vision and visual metaphor in western thought. Her
questions are specifically directed at male philosophers, including Heidegger and Levinas
(Irigaray 1993; Jay 1993: 528 ff.). In turn, this leads Irigaray to link embodiment to spatiality in
new and challenging ways. Space is no longer ‘seen’ or ‘penetrated’ but ‘enveloped’ in a
reversal based on sexual difference itself (Irigaray 1987). Irigaray’s work is important in
reminding us of the conceptual malleability of spatiality and of the gendered implications of
conceptualising it in certain ways. What I wish to provide here is an interpretation of spatiality
which is sensitive to difference and its effects, whilst acknowledging that as an embodied being I
cannot escape the influence of bodily specificity.
This, of course, raises questions about how much of the experience of spatiality is actually shared,
given the bodily differentiation resulting from gender, ethnicity, ability, age and other lines of
difference. In reply to similar questions, Susan Bordo (1990: 151) comments:
...the inflections that structure experience are endless, and some item of difference
can always be produced which will shatter any proposed generalizations. If
generalization is only permitted in the absence of multiple inflections or interpretive
possibilities, then cultural generalizations of any sort - about race, about class, about
historical eras - are ruled out. What remains is a universe of counterexamples, in
which the way men and women see the world is purely as particular individuals,
shaped by the unique configurations that form that particularity.
Bordo’s statement points to the necessity, for the researcher, of assuming some degree of shared
experience, whilst remaining alert to the location of individual stories. This is one of the
assumptions which underlies the term ‘embodiment’ here. A wide range of experiences can be
30
gathered under the heading of ‘travelling by bus’. Not all of these will be shared experiences,
but the basic features of the category ‘bus’ (e.g. rows of seats, windows, other passengers) are
shared understandings.
The body-in-the-world
In this study, I use ‘embodiment’ to imply the presence of the biological body, a presence which
is mediated by discourse but which refuses to be reduced to it. The biological body both enables
action and constrains it within a range of possibilities (Collins 2000: 181 ff.). In Phenomenology
of Perception, Merleau-Ponty (1962) develops a theory of action which, whilst it draws on
Husserlian phenomenology and Heidegger’s subsequent work on being-in-the-world (Heidegger
1962; Moran 2000), goes much further than Heidegger in emphasising the importance of
embodiment in the context of the body/world relationship:
Our own body is in the world as the heart is in the organism: it keeps the visible
spectacle constantly alive, it breathes life into it and sustains it inwardly, and with it
forms a system (Merleau-Ponty 1962: 203)
Merleau-Ponty (1962) expresses the re-integration of the intellectual and the physical in the
concept of ‘the intentional arc’. For Dreyfus & Dreyfus (1999: 103):
The intentional arc names the tight connection between body and world, viz. that, as
the active body acquires skills, these skills are ‘stored’, not as representations in the
mind, but as dispositions to respond to the solicitations of situations in the world.
They suggest that the specifics of human embodiment (two arms, two legs, binocular vision,
upright stance, opposable thumb, etc.) act as a limiting factor on the possibilities-for-action
established within neural networks, thus relating the size of these networks to the capacity of the
human brain. Further elaboration of this point is given by Kelly (2000: 175), who shows that
there is a divergence between the actions of ‘grasping’ and ‘pointing’, such that grasping is ‘not
merely a way of locating the object objectively in space’. The motor-intentional act of grasping
tends, according to Dreyfus & Dreyfus (1999: 103) towards
31
bring[ing] the current situation closer to the optimum gestalt that the skilled agent
has learned to expect.
In other words, when I go to grasp my coffee mug, I reach for and grip it in such a way that it
does not spill, without consciously having to work out how to control my movements in order to
achieve the desired result. Pointing, conversely, does require just such an objective location of
the object. Kelly’s argument is that this dichotomy between grasping and pointing effectively
puts paid to what Lakoff & Johnson refer to as the ‘absolute dichotomy between perception and
conception’ (Lakoff & Johnson 1999: 37). They argue, with Kelly, that recent advances in
neural modelling and motor concepts have rendered obsolete the idea that mental representations
are necessary intermediaries in transactions between bodies and objects. This is not to say that
no mental processes are involved in this relationship, but that these processes are part of the
‘cognitive unconscious’ (Lakoff & Johnson 1999: 12-13), which comprises all the activities
carried on by the brain without the need for conscious, intentional action. Activities such as
breathing and walking are open to conscious control, but are normally carried on without it.
Representations are, in this view, part of the conscious mind, and they have little or no role in the
everyday functioning of bodies in the world. This supports the Heideggerian notion that our
understanding of the world, and our coping with it, precede any conscious interpretation of that
understanding. As I will argue below, the experience of spatiality is generally enabled by just
such a pre-interpretative understanding. It is important for the purposes of this study to
distinguish between perceptions of space and experiences of space. Perceptions of space are, for
Husserl (Moran 2000: 177), Merleau-Ponty (1962: 98; 105; 141) and even perceptual
psychologists such as Hershenson (1999: 3), perceptions of space from the body. In becoming
experiences, however, these perceptions are mediated by the physical characteristics of individual
bodies and by the historical and cultural context in which those bodies find themselves. As
O’Keefe (1999) has argued, three-dimensional spatiality is fundamental to the way in which we
32
function as living organisms, and the brain is structurally incapable of functioning in fourdimensional space, although mathematicians may be able to model it.
In assuming that embodiment is a precondition of cognitive activity, I am also assuming, then,
that the representation of experience is a reduction of experience – the body is always
experiencing more than can be brought into language. Two possible ways of theorising this are
the neuroscientific view that at least 95% of mental activity is unconscious (Lakoff & Johnson
1999: 13; Carey 2000), and the Heideggerian concern over this reduction of everything to ‘livedexperience’ (Heidegger 1999: 91). This reduction is described by Heidegger as ‘abandonment
of being’, and his thinking of ‘enowning’ (Ereignis) is an attempt, not to capture what is lost in
this reduction, but to suggest what this loss might mean for human being (Heidegger 1999: 330).
The current study is less ambitious, but it assumes that there is a deficit in any description or
representation of spatiality. This is a problem which is not confined to research on spatiality, and
one way to partially overcome it is via the study of metaphors (Lakoff & Johnson 1999). In this
case, spatial metaphors will prove to be significant in connecting the embodied realm of action to
the processes and experiences of being a nursing student. Kenny (1984, n.p.), sees metaphors as
‘pulling the world into the body’, which neatly captures the connection.
In this section, I have been concerned with the question of embodiment and the connection
between body and world.. The body which will be discussed in relation to spatiality is, in the first
instance, the biological body. Whilst acknowledging the role of discourse in shaping the body,
positioning it within the world and representing its viewpoint, the body remains stubbornly
located in space, and in the following sections I will discuss proximity, mobility and possession,
the three dimensions of embodied spatiality which are at the core of the present study.
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Proximity – a sense of (dis)stance?
In this section, I will suggest that one’s sense of proximity (an interpretation of distance) is a
combination of the ability to distance oneself from one’s world (or to be apart from it as well as a
part of it), and the ability to dis-stance oneself from it, in the sense of bringing it into the range of
one’s concern. This combination forms one of the fundamental dimensions of human spatiality.
This view of proximity is a synthesis of Heideggerian and other philosophical approaches to
spatiality, but it is consistent with evidence from the natural sciences about the nature of spatial
perception. The work of Berthoz (2000), O’Keefe (1999) and Regier (1996) suggests that neural
structures determines our conception of space as three-dimensional and that whilst this structure
has evolved as a result of external influences, it is ontologically and phylogenetically prior to any
subsequent conception of objects (O’Keefe 1999: 59; cf. Malpas 1999: ch.2; see also Bermúdez
1998; Campbell 1994). The current study takes as an underlying assumption the view that there
are neural structures which determine spatial perception and functioning (Regier 1996). This
assumption is consistent with my claim in the introduction that embodiment is fundamental to an
understanding of human spatiality, and makes use of the work of Lakoff & Johnson (1999) on
embodied thought. The current study makes no claims to add to knowledge about neural
structures, however, and the suggested theoretical framework is intended only to assist in
analysing experiential data about spatiality.
An aspect of proximity that needs to be unpacked here is distance, or spatial separation, which
seems such an obvious concept that attempting to unpack it might seem unnecessary. The
capacity to conceive of ourselves as autonomous beings is, however, dependent on this basic
concept, which, as Malpas (1999) has shown, lies behind our ability to gain objective knowledge
34
of entities. O’Keefe (1999), has demonstrated in animals that the brain possesses structures
which build up a three-dimensional picture of the world beginning with a calculation of the
distance to some recognisable object (such as a food source). From a geographical perspective,
Law & Hetherington (2001:3) argue that
distance demands communication and interaction. Its very possibility depends on
communication or interaction. (emphasis in original)
Bauman maintains, furthermore, that ‘’...distance’ is a social product; its length varies depending
on the speed with which it may be overcome’ (Bauman 1999: xxii). This does not fully capture
the essence of distance, which is located by Heidegger (1962) in the concept of ‘de-severance’
(Entfernung) which determines the possibility of distance. For Heidegger, one first engages with
the world, ‘takes it on board’ or brings it within one’s ‘range of concerns’, and only then imposes
distances or ‘distantiality’ (Abständigkeit) upon those entities which this engagement reveals.
(Heidegger 1962: 138-148). Entfernung can also translated as ‘dis-stancing’ (Dreyfus 1991) or
‘remotion’ (Kisiel, in Heidegger 1992), and both these expressions help to gain a sense of its
intended meaning.
I use the expression ‘...engages with the world’ above, rather than with ‘entities’, or ‘things’,
because, for Heidegger, ‘world’ is prior to ‘things’. Things can be ‘ready-to-hand’ as equipment
(Zeug), or present-at-hand as entities. Things as equipment can only show themselves from their
worldly location and relevance, which are not private cognitions, but shared concerns. This
functional approach has been criticised by Levinas (1969) on the grounds that it lacks an ethical
dimension, although Carey (2000) claims that the possibility of an ethics is grounded in a world
of embodied practices.
It is important to emphasise two things here. Firstly, the possibility of distance, within the
overarching concept of spatiality, is foundational in Heidegger’s schema, and to be human is to
35
be within a world of spatial relationships (Arisaka 1996). Furthermore, being-human is
dependent on self-consciousness and the ability to question our own way of being. Being
conscious of self in turn requires the possibility of separation from the environment which
distance and dis-stancing creates, although as Harré (1998: 105) notes, ‘the state of the body...is
as much a material environment as the world outside’. Secondly, as conceived by Heidegger,
distance does not objectify the other as a thing, but establishes a basis for recognition of, or
being-with, the other (Mitsein), as co-implicated in a referential network:
The others who are thus ‘encountered’ in a ready-to-hand, environmental context of
equipment, are not somehow added on in thought to some Thing which is proximally
just present-at-hand; such ‘Things’ are encountered from out of the world in which
they are ready-to-hand for Others - a world which is always mine too in advance.
(Heidegger 1962: 154)
That is, just as items of equipment are implicated in shared networks of meaning and are only
meaningful when ‘plugged into’ those networks, so too are others encountered in action (ibid:
156), and their existence is locked into the same sort of networks of meaning by their functional
relationships with the world.
Ultimately these networks have as their horizons the totality of
embodied, worldly existence, although there is some debate as to where the horizons of these
‘regional’ networks might lie (Arisaka 1995; Villela-Petit 1996; Malpas 2000).
The argument that objects are meaningful only within networks of referential relationships
applies to a wide range of ‘things’, from hammers to hospitals. As actor-network theorists also
insist (Law & Mol 1999), objects, or ‘actants’ such as hospitals are constituted as stable objects
by virtue of their location within the networks of healthcare. One of my early interviews took
place in a Victorian building used as a psychiatric hospital. By the time of my later interviews, it
was closed and was about to be re-constituted as residential flats. The building stood still, but its
meaning had changed. For the students, it had become more distant, but was still dis-stanced
from them, or was within their range of concerns, because it persisted both in physical space (as a
building), in the conversational space of discourse and in the mental space of memory This was
36
an example of a particular way of grasping an object (the hospital), and in turn an example of an
‘affordance’ (Merleau-Ponty 1962; Kelly 2000; Urry 2001b).
Sanders (1999), drawing on Gibson (1979), suggests the concept of affordance as capturing the
body-world connection. Affordances are ‘opportunities for action in the environment of an
organism’ (Sanders 1999: 129). Affordances are ‘specific to entities and actions’ (Gibson 1979:
127). Whilst the soil affords moles the opportunity to make tunnels, it affords the gardener the
opportunity to cultivate a lawn, an activity incompatible with that of moles. This specificity is
not necessarily at a conscious level. If I enter a computer laboratory in the University, the floor
affords me the opportunity of walking on it, and I do not need to think about the floor, or the chair
on which I sit, whilst word-processing. I do not need to think about these opportunities because
they have evolved mutually between myself and the ‘equipment’ over a long period. The
concept of affordances is interesting because it helps explain why spaces are rarely discussed
explicitly. The spatial affordances which we use in everyday life, such as doors, rooms or roads,
are too transparent and too close to the body to be noticed, unless there is a breakdown or a
limiting condition, such as a frozen lock, a hole in the floor or traffic congestion.
The psychiatric hospital in the example above ‘affords’ its users an opportunity to be grasped for
various functional purposes, just as grasping a hammer affords the opportunity to knock in some
nails. In either case, the object is grasped as part of an action, such as the referral of a patient or
a hammer-blow. Proximity is the relationship within which affordances manifest themselves,
because affordances, as Urry points out, ‘stem from the reciprocity between the environment and
the organism’ (Urry, 2001b: 243-244, emphasis added). In a relation of proximity, both subject
and object, or subject and other, remain recognisable and autonomous (Honneth 1995: 69).
37
Proximity, then, is the possibility of establishing any sort of distance at all, for a human being as
organism in an environment. By ‘any sort of distance’, I mean to suggest that even sensations of
wholeness or closeness which we may experience in relation to other entities are predicated on
this possibility of distance, rather than being a negation of distance, as Hesushius (1994)
suggests. This is important in establishing the usefulness of proximity as an analytical tool, since
it can then encompass situations or narratives in which feelings of distance are conflictual or
multiple. There is, for example, a body of feminist critique which sees various devices of
science and art (e.g. the microscope, the telescope, perspective in the Renaissance) as indicative
of a specifically male desire for distance from the maternal body (Brennan 1993; Irigaray 1993).
Haraway, conversely, argues against the idea that distance itself is alienating, but maintains that
‘[v]ision is always a question of the power to see – and perhaps of the violence implicit in our
visualising practices’ (Haraway 1995: 181-182; see also Jay 1993). Hagen, however, in her
detailed study of the geometry of representative art, argues that the discovery of the key
visualising practice of perspective during the Renaissance was not so much an effect of
patriarchal or masculine ideologies, as an advance in the technology of representation. As Hagen
(1986: 8, emphasis in original) puts it:
...representational pictures, all representational pictures from any culture or period in
history, exploit the fact of natural perspective, the geometry of the light that strikes
the eye. They succeed as representations because they provide structured visual
information equivalent to the real scene represented.
Hagen’s work confirms, from an entirely different direction, one of the underlying assumptions of
the concept of embodied spatiality, which is that human bodily structures are prior to culturally
embedded interpretations, and are thus crucial to the ways in which spatiality is experienced.
Similarly, Malpas (1999: 36) has argued convincingly that the capacity to conceive of objective
space must be based on the a priori experience of subjective space. Proximity, therefore,
conceived as the possibility of distance and involvement, is bound up with the possibility of
embodied action.
38
Following Heidegger, then, the central idea within proximity is that of concern or involvement,
more specifically, from entfernung, or dis-stancing, the idea of mutual involvement in a world of
significant relationships. Because this is a study of participants who engage in a particular
constellation of actions (in this case, nursing students engaging in nurse education), I need to add
another concept to deal with the possibility of action across the spaces opened up by proximity. I
have chosen to call this ‘mobility’, although as with ‘proximity’ I intend a meaning which
encompasses the negative aspect of the concept. Mobility thus includes the concept of
immobility, and the spectrum of possibilities in-between, and the importance of mobility lies in
the possibility of action over distance, rather than in any specific form of action.
Mobility
Proximity, as discussed above, establishes a range of concern radiating from the individuated
body. Proximity establishes what counts as ‘here’ and ‘there’ for some-body. To quote
Heidegger (1993a: 359)
When I go toward the door of the lecture hall, I am already there, and I could not go
to it at all if I were not such that I am there. I am never here only, as this
encapsulated body; rather, I am there, that is, I already pervade the space of the
room, and only thus can I go through it.
This passage expresses the co-involvement of body and world in a system of practices.
I know that there is a door over there and, because of my socialisation into a world of practices,
which includes the use of doors, I know that I can use it to leave the room. I am in a relationship
of proximity to the door. But in order to get to it I have to act over a distance, to cover a few
metres. The dual meaning of ‘cover’, as both ‘travelling across…’ and ‘spread out over…’ is an
important key to understanding the concept. The point of Heidegger’s discussion of the door is
that it is not an unknown destination but, as a cultural artefact, is part of the set of practices
involved in being in a region and making that region intelligible (Dreyfus 1995: 105). The door
39
is another example of an affordance, but the concept of mobility, however, generalises the
specific affordances of doors or hillsides into the affordance of space itself. Space affords the
opportunity to move around, to be mobile, whilst retaining an egocentric (i.e. body-centred) sense
of self. This is not to say that mobility is always freely afforded, nor is it to say that the self
necessarily remains the same as a result of the exercise of mobility. What is important is the
inescapable continuity provided by bodily activity. Malpas (1999: 107) puts it thus:
That which does the unifying that makes for the possibility of a self, of mental
content or of a unitary subjective space is...nothing over and above activity itself,
and is not grounded in the prior existence of an agent.
In other words, the self cannot be conceptually separated from its spatial activity. Mobility
provides a way of designating a specifically-spatial form of agency experienced in the necessary
interactions of people and spaces. Dorn (1998) describes the different perspectives on mobility
experienced by the disabled, and frustration at one’s lack of mobility and the exhilaration of
movement are both consequences of the general affordances for action offered by spaces.
Although human societies have performed extraordinary feats of mobility since prehistoric times
(Cavalli-Sforza et al. 1995), the recent history of mobility is distinguished by its industrialisation
in the era of ‘hyper-mobility’ (Adams 1999). As Urry (2001a) puts it, ‘[t]he scale of
contemporary travelling...is awesome’. In a later (2002) paper, he attempts to explain, however,
why people feel compelled to travel. The need to be with relatives at Christmas, or the
compulsive forays of sales representatives are, for Urry, due to the desire for co-presence or ‘the
compulsion to proximity’ as Boden & Molotch (1994) call it. Urry refers to this co-presence as
‘proximity’, as does Latour (1997), but its importance stems from its fundamental existential
significance, as Heidegger (1962) and Levinas (1969) have argued, from rather different
standpoints. Proximity is not something added-on to human existence, but is a fundamental
dimension of en-worlded, embodied spatiality, and is the necessary precursor of mobility.
40
Mobility, as the individualised possibility to act over distance, is highly differentiated at both the
individual and collective levels. For example, stairs are unproblematic for able-bodied walkers
but represent a breakdown in ‘affordance’ for the differently-mobile bodies of wheelchair users
(Dorn 1998; Moser & Law 1999). Even the other side of the room may be inaccessible (for
different reasons) to wheelchair users or the newly-born. The mobility of wheelchair users may
be differentiated from that of the able-bodied by prevailing spatial assumptions, for example the
assumption that public buildings should be accessed via stairs rather than by ramps or flat
surfaces.
Mobility is thus an attribute of embodied action in the world, which is fundamental to human
being (Merleau-Ponty 1962; Lakoff & Johnson 1999; Malpas 1999), and it is both differentiated
and relative. It describes actors’ sense of their power or ability to act over distance, as distinct
from proximity, the sense of distance itself. Albertsen & Diken (2001: 3-4), drawing on
Boltanski and Thévenot (1991) put it thus:
Mobility is what makes action at a distance possible. As Boltanski suggests, ‘action
at a distance’ is the ‘very attribute which describes in the most concise and striking
fashion the intuitive content of the idea of power’.
Boltanski and Thévenot (1991: 200-210.)develop the concept of ‘regimes of justification’ to
explain the deployment of power across networks, even in the absence of overt rules or sanctions.
Regimes maintain themselves through the creation of ‘grandeur’ (1991:135) which imparts a
sense of awe to the ‘subjects’ of the regime. Urry (2002: 262) thus sees mobility as performed
under a ‘legal, economic [or] familial obligation’. Thus, under the domestic regime of
justification, for example, one feels compulsion to visit one’s parents (or parents-in-law)
regardless of whether this is an enjoyable experience or not.
The reason for adopting this theory here (apart from its own grandeur as the work of French
intellectuals) is that it provides a social model relating to spatial phenomena and the power
relations which they exemplify. I will return to this theme in the discussion of the data, but
41
although some aspects of the power-relationships embedded in spaces are captured by the concept
of mobility, a third term is necessary to capture the spatial significance of the other. That term is
what I will call possession.
Possession
The following passage from Philip Pullman’s The Broken Bridge (Pullman 2001: 13) eloquently
describes the spatial sense of possession:
Everything from the airfield to the caravan site, from the main road to the edge of
the sea, was Ginny’s. She owned it, first, because she knew it; during the years
they’d lived here, she’d wandered over this gently sloping margin, this halfway place
between the hills and the sea. She owned it because she’d drawn it, from the insects
on the dry-stone walls to the decaying church half-buried in the dunes…And she
owned it, finally, because she loved it.
Possession is not propositional (‘I own this house and forty acres around’) but emotional, as the
above extract from The Broken Bridge suggests. It is easy to find examples of affective
relationships with spaces. Hillwalkers might summon up the atmosphere of their favourite ridge,
whilst many people dislike being in banks or social security offices. In terms of this study,
universities are diverse collections of spaces, some of which are more popular than others.
Sometimes spaces are transformed – sports halls become exam rooms, and venues for
graduations, each producing a different emotional response. Neither proximity nor mobility alone
can capture the affective relationships to space which I wish to examine here. Moreover,
proximity and mobility do not fully address the questions of power and power-relations which, as
Paechter (2001: 3) points out, ‘inher[e] in the multiple and complex relationships between all
individuals, groups, institutions and even spaces in a given society’. Nor do they capture the
social aspects of spatiality (and temporality), as Doreen Massey has stressed (Massey 1992). In
order to include both time and affectivity in the theoretical framework, therefore, it is suggested
that a third term, ‘possession’, should be included with proximity and mobility.
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As Robert Musil suggests, in The Man Without Qualities (Musil 1995: 610), the Latin roots of the
word ‘possession’ (potis and sedere) indicate that it means to ‘sit upon’ or to ‘beset’ something,
and suggest its etymological connection to ideas of land and property. The extract above conveys
the temporal element of this relationship: it is not possible to gain possession of a space, in this
sense, without taking the time to acquaint oneself with it, to be there. This would apply even in a
virtual sense, such as in the case of one who takes possession of a discussion group on a website.
‘Spatiality’, as a summative concept, thus attempts to represent the human dimensions of space.
Proximity, mobility and possession are three qualitative dimensions of spatiality, whereas length,
breadth and height are merely three quantitative dimensions of distance in so-called ‘Euclidean
space’ (Hershenson 1999: 3). I have established that proximity is a relationship of distance, and
that, in concerning myself with a space such as a room I distance myself from it. My relation of
mobility to the room, based on this proximity, is my ability to act over distance, to walk around it
or to enter and leave it. But the room is not simply given, it has been built by somebody, for
somebody, to use for something. Even if it is useless in a functional sense it may be a work of
art or a religious symbol. My relationship with the room results from my relations to the social
processes which determine its meaning. Even the absence of others from a space is a form of
social interaction, since presence and absence are only meaningful given the existence of others.
This suggests that privacy and possession might be related concepts, although spatiality is not
primarily about privacy, nor is privacy primarily about spatiality. Yet the overlap between the
two concepts is important.
As Inness (1992: 3) suggests, ‘[e]xploring the concept of privacy resembles exploring an
unknown swamp’. The debates around privacy are both legal and philosophical, but in neither
case is there clarity as to the basic definition of the concept. According to Inness, however, an
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initial distinction can be made between privacy as isolation from... [an external world, sphere or
space] and privacy as autonomy or the right to control access to... [an intimate space, information
or the content of decisions] (ibid: 6). Reiman (1976: 39) argues that ‘[p]rivacy is a social ritual
by means of which an individual’s moral title to his [sic] existence is confirmed’, and he goes on
to suggest that:
The social ritual of privacy seems to be an essential ingredient in the process by
which “persons” are created out of prepersonal infants
This fits with Heidegger’s assertion that ‘...Dasein is in each case one’s own... a world which is
always mine too in advance.’ (1962: 154). It also fits well with Lakoff & Johnson’s work on the
embodied mind, and their assertion (1999: 267) that:
we have a system of different metaphorical conceptions of our internal
structure...[a]nd there are a small number of source domains that the system draws
upon: space, possession, force, and social relationships.
The cultural norms of Western society promote self-possession as a positively desirable state, as
Lakoff & Johnson (1999: 273) point out, and this entails a high degree of control over one’s
bodily and mental functions. Loss of this control equates to a loss of privacy, and a
corresponding loss of self.
A university library is a good example of a space, or a collection of spaces, where different forms
of privacy co-exist. Carrels (small cubicles for study) provide a degree of isolation from other
students, but are subject to the surveillance of porters enforcing regulations. Staff offices within
the library are accessible to other staff members but not students. Reading desks are less
isolating than carrels but can still be kept as a space free of major intrusions, except perhaps by
one’s friends. The issue in the library, however, is not privacy as such, but the ability to do what
one needs or wants to do, subject to whether that action is within the conventions of library use,
or, if not, whether it can remain undetected. The conventions of privacy are only part of one’s
ability to make sense of the library and to get things done there. Knowledge of its workings and
layout, which is gained mainly by repeated use, is a factor, as is social interaction – asking
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questions or telling others to be quiet. None of these factors are unique to libraries, but what is
common to all of them is that they contribute to our being able to cope with, or possess, spaces.
Possession thus encompasses privacy and related concepts such as isolation and autonomy, and
in doing so implies that space must be shared with others. In order to make this description of
possession more theoretically coherent, I will once again refer to the work of Heidegger.
In Being and Time (Heidegger 1962), the concept of Dasein refers to the locatedness of human
being, literally its ‘being t/here’ (Inwood 1999: 42). From a Heideggerian perspective, spaces
are demarcated by Dasein’s ‘concernful coping’ and ‘foresight’. Spaces are in relation to
Dasein, and because ‘Dasein is an entity which is in each case I myself; its Being is in each case
mine’ (Heidegger 1962: 150), it (Dasein) is self-possessed, i.e. it has ownership of its self.
Crowell (2001) points out that this passage from Being and Time is insufficient in itself to
establish more than a ‘formal reflective awareness of the ‘I’ as Heidegger himself puts it
(Heidegger 1962: 151). Against Husserl, Heidegger is not apparently interested in establishing
the authority of the ‘I’ with regard either to its contents or its self awareness (Crowell 2001: 435).
Crowell, however, goes on to show that Heidegger, in Division II of Being and Time, develops
another sense of the ‘I’ as the being of a being which can give reasons, or can take responsibility,
for its actions (ibid: 449), including taking responsibility for itself.
In Heidegger’s terms, then, the responsible ‘I-self’ is inseparable from, and gives meaning to, the
‘world’ into which human beings are always already thrown, in common with all others. By
definition, Dasein, the human way of being t/here, ‘opens up’ or ‘clears’ spaces-in-the-world for
itself and is therefore always spatial. But as Heidegger goes to great lengths to show, Dasein is
also temporal. The detailed logic of Dasein’s temporality is complex (Blattner 1992; 1999) and
need not be fully explored here. The essential point is that human being is unavoidably shaped
by temporality, both by the past as either ‘tradition’ or ‘heritage’ (Heidegger 1962: 437; Fritsche
45
1999: ch. 2) and by the future as possibility, one’s ‘for-the-sake-of-which…’ (Heidegger 1962:
365 ff; Blattner 1999, ch. 2). Possession, as I use the expression here, locates this temporal
process in space, as, following Heidegger’s own reasoning, it must be so located (Arisaka 1996:
36-38). Heidegger, in fact, eventually re-prioritises space over time (in the form of the ‘site’), in
the context of thinking ‘appropriation’ (Ereignis) (Heidegger 1972: 23; see also 1999: 259-264).
There are thus grounds for thinking that there must be a human capacity or process for integrating
experiences of space with consciousness of time, and possession is the name which I give to this
process-dimension of spatiality.
Thus, in studying for a degree, I inherit the role of student from others who may have played out
their roles earlier, and I am simultaneously drawn through the process by the future possibility of
obtaining a degree. In going through the process, I occupy spaces as ‘somebody’, and my
relationship with spaces is mediated by the kind of ‘somebody’ that I am. This is not to suggest
that the occupation of spaces is always goal-driven or purposeful. Even as a bored youth
hanging about on a street-corner, I am, as it were, ‘stretched-out’ in time across the space of the
street-corner in my role as a bored youth. This relationship between time and space, however,
stems from the pervasiveness of spatial metaphors in the language which we use to talk about
time (Lakoff & Johnson 1999: ch.10). Heidegger’s temporal schema is itself an attempt to redescribe time, not as a series of ‘nows’, but as a ‘unity of that horizon from which each being can
present itself in the world’ (Dastur 1996: 165). He argues that because human beings are capable
of death, and are therefore subject to finitude, time can be experienced as a unity in which future
and past ‘co-temporalise’ the present. Thrown into a present in which I am a student, because of
what ‘has been’ in the past, I project myself upon a future which, as a possibility for being, is also
with me in the present. This is not to suggest that the experience of this unity needs to be on an
epic scale. It is enough that I be there in the seminar room because I was there last week and will
46
be there next week. Past and future are stretched out across the space of the room, which is
‘haunted’ by memories and possibilities.
De Certeau (1984: 108) suggests that ‘[h]aunted places are the only ones people can live in’,
precisely because the places in which we live are suffused with the memories and possibilities
which create a sense of self. My relationship with spaces is also influenced by my mobility in
being able to get to them, but the possibility of getting there and the fact of being-there are two
entirely different things, as Michael Arlen has eloquently described in the case of the Armenian
diaspora (Arlen 1975). In Passage to Ararat, Arlen suggests that these displaced Armenians have
a sense of possession (as I use the term here) of Mount Ararat, the dominant mountain in
Armenia, even though individuals within the diaspora may never have spent time in the physical
region of Ararat. The temporal aspect of possession is, in this case, cultural as well as individual.
This does not mean that possession generally means ‘possession of land’, nor does it restricts the
use of possession as an analytical concept to a specific kind of timeline or geographical scale.
Possession applies to any kind or scale of space, even literary spaces. My own use of certain
writers here is partly a question of possession of their textual spaces rather than others, and this
possession is itself a matter of contingency: I feel more ‘at home’ with one work than another.
We have, then, our own ways of possessing (or haunting) spaces. If, for example, I study in my
own room, in a house in which I enjoy friendly relations with the other occupants, then my sense
of possession of the space will probably be strong. If I study in a corner of a bus station then my
sense of possession of that space will be weak. This is not to say, however, that possession is
distributed solely along an axis representing power (strong/weak, low/high). The important point
about possession is that as humans we occupy space, and as embodied creatures, we cannot avoid
occupying space temporally. Possession is to have a temporal relationship with that space, to
47
make it a haunt, to dwell there, or, conversely, to be prevented from having had a temporal
relation with it, to be dispossessed.
Possession, however, is not just a temporal relationship. Because we spend time in spaces, we
cannot avoid having an affective relationship to them. As Heidegger perceptively argues, even
indifference is a mood (Heidegger 1962: 172-179). Indifference to a space is an attitude, a way
of standing-towards it. I will use the example of a bus station to further illustrate what I mean by
possession, in the light of the above discussion. If I just walk past (or even think about) the bus
station on the way to somewhere else, it functions as a representational space, a space which
announces itself as being ‘a bus station’ but no more. I do not think of it in the abstract, but as a
concrete space, to which I have a proximity relation. As a passenger awaiting a connection,
however, I engage in spatial practices in relation to it (which may include avoiding it for as long
as possible). My spatial practice in relation to it relates to my lack of power over it. I
experience it as bleak, usually cold, lacking somewhere to sit, a space which for me is transient
and in which I do not wish to linger unavoidably.
Conversely, as station manager, my relationship towards it, my sense of possession, would be
very different. I have an office, I know some of the regular visitors, I spend a great deal of time
there. I may still think of it as bleak, cold and dirty, but I have some control over it, based on
my knowledge and my position as legitimated by the local council. From the point of view of
the council, as an institutional body, bus stations are representations of space, abstract spaces.
The bus station is discursively constructed as part of an ‘integrated transport policy’, and is
described quantitatively, as an area of x m2 through which y buses and z passengers pass every
day.
48
The three forms of spatial knowledge of the site are thus in tension. There is tension between the
architecture and its function, tension between its representation, its intended use and the uses
made of it, such as a shelter for the homeless. Someone forced to sleep rough in the bus station
also engages in a spatial practice, but one which incorporates resistance. Even more
disempowered by the reductive functionality of the bus station than the normal user, it can be
argued that even the rough sleeper has the power to trigger action, even if this turns out to be the
action which prevents her from sleeping there. One who lacks power remains in a reciprocal
power relation, as Foucault has pointed out (Foucault 1984: 247).
The point of the above discussion is to show that possession is the dimension through which
power-relations are manifested in spatiality. As the discussion here revolves around embodied
spatiality, I now need to bring out the relationship between embodiment and possession. As an
embodied being, I ‘own’ my body, but it is never entirely mine to dispose of as I wish, given my
involvement in a world of practical entailments and normative actions. My body, as a student, is
placed in certain ways by the requirements of the institution. This placement is a negotiated
settlement, as it were, between different proximities and mobilities. My attendance (or
otherwise) at lectures reflects a ‘compulsion to proximity’ (Boden & Molotch 1994) and a degree
of mobility. The ownership of my body and of the lecture theatre are intertwined – I own the
space, I am at home there, but I am also ‘owned’ by the institution, as the legitimating, civil
regime under whose auspices the lecture is held. Thus, possession is contested and even my nonpresence in a space involves issues of possession, provided I have a proximity relationship with
that space. As a student who, in choosing a negative form of mobility, fails to arrive for a lecture,
I maintain a degree of possession in relation to the space of the lecture theatre. My presence and
absence are merely two sides of the same possession. This possession is not a static ‘slice in
time’ (Massey 1992: 68), but requires an element of time to realise it. Our relationships with
spaces constantly evolve, in the way in which a house becomes a home over time, or a particular
49
journey becomes habitual. Again, this evolution need not be experienced in a positive way. The
feeling of wanting to be dispossessed of a space is familiar to airline passengers, or to students in
an overcrowded lecture room.
Possession thus completes the spatial triangle which is based on proximity and set in action by
mobility. Possession, therefore, can be regarded as a negotiation between self, space and other.
As Heidegger (1962: 154) puts it:
The others who are thus ‘encountered’ in a ready-to-hand, environmental context of
equipment, are not somehow added on in thought to some Thing which is proximally
just present-at-hand; such ‘Things’ are encountered from out of the world in which
they are ready-to-hand for Others - a world which is always mine too in advance.
That is, just as items of equipment are implicated in shared networks of meaning and are only
meaningful when ‘plugged into’ those networks, so too are others encountered in action (ibid:
156), and their existence is locked into the same sort of networks of meaning by their functional
relationships with the world. To talk with a professor in her office is not the same as talking to
her in the pub. To be a nurse in an acute hospital is different to being a nurse in a community
health centre.
Possession is shared possession of space, and space, in a Heideggerian interpretation, is neither
exclusively private nor public (Arisaka 1995; Young 2000). For Heidegger, being-with others
(Mitsein), the sharing of space, is a component of human being ‘Knowing oneself [Sichkennen]
is grounded in Being-with, which understands primordially’ (Heidegger 1962: 160-161). Shared,
socially-constituted understanding thus precedes any interpretation, and ‘just as Dasein’s own
spatiality is essential to its basic state of Being-in-the-world’ (p.148), so must the shared spatiality
which arises from being-with others also be essential to being-in-the-world. According to
Heidegger, shared understandings are ‘primordial’, and therefore inescapable, an insight which
50
accords with Lakoff & Johnson’s (1999) work on the relationship between shared understandings
based on embodiment, and shared spatial concepts.
Without shared understandings of what one does with equipment - rooms, desks, books - life
would be very difficult. But sharing understanding is not the same as sharing the same
interpretation. I might share the bus station with someone sleeping rough there, but although we
have a shared understanding of the bus station as functional entity - as equipment - we interpret it,
and therefore possess it, in different (or differentiated) ways. It is worth noting that Levinas
(1969) relates proximity specifically to the recognition of the existence of the Other, and it is the
failure of Heidegger to address questions of the ethical relationship with the other across distance
which Levinas criticises. Possession, as I use it here, takes account of this aspect of proximity,
and should not be seen as an inherently conflictual way of experiencing spatiality. Rather, it
involves a mutual recognition that space is shared and that this joint possession can be beneficial
to the parties which are involved in that sharing.
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Summary
In this chapter I have enlarged on the theoretical framework which I briefly described in the
introduction. As with all frameworks, there is much to be added before the structure is complete.
This conceptual framework is predicated on the existence of an intimate self (one which can have
knowledge of itself) which locates itself within a world of shared practices and meanings.
As it stands, however, it consists of three elements, proximity, mobility and possession, the
combined experience of which constitutes spatiality. Proximity establishes the possibility of
distance between self and environment, whilst acknowledging their mutual co-dependence.
Mobility is the possibility of action over distance, and possession is an interpretation of the way
in which a given space discloses itself to the individual over time, in terms of mood and powerrelations and in relation to relevant proximity and mobility factors. The three dimensions are
dependent on each other but they can be differentiated, in the same way that structure and agency
are ‘not separate but separable’ (Shilling 1992; cf. Wilmott 1999). The discussion of possession
has necessarily been more complex than the discussion of proximity and mobility, because it is
the most innovative of the three dimensions, and because it is intended to encompass both the
temporal and affective aspects of spatiality, as well as the aspect of power. The reason for
adopting a theoretical framework such as proximity-mobility-possession is to facilitate the data
analysis, introducing new concepts which help to illuminate the themes which emerge from the
interview material. Next, in chapter 3, I set out the methodological basis of the study, which will
entail further justification for the theoretical framework, whilst in subsequent chapters I begin to
explore the empirical data with its help.
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Chapter 3-Methodology
53
“What I’m getting at is that the more important and fundamental the property being tested,
the simpler the needed equipment...”
(Isaac Asimov, The Caves of Steel)
Introduction
IN the previous chapter I set out a theoretical framework for interpreting spatiality, and the
purpose of this chapter is to situate the use of particular research methods in relation to this
framework, their philosophical background and the type of knowledge sought. Researchers do
not always reveal their reasons for researching a specific topic, or the methodological history of
the research design. Despite its importance in determining the outcome of the research, this
‘research frame’ is rarely made explicit, which, according to Thorne et al. (2002: 8):
makes an important difference in the way the research results can be interpreted and
applied to ongoing inquiry or to practice.
In this chapter I describe the research frame as it relates to the theoretical framework which I
outlined in Chapter 2. The research frame is the general set of disciplinary practices,
philosophical principles, personal interests and pragmatic considerations which form the
background to the research, whereas the theoretical framework is the specific set of concepts
which are to be tested against empirical data.
The first section in this chapter briefly describes the background to the research and its effects on
the way in which the study was pursued. Situating research in this way is becoming more
common amongst social researchers, although its value is disputed. The second section
addresses the structure of the research frame in more detail, under the headings of ontology,
epistemology, theoretical perspective, and methodology. Within the sub-section on theoretical
perspective, I discuss the question of phenomenology and its relevance to the current study.
Research methods and the practical aspects of the research are discussed in Chapter 4.
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The research and the researcher: In search of the lost world?
Before I move to a discussion of the methodology of the study, there is some unpacking to do in
respect of the spatial metaphors most often deployed in this type of research. ‘Exploring’, in this
context, implies movement through and around the data, perhaps stopping at interesting vantagepoints from time to time in order to note salient features of the landscape. In exploration, there is
sometimes a symbolic objective (the summit, the pole or the lost world) which justifies the
journey, but it is the learning experience during the journey which is the significant outcome.
Bateson (1973: 22) points out that ‘an explorer can never know what he [sic] is exploring until it
is explored’. The creation of hypotheses and the use of experimental methods (“what will happen
if we try this?”) is different from the process of entering a discourse to extract shared meanings
(‘what will we find if we go there?’).
The initial data analysis, in the form of the coding process, might be likened to an aerial mapping
exercise, plotting the co-ordinates of landmarks or places but unable to gain any sense of their
atmosphere or inner workings. The data exploration phase attempts to remedy this lack by
moving-in on the ground and getting close to the participants’ discourse. In a sense, this is the
real exploratory phase, despite Stronach & Maclure’s (1997: 102) characterisation of ‘fieldwork’
in current educational research:
The practice begins as an expansive, prolonged and colonially sponsored immersion
in exotic cultures....[f]inally, it is condensed in the 1980s to a notion of fieldwork
that involves handfuls of semi-structured interviews clinging precariously to the
fading memory of a theoretical sampling rationale.
The process of engaging in conversation with the participants is thus in one sense the symbolic
objective of the expedition. The outward journey, which involves such expedition-like activities
as gathering sponsorship and buying supplies (tapes and books) and the return journey, which
involves reflection on the symbolic objective and, in its later stages, dissemination of its findings,
are complementary, although there are precedents for expeditions whose perilous return journeys
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were perhaps more interesting than their objectives, attained or otherwise (e.g. the Shackleton
expedition, or the Apollo-13 lunar mission).
Outram (1999: 284), in a discussion of the relationship between exploration and knowledge in the
Enlightenment, suggests that:
...exploration knowledge was profoundly at odds with attempts...to find
epistemological legitimacy for experiment-based science in a denigration of
knowledge based on the senses
Exploration knowledge, as Outram (ibid, p,283) points out, is largely based on trust in the
explorer’s veracity in reporting the sense data collected along the way. In this respect, extracts
from interviews function like photographs, snapshots from a conversational journey which
convey only a partial, filtered sense of their spatial location. The journey is recreated in a
different form by the narrative of the research text, rather like the explorer’s slide show.
Veracity is thus a function of rhetorical ability rather than reproducible experimental conditions
(Law & Mol 2001).
This (over-)extension of the expedition metaphor confirms the importance of foregrounding the
research process. In this chapter, the extended ‘return journey’ from the data collection begins,
even though the data itself lies ahead. As Lakoff & Johnson (1999: 194) point out, ‘[t]he very
flexibility of the concept of a journey makes it extremely useful in metaphorical thought’.
Describing the research process as a journey avoids the necessity of imposing closure on
processes, such as learning or understanding, which otherwise resist closure (Strathern 2000),
since the destination of the journey need not coincide with the attainment of such learning or
understanding. The use of ‘journey’ and related metaphors of movement thus restores a sense of
stability to processes which, as Haggis suggests, might otherwise be unmanageable, or chaotic
(Haggis 2002). In the course of exploring the data, I reflect on the importance of the journey
metaphor to the educational process, and on possible alternative metaphors.
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Describing the research frame will involve detailed consideration of the philosophical ideas
which inform it and its relationship to the research methods. The researcher however, exists prior
to the research and prior to consideration of any of the philosophical questions discussed below.
As the researcher, in conjunction with supervisors and others, pursues research questions, s/he
encounter other projects, other texts and other researchers, and these influence the way in which
the project develops. Personal and material spatiality surfaces here, in such ways as commuting
by train, which provided contact with postgraduates in other departments (English, Modern
Languages, Film & Media Studies), and sharing an office in the university. Consequently, the
project started with a sense of differentiated distance from colleagues, continual travel and of
opening up my own space within the university, All these affected my thinking at an early stage,
and the proximity-mobility-possession framework can be seen in outline in these three senses of
spatiality. Distance from colleagues is a proximity issue, travel revolves around mobility and
having access to one’s own space is about possession, although all three dimensions are interrelated.
There is also a connection between the practicalities of being a situated postgraduate and the
nature of the research frame. The physical act of walking from station to university, and the
solidity of the terrain and the buildings which I passed on the way, convinced me that a realist
approach – one which acknowledged the existence of a mind-independent world – was correct
(for me). The phenomenological slant came from an interest in Heidegger, which in turn had been
stimulated by an exchange visit to the University of California, Berkeley. Because I was an
inexperienced researcher, I was attracted to what seemed like the most obvious and
straightforward data collection method – the face-to-face interview – which was also something
at which my principal supervisor had much experience. It was suggested that researching
nursing students offered a way of accessing a larger pool of participants than would have been
available in other areas of adult education. The fact that a second, nursing-only campus existed,
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geographically separate from the main university, was seen as a source of spatial interest, and it
was also considered advantageous to develop a cross-departmental project.
Finally, although there were good reasons for researching nurse education, I was too much in awe
of what I perceived as both the professionalism and high workload of nursing students (Howard
2001: 35) to want to intrude excessively on their lives by using some form of ethnographic or
participative method. They were also mainly ‘mature students’. Although these constitute a
high proportion of the student population overall (Osborne & Davies 2001), mature students are
constructed in opposition to ‘traditional’ students, typically regarded as those aged 17-21 (Agbo
2001: 4). As mature students, nursing students coped with conflicting demands and took their
chosen discipline seriously but required different kinds of support from so-called traditional
students (Cuthbertson & Smith 2001; Howard 2001). Thus, I approached them in a way which
sought to minimise my intrusion as a researcher and my disturbance of their ‘balancing act’
(Schuller et al. 1999)
The circumstances of the research as outlined above are probably similar to those of most
doctoral projects. Failure to take these circumstances into account would, however, lead to a
false picture of the research process, as Cooper & Woolgar (1996: 148) suggest:
...It is extraordinary that almost all sociological research texts assume that
researchers work on their own, make their own decisions and otherwise proceed in
isolation of the demands of their colleagues, their institutions and discipline.
Cooper & Woolgar argue that research is a complex interaction between its producer(s), its
sponsors and its audience, and that it is problematic for the researcher to make this interaction
relevant and visible without alienating the very audience which she is attempting to inform. In
the current study, it is suggested that the experience of spatiality is pervasive, and must therefore
affect the researcher in some way. More generally, Bhaskar (1979: 69) argues that all scientific
research is value-laden, and that the selection of a problem to be addressed is itself an expression
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of a value judgment. He also argues (ibid: 72-73) that attempts to lay out those values in relation
to their effects on the research process (as I attempted above) are futile, since either
consciousness of the underlying values leads to the possibility of objectivity, in which case the
attempt is unnecessary, or unconsciousness of the same values (despite professions to the
contrary) renders the statement misleading. Whilst Bhaskar’s argument is logical, a certain
amount of background information is desirable in this case, again because the topic itself calls
attention to the spatial background out of which activity arises.
Although the circumstances related above are not sufficient reasons for pursuing a particular
methodological path, the role of chance and contingency in research has been severely
undervalued (Dutch 2001). For example, the work of Lakoff & Johnson (1999) has been
influential on the assumptions driving this project, and Sowa (2003) points out that their thinking
in turn is heavily influenced by their personal reactions to the teaching of Chomsky in the early
1960’s. Whilst this is partly acknowledged in their published work, the full extent of Chomsky’s
influence is made clear by Sowa’s ‘insider’ knowledge. Were it not for this contingent fact of
specific inter-personal contact, the direction and emphasis of Lakoff & Johnson’s own research
might have been somewhat different. Similarly, my own research direction was contingent upon
specific spatial and temporal circumstances.. In the next section I discuss in more detail the
components of the research frame which result from these circumstances.
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Four levels, and a leap into the unknown
In this section I discuss some theoretical questions concerning the research frame. Crotty (1998)
suggests that the formal structure of the research frame should describe its ontology,
epistemology, theoretical perspective, methodology and method, and I will use these headings to
build a picture of the overall research frame of this project, although the discussion of method
will take place in Chapter 4. The discursive separation of the headings does not imply that these
are isolated considerations, since the opposite is the case. Each is dependent on the other, in ways
which should become clear below.
The ontology of this project needs to be made explicit because the nature of space is itself a
fundamental component of any ontology. The Christian Church imposed its own ontology prior
to the ‘Copernican revolution’ (Russell 1961: 521), whilst current Western ontology is based on a
Physical-mathematical conception of space (or space-time) as bounded by the curvature of the
universe at one extreme and by the existence of some form of fundamental particle at the other.
In this ontology, the physical nature of the universe is discoverable by science and can be
described in languages of various kinds.
Ontology is described by Heidegger (1962: 32) as ‘that theoretical enquiry which is explicitly
devoted to the meaning of entities’, and Heidegger’s project is explicitly to radicalise ontology
via the phenomenological study of existence (Moran 2000: 197). This radicalisation situates
spatiality at the intersection of human being and world, both of which are conditional on there
being an ‘earth’ which makes the existence of worldly humans possible. The meaning of
‘spatiality’ within Heideggerian ontology therefore derives from this human-world relationship.
The ontological pre-suppositions of the research are that human beings are meaning-makers,
rather than meaning being given by the transcendental reality which is ‘out there’ prior to and
regardless of the existence of beings. This is not to say that there is no such mind-independent
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materiality, but that such materiality is meaningfully structured by the embodied existence of
human beings and their specific features. Our knowledge of this materiality is thus subject to
constraints as a result of embodiment, and this gives rise to epistemological considerations, as I
will now discuss.
Epistemology is concerned with the possibility of (gaining) knowledge under various conditions
of reality, or ontologies. The three main strands are objectivism, constructionism, and
subjectivism. According to Crotty (1998), objectivism is concerned with the possibility of
certain, value-free knowledge, usually of the natural (as opposed to human) world, and therefore
tends to be associated with science and positivism. Subjectivism is at the opposite end of this
continuum, and suggests that knowledge is discursively created by subjects and is therefore
entirely relative.
Constructionism is in the middle of the continuum, and assumes (broadly) that there are objects,
but that our knowledge of them is always socially constructed or mediated, and therefore always
partial and provisional. This is an epistemological view which studies in the sociology and
philosophy of science have endorsed (e.g. Kuhn 1962; Latour & Woolgar 1986; Latour 1987).
The current study situates itself in this middle position, which. as Paley (1998) suggests, is
compatible with the Heideggerian position outlined above.
This is, then, a constructionist (Crotty 1998: 42) project based on transcendental realism (Bhaskar
1975: 56-62; 1979). It is based on the idea that there is a reality which precedes (and exceeds) the
existence of humans, but which is given meaning only by human cognitive and social activity.
This is opposed to empirical realism, in which ‘[t]he world is what men [sic] can experience’
(Bhaskar 1975: 58). In Bhaskar’s terms, there is an ‘intransitive’ reality of which we can have
‘transitive’ knowledge, but which precedes, and is independent of, our existence. If this were not
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the case, science, and all other forms of knowledge would be impossible. As Bhaskar (1975: 39)
argues:
To be is not to be the value of a variable; though it is plausible (if, I would argue,
incorrect) to suppose that things can only be known as such. For if to be were just to
be the value of a variable we could never make sense of the complex processes of
identification and measurement by means of which we can sometimes represent
some things as such. Knowledge follows existence, in logic and in time; and any
philosophical position which explicitly or implicitly denies this has got things upside
down. (emphasis in original)
This position fits with Heidegger’s assertion that we are always already ‘thrown’ into a world
(Heidegger 1962: 174). It is important to establish the existence of such a world not only to
make the epistemological basis of the study consistent with its theoretical sources, but also to
make it possible to talk of ‘spaces' as entities, as opposed to space as a relational concept, the
subjective/objective distinction discussed by Malpas (1999: 35-38).
There are those who appear to argue for a view of reality, as distinct from knowledge of reality, as
entirely socially constructed. According to Searle (1995: 157), these include Dummett,
Goodman, Kuhn, Feyarabend, Putnam, Rorty, Maturana, Varela and Winograd, together with
Derrida, against whom Searle’s critique is principally directed. Their views can be summed up
under the heading of ‘anti-realism’, and Searle asserts that anti-realism makes it impossible to
conceive of ‘a reality independent of our representations of it’ (ibid). Searle (p.154) argues that:
Realism is the view that there is a way that things are that is logically independent of
all human representation. Realism does not say how things are but only that there is
a way that they are.
Searle is clear that this argument does not, of itself, make any claims about the way things are,
even non-material things like space and time. What is at stake in the world in which we live is
the possibility of different descriptions of external reality, rather than different realities (Searle
1995: 165). Similarly, Heelan (1983: 279) concludes, in his survey of the hermeneutics of
perception, that ‘the essence of being a human perceiver is to-be-in-a-world’. The existence of a
(spatial) world does not depend on the existence of observers, or ‘client-perceivers’ as Heelan
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calls them, but the observers depend on the world. According to Cerbone (2000: 269) Searle’s
arguments do not function as proof of external realism, but the point which both Searle and
Heidegger make, in different ways, is that asking for such proof is itself proof of a misconception
about existence. For Heidegger, human being is being-in-a-world, and the notion of a worldless
subject is literally non-sensical.
A cave is an example of a space which is independent of human beings in terms of its geological
origins, but which fulfils various human purposes and hence acquires multiple meanings, as (e.g.)
shelter, temple or art gallery. Its spatial meanings are thus human constructions, whilst the ‘facts’
about the cave – its length, geological nature or bat population – might be held out as ‘objective’
by scientists, despite arguments for a socially-constructed dimension of ‘objective knowledge’
(Latour & Woolgar 1986; Latour 1987; Law & Mol 2001). Law & Mol (2001) suggest that there
are in fact specific spatialities which attach themselves to supposedly universal scientific ‘truths’
or technological objects. Although, for example, a metre is apparently a metre everywhere, it
takes effort, expressed across space, to maintain the standard as a standard. Where this effort
fails, other standards apply, as on a remote island, where a piece of driftwood might be pressed
into service as a standard (but arbitrary) measure.
The same argument applies to a built space such as a classroom – its physical parameters are
measurable by science against ‘standard’ quantities, and on one level can be objectively
compared to other classrooms. The idea of a classroom, however, is only mobile, or what Latour
(1999) calls an ‘immutable mobile’ within a network which sustains its meanings. These
meanings, are ‘located’, for its users or, in other words, they are spatially constructed, and so, to
use Bhaskar’s term, are ‘transitive’, for example, a 'classroom' may have different meanings in,
for example, Scotland, Botswana and Hong Kong.
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Given that there is a world to be perceived and experienced, then, what would be the appropriate
way to gain knowledge of the world in general or about space in particular? It would be possible
to measure many of the parameters of student usage of space in ways which would conform to the
requirements of a scientific, objective study. The frequency of library visits and the mileage
driven to placements could be recorded, or different configurations of seating in lecture rooms
could be tested experimentally for their effect on student behaviour. This form of research would
not be able to answer the research questions as set out above, however, because these are
questions about meaning, rather than questions in which a meaning is assumed. Equally
importantly, it would lack the inexactness which, as Heidegger astutely points out, is required for
rigorous inquiry in the human sciences (Heidegger 1999: 104). As Cioran (1976: 222, cited in
Crotty 1998: 81) eloquently puts it:
Our inmost aridity results from our allegiance to the rule of the definite, from our
plea in bar of imprecision, that innate chaos which by renewing our deliriums keeps
us from sterility. (emphasis in original)
It is this inexactness which enables the discovery of new forms of meaning-making activity,
whereas the precision of scientific methods enables predictions to be made once these activities
have been described. Heidegger (1999: 104) states the same view even more clearly:
The ‘human sciences’ by contrast [with the ‘exact’, i.e. natural, sciences] must
remain inexact in order to be rigorous. That is not a lack, but an advantage of these
sciences. Moreover, execution of rigour in the human sciences in terms of
performance always remains more difficult than carrying out the exactness of ‘exact’
sciences. (emphasis in original)
Here, Heidegger is concerned to preserve being as that which lies beyond beings and is always in
excess of what can be discovered about beings. In doing so, Heidegger, seen in his historical
context, is perhaps challenging Weber’s ‘passion for empirical verification or his concern to
explain in causal terms’ (Crotty 1998: 71), a passion antithetical to Heidegger’s own project (cf.
Heidegger 1999: 101).
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A constructionist-realist epistemology has therefore been adopted, in which the independent
existence of a material world (populated by embodied beings) is acknowledged, but in which
also, knowledge is negotiated and provisional rather than discovered and fixed. Clearly, there is
a difficult balance to be attained between shared meaning and personal account, and the next
section begins to explore how this might be attained through a phenomenological approach.
The Theoretical perspective
Given the constructionist-realist stance outlined above, the most likely theoretical perspectives to
stem from it might be those aligned with interpretivism, such as symbolic interactionism,
phenomenology or hermeneutics (Crotty, 1998: 5). According to Harris (1996: 1):
Symbolic Interactionism rests on three primary premises. First, that human beings
act towards things on the basis of the meanings those things have for them, second
that such meanings arise out of the interaction of the individual with others, and
third, that an interpretive process is used by the person in each instance in which he
must deal with things in his environment.
Although all three of the above premises apply to the current study, the focus of symbolic
interactionism on interpersonal relationships and role-taking makes it less useful for the study of
phenomena such as spatiality. Crotty (1998: 79) distinguishes between ‘constructivist’ and
‘constructionist’ approaches, and symbolic interactionism is a constructivist approach in that it
‘describes the individual human subject engaging with objects in the world and making sense of
them’ (ibid) whereas in constructionist approaches, we are delivered over to a pre-existing
complex of culturally-determined meanings.
Phenomenology, far from being about those
culturally-determined or ‘negotiated’ meanings themselves, is, in its Husserlian form, about
certainty, although it bears a different relationship to certainty from that of traditional scientific
objectivism. Phenomenology seeks to reach grounds, essences, foundations and ‘the things
themselves’, even if it acknowledges that it can never quite reach them It is the ‘way’ (as in
Heidegger’s (1971) On the Way to Language) which is important to phenomenology, the way
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which leads through the unmediated experience of existence. For the researcher results cannot be
in the form of ‘unmediated’ experiences, which have to be reduced to language in order that they
can be shared. Although the perspective which will emerge in this study is, therefore, not ‘pure’
phenomenology, it is worth exploring the development of phenomenological thought in order to
assess its usefulness to the study of spatiality.
As Moran (2000: 6) relates, the roots of phenomenology extend much further back into history
than Husserl, but his work is generally credited as being the source for its adoption by
researchers. Husserl was initially concerned to found philosophy on the certainty of ‘[t]racing
acts of cognition to their ground in acts of clarifying and fulfilling intuition’ (Moran 2000: 107;
see also 124). This tracing process involved what he called the ‘phenomenological reduction’,
the exclusion of all but pure intuition from consideration by the ‘ego’. It is important to note
that this reduction excludes the application of theory or logical inference to the data as the
experiencing subject) (re)cognises it. Meaning should not be imposed on the data in
phenomenological research, rather, the data, as pure unmediated experience, is the meaning. As
Crotty suggests, ‘[p]henomenology is about saying ‘No!’ to the meaning systems bequeathed to
us’ (Crotty 1998: 82). This lack of presupposition itself forms a theory, and the same problem
occurs with derivations of phenomenology such as ‘grounded theory’, as Thomas (1997: 5) and
Schuttermaier & Schmitt (2001: 1) both suggest. In defence of Husserl, Spiegelberg (1971: 83),
points out that
In Husserl’s case, the phrase ‘freedom from presuppositions’ stands for the attempt
to eliminate merely presuppositions that have not been thoroughly examined...It is
thus not freedom from all presuppositions, but merely freedom from unclarified,
unverified and unverifiable presuppositions that is involved.
Despite this proviso, and as Husserl and his critics realised, the attempt to ‘bracket out’ what
Heidegger (1962: 34) calls the ‘ontic’ manifestations of the ‘life-world’ was highly problematic
(Bell 1991). These ontic manifestations - physical objects in space and time, and assumptions
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and prejudices rooted in everyday life - are not easily eliminated. As Moran (2000: 191) puts it;
‘[t]rue phenomenology, for Husserl, cannot be founded on any science of human being’ (cf.
Bhaskar 1975: 56). Husserl intends the opposite, which is to found all science on
phenomenology This is the basis for Husserl’s dispute with Heidegger over the latter’s
appropriation of phenomenology in Being and Time. Husserl viewed Heidegger as doing a form
of anthropology rather than true phenomenology, as did Heidegger himself in his later work
(Brandom 1992). Nevertheless, Heidegger’s project, in Being and Time, is ontological, whilst
Husserl’s grounding of science is epistemological. Whilst Heidegger sought to show how human
being manifests itself in the everydayness of (for example) ‘coping’, ‘mood’ or ‘guilt’, Husserl
searched for a ‘transcendental idealism’ (Moran 2000: 190), radically separate from
everydayness. For Husserl, the everyday life of things and individuals acted to obscure the
phenomena, the ‘things themselves’. Heidegger criticised Husserl in turn, rejecting
transcendental idealism, the idea of pure description (that is, without interpretation) and the lack
of concrete historical thinking in Husserl’s work (Moran 2000: 20), although Levinas (1998: 131,
cited in Moran 2000: 327) attributes to Husserl:
...the principal intellectual means for substituting a human world for the world as
physico-mathematical science represents it.
Heidegger, against Husserl, sees everyday life on two levels. Firstly, it amounts to a lostness, a
forgetfulness or a covering-up of being (Heidegger 1962: 264), in which human beings are
absorbed in, and carried along by, a complex of cultural practices and norms. Heidegger refers
to this state as ‘Das Man’, the ‘they’ or the ‘one’ as in ‘this is what one does...’. At the same
time, the modes of human relations to things within a world, as equipment or otherwise, are the
means to ‘unveil a primordial kind of being of Dasein’ (Heidegger 1962: 210). Heidegger is
ostensibly no more interested than Husserl in exploring the cultural practices and norms which
shape everyday life, although as Fritsche (1999: 59; see also 188) points out, Heidegger himself
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partakes of these cultural practices in a highly politicised manner, and they permeate Being and
Time just as much as they do the popular newspapers of the time (Holub 1999).
This is not just an arcane point of philosophical debate, however, since it fundamentally affects
the conduct of the research process. Husserl is not an empirical researcher, but is concerned with
the nature of representation and cognition, with how it is possible to have knowledge of anything
rather than with acquiring knowledge as such and although Heidegger continually reiterates that
he is interested in Being rather than (human) beings, he seems more attuned than Husserl to the
complexity of how humans cope with the world8
Both Heidegger and Husserl thus pose difficulties as ‘guarantors’ of a phenomenological
theoretical perspective. The point of research, for Heidegger, is not the validation of a hypothesis
but a questioning leap into the unknown. The reduction of the world to ‘lived-experience’ and
thus to representation is, in Heidegger’s view, a disaster (Heidegger 1999: 92-93). This, of
course, opens up the paradox of how to represent a phenomenon, such as spatiality, which lies
somewhere between representations of lived experience and ‘the things themselves’. The
experience of spatiality is always more than can be adequately represented The only way in
which I can know this to be the case is through my own experiences, but I can only describe these
through language, and thus through the cultural categories which are embedded in it. On the
other hand, acknowledgement of the existence of an external world means that there has to be an
excess of ‘world’ over ‘experience’ – how can I describe what is happening in a distant part of the
world, or even behind me? This is not a problem unique to the study of spatiality, and it means
that a study such as this can only provide a partial description of that aspect of experience which
it chooses to describe.
See Føllesdal (2000) for a defence of Husserl against Heidegger’s, and Dreyfus’s, critique, and Dreyfus’s response
to Føllesdal in Wrathall & Malpas (2000)).:
8
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The reason for the extended discussion of phenomenology here is to emphasise that this point has
been problematic even for those, such as Husserl and Heidegger, who have spent most time in
thinking about it. The lesson which must be drawn from study of the primary sources of
phenomenological thought, by would-be phenomenological researchers, is that neither Husserl’s
‘bracketing-out’, in the ‘phenomenological reduction’ nor Heidegger’s ‘thinking the question of
Being’ can themselves form the sole basis of viable research methodologies, and conversely, that
many of the research methodologies which claim to be phenomenological are misinterpretations
resulting from the absorption of phenomenology into various Anglo-American research traditions
(Paley 1998; Searle 2000: 71-88). Searle makes the point that there is no reason why
phenomenological and causal explanations cannot co-exist, provided the question permits these
forms of explanation, but the debate continues within nursing studies and elsewhere as to whether
it is possible to conduct phenomenological research in the true Husserlian sense (Crotty 1996;
Yegdich 1999). The current study uses a derivative version of phenomenology, a version which
Benner (2000: 299) calls ‘interpretive phenomenology’, in which descriptions of phenomena are
sought via their symptomatic representation in speech, writing or other representations. This
would seem to preclude any direct access to the phenomenon of spatiality, but there is a way
round this problem, through the study of spatial metaphor. Pratt (1992), however, cautions that
Although some of the spatial metaphors circulating through contemporary academic
discourse are useful aids for problematising positionality, others dress up and
potentially reproduce some very conventional intellectual subject positions (for
example that of the distanced observer), underwrite new sets of dividing practices,
and promote a remarkable arrogance or naivety towards the construction and
destruction of and caring for places.
Speech and writing are forms of language, and Hardin (2001: 13) suggests that post-structuralist
understandings of the self as constructed through language negate the ‘unspoken assumption that
individuals are free acting agents’, and suggest that discursive positioning, or the emergence of
the subject from language, constrains action. Recent thinking on the relation between cognition
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and embodiment, however, suggests that linguistic constraints on thought are consequences of
embodied action (Lakoff & Johnson 1999; cf. Regier 1996; Lakoff & Nunez 2001). Lakoff &
Johnson argue that it is bodily action in the world which produces language, via metaphor, and
that attempts to disembody language, as with analytical philosophy, are doomed to fail as
explanatory frameworks for reality.
The zone of slippage in which language moves from being a metaphorical space to being about
space is thus an important methodological area, and It is important to separate representations of
space from the lived experience of space, a point made explicit by Lefebvre (1991: 44-6) and
further developed by Soja (1996). Heidegger goes further, regarding even ‘lived experience’ as a
reductive concept, and implying that the reduction of being-in-the-world to ‘lived-experience’
which ‘knows no limits’ is ultimately a refusal to acknowledge the finitude of human, spatial
existence (Heidegger 1999: 91). For Heidegger, live[d] experience is the domination of being by
human self-representation. How might this affect what can be researched, or indeed the
desirability and meaning of research itself? How can we reconcile the insight that embodiment
brings the world into thought with the notion of beyond-ness and the critique of ‘lived
experience’ as reductive? To some extent these questions have to be set aside in the current
context, but there remains the question of the extent to which the experience of spatiality can be
shared and represented.
Heidegger’s explanation of interpretation (1962: 188-195) supports the idea that all interpretation
is predicated on prior understanding, or ‘fore-sight’ (Vorsicht). Our interpretation of a door is
predicated on an understanding of the way in which it relates to rooms, corridors, hinges and
doorknobs. We know what doors do, and interpretation builds on that understanding. If
someone slams a door and locks it from the inside, we might interpret that as a demand for
‘personal space’. Alternatively, an open door to a professor’s office might signify her
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availability for consultation. The key element is the sharing of this understanding, Even ‘selfprofessedly subjectivist’ accounts, which Crotty (1998: 83) sees as typical of the kind of
phenomenology mainly practised by American nurse researchers, depend on shared
understandings to make interpretation possible. In Heidegger’s account, these shared
understandings are not the object of his questioning, but a means to another end entirely: the
clarification of the question of Being (Seinsfrage) itself. Although the current research addresses
spatiality via the study of human relationships with space, or, more precisely, nursing students’
relationships with space, these relationships are not its object. Rather, its object is the
phenomenon of spatiality itself.
This is a phenomenological study in that I am attempting to access a phenomenon which I have
labelled ‘spatiality’ via the lived-experience of a group of participants. Lawler (1998:105) points
out that researchers in this tradition are ‘asking different questions and seeking to know the world
differently’. As Crotty relates, phenomenology and research have had a complex relationship,
especially in nursing, and there have been misunderstandings of both principle and method
(Crotty 1996; cf. Lawler 1998). Even given the understandable focus of nursing research as
being on the patient, as opposed to phenomena such as pain or stigma (Thorne et al. 2002), Crotty
(1998: 48) sees:
a rampant subjectivism...in the turning of phenomenology from a study of
phenomena as the immediate objects of appearance into a study of experiencing
individuals.
The current project is about the phenomena of ‘space and spatiality’ and is not about individuals
as such, but even phenomenological researchers need to work with research participants to
provide data: introspection is not enough. Green & Holloway (1997: 1015) argue that
the phenomenological approach has a humanistic ideology that nursing, with its own
discrete professional values, can both identify and feel comfortable with. These
professional values include...participative aspects that emphasise the actor’s own
meanings and interpretations
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It is arguable whether, in fact, phenomenological approaches do have a ‘humanistic ideology’.
Heidegger in particular has been accused of ‘anti-humanism’ (Holub, 1999) and indeed has
denied being a humanist in his own writing (Heidegger 1993c). Nevertheless, the empirical
component of this study is about how nursing students experience spatiality as they cope with
their world. Thus, the study is not truly phenomenological, but involves a series of prior
assumptions about, for example, who nursing students are and what spatiality might mean, with
further assumptions about embodiment and its inseparability from spatiality. Spatiality is thus a
phenomenon which can be further explored and conceptually enriched through the study of
everyday practices and their related affective states.
In the introduction, the evolution of the research questions was traced in the following table:
Figure 2: the research questions again
Question
Reason for asking
What is meant by ‘spatiality’?
Own interest
What is meant by spatiality in
the context of nurse
education?
Attempt to cross disciplinary
boundaries, reinforcing and
deepening analysis of previous
research in field
Desire to enhance student
experience, lack of attention to
spatiality in nursing literature
How does spatiality affect
lives of nursing students?
Body of knowledge to which
study might contribute
Theories of space
Theories of space, nursing
literature
Literature of student
experience within nursing
literature
In the current study, it is suggested that answers to questions about student experience might be
used to provide knowledge about the way in which spatiality is experienced, rather than simply
providing knowledge about specific aspects of the student experience itself. To do
phenomenological research, as I use the term here, is to derive descriptions of phenomena from
descriptions of everyday life. This in itself constitutes critical activity (Crotty 1998: 112) since
for both Husserl (Moran 2000) and Heidegger (1962), the existing state of our understanding of
the relationship between phenomena and natural science (for Husserl) or Being (for Heidegger) is
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unsatisfactory. To engage in further analysis of everyday life is, however, to engage in cultural,
as opposed to philosophical, critique, and to move beyond phenomenology (Paley 1998).
Heidegger provides no clear statement of how the disclosures of phenomenology are to be applied
in everyday life and indeed, claims that ‘[p]hilosophy is useless but at the same time masterful
knowing’ (Heidegger 1999: 26, emphasis added). By ‘useless’, here, Heidegger specifically
means that true philosophy does not partake in ‘machination’ (ibid), the quantification and
reduction of everything to efficient use. Providing specific recommendations for practice is thus
not, in Heidegger’s view, the point.
It is therefore, difficult and indeed pointless to attempt ‘pure’ phenomenological research, which
would have to ‘bracket out’ all the external factors mentioned above. On the other hand, thinking
about phenomenology can help to identify whether there is a phenomenon to research at all.
Additionally, the humanistic tradition imposes an ethical obligation on researchers in which
outcomes related to the needs of the participants are considered to be important (Moch & Gates
2000). The current study attempts to address these considerations, and is intended to have
outcomes at three levels. At the level of the ‘useless’, the study should provide an argument for
the existence of something called spatiality. At the level of lived-experience, the study should
provide a medium for the discursive contributions, or ‘voices’ of the participants to be heard.
Finally, at the level of ‘machination’, the institutional level, the study should provide some
guidance for the improvement of whatever might be found to contribute to a ‘positive’ spatiality.
In the next section, I will discuss methodologies which might contribute to achieving these aims.
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Methodology
It is not my intention here to engage in a debate between qualitative and quantitative methods
which Flyvbjerg (2001) has shown to be partly the result of social science attempting to predict
the unpredictable. Educational research is currently under pressure to produce predictive results
based on numerical evidence as in random controlled trials (Moore et al. 2003). Chiarella (2002:
202-204) draws attention to the predominance of qualitative research in nursing studies, and
suggests that this ‘has been accorded lower status [compared to methods such as random
controlled trials] as a means of providing evidence about practice’ (see also Smith 1994). The
qualitative/quantitative debate is ultimately fruitless, according to Schuttermaier & Schmitt
(2001), as it is confusing ‘method’ with ‘methodology’, but in Chiarella’s view, the use of
qualitative methodologies forms part of a long struggle to differentiate nursing from medicine.
Because of the ‘outsider status’ (Chiarella 2002: 31) of the current study, which is based neither
in nursing studies nor in a ‘positivist’ field such as medicine or experimental psychology, there is
no clear disciplinary tradition to influence the choice of a particular methodology. Educational
research itself has been subject to heated debates about appropriate methodologies, and whilst the
methodology of the study must ultimately be determined by the research questions, there is also
an element of partiality, stemming from the personal context of the research. in the decision to
side with those nurse-researchers who have opted for a qualitative approach. This is not to say
that all those involved in nursing research are open to such methods and methodologies. Moch
(2000: 127) gives the example of a journal article (on the topic of the researcher experience in
qualitative research) which was rejected because it had, in the reviewer’s (only) words ‘No
Objectivity!’. As Usher (2000: 54) points out, we should ‘take nothing for granted in doing
research’, but as he also emphasises, research takes place in a worldly context and is not some
form of ‘transcendental activity’.
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The use of a qualitative methodology is, however, primarily justified and required by the affective
and experiential nature of the phenomenon in question, rather than by any disciplinary tradition
There are, of course, many variations on the qualitative theme, such as:
grounded theory studies, phenomenologies, ethnographies [and] a wide range of less
prominent methods, such as narrative analysis, qualitative case analysis, discourse
analysis, participatory action research, naturalistic inquiry, feminist methodology,
and biographical analysis (Thorne et al. 2002: 9)
The predominant focus of nursing research is the nurse-patient relationship in its many forms
(Chiarella 2002: 203) or ‘...human responses to actual or potential health problems’ (Reynolds &
Cormack 1994: 159), and it is therefore rooted in a dialogical, person-centred view of research.
In the previous chapter, I argued that the best approach to the study of spatiality would be to use
a three-dimensional model (the Proximity-Mobility-Possession framework) which started from
assumptions about embodiment and the existence of physical reality, albeit a reality which might
be described in various ways. Each of the three ‘dimensions’ represents an aspect of the
experience of space, related to distance, action and time. The conceptual framework is
predicated on ‘mine-ness’ and the existence of an intimate self which constructs or locates itself
within a world of shared practices and meanings. This suggests that, in order to access
knowledge about spatiality, there has to be a contribution from the intimate self of the other, and
phenomenological research raises questions about the possibility of acquiring knowledge of, or
from, the other. Husserl (1960: 114-115) puts it thus:
The character of the existent ‘other’ has its basis in [a] kind of verifiable
accessibility of what is not originally accessible. Whatever can become presented,
and evidently verified, originally - is something I am; or else it belongs to me as
something peculiarly my own.
In other words, I cannot directly access the experiences of the other, but can relate to it only
insofar as I have access to shared experiences, or at least a similar reality to that of the other.
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Summary
In this chapter I have discussed at some length the philosophical basis for the current research.
This has involved a certain amount of untangling of the relevant epistemological, theoreticalperspectival, methodological and methodical considerations. The study embraces realism,
constructionism, and interpretive phenomenology. Its use of realism enables the existence in
principle of physical spaces and objects, whilst the adoption of a constructionist epistemology
acknowledges the role of cultural factors or pre-dispositions in gaining knowledge of those spaces
or objects. The phenomenon of spatiality is argued to be anchored in material existence but
essentially consists of interpretations of that existence. The methodology of the study is thus, of
necessity, based on a realist ontology and a constructionist epistemology, an acknowledgement
that that there is something shared and concrete which precedes our descriptions, interpretations
and knowledge-gathering activities. I have discussed the different ways in which the term
‘phenomenology’ has been used in the research context and whether the phenomenon of spatiality
can be adequately represented in language. In the next chapter, I will discuss the specific
methods used in the research and some of the practical and theoretical issues around these.
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Chapter 4-Method
77
“A human brain...cannot be completely analyzed by any mathematical discipline now known.
No response can therefore be counted upon as a certainty”.
(Isaac Asimov, The Caves of Steel)
Introduction
GIVEN the epistemological, theoretical and methodological considerations outlined above, a
number of data-gathering methods might have been used in this study. What I will present in the
data-analysis chapters is drawn from a series of stories about aspects of experience, events or
emotional states related to space and spatiality. The ‘method’ consists in creating interpretations
of stories which are themselves interpretations of experience (Freeman 2000; see also Usher
2000: 53). I will go on to interpret these stories in terms of the theoretical framework presented
here, rather than simply describe their phenomenal content, because I believe that the richness
and complexity of these everyday interactions has explanatory power, both in relation to the
concept of spatiality and to the activities of the participants.
At this stage, however, I should clarify that, although I referred to ‘stories’ above, I will not be
focusing exclusively on narrative or story-telling as ways of analysing the data (Coffey &
Atkinson, 1996, ch.3; Harré 1998), but will be analysing the material thematically rather than, for
instance, from a life-history perspective (West 1996). Although the primary analysis is thematic,
however, parts of the interview material clearly constitute ‘stories’, which may provide a means
of access to the assumptions which underlie participants’ statements, although there are questions
of ‘voice’ and ‘audience’ to be addressed here (Ochberg 2000: 109; see also Collins 1998).
Specifically, the researcher needs to ask whether the voice of the participant is directed at, and
attuned to, the researcher in ways which influence the sort of information presented. Here,
Bakhtin’s concept of ‘polyvocality’ is useful, in highlighting the capacity of language to speak
from a cultural position, as well as from a culturally-embedded agent (Morson & Emerson 1990).
As Ochberg (2000: 111) points out, there is more to answering questions than factual responses:
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The self-images that narrators see reflected in the eyes of an audience matter because
of the life-historical resonances they evoke
These resonances need not be positive affirmations, but, according to Ochberg, can also
be a form of self-denial, or a reciprocal interrogation of the interviewer. The role of researcher
as audience is thus one which needs to be borne in mind when analysing narrative, or other
participant statements. The statement itself can, however, be problematised. Foucault (1972:
107) says of the statement that it has:
…a modality that allows it to be something more than a series of traces, something
more than a succession of marks on a substance, something more than a mere object
made by a human being; a modality that allows it to be in relation with a domain of
objects, to prescribe a definite position to any possible subject, to be situated among
other verbal performances, and to be endowed with a repeatable materiality.
(emphasis added)
Foucault’s main point here is that the statement is part of a discourse (or discursive formation),
part of an ongoing conversation between people, culture, language and objects, and is thus more
than an individual utterance. That it is also endowed with a ‘repeatable materiality’ connects it
not just to other statements but to a world, a theme which is also found in the work of Bakhtin
(1994) and his concept of heteroglossia and polyvocality (Morson & Emerson 1990), or
positionality (Holloway & Kneale 2000). For Bakhtin, discourse or speech utterances embed the
speaking subject in a web of material and social relationships, which speak through the subject.
There are thus links between the idea of ‘being-with’ which was discussed above in relation to
possession, and the emergence of materiality (and with it, spatiality) from language. It is
unlikely, however, that any practical methodology whose final expression is a written text could
hope to capture the full richness of an embodied existence, as Philo (2000) discusses in relation to
Foucault and Roussel. This point was made above in relation to the phenomenological method,
but there is a counter-point in that narrative or story-telling are themselves enriching processes
(Coffey & Atkinson 1996: 55) which restore the ‘colour’ to the faded outlines of materiality. De
Certeau, meanwhile, makes an explicit connection between spatiality and narrative – ‘[e]very
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story is a travel story - a spatial practice’ (de Certeau 1984: 115), whilst Lakoff & Johnson (1999)
show that this connection between bodily action, space and language is supported by a variety of
evidence from cognitive science and linguistics. It is thus reasonable to pursue the topic of
spatiality via language and in particular the language of research participants in the interview
situation. As I argue below, the interview was the most practical and least intrusive way of
obtaining data, given the constraints of the nursing situation.
The interview material which I draw upon in the following chapter(s) is produced by human
beings using language in social and historical contexts (Allen & Hardin 2001), or worlds, in a
Heideggerian sense (Heidegger 1962: 114) The relationship between language and world is
reciprocal, that is, these worlds or contexts are themselves ‘open spaces’ in which forms of
language can evolve, diversify, flourish or become extinct. As Strohmayer (1998: 111) suggests,
Only the spaciousness of language, or the impossibility of a one-to-one match
between word and object, is what allows for meaning in the first place, not in the
form of a Husserlian appearance, but in the form of an ‘understanding’ of what
meaning is attributed to a word, a concept, a sentence. (emphasis in original)
There is thus no such thing as an isolated piece of text, independent of a world or context (or
inter-text) (Usher, 2000: 51) although there can be texts, or objects, which have been ‘deworlded’ and which are therefore difficult or impossible to interpret, e.g. the obelisk in Kubrick’s
2001 – a Space Odyssey (1968). Because languages and texts need to be understood in their
worldly contexts, it is important to share at least some experience of the world of the participants.
Being part of the world of the university to which the students belonged was therefore helpful to
the research.
In the current study, what is of interest is the diverse ways in which students made sense of their
spatiality, irrespective of whether this sense-making could be generalised to predict the best forms
of practice for future students.
The problem is to find an appropriate way of accessing the
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spatial aspects of student experience. Students are by definition part of an organisation, and as
Morgan (1993: 169) suggests, organisations and their members are driven by a multitude of
‘hidden forces’ which it is the function of research to reveal and analyse. This ‘iceberg’ effect
can be overcome using terms such as ‘spatiality’, into which the isolated fragments of experience
can be gathered. Anderson (1983: 77-78) describes the process more eloquently:
Like a vast shapeless rock worn to a rounded boulder by countless drops of water,
the experience was shaped by millions of printed words into a ‘concept’ on the
printed page, and, in due course, into a model.
The essence of the phenomenological method, as I discussed above, is that the data operate not
only on the ‘surface’ level of lived-experience but at two levels – the level of lived experience
and the level of the phenomenon.
What is given in language is ‘symptomatic’ (Massey 2001:
35) of something happening ‘in the depths below’. Lakoff & Johnson argue that there are three
significant levels which, when taken together, structure human reality. Briefly, the level of
neural embodiment is the level of cells, nervous systems, neurons and other ‘wetware’ of the
body. The level of the cognitive unconscious is the level at which the neural ‘body’ is organised
in specific ways, e.g. to enable breathing or other bodily functions, talking and cognitive activity
generally, and the phenomenological level is the level of consciousness (Lakoff & Johnson 1999:
102-103). None of these levels, taken alone, provides a comprehensive account of the world.
The pervasiveness of metaphor in language, however, provides a bridge between the three levels
(ibid: 128).
Lakoff & Johnson’s work draws on positivist scientific evidence, but in many ways, including its
critique of Cartesianism and analytic philosophy, it confirms some of the insights of
phenomenological thinkers, whilst at the same time establishing that the scope of difference is
ultimately limited by embodiment. It also provides an analytical tool, the study of metaphors
within language, which directly links spatiality, bodily action and language. Given the importance
of language and metaphor, and the existence of shared conceptions of phenomena relating to
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spatiality, it would seem that some form of dialogue with participants would be required. The
next section discusses how this dialogue was to be achieved.
Interviews and other stories
Although I have suggested that dialogue is important, there are several ways of engaging in it,
and there were two sets of constraints on the data collection process. The first was imposed by
the choice of nursing students as research participants and the necessity of submitting research
proposals to an ethics committee in the relevant academic department, which was rightly
concerned to protect its students from intrusive methods and to maintain their privacy and
anonymity. Posing covertly as a nursing student would have been ethically unacceptable,
especially since contact with patients might have been involved. The ethical aspect, and my own
status as a ‘non-nurse’ also ruled out any form of ‘insider’ ethnography. Equally, there was no
suitable way of operating as an ‘outsider’ (Chiarella 2002: 25), or even an ‘outlaw’ (Pierce 2000:
148), in an ethnographic approach.
The second set of constraints resulted from the desire to gain a perspective on the full range of
participants’ spatial activities. Being openly present as a researcher within classroom situations
might have been possible, but would only have allowed access to one of the many kinds of spaces
used by nursing students. Gaining access to homes, accompanying students on journeys to
placements or being around them in placements for extended periods would have been intrusive.
It is possible that this reflects my perceptions of what Chiarella (2002: 39) calls ‘the nurse as
ministering angel’ image, which creates a ‘halo effect’ (ibid: 51). This made me reluctant to
occupy the space and time of the students more than was absolutely necessary.
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This suggests that the face-to-face interview would be the most appropriate method (Smith 1996:
59; see also Witz et al. 2001). As Urry (2002: 259; see also Giddens 1993: 178; Boden &
Molotch 1994) points out, human beings attach a special significance to the ‘face-to-face’
encounter, in which the expressions of participants can be mutually monitored and other forms of
non-verbal communication can take place. Smith (1996: 60; cf. Harré 1998) argues that the
interview overcomes the gendered limitations of questionnaires and other survey instruments,
which often ‘as[k] only those questions about social life which men want answered’. Interviews
themselves, however, are problematic, and Baker & Johnson (1998:230) argue that:
Language comes to be seen as a resource for describing states and assembling social
realities in particular, setting- and listener-relevant ways. Interview talk cannot be
viewed naively as more or less truthful or complete or valid in some a priori way.
Given the underlying assumption of the study that spatiality is embedded in the world, and that
my situated embodiment is part of that world, this raises the question of my own gender (and
other) biases and their possible effects on the type of questions asked and the direction taken by
the interviews. This is a difficult, if not impossible, question to answer, and I have chosen not to
pursue it systematically here, given both the impossibility of achieving gender neutrality from a
situated gender perspective, and because only two of the nursing students interviewed were male.
In a larger study with multiple researchers of different genders, this could perhaps have been
explored more fully. Whilst there were differences between male and female responses, these
were not consistent differences, and there were equally significant differences between
individual respondents. There is thus an argument for regarding gender, in this context, as a set
of practices rather than as an essential difference. Some of the interactions reported in the
interviews might thus be seen as revealing gendered practices, but the overall focus of the study
was on spatiality as providing the possibility of differentiated practices, rather than on a particular
aspect of differentiation.
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In the research interview situation, there is a need to balance the researcher’s desire to steer the
interview towards relevant topics with allowing the interviewee to suggest what might constitute
‘relevance’ or the emerging phenomena (Witz et al. 2001: 216) but here it is worth recalling
Strohmayer’s (1998: 111) reference to ‘the spaciousness of language’, in which interviewer and
interviewee can ‘stretch out’ and interrogate each other’s claims about meaning. This
spaciousness is not available in research instruments which confine participant responses to
agreeing or disagreeing with given statements. The interview also has limits as a research tool,
being a ‘snapshot’ rather than a moving picture, although it has the potential to elicit narratives
which depict the historical and futural9. Before I describe the interview process itself, however,
the next section outlines the geographical background.
A tale of two sites
In this section, I will fill in some of the background to the sites in which the research took place.
Given that the study relates to space and spatiality, it is important to establish the specific
geographical features of these two sites, and because of this specific geographical description of
the region involved, it would be difficult to convincingly disguise the institutions involved. Thus,
they retain their real names, and the main University of Stirling campus is designated SC, and its
satellite Highland Campus is designated HC. Participants have all been given pseudonyms, and
extracts from interviews have a unique ref. no.(e.g.<Terry 20>). Appendix 1 lists the
participants under these pseudonyms and provides brief biographical details of each.
The move in nurse education towards an academic qualifications structure under Project 2000 has
had effects on both the sites involved in the study. The two sites, however, had rather different
histories. Stirling is a small city in the Forth Valley of Central Scotland, and Stirling District is
an area which:
9
see Orme (1969) for discussion of the problems of temporality and memory.
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...lies at the very heart of Scotland. It covers 220,000 hectares from Tyndrum and
Crianlarich in the southern highlands to the villages of Killearn and Strathblane in
the south west and the former mining villages of Plean, Fallin and Cowie in the east.
The 83,000 population splits 50:50 urban to rural, with the urban population centring
around Stirling, Dunblane and Bridge of Allan. (COSLA 2002)
Stirling University received its charter in 1967 and was built on a greenfield site two miles
outside the city. Its department of Nursing and Midwifery was opened in 1997 after the
University had taken over the nursing role of Falkirk College, which had formerly undertaken
nurse education for the former Central Region. The city of Inverness has a marginally larger
population than Stirling itself (c.42,000) but its surrounding region is much larger, and is, as an
official website declares:
one of the most beautiful and sparsely populated areas of Europe, extending to
10,000 square miles [2,560,000ha.] The Council provides a wide range of essential
services to 208,000 people living in the Highlands. (COSLA, 2002)
Highland Campus was formerly a nursing college adjacent to Raigmore Hospital, on the outskirts
of Inverness, which has been an NHS Trust hospital since 1993 and is the largest acute hospital in
Highland Region. Taken over by the University of Stirling in 1995, it remained primarily a
nursing centre, with occasional use by other departments in connection with part-time degrees
and distance learning.
The adjoining Raigmore Hospital provided some, but not all, the acute placements for HC, and
many of the students went on placements either in other parts of Inverness, or in more distant
parts of the Highlands. It was unusual, however, for HC students to do placements at, say,
Stirling Royal Infirmary, or another institution outside Highland Region, unless a particular
specialism was unavailable, and HC offered a diverse range of possible placements in all four
branch specialisms (adult, paediatric, learning disabilities and mental health).
There are around 22 academic staff at HC, together with administrative and library staff. The
head of department is based on the Stirling campus, and an Associate Head of Department is
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based in Highland campus. The two sites are approximately 256 km apart by road (see map in
Appendix 2).
Over half of the participants (n=9 for HC and n=7 for SC) in the study were from Highland
campus (HC), and there were, therefore, questions in the schedule about the institutional status of
HC in relation to SC (Stirling University, the main campus), which gave rise to some interesting
responses. The unique geography of the Highland region made the lives of the HC participants
more spatially diverse than those of their SC counterparts, and there was a clear sense in all the
discussions with HC students that they saw themselves as peripheral to the activities of SC,
whereas SC students had no such concerns in relation to HC. Articulating the HC students’
concerns is therefore a way of acknowledging their generous co-operation with this project.
The selection process comprised two rounds of invitation letters which were sent to course tutors
(at both campuses) via the Nursing & Midwifery departmental office. The invitations covered the
full spectrum of Diploma and Degree-level undergraduate courses running at the time, but not
postgraduate courses, although one PhD student was recruited via her role as a course tutor.
These were issued to students in classes by tutors, and students responded using reply-paid
envelopes. The response rate was relatively low (21 replies out of 240 invitations, or about 9%),
suggesting that the target group were both busy and, as the course tutors had informed me, ‘overresearched’. Most of this research was generated by nursing students themselves in the form of
project work. The split between students from the two campuses involved suggested that the
Highland campus students were more enthusiastic about being researched, since their response
rate was approximately double that of the Stirling students.
The interviews were carried out in two rounds, the first of which was nominally a pilot study. In
practice, both the participant response and the functioning of the schedule were sufficiently
satisfactory in the first round for these interviews to be regarded as the main study, with the
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second round (probably for reasons of timing and class organisation) providing fewer volunteers.
The schedule was modified only slightly between rounds, with a ‘tick box’ section on types of
computer usage deleted as being irrelevant. The interviews were conducted in a variety of
settings, ranging from the student common room at HC, through the postgraduate room in my
‘own’ part of SC to a placement (day care centre) and a student’s home. All of these spaces had
implications for the power-relations of the research process. In my introductory letter, I
indicated that the participants were free to choose the interview venue, and I indicated my
willingness to come to them, as recommended by Smith (1996: 63). Most of them, however,
chose to be interviewed on the campus at times when they were there for other reasons. The
physical setting differed, however, between the two campuses. At HC, I used the student
common room, whilst at SC, where I was on ‘home ground’, I used empty seminar rooms or the
postgraduate ‘office’. A home visit was necessary to rendezvous with a student who was inbetween remote placements.
In most cases the students were not under specific time constraints on the occasion of the
interview. One was on a lunch break during a placement, and therefore had less time to spend
than might otherwise have been the case. Marrow (1996: 44) notes the problem of interruptions
when using public spaces, but these were not a problem in any of the interviews. She also notes
that the nurses in her (unrelated) research tended to bring up grievances about Project 2000 which
she had to postpone to the end of the interview and which frequently went unresolved. In my
case these grievances tended to arise in the course of discussing spatial issues and thus formed
part of the interview. Otherwise, interviews ended when I had been through the schedule and had
followed up any particular questions which arose, although the best material often came out in the
closing exchanges (I soon learned not to stop recording until the participants had left the room).
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Although I left each interview with a tape or mini-disc full of useful material, the participants left
with no material benefits from the research. Smith, however, suggests four ways in which
participants may benefit directly from the research interview (Smith 2000: 19). They may gain
new insights into personal experience, or the interview may validate their own perceptions of
reality. The interview may help them to integrate past events into their present sense of self.
Finally, the interview may help them to formulate accessible depictions of life history. Clearly
there will be huge variations in the value of any or all of these benefits to participants.
Participants spoke at the time of finding the conversations ‘interesting’ or ‘enjoyable’, which
went some way towards allaying my fear of being intrusive.
The interview schedule is reproduced in Appendix 3. It was produced by considering the
patterns of activity which, as a student, I felt would be typical of a mature student at the specific
sites chosen for the study. The questions were designed to be as open-ended as possible, with a
view to maintaining the validity of the responses.
The section on metaphor, in which a list of possible metaphors representing the University was
shown to the participants as a stimulus for their own views, was prompted by Gordon &
Lahelma’s (1996) paper, School is like an Ants’ Nest, and by an exercise which I had carried out
with a class of part-time mature students. This involved them in brainstorming and discussing
various metaphors for the university or for their situation relative to it. In the interview situation
the method was less successful, and tended to break up the flow of the conversation.
The schedule itself does not mention space or spatiality as such, but my introductory preamble, or
‘opening statement’ (Knight 1998: 1288) explained that the study was concerned with the spaces
in which the participants studied, which could be ‘on the kitchen table’, ‘in the library’, ‘on a
placement’ and so on. This led into the first question which was ‘where do you do your
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studying?’. The purpose of the preamble was to stimulate diversity in thinking about spaces
without suggesting that there might be a ‘right’ or ‘wrong’ answer to any of the questions.
Cohen & Manion (1989) refer to this technique as ‘the funnel’ (quoted in Marrow 1996: 44).
Even this innocent-sounding preamble, however, imposes a hierarchical form on the text, a form
which is inescapably set up by the research situation. This is the case even if the flow of
information is not all one-way.
The schedule focused almost exclusively on the participants as nursing students. Whilst this was
in line with the focus of the project as it had developed at that stage, there could have been
specific questions which addressed their identities outside the world of nursing. Nevertheless, all
the participants revealed much about their personal circumstances, and the pictures which
emerged from the transcripts were of complex individuals and life-histories.
Data analysis – the method
The interviews were all recorded and were transcribed using IBM ViaVoice, a proprietary speech
recognition system. This proved very successful, and the system managed to interpret all but the
most difficult proper names (‘Wick’, but not ‘Drumnadrochit’), leading to improvements in the
quality of the data handling process (Cane 1998). Because of the speed of the process, as
opposed to my slow typing, there was less temptation to skip sections, thus invisibly editing the
transcript. Speech recognition also created an opportunity to ‘relive’ the conversation in a more
immediate way than would have been possible with a typed transcription, with the prospect of
developing ‘theoretical sensitivity’ (Knight 1998: 1288) to the data. As Strauss & Corbin put it,
‘insight and understanding about a phenomenon increase as you interact with your data’ (1990,
cited in Knight 1998: 1288). Witz et al. warn that merely by working with transcripts ‘one does
not reach the feeling of complete understanding that is possible by absorbing and immersing
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oneself in audible aspects and nuances’ (Witz et al. 2001: 213), and with this in mind I re-played
the tapes from time to time in order to reinforce my perception of the participants’ moods, vocal
expressions and the ways in which they emphasised certain points.
This resulted in a rich ‘harvest’ of data, with around 750 individual paragraph-length segments.
These were initially coded within the transcripts, to preserve context. This proved valuable at all
stages of the process, since statements were kept in their original context until their final
appearance in the text of the study. Coffey & Atkinson (1996: 26) suggest that coding is a
process of ‘ generating concepts from and with [the] data’. As Richards & Richards (1995: 81)
suggest, the application of categories to the data ‘offer[s] not just a code-book but a conceptual
structure’, which should be ‘a flexible container for complex contents’. Richards & Richards also
suggest that categorisation can be ‘data-driven’ or ‘theory-driven’, ‘bottom-up’ or ‘top-down’
respectively. These spatial metaphors are interesting in themselves, but more importantly, the
methodological separation between the two is difficult to sustain. The difficulty increases as
categories shift from being objective (e.g. use of ICT, length of journey to campus) to subjective
(e.g. anxiety in computer laboratories, boredom on journeys). There are also questions about
what counts as theory. Even the spatial metaphor of enclosing the ‘complex contents’ of the
data in a ‘container’ (however flexible) suggests that the data, once collected, can be closed off
from something. The data are assumed to be complex, but what renders them complex is their
‘material existence’ (Foucault 1972: 100), which is lost as they are ‘organised’ into the
researcher’s own text. This material existence is only partly restored by the researcher’s shared
knowledge of the participants’ world, which is unavoidably incomplete. The process is rather
like a carpenter trying to recreate a tree from the pile of planks into which it has been sawn. This
is a problem which is recognised in the philosophy of transcendental realism underlying the
study, as the possibility of different descriptions of an inexhaustible reality.
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Although the three themes of proximity, mobility and possession were the basis for the coding, a
number of sub-themes were developed directly from the data as it was repeatedly reviewed.
Most of the material fell easily into segments, which were either whole responses to questions or
parts of longer responses. Sometimes shorter responses were edited together by omitting
interjections from the interviewer. Each segment was then allocated a unique index number
consisting of a letter which identified the pseudonym of the participant and a number which ran
consecutively from the beginning of each interview. In the coding process, the theme and subtheme were recorded as editing changes to the transcript document using the <track changes>
facility in the Microsoft Word <Tools> menu. This enables highlighting of additions to the
original text. By reading through the transcripts and listing index numbers against themes and
sub-themes, a coding table was produced enabling rapid location of statements by opening the
relevant transcript file and using the <Find> facility to locate the index number. An example is
given below (figure 3):
Figure 3: themes and occurrences
Theme /sub-theme
Proximity-concept of
University
Occurrences
G41,G42,G43,G44,G45,G53,J20,J21,J46,
L28,B27,M40,M41,M43,M44,M45,M46,
M52.M53,M54,D9,D69,D70,E59,E60
In the table, themes emerging from the data are coded as sub-themes relative to the main theme of
Proximity, producing a hierarchical table. The main themes were used as a form of typological
classification of the sub-themes, a classification which underwent several stages of revision as I
became more familiar with the data. The second part of the table lists the kind of statements
which fell into each sub-theme (figure 4, overleaf):
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Figure 4: Thematic headings and issues arising in data
Thematic headings
Proximity-concept of
University
Issues arising in data
sense of isolation at HC, ivory-tower
mentality of staff, SU as resource vs.
neglectful partner, relative size of HCSU, informal knowledge of SU prior
to entry, scope of possible placements,
It was originally intended to use one of the commercially-available qualitative data-analysis
(QDA) packages, such as QSR NUD*IST or Atlas/Ti, for this purpose. There has been some
critique of the usefulness of these packages in the literature (Coffey & Atkinson 1996: 166;
Pateman 1998; Morison & Moir 1998). Pateman points out that most of the functions of
dedicated QDA packages can be performed, albeit less efficiently, by word processing software.
The assumption that using an analysis package was a necessary part of the study was also
challenged by post-graduate colleagues who had explored the issue and who had resorted (in one
case) to traditional paper-based methods. Thus, there were factors external to the study which
influenced its methods.
It was felt, in any case, that the most significant issue in pursuing the analysis was the coding and
categorisation of the data, which could not be automated (Pateman 1998: 81) and was therefore
the area most likely to be subject to the idiosyncracies and inconsistencies of the individual
researcher. In larger projects various forms of cross-checking between coders would have
eliminated some of these inconsistencies, but the individual nature of the Ph.D project precluded
this. Because the chosen method involved repeated readings of the interview transcripts over an
extended period, however, many of the inconsistencies were removed and sub-themes
rationalised or eliminated as reading progressed.
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Principles of the analysis
The data were analysed thematically in the first instance, but there was also some linguistic
analysis, which was specifically concerned with the use of spatial metaphors, as suggested by the
work of Lakoff & Johnson (1999; see also Paechter 2001). Allen & Hardin (2001: 164) claim
that any ‘thematic’ analysis of interview material ‘reproduce[s] a common-sense perspective
which is difficult to shake’. They argue that an approach based on critical discourse analysis is
necessary in order to overcome the deficiencies of the phenomenological approach. As ‘we
enact our roles and relationships in language’ (ibid: 165), it is the differences expressed through
our inherited language which must form the basis for analysis. The problem is to show that the
material is open to interpretation in a meaningful way - that is, it means more than it says it does.
As Hardin (2001: 11) puts it:
...innovative research studies require moving beyond individual levels of analysis
into broader historical, social and cultural understandings of human behaviour.
As I have argued in earlier sections, there are good reasons to believe that language does not tell
the whole story about spatiality, and that spatiality and embodiment are co-implicated in
constructing knowledge about reality. Allen & Hardin are, however, right to point out that ‘the
reproduction of [linguistic] relationships point[s] to the power relations embedded in social
structure’ (Allen & Hardin, 2001: 167). Thus, what is sought in the analysis of texts is not so
much individuals’ descriptions of reality as it exists ‘in’ their experience, but maps of the lines of
difference which run through the texts. In other words, it should be the differences and contrasts,
the asymmetries, between various accounts of reality, rather than the content of particular
accounts in themselves, which are revealing, and this proved to be the case with the data here.
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There has also been much controversy over the methodological issues surrounding the validity of
qualitative research and data analysis. Whittemore et al. (2001: 523) suggest that it is not
possible to use the criteria traditionally associated with quantitative research in a natural science
mode, criteria such as internal and external validity, reliability and objectivity. They suggest
(ibid: 524) that:
Qualitative research seeks depth over breadth, and attempts to learn subtle nuances
of life experiences as opposed to aggregate evidence...Qualitative research is
contextual and subjective versus generalizable and objective.
The distinction between qualitative and quantitative research is, however, a false dichotomy, and
beside the point, as Schuttermaier & Schmitt (2001) point out. They contend that, because all
research involves ‘a dialectical process of deduction-induction’ (p.2) and:
...the debate about which method is the most ‘correct’ approach...only disguises the
fact that all researchers set out to find what it is they want to find, regardless of the
methods adopted. Therefore, any claims to universal validity are simply an illusion.
(p.5)
The point I am making here is not that method is unimportant, but that, given the constructionistrealist epistemology which I outlined earlier in the chapter, claims for the objective validity of
one method over another cannot be sustained. Equally, I cannot claim that there is no other valid
epistemology, although I can argue for the one which I have in fact used here. Against
Whittemore et al., I would, however, argue that the epistemology and theoretical perspective used
here are neither objective nor subjective, and with Bhaskar (1975) that this does not prevent the
use of reasoned argument to convince an audience that one method or result is preferable to
another.
One of the validating methods which can be used here is that of inter-study comparison, and in
this case I have been able to refer to several studies of the nursing student experience (May &
Domokos 1992; May et al. 1997; Lauder & Cuthbertson 1998; Howard 2001). Given that the
experiences of nursing students often provided contradictory evidence, even within a small
sample such as this one, the statements as a whole are in line with those in earlier studies.
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Summary
This chapter has discussed the underlying rationale for the research processes used in this study.
Reference to the work of Lakoff & Johnson (1999) suggested that embodied metaphor would
form an important bridge between the world and the texts which form the empirical data for the
study. In turn, this suggested that the data should take the form of interviews or conversations
with the participants, although this was not the only form it could have taken under different
circumstances. The data-gathering, coding and analysis methods were described, and their
limitations were acknowledged.
The combination of method and theoretical framework used here is a tool, and ‘tools help but
have no life or capacity to construct by themselves’ (Schuttermaier & Schmitt 2001:1). The
research is thus a test of the usefulness of this tool (or tool-kit) in a specific context. The tool is
designed to select, differentiate and contribute to the analysis of statements arising in the course
of qualitative research generally, and not just the interviews carried out in this study.
Before I begin to look at the data itself in Chapter 6, however, Chapter 5 explores the nursing
background and the literature which informs the study in this area.
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Chapter 5-Nurse education
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Oh, improve health, raise the standard of living. The usual talk, it didn’t impress me...It’s
just a matter of humoring them and hoping they’ll keep within reason in their notions.
Maybe some day...
(Isaac Asimov, The Caves of Steel)
Introduction
THE purpose of this chapter is to provide background information about nurse education as the
specific field in which the empirical research was conducted and from which the research
participants were drawn. Nursing is a major source of employment and a vital component of the
National Health Service, and is therefore the subject of much debate, particularly in terms of the
recruitment and retention of staff (Kirpal 2003). It should thus represent an important area of
interest to researchers. Despite the high profile of nursing within policy discourses, however,
the spatial aspects of the nursing student experience have been under-researched. This is
probably because, as was suggested in Chapter 1, space is too close to us, too much taken for
granted and too transparent, to be regarded as an important research topic in its own right. The
circumstances of nursing and of nurse education, however, give rise to a number of interesting
spatial issues, to which this chapter will draw attention. It is important to emphasise, though, that
the focus of the study is on the use of the proximity-mobility-possession framework as a way of
engaging with spatiality generally, rather than an attempt to provide substantive conclusions
about nurse education.
In common with other healthcare interest groups, nursing is affected by the ongoing
transformation of NHS working practices as a result of the introduction of Primary Care Trusts
and other organisational changes within the healthcare system generally (May et al. 1997; Knight
1998: 1287; Woods 1999; DoH 2001; Jarvis 2001). Within the context of these changes, not
only is the identity of nursing itself once again brought into question, but the structure of nurse
education is also challenged. A further round of re-organisation is on the way with the
integration of trust services into unitary NHS Health Boards, due to take place in 2004. These
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organisational changes are already well documented, but their effect on the spatiality of nurses
and, more specifically, on nursing students have not been directly researched. The current study
merely provides an analytical framework for carrying out further targeted studies in this area, but
even then, it is first necessary to explore the historical background of nursing in order to put the
current situation of nursing students into perspective.
The historical background of nurse education
The relationship with space is a fundamental relationship for nursing students, as indeed it is for
practicing nurses. In the mid 19th century, there were struggles over whether nursing should be
located in the home (domiciliary nursing) or within medical institutions and over the ‘registration
issue’, which referred to the right of nursing to be represented as a body in public space (Rafferty
1996). Representatives of government, the universities, medical schools, hospitals and
specialised colleges have since argued intermittently over where nurse education ought to be
located. These histories (or, more appropriately, herstories) of nurse education and of nursing
are, as Rafferty points out, stories about the contestation of knowledge and the nature of work.
Rafferty (1996: 188) argues that:
Nursing has invested much of its intellectual identity in science, although social rather than
natural science. Nursing’s intellectual alignment with social science has partly been defined
in opposition to the alleged positivistic and technocratic values of medicine...part of a desire
to cleave a cognitive course which distances nursing from medicine
Since its inception, nurse education has been a controversial and multi-dimensional issue, within
which the natural-science vs. social-science debate, to which Rafferty alludes above, continues.
The two main themes of the continuing arguments around nurse education have, therefore, been
firstly, the professional identity of nursing (Davies 1995) and secondly, the appropriateness of the
various institutional arrangements charged with the delivery of sufficient qualified nurses to meet
the growing demands of the health care system (May et al. 1997). This ongoing debate was
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translated into policy via the Project 2000 proposals, put forward in 1986 following a debate
begun in 1972 (Boreham et al. 2000; UKCC 1986).
Nurse education has undergone major structural changes over the thirteen years since the initial
implementation of Project 2000 in 1989 (May et al. 1997). Project 2000 began the process of
moving nurse education away from being a largely practice-based training process, in which
student nurses were in-service trainees who worked for, and were paid by, healthcare institutions
during the training period (Jacka & Lewin 1987, quoted in Holland 1999: 230). Instead, under
Project 2000, they became nursing students, with supernumerary status in relation to some (but
not all) of their practice placements (UKCC 1986; May et al. 1997). This meant that they were
not rostered, or counted towards staffing complements, in these situations. Apart from the
economic implications for health care providers (Lloyd-Jones & Akehurst 1997), this was an
important distinction, according to Infante (1985, quoted in Holland 1999: 230) in that it implied
that the transitional moment of ‘becoming a nurse’ would be deferred until after training had been
completed. As May et al. (1997) show, and as the current study confirms, this deferment of the
transition from student to nurse did not reflect the experience of the participants, most of whom,
as mature students, either brought a nurse-identity with them into college or rapidly acquired one.
The student identity was secondary, although it did have some significance, as I will discuss
below in connection with the data.
The transition of nurse education from specialised colleges and nursing schools into the Higher
Education system was the outcome of a complex political process both within and outside nursing
itself (Rafferty 1996; Davies 1995). Nevertheless, nursing became an academic topic with its
own degree structure, comprising an 18 month Common Foundation Programme (CFP) and an 18
month Branch Programme in one of four specialisms (Holland 1999: 231; May et al. 1997).
Departments of Nursing (and Midwifery) were established in a number of universities, often as a
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result of the assimilation of former colleges or nursing schools. This is the context in which the
participants in the current study worked and studied.
Nursing – back to the future?
Whilst the dynamics of this shift into HE are yet to be fully resolved (May et al. 1997), the
spatial movement of nursing into HE parallels the beginning of a move towards a ‘new
professionalism’ in nursing (Davies 1995). As Spitzer (1998) observes, there has been a
movement towards the differentiation of nursing from medicine, in which ‘the diagnosis and
treatment of human responses’ is contrasted with ‘[the] pathology, diagnosis and treatment of
disease’ (ibid: 788). At the same time there has been a trend towards clinical specialisation and
the training of nurse-practitioners in the medical model. Davies (1995) argues that this trend,
whilst it promises to allow nurses the opportunity to practice in their own right instead of being
support staff for doctors, could also lead to nurses becoming absorbed in the management of
auxiliary staff. Thus, a distanced, masculinist model of practice which, she argues, characterises
the medical profession, would be reproduced in the sphere of nursing. Although Davies is
specifically concerned to bring out the gendered aspects of professionalism, the policy discourse
also treats the new model of professionalism as an issue, as recent government documents on the
future of healthcare (DoH 2003) confirm. The role of the nurse is increasingly seen as that of a
skilled practitioner, with unskilled or lesser-skilled tasks delegated to non-nursing staff. This
strategy is, however, dependent on the ability of nurse education to deliver enough suitablyqualified candidates. As Jarvis (2001: 11) points out, plans to delegate more of the work of
doctors to nurses depend on the ‘supply [of nurses]...an increasingly scarce commodity’. The
role of the nurse is potentially ‘hollowed-out’ by this trend, which Davies (1995: 135) calls the
‘polo-mint problem’. The essence of nursing, according to Davies (see also Benner 2000) lies in
sustained, interactive contact with the patient, and this is threatened both by movement towards a
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consultancy role, and by workload and staffing problems which result in a task-oriented, reactive
approach to patients. Thus nursing disappears into ‘the hole in the middle’ of the polo-mint.
This problematisation of the nursing role might be expected to play out differently across the
varied spatial settings in which nursing is currently practised, and thus forms part of the research
interest in this study.
In connection with questions of professional identity, there is also the (equally contentious) issue
of the place of research in constructing the self-image of nursing. The medical profession,
historically, has appropriated, and legitimated itself by, the power of ‘positivist science’ (Yegdich
2000a: 29-30). As Rafferty (1996: ch. 1) notes, there have been sporadic attempts to put nursing
on a ‘scientific’ or ‘evidence-based’ foundation, but nursing has only recently begun to build an
extensive research base of its own, and to make research an intrinsic part of nurse education. It
is this openness to research which is said to characterise the ‘new professionalism’ (Davies 1995)
of nursing. Loughlin (2002) points out, however, that there are dangers in relying on ‘scholarly’
references to support health-care practice, without ensuring that these references are themselves
based on practice rather than on endless circles of referentiality. This is, of course, a danger in
relation to the current study, one which its use of in-depth material from practitioners is designed
to counter.
Whilst the professional identities of nurses were brought into question even in traditional hospital
settings, the trend towards diversified spatial settings for nursing practice extends and deepens
the debate. An increased emphasis on Primary Care (DoH 2001; Jarvis 2001) places nursing in a
collaborative role, with doctors and support staff, as the first point of contact for clients in the
community. The development of NHS Direct (NHS24 in Scotland) has, for example, resulted in
nurses responding to patients from telephone call centres, ‘[whose] role is not one of diagnosis
but rather one of assessment and reassurance’ (NHS Direct 2002). As Jarvis (2001: 6) points
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out, this is both a consequence of ‘increasing consumer expectations’, in line with the provision
of telephone banking or 24-hour filling stations, and:
the increasing feminisation of the GP workforce, with an attendant trend towards part-time
working and increasing focus on the conflicts between home and work issues.
This is in line with Davies’ (1995) call for a ‘new professionalism’ in healthcare as a response to
feminist critique of gendered social structures over the past forty years. These ‘struggles for
recognition’ (Honneth 1995; Taylor 1994), in the context of nursing as a profession or otherwise,
are still going on. (Davies 1995: 19-65). The issue for this study is not so much the construction
of ‘nursing’ as a profession, or the gendered construction of nursing skills over time, but rather
the ways in which spaces and nursing students interact in the context of nurse education. The
relevance of this evolving ‘new professionalism’ to the current study is that these trends in
healthcare policy, although initially manifested at a macro-level of socio-political policy, or
‘organisational governance’ as Woods (1999: 121) calls it, also manifest themselves spatially in
the lives of nurse students. Although, in this study, I seek to explore the micro-level of everyday
life, the level at which learning is transacted, the macro-level generates conditions and
constraints. These may be the result of deliberate policy decisions, or, as Woods suggests, they
may be contingent in the sense that they are produced by conflicts between ‘dominant’ and
‘marginal’ stakeholders, each pursuing interests or ‘idealisations’ of their own. Nursing students
are marginal stakeholders in the sense that they have little input to policy-making, although
nurses might well be considered as major, if not dominant, stakeholders in the healthcare system
as a whole.
So far, then, I have briefly discussed the evolving context of nurse education, the parallel, if
contested, rise of a new professionalism in nursing, the increasing importance of nursing research
and the diversification of settings resulting from policy trends in healthcare. There is, of course,
an existing literature concerning the experiences of nursing students under the Project 2000
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regime, and the next section reviews this literature. Although it does not set out to be exhaustive,
it covers a sufficiently wide range to establish the point that the debates around nurse education in
general and Project 2000 in particular have, in my view, focused too narrowly on nursing students
in the context of their institutional ‘bodies’, and have thus failed to make important points
regarding nurses as embodied and located beings. This does not necessarily mean that the
current study will come to radical conclusions about the nature or problems of nurse education.
In fact, there is a strong correlation between my own findings (in terms of the specific problems
facing nursing students) and those of earlier studies (e.g. May et al. 1997). This study is
intended to demonstrate not so much what the nurse-educational issues are, although they are
worth reiterating, but to show how they relate to the spatiality, the lived-experience of space, of
the students concerned..
The nursing literature and Project 2000
Before reviewing the critical nursing research literature, it is necessary to describe the context in
which nurse education is currently provided, The key document here is Project 2000: A new
preparation for practice (UKCC 1986) in which the UKCC laid out its vision of the future of
nurse education provision in the UK, at a time when ‘[a] bewildering amount of change [within
health care] was already under way’ (ibid: 3). This vision started from the premise that the
existing system of ward-based nurse training, in which trainees provided a substantial
contribution (around 20%) of the overall nursing and midwifery staffs in hospitals, was deeply
flawed. The key to the future of health care provision was increased flexibility and this was to be
promoted by the spatial dispersion of care, in a reversal of the centralising tendencies of 18th and
19th century medicine (Rafferty 1996; cf. Foucault 1973). This in turn made the provision of
training via acute hospitals ‘less appropriate’ (UKCC 1986: 19). The future thus lay in a strong
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initial education programme (the Common Foundation Programme or CFP) followed by modular
provision of specialist courses. Of particular importance here is the linguistic shift from
‘training’, in which student nurses were employees from the outset, to ‘education’ in which
nursing students participated in a (roughly) similar way to non-nursing students. There continue
to be considerable differences between the experiences of nursing and non-nursing students,
however, and this will be an issue in the discussion of the empirical data.
The shift from training to education discussed above resulted in more institutional involvement
from outside the healthcare sector than had previously been the case. The Project 2000 report
notes that, in Scotland c.1985, a college of education, five colleges of higher education and even
two universities were involved in various aspects of nurse education. The report makes the point
that this provision was poorly co-ordinated and was supplementary to that of the colleges of
nursing (and midwifery) attached to hospitals. Furthermore, the fragmented nature of the
existing training and qualification structures created a ‘vacuum’ between the identity of nurses as
‘assistants’ and as ‘managers’. Nursing, as an activity in its own right, fell into this vacuum and
disappeared (UKCC 1986: 38; see also Chiarella 2002: 47; Davies 1995). Part of the process of
change initiated by the report consisted in the replacement of a two-tier system of registration
involving Enrolled Nurses (EN) and Registered Nurses (RN) with a single level of ‘registered
practitioner’, thus filling the vacuum and giving nursing a more coherent purpose and identity.
The report (UKCC 1986: 33, see also p.35) promotes:
...a new model of professional regulation...a more mature approach to what a professional is
and should do; taking personal responsibility for one’s own development, discussing
principles, and participating in policy decisions are all part of this.
This reflects discourses of flexibility and individualisation which have arisen over the last thirty
years, including discourses of lifelong learning and enterprise. (Edwards 1997; Morgan-Klein &
Gray 2000). Given the higher level of professional autonomy expected of future practitioners, the
report proposes a radical alteration in the status of entrants to the profession. A further
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concurrent shift occurs in the curriculum, which moves (at least in the proposed Common
Foundation Programme) from a focus on ‘disease’ to a focus on ‘health’ (p.46). Nursing, under
Project 2000, is to be refocused on holistic consideration of the needs of the client, rather than on
a task-based approach under institutional direction.
The report (UKCC 1986: 55) sets out three general principles of being a student (although the
second and third are closely related). These are
that the student can clearly become part of an educational establishment, can become
increasingly self-directive as the educational programme progresses and can be permitted to
explore areas of knowledge and skill on an individual basis.
These principles will form an important aspect of the discussion of the data, and are all, to
differing extents, contested issues for the participants. The underlying change is that students are
to be ‘supernumerary’ in terms of the health care workforce, rather than being a substantial part
of it, in a shift from ‘training’ to ‘education’. This might be expected to alter the experience of
students on placements, who are required to negotiate their formal and informal relationships with
existing staff on the basis of a new asymmetry in their status. This was also a topic which
emerged from the data.
To summarise, then, Project 2000 aimed to re-establish nurse education in line with a
fundamental restructuring of the profession. Entrants would become students rather than
trainees, and partnerships would be formed between health care providers and higher and further
education institutions in order to deliver the new CFP and subsequent branch programmes. Since
1986, however, there has been a continuing debate over the proposals and their subsequent
execution. The next section will discuss some of the literature which contributes to this debate.
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Project 2000: the critical literature
The previous section discussed a UK-wide report, which nevertheless contained specific
proposals relating to nurse education in Scotland. The first substantial review of the progress of
Project 2000 in Scotland was conducted by May & Domokos (1993) on behalf of the National
Board for Nursing, Midwifery and Health Visiting for Scotland (NBS). By the time this report
was published, the first Project 2000 students were still in the nurse education system and had not
reached the registration stage, thereby making it difficult to draw substantive conclusions about
the success or otherwise of the project.
May & Domokos, however, were clear that ‘different images of the professional role exist
throughout the education and service sides of the health care system’ (ibid: 3). This was to be
expected given the scale of the transformative task initiated by the project. In the transitional
period, there were those who were bound to the previous system by their own training and
experience, together with those who espoused the new professional identity of the singlepractitioner model. Resistance to this new identity had a ‘strong clinical emphasis’ and centred
on
...the increased emphasis on community [nursing], the shortness of clinical placements and
the non-rostered [i.e. supernumerary] status of students. (ibid: 4)
Again, these issues will surface in the data analysis sections of the present study, but the section
of May & Domokos’s report which is of most relevance here is that on ‘teaching and learning
processes’. In this section, a number of issues are raised which are, in terms of the present study,
spatial issues. These include the audibility of lectures (ibid: 16), the shortage of study space
(ibid: 18) and the variable usefulness of, and practical difficulties with, placements (ibid: 20-21).
A final point made by May and Domokos is that the shift to Project 2000 and student status has
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created confusion around the question of whether attendance at lectures and other classes should
be compulsory (ibid: 26). This in turn adds to the difficulties surrounding the concepts of
learner autonomy and professional autonomy to which I referred above and to which I will return
in connection with the data.
May & Domokos’s report thus confirms that the problems discussed here under the general
heading of spatiality were problems common to nursing students at different times and in
different parts of the country. There are also questions as to why, as perceived problems or
barriers to learning, they still arise, some years after they were first raised as issues. The results
of this study suggest that this is because the importance of the spatial aspects of the student
experience has been severely undervalued.
A more recent report on the effectiveness of Project 2000 is that of Runciman et al. (1998). To
some extent, this report, also produced for the NBS, followed logically on from that of May &
Domokos, in that it was prepared five years later, at a time when the first cohorts of nurses to
have been educated under the auspices of Project 2000 had been in employment for up to 27
months. Its research questions were designed to discover whether these nurses were, or were
not, perceived by employers to be adequately skilled for their roles. Usefully, it also wished to
find out whether employers distinguished between skills, performance and competence in the
context of nursing. What it did not do directly was to look into the student experiences of these
nurses, or the experiences of those involved in delivering nurse education to them.
The main issue raised by the Runciman study is again the issue of professional autonomy vs.
student autonomy. In the opinions of the managers and supervisors interviewed, the newlyqualified nurses who had been trained under Project 2000 had frequently spent too short a time on
specific placements to fully develop their practical skills in certain areas. The short placement
meant that tasks were not repeated often enough for the students to progress from ‘novice’ to
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‘expert’ in that task (Dreyfus & Dreyfus 1986; Benner et al. 1996; Eraut 2001). This is not,
however, solely a question of skills acquisition. It is, rather a question of professional
socialisation, and lack of sufficient time for this raises doubts as to the adequacy of the overall
placement process, as Runciman et al. (1998) argue.
The most significant report in this section is that of May et al. (1997), Preparation for Practice:
Evaluation of nurse and midwife education in Scotland. This report evaluates delivery of the
interim phase of Project 2000, preceding full transfer of responsibility to the HE and FE
institutions in 1996. It incorporates a substantial qualitative element, and many of the participant
statements foreshadow statements made by participants in this study.
I will refer to specific examples in connection with the data analysis, but the May et al. report
again serves to confirm that the student statements recorded for the current study were consistent
with those made by other students in other places, some three to seven years earlier.
As with Runciman et al., findings of interest here include the following:
placement length was influential in determining the development of a range of skills
and adequate assessment of practice. (May et al., 1997: ii)
Placement-based learning was compromised by [students] being required to fill gaps
in service. (ibid: iv)
A number of other findings from this report will be discussed in later chapters, but the problems
encountered by students here are in line with those reported by May et al.. I should stress,
however, that these problems are not themselves the focus of the current study but provide
evidence for the ways in which spatiality is experienced by the participants. These participants
draw upon many sources for their identities, but for the purposes of the study the most important
of these sources is the discourse and nature of nursing itself, which is discussed in the following
section.
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The nature(s) of nursing
A basic question which underlies this study concerns the nature of nursing itself. There is a rich
literature concerning this topic, and for reasons of brevity and relevance I will review only the
material which has influenced this study.
A useful departure point for this section is Rafferty’s The Politics of Nursing Knowledge
(Rafferty 1996). The author argues (p.186) that, historically:
nurse education policy was more the product of conflict than consensus, and its
implementation was predicated predominantly upon political and economic contingencies.
Whilst nursing is now mainly associated with institutionalised healthcare, whether publicly or
privately funded, there was a historical period, prior to the mid-19th century, in which ‘nursing’
was mostly ‘domiciliary nursing’. This was an activity carried out in the homes of the sick or
injured, rather than in centralised hospitals or other spaces devoted to the purpose, and it is
important to recognise that much nursing or caring activity still takes place outwith institutional
settings. Rafferty (1996: 187), however, traces the complex historical linkages between
personalities, institutions, the state and nurse education, and concludes that:
...notwithstanding the insights derived from two decades of scholarship, our
understanding of the role that knowledge and education play in mediating the power
relations between different status groups within health care remains incomplete, if
not inchoate. What is needed is a historical sociology of nursing knowledge to take
the analytic...forward.
I would argue that not only a historical sociology, but also a spatial sociology, is required to
reach such an understanding of the power relations within nursing and specifically within nurse
education. This is because the range of spaces involved is much wider than specific health care
sites alone. Learning and nursing both happen in other places and spaces, and all of these
interact. These spatial interactions have historical effects. As Rafferty notes, conditions in the
homes of many working people were transformed as the factory and the hospital centralised
(though not in all cases) production and ‘sickness’ (Rafferty 1996: 39). Conversely, the
reputation of hospitals as fearsome places changed to reverence, as they developed into centres
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for recovery and care (ibid: 25, cf. Foucault 1973: 18). These tendencies are part of a process
identified by Foucault as being crucial to the development of medicine in the 18th and 19th
centuries, a process in which the singular and heterogeneous spatiality of the (sick) person was
replace by a homogeneous space of classifications (Foucault 1973, ch. 1).The subsequent
emergence of the educational role of hospitals involved a series of spatial interactions between
these hospitals, laboratories and medical schools (see also Schwirian 1998: 62). These spaces of
interaction mediated the competing influences of administrative bureaucratisation, scientific
discovery and the medical establishment on the development of nursing and nurse education or
training. Rafferty’s study is useful in its well-documented presentation of the historical
development of nurse education, but does not directly address the spatial issues generated
alongside issues of power and knowledge.
Another author who addresses general issues of nursing identity, with particular reference to
gender, is Davies (1995). Davies suggests that nurses have had an on-going problem with their
identity because of the male-dominated power-structures associated with medicine. The notion
of ‘professionalism’ itself is, she argues, a patriarchal concept, the adoption of which, as an
aspirational goal for nurses, is deeply problematic (Davies 1995: 62). Davies also points out that
the entire ‘manpower’ model of the NHS is predicated on massive assumptions about gender
roles and career trajectories, and she outlines the kind of support structures which might be
possible were nursing to adopt a ‘womanpower’ model (p.70). The importance of Davies’ work
to the current study is that it demonstrates that everyday life, in this case the everyday life of
nurses, can be structured by pre-reflective understandings, such as understandings of
‘professionalism’, which can be re-interpreted and questioned by appropriate forms of enquiry.
Whilst Davies takes gender as her central theme, I have taken spatiality, but without attempting to
emulate the ‘gendered spaces’ approach of, for example, Best (1995), Munt (1998) or Gordon et
al. (2000).
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Chiarella (2002) comes to similar conclusions to Davies about the fragility of concepts such as
‘professionalism’, but takes a rather different approach, focusing on the problematic legal status
of nurses as symptomatic of deeper ‘difficulties which [they] experience in their political,
professional and clinical lives’ (p.13). Using an extensive range of legal case studies, she argues
that there are five images of the nurse which have influenced public and institutional perceptions
of the nursing role (p.32). These are:
1. the nurse as domestic worker
2. the nurse as the doctor’s handmaiden
3. the nurse as a subordinate professional
4. the nurse as administering angel
5. the nurse as autonomous professional.
Chiarella argues that the first three are ‘stock stories’, often imposed by doctors or administrators,
in which nurses are ‘under [their] control’. The last two are ‘outsider stories’, actively promoted
by nurses themselves at various historical junctures in order to alter perceptions of their role. In
the context of the present study, this is important, because nursing students are involved in an
additional story, that of the shift into the academic world of Higher Education, or, ‘the nurse as
academic student’. Their identities are thus doubly problematised, since, as Chiarella suggests,
‘[t]he five images...are not separate or distinct in the daily lives of nurses’ (ibid: 232). There is
therefore an inherent difficulty for nurses and nursing students in conceptualising their
relationships with other health workers, patients and even with each other. This difficulty
extends to their relationships with spaces, an important consideration for two reasons, Firstly,
changing conceptions of the functions of healthcare and the roles of those who work in it are
putting nurses into a wider range of spatial settings than before (UKCC 1999). Nurses are to be
found in primary care centres, call centres and health promotion settings, as well as the acute
clinical settings popularly associated with nursing. Secondly, the problems of identity
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highlighted by Chiarella feed into what Davies (1995: 135) calls the ‘polo mint problem’, where
nurses are either overloaded with unskilled routine administrative and ‘domestic’ duties, and
therefore have insufficient time to practice nursing as such, or are given managerial and
professional responsibilities which have a similar effect but from the opposite direction. Either
way, their nursing role is ‘hollowed out’ and devalued.
The questions which Chiarella addresses have recently been the subject of a publication (RCN
2003) by the RCN (Royal College of Nursing), entitled Defining Nursing. This currently
represents state-of-the-art thinking around the topic, and it is significant that there was a
perception at the highest level of nursing that the profession suffered from the lack of a clear
identity and vision of its purpose. The current study should, therefore, have a function in helping
to unpick the complex strands which make up nurses’ professional identity. The RCN report
suggests (2003: 15) that nurses have a role as an ‘amalgam’, or connecting substance for a variety
of other functions and activities. This is a useful spatial metaphor, to which I will return.
The maintenance of a coherent self-image and sense of purpose for nursing students is thus both
important and difficult, in a period of transitions within the healthcare system. Carberry (2001)
suggests, however, that there are tensions between the certainties demanded by evidence-based
practice, and a world where nursing ‘positions’ are multiple, and knowledge is ‘fluid and plural’
(p.83).
Her work suggests that acknowledgement of this multiplicity and fluidity can be
emancipatory, but only if it leads to a continual reflection on, and re-telling of, the stories which
establish positionality and power (see also Francis 2000).
In another discussion of issues of power and positionality in nursing, Hicks (1999: 130) points to
the need for ‘reconsideration of both the theoretical and practical foundations of clinical care’ in
order to deal with the ‘advent of audit, accountability and litigation’. There is thus a requirement
for nursing to be founded on the rational application of principles and the evidence of empirical
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research, rather than the traditions and ‘ritualistic practices’ of the past. The insertion of a
research role into nursing models, as Hicks suggests, has gender(ed) implications, moving the
perceived stereotype of the empathic feminine nurse towards a more ruthless, positivist and
masculine image (1999:136; Yegdich 1999: 85; see also Owens & Glennerster 1990: 40; Davies
1995).
There is a certain historical irony in this, given Florence Nightingale’s passionate advocacy of
statistical research techniques (Schwirian 1998: 60-61), which themselves reflect a ‘masculinist’
model of the scientific method. According to Rafferty (1996: 44), however, Nightingale opposed
suggestions that nurse education should become an academic, university-based discipline because
nursing ability, for Nightingale, was a question of character rather than of the possession of
medical knowledge (Chiarella 2002: 44). More recently, Robinson (1994: 10) has argued that:
Although we may apply natural science knowledge in some aspects of nursing
practice (and therefore need to understand the different frames of reference to which
natural science relates), we have also to distinguish between this knowledge and
knowledge for the activities which we call ‘nursing’ and which in themselves
represent a social process. (emphasis in original)
This epistemological split becomes an issue for nursing students in the space of the placement,
where they confront different perceptions of the extent to which either form of knowledge should
validate practice. Loughlin (2002) argues that the separation of theory and practice is based on a
false premise, and that nursing in particular cannot be divorced from its practical context.
Fealy (1999) goes further into the question of the theory/practice relationship which
is at the core of nursing education and its transition into higher education. Drawing on Carr’s
typology of theory/practice relationships (Carr 1986), he points out that the regulation of practice
by science and scientific theory is not the only form which the relationship can take. The
information flow from theory to practice is not necessarily unidirectional, an important
consideration when students are making continual spatial transitions from classroom to
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placement. The experience of nursing students on placement is, as I will show, mediated in part
by their use of evidence and theory in the process of becoming socialised into the profession.
Hicks (1999) points out that there is a danger that the move towards a more masculine
(i.e.’managerial’ and ‘scientific’) model may reinforce existing gender inequalities and
imbalances, confirming males in their domination of the higher echelons of the profession. If
that were to be the case, then it is possible that spatial consequences would follow, perhaps in the
form of a harsher regime (e.g. greater expectations of personal mobility) for students.
In the present study, then, I do not set out to problematise existing models of nursing, but I
highlight areas of the data where conflict occurs. The traditional image of nursing is of acute
care work in hospital settings, and previous research has found that this self-image is prevalent
amongst nurses themselves (Heslop et al. 2001), although Tierney (1998) notes that ‘community
[nursing] has been emphasised increasingly over time’. Tierney goes on to discuss the influence
of post-modernist views on the debate around nursing models, and concludes that professional
diversification needs to be supported by a coherent vision of what nursing is about. At the same
time, some of the insights of post-modern thought are useful in keeping nursing models ‘open and
alterable’ (Reed 1995, cited in Tierney 1998: 84). Benner (2000: 306) also uses the metaphor of
openness to describe a Heideggerian approach to nursing, an approach which is based on ‘care’ as
both a fundamental element of human being and that which is increasingly absent from the
calculations of the scientific-technological-industrial complex which has commodified health and
disease. Whilst Benner’s work is not specifically concerned with the spatiality of nursing, it
attempts to apply Heideggerian phenomenology to nursing in general, although there has been
much critique of her work, both of its interpretations of Heidegger and phenomenology (Crotty
1996; see also Barkway 2001) and of its relevance to nursing practice, especially in British
nursing circles (Lawler 1998). It nevertheless establishes a link between Heidegger’s work and
nursing which will be further explored below.
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The above discussion has shown that there are major issues of identity attached to the business of
nursing. This has established a basis for exploring the spatiality of nursing, which as embodied
activity must negotiate these identity issues in spatial settings. In any event, it is important to
explore the landscape of nursing in order to reveal problems hidden by the very transparency and
familiarity of spatial, embodied life. In the next section I give some examples from the literature
where spatial issues are implicitly raised, but are not discussed or analysed as such.
Space for nursing: conspicuous by its absence?
Heslop et al. (2001) provide a good example of a paper which highlights spatial issues without
labelling them as such. They describe some of the problems experienced by Australian graduate
nurses in transition from undergraduate programmes. This process is seen as an ‘obstacle
course’, an example of the ‘journey’ metaphor, in which students are socialised into the
profession within hospital settings which are the site of ‘ritualistic’ and even ‘destructive’
practices. Yet it is these hospital settings which, according to the authors, prove most attractive
to aspiring professional nurses. ‘Locality’ was specifically identified as the single most
important factor influencing students’ choices of graduate programme
(p.629). ‘Familiarity’ was another significant factor with spatial implications, and I return to
ideas of ‘familiarity’ or ‘at-homeness’, both of which relate to possession, in my discussion of the
data. Heslop et al. thus draw attention to some potentially interesting spatial issues without
themselves addressing their importance, which is not, of course, the purpose of their paper.
Cope et al. (2000) report on the placement experiences of Scottish nurses who had recently
completed their training. They note that students ‘have to succeed in joining and being accepted
by the community of practice’ (ibid: 852) and make a useful distinction between ‘social
acceptance’ and ‘professional incorporation’ as they occur in this context. The placement
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experience, for Cope et al., was seen as an experience of social interaction rather than spatial
activity, as I characterise it below. Both standpoints are legitimate ways of researching the same
topic, and Cope et al. reach similar conclusions to the present study about the ways in which
joining a community of practice is both important to nursing students and neglected ‘in course
planning or curriculum development’ (ibid: 854). What is missing is a sense of how the space of
the placement interacts with other spaces in the lives of students. Indeed, the notion of
‘placement’ itself is not differentiated or problematised. As the participants in this study point
out, placements are highly variable both in terms of their function within the healthcare system
and in the quality of the learning experience derived from them.
More generally, Thomas et al. (2002) offer some insight into the changes which have begun to be
implemented in nurse education following the recommendations of UKCC (2001) and the DoH
report Making a difference (DoH 1999). These include the use of problem-based and enquirybased learning, the fostering of ‘learning communities’ and team-working. One of the aims of
these changes is to more fully integrate the university into its local community and to enable
students to make better use of local resources. These are clearly spatially-significant aims, and
their implementation in any given location would require more attention to the particularities of
place and space than Thomas et al. acknowledge.
Similarly, Brown & Edelmann (2000) address the problems of stress for Project 2000 students
and qualified nurses. Although they identify ‘environmental demand’ as one form of stress,
their paper treats stress as an individualised, psychological condition rather than as a conjunction
of social, psychological, physiological and spatio-temporal factors. For Brown & Edelmann,
stress can be alleviated by ‘support’ and by ‘coping techniques’ and does not appear to have
material causes or be amenable to structural solutions. Again, an approach focused on spatial
location can be revealing about stress, and may also reveal potential solutions. In the current
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study, discussion of accommodation problems on placements revealed that booking
accommodation on placements was stressful due to inadequate information coupled with supply
& demand problems. The autonomy expected of nursing students caused this stress to be
downplayed by students who ‘didn’t want to be seen to make a fuss’. The students’ spatiality
was characterised in this case by unease caused by the obstacles, both physical and metaphorical,
which they encountered in arranging placements.
Lloyd-Jones et al. (2001) approach the placement via the question of mentoring, and again,
although passing reference is made to students and mentors ‘[being] together in the placement
area’ (ibid: 159), theirs is a study which focuses on time to the exclusion of space. The linkage
of time and space is illustrated in the current study, where, for example, students on community
placements in remote areas felt that they benefited from ‘quality’ time spent on car journeys with
their mentors, journeys which were not in themselves ‘work’ or ‘learning’ as defined by LloydJones et al.. It would thus have been interesting to know how spatial details of particular
placements contributed to the quantity and quality of student-mentor contact in the Lloyd-Jones
study.
One study which does address the spatial issues generated alongside issues of power and
knowledge is that of Burden (1998). Burden discusses ‘space’ in the context of ‘curtainpositioning strategies within the maternity ward’, and hers is one of a small number of extant
nursing studies which are overtly spatial (see also Edwards S.C. 1998, Båck & Wikblad 1998).
Burden makes the important point that ‘survey and experimental studies do not facilitate the
observation and analysis of the meaning of everyday activities’ (Burden, 1998: 17). The
meaning(s) of an activity cannot be inferred without referring to social contexts.
These contexts are accessible, however imperfectly, through interviews with social actors.
Burden also discusses the problems of researcher participation and influence on these contexts, a
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problem to which I return in the methodology chapter (below). In her study, consideration of
spatiality connected it to issues of privacy, isolation and communication, each of which were
mediated by a particular spatial strategy (curtain-positioning), but were not brought into discourse
directly . Thus, spaces were qualitatively altered in the course of social interactions, and
research into spatiality produced answers across topic boundaries.
Båck & Wikblad (1998) discuss the specific issue of privacy in hospital. This is relevant to the
current study because privacy is partly a question of the possession of space and the control of
boundaries. Their study indicates that being able to monitor and provide appropriate degrees of
privacy to patients is a skill which requires practical experience in order to apply it in line with
patient needs (see also Smith 1994: 85). This is part of a range of spatial experiences which, as I
will argue, are crucial to the learning experience as a whole.
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Summary
This chapter has reviewed some of the relevant literature in the field of nursing and nurse
education, in order to situate the present study within that field. Discussion of this literature has
established that there are tensions between different notions of nursing identity. There is a lack of
nursing literature which directly addresses the questions about spatiality which are asked here, but
the existing literature suggests that nursing is in a transitional state which is leading it away from
traditional ideas centred around the hospital, to a more dispersed spatial model of nursing activity.
Several questions arise from this discussion. Firstly, if nurses are involved in spatial transitions,
both contingently in their education and structurally in the course of changes in the profession,
what tools can be used to to make sense of these transitions? Secondly, is there anything in the
spatiality of nursing students, or nurses themselves, which needs to be addressed in the interest of
better retention and recruitment. Finally, is the lack of spatial discussion in the literature a
reflection of the lack of inter-disciplinary discussion of spatiality generally? The current study
attempts to provide answers to these questions. Meanwhile, the next chapter begins to examine
the empirical data obtained from the nursing student interviews.
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Chapter 6-Into the data
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“You, Mr Baley, won’t even believe that a City dweller is capable of crossing country to get
to Spacetown. Crossing space to get to a new world must represent impossibility squared to
you.”
“That won’t last” said Baley confidently. He looked at the strips stretching to either side ,
with their human cargo whipping to his left more and more rapidly as their distance from him
increased. He had felt the strips beneath his feet many times a day almost all the days of his
life, but he had not bent his knees in anticipation of running them in seven thousand days or
more. He felt the old familiar thrill and his breath grew more rapid...
(Isaac Asimov, The Caves of Steel)
Introduction
IN chapter 4, I looked at some of the issues surrounding the data collection process, in terms of
the participant/researcher relationship. Here, I start from the knowledge imparted by the
participants. As in the rest of the study, what I wish to show is that the ways in which participants
experience space in the course of everyday activity can be related to the proximity-mobilitypossession (PMP) framework which I outlined in Chapter 2. In order to demonstrate this, I need
to begin from the experiences of individuals and deduce their ways of experiencing from those
concrete experiences.
To give an example which occurs in the data, a participant may have a particular experience of
using the library, perhaps disliking of the noise made by other students. The participant’s sense
of possession of the library is reduced because of this noise. Another participant may prefer to
engage in continual social interaction in the library, thus creating a noisy library, and in doing so
increases her own sense of possession, at the expense of the other, who dislikes noise. It is thus
not possible to generalise about whether students prefer quiet or noisy libraries, although it might
be possible to state that ‘x% of students surveyed said that they preferred the library to be quiet”,
based on a different research method. This figure is in itself insufficient to reconcile the ‘quiet’
and ‘noisy’ students, not to mention the librarians.
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It is possible, however, to suggest that there is an underlying concept (possession) around which
these preferences for different noise levels revolve. The issue is more complex than simple
preferences, and the dynamic and temporal aspects of ‘possession’ enable it to account for the
varying nature of the experience of the library, for example in and out of term-time, or at different
phases of the essay-writing process. Possession leads away from a concept of the library as a
homogenous space to a ‘heterotopic’ conceptualisation which accounts for its many
contradictory functions, to which I will return. With this in mind, I will now begin to explore
the data, looking first at the geographical relationship of the two campuses and its consequences
for relationships of proximity.
(In the extracts presented below, participants have been allocated pseudonyms, and the numbers
which accompany these refer to the indexing system as described in Chapter 4.)
The research participants were situated in two major overlapping institutional spaces.
The areas served by the respective health boards, Forth Valley for SC and Highland for HC were
clearly defined and different in geographical size by a factor of about twelve in favour of
Highland. The University as a whole, conversely, had an undefined catchment area, although
drawing many of its students (c. 85%), from the Forth Valley and Central Scotland. The pattern
of recruitment to HC followed a similar pattern, with approximately 80% of its students
recruited within its extended locality (University of Stirling 2001).
In the case of the HC students, the boundary between their campus, formerly the nursing college.
and the adjacent hospital was somewhat fluid. Although the two sets of buildings were
physically separate, they were less than a minute's walk away from each other. Buses came to
'Raigmore Hospital', rather than 'the University', and all the coming-and-going of a busy acute
hospital, with ambulances and especially helicopters, maintained the medical atmosphere, or
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‘gave [the campus] a buzz’ as one participant put it. Many of the students chose to eat in the
hospital canteen. This was constantly busy and one could immerse oneself in an atmosphere of
activity, professional gossip and banter. The identity of the ‘University of Stirling, Highland
Campus’ was announced by signs, but these buildings were otherwise dominated by the more
obvious physical presence of the hospital. The institutional merger with SC appeared to have
little influence on the spatial relationships between hospital and college, and few practical
implications for the day-to-day activities of the students, except perhaps in relation to the library,
which will be discussed in chapter 7.
As Nespor (1994) recounts in his study of physics and management students in the US, the
negotiation of the boundary between ‘student’ and ‘professional’ spaces is part of a larger process
of spatio-temporal ‘funnelling’. Student’s understanding of their identity at HC was conditioned
by this funnelling effect, in this case towards the professional identity of healthcare:
…everybody around here is in the health professions, everywhere’s just people in
uniform, doctors, nurses and so on, and you are constantly reminded of the fact that
you're a nursing student, and that you are not doing physics or something. (Doreen,
15)
It is interesting that ‘physics’ should be seen by Doreen as a discipline highly differentiated from
nursing. Nespor’s characterisation of the spaces occupied by physics students depicts them as
closed-off from other disciplines and from the public, in a hidden world of esoteric apparatus and
knowledge. Although the medical world has been similarly characterised (Davies 1995: 59), the
hospital’s functional role, and the role of nursing within that space, requires boundaries which are
permeable. For the nursing students at HC, Lave & Wenger’s (1991) ‘legitimate peripheral
participation’ is enabled by the permeable boundaries of the hospital and its spatial proximity to
the hospital, even for those students who are not officially on placement there.
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At SC the spatial situation was (and remains) quite different. The Department of Nursing and
Midwifery was housed in new, purpose-built premises (connected by corridor to other
departments), but there was no significant health-care institution within walking-distance. The
nearest large hospital (Stirling Royal Infirmary) was approximately three miles away.
Consequently, the funnelling effect noticeable at HC was not maintained by local, spatial
arrangements, and the locality was dominated not by a hospital, but by the University, so that,
outside the boundaries of their own building, nursing students were dissolved into a much larger
student body.
The funnelling process, however, was maintained in other ways. Nursing students were set a
more intensive temporal schedule than other students, working a 48-week academic year outside
the two-semester system (which effectively provided for 24 weeks of teaching time). This led to
nursing students spending time on campus out of semester when
...you could probably find a [study] room anywhere, if you wanted to spread stuff
out, a little bit in the library, around the computers, wherever. There's a big variation
in how easy it is to find space between when the regular students are here and when
they're not here. (Karen, 72)
This seasonal variation is also experienced by academic staff, but is more marked for nursing
students because they rely on a set of spaces which they share with other undergraduates. These
possessions are public (in the sense of being shared) spaces, whereas staff have access to spaces
which remain more-or-less the same over time. In the quotation above, the sense of possessing
these public spaces is modulated by the presence or absence of non-nursing students as ‘others’.
For nursing students, the experience of spatiality is thus partially constituted by their sense of
possession of the space of the university. Nespor’s ‘funnelling process’, the process of
professional socialisation, is partly maintained by the different temporal flows of students through
the spaces of the campus, which creates differentiated senses of possession for nursing and nonnursing students.
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Two participants with previous experience of Higher Education had mixed feelings about the
high degree of focus experienced on nursing courses, enjoying the ‘supportive’ environment but
missing the cultural opportunities provided by University life. Otherwise there was little evidence
that contact with non-nursing students was either specifically sought or had any effect on the
learning process and the experience of the spatiality of the campus at SC. This is a consideration
almost entirely absent from the literature on Project 2000, which, because it largely originates in
nursing studies, focuses on nursing students as nurses and not as students. Whilst recent changes
to Project 2000 priorities (Howard 2001: 37-38) have made this less of an issue, with shorter
Common Foundation Programmes and more clinical involvement in the educational process,
there are still reasons to pursue the question, as I will discuss in the following section.
Is there a world outside nursing?
One HC participant had been a student at SC some years earlier, and was thus able to compare
her experiences of nursing and non-nursing programmes. In this case, the funnelling effect was
related to the level of support provided by fellow HC students:
Yes, I don't know whether it's the course, or it’s people on the course as well, I
would say that they are much more supportive here of each other, than everywhere...
I felt, it's because it's a smaller campus as well, everybody tends to know quite a lot
of people, I'm not saying that...you know, there's always somebody there you can
talk to here if you're stressed or whatever, there are a few of my friends on the course
who have got young families, younger or older families and have certain social
situations that make it difficult sometimes for them to come into the library or
whatever, and you always say, well, if you’re needing a hand, just let me know, I
find that so much more supportive here. I was on a completely different course, so I
don't know if it's because we are supposed to be going into...a caring profession or
the people that are coming in are a different personality and I think it's... part of it is
that we’re on a smaller campus as well because Stirling's huge, there's so many
different people from so many different backgrounds doing completely different
courses and there's a tendency to get swamped, whereas here, it’s smaller, so I
suppose it's easier to get to know people… (Wanda, 30, emphasis added)
Several interesting points arise from this passage. There is repeated emphasis on the ‘supportive’
qualities of HC students, but doubt about the reasons behind this – is it because of the supposed
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nature of the ‘caring profession’, or because of the type of people who become nursing students,
or because of the smaller campus? The first point reflects the problem of multiple identities
highlighted by Chiarella (2002) and Davies (1995), in which nurses are torn between several
possible ways of being, including models of ‘professionalism’ constructed, according to Davies in
the gendered world of medicine. The second point is the related one of seeing nursing as being a
‘calling’ (Chiarella 2002: 136) requiring different qualities of its entrants from those of a nonnursing student. The issue here is not whether nursing is a ‘calling’ but whether it causes nursing
students to position non-nursing students as Other. When this is combined with the metaphor of
being ‘swamped’, as experienced during her previous course at SC, it creates a picture of a
strongly-constructed group identity. The third point is thus that the smaller campus, with its
history of nursing studies and its ‘remoteness’, is seen to constitute itself as an ‘organic
community’ (Gemeinschaft), in which ‘everybody tends to know quite a lot of people’ against the
‘faceless’ Gesellschaft represented by SC.
The use of ‘we’ to refer to the nursing student community (a common occurrence in the
interviews) is similar to its use as reported by Wichroski, which indicates ‘a reluctance...to speak
in terms of the self without reference to the community’ (Wichroski 1997: 269). The same
student had reported earlier that, in conversations out on placements, ‘...you get everybody
comparing what was in the past with what is now’ (Wanda, 29) The use of ‘everybody’
maintains the collective voice, whilst the ‘past’ to which the student refers is the pre-Project 2000
past of nurse education, prior to the introduction of academic pedagogical methods and
supernumerary status (Howard 2001: 33; Rafferty 1996). Had this extract been taken in
isolation, I could have claimed it in support of a nostalgic interpretation of Gemeinschaft versus
Gesellschaft (Giddens 1991). In the context of the conversation, however, it reflects a slightly
different view:
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you can't compare what they've done with what we've done because you've not been
through their side of things and they've not been through your side of things…
(Wanda, 29)
This reflects not so much a nostalgia for the past as the fragmentation of the nursing body along
the lines of (crudely) academic/non-academic training or post/pre-Project 2000
Another extract, however, seems to contradict the idea that nursing students are purely focused on
their own discipline:
If I were eighteen, this would be an horrendous disappointment, because for an allround education the university experience isn't happening... (Doreen, 20)
The participant in this case had also gained previous experience of higher education outside
nursing, and elsewhere in the interview speaks about the excitement of the cosmopolitan life she
had experienced as a music student in a large Scottish city:
For me, as a very mature student, I've been at college before...being able to join the
University Orchestra, or the College Choir, would be brilliant. Here, we have
absolutely nothing, other than the fact that we are nursing students, I think the focus
is far too limited, for an all-round education, this is not where you would get it
(Doreen, 16, emphasis added)
The two metaphors here suggest that, for this participant, the spatiality of HC is experienced
visually, in terms of a ‘view’, and spatially, as a restriction. Her sense of proximity, as with
some of the other examples below, is generated by the physical proximity of one spatiality being
opposed to the remembered proximity of a different and more satisfying proximity elsewhere.
In feeling this dissonant sense of proximity, she presents an alternative view of the Gemeinschaft
version of ‘community’ with its ‘conflict, oppressions and limitations’ (Usher & Edwards 2000:
34). This example illustrate the dangers of being selective in using participant quotations,
however, because the extract continues ‘...but at 40 with the kids and a house, that doesn't
matter… (Doreen, 20)’ The point here is that the participant sees maturity as narrowing the focus
of her efforts, a view discussed by Webb (2001: 410), who suggests that there is a more complex
relationship between age, previous educational experience and family ties than is sometimes
acknowledged in the literature on mature student experience.
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Along with the cultural advantages of a larger institution, there are potential problems of
academic compartmentalism, which this participant’s previous experience enabled her to
appreciate:
I feel that certainly in the CFP [Common Foundation Programme], some of the
physiology...because of my previous knowledge, I found that some of their
information wasn't accurate, or wasn't entirely accurate, I know physiology is a
complicated subject, sometimes it takes a while to get to grips with it, but maybe
having more specialised teaching, you know, somebody who has done physiology
outwith nursing would be a help......but in some ways it's an advantage having the
nursing perspective, because that's a perspective you have to have anyway, but I do
find that...there was some confusion over some of the more complicated parts of
physiology, and I'm sitting there thinking, ‘no that's not right, it should be the other
way around’, and eventually they have turned round and said ‘yes, that is right’, but
for those who haven't got a background in physiology, physiology is hard enough to
take on as it is, without having confusion given by teachers, so maybe it would help
having somebody who's got...more in-depth qualifications in the subject and an
understanding in that area. (Wanda, 33)
The point here is that only by experiencing other worlds can a perspective be developed on any
given world, a world which otherwise seems self-evident, a world which is ‘understood’ (in
Heidegger’s (1962) sense of the word) prior to any conscious interpretation. Because nurse
education, conceived as vocational training, has traditionally been based in specialised
institutions attached, for the most part, to hospitals, it has not been in close proximity to the range
of academic disciplines available within the university setting. In other words, this has limited
the opportunities for practitioners to work with (and therefore to bring into their range of
concerns) academics in other fields, which is not to say that the field of nursing studies lacks
reference to other academic fields, as the literature shows (Tierney 1998; Crotty 1996; Fogel
Keck 1994). This is a spatial issue because it is as much the spatial contingencies of local
geography, departmental siting and building design, rather than institutional policies which
mediate the interactions of teaching staff, students and researchers. Policies, of course, lie behind
decisions on siting and building design, but the complexities of spatial interaction are such that
they can only partially influence the outcomes of interactions, as Hillier acknowledges (Hillier
1996; 1999; Hillier et al. 1998).
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Knowledge and the world of nursing
There is a different proximity problem which applies to students from non-nursing backgrounds
(such as the participant above). As May et al. note, quoting a midwifery mentor,
[recruiting students other than qualified nurses]...made us realise how much of our
nursing knowledge we take for granted. (May et al. 1997: 219)
Nursing is a region, in the Heideggerian sense, within the world of healthcare, and as such,
involves a wide range of pre-conscious assumptions and tacit knowledge. As a ‘supplier’ to the
largest occupational group (for women) in the country (RCN 2002), nurse education involves
substantial numbers of students, and the background of the staff involved in teaching them is
predominantly in nursing itself. There is a large and rapidly growing body of nursing research
which provides an evidence-base for practice, but there is also a vast amount of tacit knowledge
which resides with practitioners. Tacit knowledge is ‘...rooted in individuals’ experience and
spread through direct communication’ (Tsui-Auch 2001: 718). Both institutionally and
individually, nurses overwhelmingly learn from other nurses, and are in proximity to other nurses.
Again and again, participants referred to ‘we’ or ‘the girls’ when talking about nursing students.
It could be argued that this is a question of group identity rather than an experience of spatiality,
but the two concepts are not in conflict, since ‘being-with’ is a fundamental condition of human
being which, manifested as possession, is also a fundamental element of spatiality.
The above discussion suggests that a sense of proximity is an important way of experiencing
spatiality for the participants. Having a preconception (Vorsicht, in Heidegger’s terminology) of
the university, or other purposeful space, having a sense of proximity to it, having it within the
range of one’s concerns, all these affect the way one experiences being a nursing student in
spatial situations. The ways in which identity is experienced by nursing students suggest that
there are interactions between different forms of community, or ‘worldhood’ (Heidegger 1962:
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114) which form important components of this identity. Although ‘identity’ and ‘spatiality’ are
not synonymous, they are connected via the notion of worldhood, and I will now discuss one
aspect of this connection - ‘nighness’ - as it relates to the PMP framework and to the experiences
of the participants.
Although, in the first extract in the section above, the ‘smaller’ size of HC relative to SC is a
spatial factor affecting the experience of being a student there, it is important to consider what
‘smaller’ means in this context. The implication of the passage is that it is smaller in terms of its
‘population’, that is, it is only occupied – possessed - by nursing students. This is not a
discussion of floor area or student numbers. It is an example of Heidegger’s distinction between
‘nearness’ and ‘nighness’ (1971a: 104; cf. 1971b: 175). Parametric distance cannot measure the
closeness or distance of neighbours or colleagues, which Heidegger characterises as ‘nighness’.
Nighness is more than ‘being within one’s range of concerns’, or proximity, and more than
mobility, being able to act over the intervening distance. It involves an affective relationship, but
is not synonymous with possession, the object of which, as I use it here, is always a space.
Nighness to supportive colleagues is what establishes a particular relationship of possession here.
The spatial metaphor in ‘supportive’ also gains significance from the work of Lakoff & Johnson,
which suggests that the physical action of supporting, of keeping something up, is related via its
metaphorical usage to the conceptual structure of feelings-as-objects (Lakoff & Johnson 1999:88;
230-231).
Nighness and possession, however, both have negative sides. For Anita (a post-graduate student
who was also a tutor) the relationship with SC resulted in a form of dispossession. In discussing
her feelings about the SC/HC merger, this was expressed as the kind of indefinable strangeness
captured by the German word Unheimlich:
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[I] feel the proximity of the hospital in an ambiguous way - in one sense it makes
the Highland campus seem closer to the hospital than the University...it's an odd
relationship, because we used to be part of the same organisation as the hospital, but
on the other hand it also means that there's a huge resource over there, it's an odd
relationship now, it's not negative in any way, it's not that people feel we're different
from the way that we were four years ago...when we came in...it's just different...I
suppose that change started a long way back when the hospital trusts were set up and
we weren't part of the health board altogether, so part of it traces back to their
changes...it's very strange...(Anita, 20, 21)
That the proximity relationship does not depend on parametric distance is demonstrated by the
second line above, in which it is implied that HC ought to feel closer to the University than the
hospital, but does not, in fact, feel close. The sense of possession felt by this participant is
constructed partly on the basis of her sense of proximity, which maintains HC as a ‘world of its
own’ essentially independent of its dominant institutional parent. The indefinability and
'strangeness' of the difference seem to arise from the ambiguous nature of the ‘odd relationship’
of HC to the remote SC and to the world of nursing and healthcare, which appears close
physically but is now more distant institutionally. There is thus a split sense of proximity which
generates dissonance between the institutional world of the university and that of the healthcare
system. Possession thus emerges from this split sense of proximity, in this case as a ‘strange’
sense of dispossession. The feeling that things are not as they might be, or ought to be, alters the
sense of possession, but cannot abolish it, since it encompasses both positive and negative
‘possessions’, with a range of ‘in-betweens’.
One of the SC participants, Terry, neatly illustrates this connection between proximity, distance
and possession:
I know it's [HC] there, but I haven't actually thought about it as part of the
University, I know it's part of our campus, but it’s faraway, I never really thought
about it… (Terry, 27)
HC is on the horizon of Terry’s range of concerns, just within view but not close enough to grasp
as an affordance (Gibson 1979; Kelly 2000). It is therefore in the proximity of the participant
but not in his possession, nor is he called upon to exercise mobility in relation to it. This is not,
however, to suggest that this is a static relationship:
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...it's [visit to HC] being talked about, Highland campus and Stirling, us meeting up
and spending some time, and know what’s happening, meet the students from up
there to discuss things and see what's going on, to exchange ideas, a different
viewpoints, I think that would be really good, it's been talked about but nobody's
really acted on it yet. (Terry, 25)
The sense of ‘farawayness’ might be replaced, after the visit, by a sense of nighness, of
graspability and therefore of possession. Whilst there is a slight contradiction between the two
quotations (‘I never really thought about it’ and ‘it’s being talked about’), it does not affect the
shift from proximity to possession which will inevitably occur when the two groups come
together. This relationship between the two campuses was mediated by various features of the
institutional politics of the university, as the next section will show.
In the course of discussion about perceptions of the University, a course tutor10 at HC came up
with the following metaphor for SC:
Eldorado-cum-Mothership, ...it feels like checking back in with the control
centre...and the power source as well I think. (Anita, 22)
The locus of control - the committee meetings and the offices of those in charge - was thus firmly
situated at SC:
[I think] there is an issue of power relations between [SC and HC]...a sense of being
out on the periphery, a sense of not being in the centre of decision making and ...not
being aware of what's going on all the time...we don't meet many people, we're not in
those informal networks, most of our contacts are with the other end of the
department, and not even very much with other departments within the faculty...so
our links are really quite limited...we miss out on all those informal things. (Anita,
23)
This passage reveals that the dissemination of certain types of knowledge within and across the
institution is not just a matter of e-mail lists and departmental newsletters, but involves ‘the
compulsion of proximity’ (Boden & Molotch 1994; Urry 2002: 159) in other words, informal,
face-to-face contact on a daily basis. Face-to-face contact is, of course, no more neutral in power
terms than any other form of communication (Nespor 1994; Scott 2001: 40). Although some
meetings between staff members were held at a venue half-way between the two sites, there were
still many occasions when staff from either site were compelled to make the full journey. The
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level of mobility expected of staff was thus quite high, but what is significant here is that distance
had not been abolished by , but was maintained both by physical spatial arrangements and by
particular alignments of networks. The experience of spatiality, for this participant, was thus one
in which her proximity relationship with the University (as institutional hierarchy) interfered with
her sense of possession of the locality. Her mobility, required under a ‘civil regime of
justification’ (Boltanski & Thévenot 1991: 202; Albertsen & Diken 2001: 3-4), far from
increasing her sense of possession across the space of the University, actually reduces it, because
the remoteness of SC in terms of mobility was reinforced by an apparent lack of interest or
involvement in HC activities ( a proximity relationship) amongst SC staff:
I don't know, I've been here [SC] many times, and I feel comfortable here, but I also
get the feeling that hardly anyone here knows who we are or knows of our existence
- I was at a meeting this morning and the chair asked if there were any issues from
HC and a few eyebrows shot up, I don't think they'd thought, I don't think they knew
who I was and I don't think they'd consider that was relevant…Before we joined I
rather naively thought there would be more traffic, south to north, we'd be seen as
quite a good resource that other departments would make use of...
(So there's a perception that you're quite isolated?) Yes there is. (Anita 22)
The purpose of this discussion is to highlight the way in which spatiality is constitutive of the
historical experience of the institution as a whole, whilst it is rarely foregrounded in institutional
discourse. It would require more research using a different set of informants to produce a
balanced account of this aspect of spatiality, but the example suggests that analysis of the
relationship between proximity, mobility and possession would be a useful way of pursuing this
research.
Perceptions of distance between HC and SC were, therefore, important, although this applied
more to staff than to students:
I suppose from a student's point of view I'm not really aware of the relationship
[between HC/SC], it's more for the administrators and managers here, I don't really
consider myself part of Stirling University, I'm more of a Raigmore student...(M23)
10
interviewed in her capacity as a postgraduate student
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The proximity of the University was reduced by the lack of any perceived connection or
involvement between the two sites. None of the participants at either site had visited the other
campus in the course of their nursing studies, although one had done a (non-nursing) degree
course there and another had visited briefly ‘as a tourist’. There was a high level of curiosity as
to what the other campus was like, and there were intermittent suggestions for some sort of coach
trip in one direction or the other.
There was thus a perception amongst HC students that HC was peripheral to the interests of the
University as a whole, although in relation to the overall size of the Dept. of Nursing &
Midwifery, the HC staff and students made up about 40% of the total. This feeling was apparent
in an exchange about spatial metaphor:
(Q: Do you think of SC as being up or down from HC?)
I think I say I'm going down the road, not using up or down in any evaluative way
(laughs) ...we do joke about how the road south to north is much longer than north to
south, but that was always the case. (Anita, 25)
The second sentence above, although apparently flippant, is only partially so, reflecting a feeling
of asymmetry in the power relations between the two sites. The north-south divide was an issue
in other ways.
I had really expected that other departments would want to make use of the north,
that [SC] departments like Education and Social Work would be sending students,
and that other people would be interested in research...the nature of our area is so
different and unique...and natural sciences too, I had expected that there would be
something there to engage them ...it's all a little disappointing (Anita, 50)
Anita seems to suggest here that HC should be regarded as a resource, a kind of field centre to
which SC nursing students could come to take advantage of opportunities not available in Central
Scotland, such as the possibility of placements in remote rural communities. This lack of interest
or ‘engagement’ on the part of SC again suggests that the proximity relationship between them is
weak. A strong sense of possession at HC is suggested by talk of ‘ [t]he different and unique
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nature of [our area]’, and a lack of mobility between the two sites contributes to a diminished
sense of possession of the University space as a whole.
In the above quotation, what contributes to the north being a potential ‘resource’ is its
difference and distance from other regions, but this difference was not always apparent from
‘outside’, andthe reality of rural life in Highland Region was not always what the students
expected:
…they get surprised when they come across rural problems, and I think they have a
picture of the west Highlands as being really twee and cuddly, a bit like the Monarch
of the Glen, but they come across alcohol problems and child abuse and ...it’s very
difficult for them. (Anita, 28)
This extract illustrates the increasing range of problems with which nurses are expected to engage
as their role expands (Magennis et al. 1999). The problems of alcohol and child abuse are not
confined to Highland Region, and as the extract suggests, the public image of ‘the Highlands’ is
that of a scenic area, a picturesque wilderness, rather than that of a region with multiple areas of
social and economic deprivation (Scottish Executive 2002). This difference in perceptions is
emphasised during the course of journeys to HC, even relatively short ones:
It's [journey to HC] not too bad, only about 20 minutes, the only complaint would
be... the single track roads up here. (Andy, 23)
The phrase 'single-track roads' has connotations of remoteness, sheep, hills and slow journeys,
and all of these characteristics of the region, are, as Urry (2001b) puts it, ‘consumed’ by tourists
whilst problematic for ‘locals’. Differences in terrain and scale between HC and SC alter the
effect of placements on the student experience, and the role of the tutor is also subtly altered,
leading in some cases to a more concentrated experience and to a better relationship between
student and tutor :
In a way going to visit the more remote [student on placement], it's a more intense
visit...I'd be there for longer and I'd have a very clear idea of what we were going to
do...It's to make going that distance worthwhile. and also to address issues about
isolation and working alone and unsupervised that sometimes students have when
they're working in areas like that, and also some of the issues that they will have
come across…
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(Q: Would you say isolation was a big problem for them [the students]?)
It can be...if you're a two hour drive from the next person in your group, and we do
try to put them as near together as possible, occasionally if you put them into an area
like Lochaber or the far North, there will be one or two who will be a long way from
the rest of the group, and particularly if it's winter they do feel very cut off. (Anita,
28/29)
Here again, the issue of proximity is extremely important, and there is an alteration in the sense of
proximity due to perceptions of the increased difficulty of the journey. The sense of ‘feeling cut
off’ is not dependent on whether the journey actually needs to be made, although that will
sometimes be the case, but on the possibility of making the journey. In terms of the PMP
framework, the students’ mobility is restricted, leading to a reduction in proximity.
The tutor’s efforts ‘to make going that distance worthwhile’ bring in another set of metaphorical
concepts: the ‘Time is a resource’ metaphor (Lakoff & Johnson 1999: 162). ‘Going that
distance’ is an expression of time as space, whilst the implication is that time is expensive,
making it necessary to get better value out of the visit. In this case. the tutor’s sense of
possession (with regard to the supervisory visit) is enhanced both temporally and spatially.
Overcoming the obstacle(s) presented by the difficult journey is rewarded by a better visit. In the
PMP framework, one of the key features of possession was that it describes the relationship
between self and space over time. This extract describes how possession is gained in placements:
I like to give myself three days to fit in to, and to know where things are, not the
routine as such, but to get familiar with the particular times, breakfast lunch and
dinner, that kind of thing so I say to myself, ‘three days to be able to gain the
confidence of my supervisor’, and if I'd gain the confidence of my supervisor, her
confidence would allow me to do more...(Naomi, 22)
The reason for describing this process as ‘[gaining] possession’, and not as ‘familiarisation’ is to
acknowledge the wide range of positive and negative feelings which spaces afford the students or
other actors involved with those spaces. It also acknowledges the power relations which apply to
them. One final extract on this topic illustrates how possession does not automatically increase
over time:
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there was the one particular placement, I walked in, and automatically thought, I'll
suss this out, I got the feel for, well, at this isn't exactly...student friendly, I know
where I stand, so I'm really going to... Very hesitant to mention that I was an
enrolled nurse, and then as you get to know people, as you do, it came out that... I
was an enrolled nurse, and my supervisor overheard it, and it wasn't taken very well,
so apart from it being a less than marginal OK placement, it decreased dramatically
after that, very snide, very unpleasant, but I stuck with it and did what I could, and
when you're working by yourself with particular patients, you do tend to say, well
this is the time when I'm actually going to make the most of it, and do what I think
was right (Naomi, 21)
In this extract, it is clear that issues of identity pervade the space in which the placement is
operationalised, and that these prevented the experience of the placement being a useful and
enjoyable one for the student. Recognising that possession of the placement setting is an
important component of professional socialisation would be a first step towards improving the
process. Taking an overtly spatial approach might mean concessions and negotiations, and
acknowledging that all spaces are shared spaces by definition.
Mobility and the journey
This section extends the exploration of the data by focusing on issues of mobility, the power to
act over distance. Action over distance implies that both the departure point and the destination
or target of the action are within the range of concerns of the actor. Mobility across this range of
concerns may, of course, be impeded both by contingencies and by structural constraints.
Examining the use of the metaphors and discursive constructions, especially those around the
concept of ‘journey’ helps to identify these contingencies and constraints as they affect the
student experience of spatiality. Essentially, the journey connects two or more domains (e.g.
home-college), but also acts as a space in its own right, and as a spatial metaphor for the learning
process. In the following sections, I begin to address each of these meanings.
One of the questions which originally inspired the study was ‘why does walking help thinking?’.
The following extract explores the relationship between the physical and the cerebral:
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I really like my time walking, I'd just come out of the [name] building and walk, I
enjoy the peace it gives me, the time to unwind, and just reflect on things, or if
you've just come out of something and your head is buzzing...so I enjoy my walk and
the benefits of physical activity as well (Karen, 10/11)
Walking is a good example of the intertwining of the spatial, the metaphorical and the temporal moving through physical space in a way which enables concentration on things other than the
activity itself. In this case Karen’s home was near enough to the campus for her to walk to
classes. The extract continues:
It started off, I felt very apprehensive because it was such a big step and it was new
and you felt like this new kid on the block, even though you knew there were other
people, there were feelings of apprehension, now you just concentrate, I really enjoy
the walk, all that wildlife, there's a pleasurable sense as you walk along, of the smells
and the flowers and seeing it turn all green and lovely which is nice, and then you
walk across the bridge and that's you in and I'm concentrating on what's ahead of
me. (Karen, 12/13, emphasis added)
The interesting points here are the shift from the physical mobility of walking to the metaphorical
mobility of the ‘big step’, the shift from a weak to a strong sense of proximity (from ‘outside’ to
being ‘in’) and the concurrent increase in Karen’s sense of possession (‘now you just
concentrate...’) as she exercises her mobility in moving to what is ahead, both in the physical and
temporal sense. Karen had, by her own admission, little in the way of domestic responsibilities,
and was thus able to experience walking as pleasurable rather than as a slow means of travel (or
resistance to mobility).
In other interviews, however, the relationship between personal space and activity was expressed
in connection with driving. HC students rarely mentioned walking as the distances involved were
(usually) too great or (occasionally) too short to count as ‘a walk’. Driving was an important
part of living in Highland Region, as was highlighted by one student:
If you've got company it is [useful time] but if you're on your own...the scenery's
nice but...the weather's horrible...I got up to Wick and the day after we were snowed
in [at] Helmdale [which] is wicked...I do at least 12,000 miles [per year] down to
Birmingham and back...so I'm used to long journeys (Helen, 30)
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Attitudes towards driving are important in establishing the significance of distance and thus the
ways in which spatiality is experienced via the journey. Helen’s car, and the road system, and
the fuel supply, and a multitude of other contributory elements, ‘knot together’ to position her as
a mobile actor. It is the relative stability of this knot which is important. When the stability of
the knot breaks down, on a snowy day in Wick, her mobility is brought into question. The
‘handiness’ of the road transport system (its Zuhandenheit, in Heideggerian terms) begins to
break down and the interdependence of its elements becomes apparent - the car becomes a useless
lump of cold metal. Her phrase‘...but I’m used to long journeys’ serves to confirm that her
mobility is justified by both the ‘industrial’ and the ‘domestic regimes of justification’ (Boltanski
& Thévenot 1991: 200 ff.). The industrial regime provides and profits from the technologies
which enable Helen to fulfil her domestic obligations (Urry 1999: 262).
Given the complex systems which create and sustain it, it is not surprising that mobility is highly
differentiated, and the work of Doreen Massey (1992; 1994a; 1994b; see also Bridge 1997) is
exemplary in exploring the spatio-political implications of this. This differentiation was apparent
in the statements of those who did not drive. Most journeys to placements, if they were
undertaken by public transport, took several hours, and although it was possible to use the time
for study, the effect was that the students concerned were deprived of quality study time, or time
with their families. Trains were not always available, and the bus - on winding and hilly roads was not a good environment for reading, much less writing. The under-valuation of the students’
time reflects a particular conception of their professional identity (Chiarella 2002), but more
importantly for this study, it also reflects an underlying assumption that mobility is a duty as well
as a right, an assumption which remained valid whether or not the students had access to cars.
Despite the cost of car ownership relative to income, the deficiencies of public transport provided
an incentive to take up driving:
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I don't have a licence, but I am going to be getting a car, so I am working towards
getting my licence. (Naomi, 9)
It was clear from discussion of remote placements in the Western Highlands that driving was one
of the skills necessary to function as a community nurse, and probably in other branch
specialisms as well. Although not on the curriculum, the expectation was incorporated in job
descriptions and other discourses. One postgraduate student and tutor raised the related issue of
car ownership:
...sometimes [travel problems] can disadvantage [students] in the experience they
can get, I visited a student last month who was a third year doing community nursing
in Skye, and she can drive but she doesn’t have a car, if she could have had a hire
car...we’re negotiating to get this, it seems to me very slowly...if she could have had
a car she could have had a much better experience, she could have taken on a
caseload and functioned really quite well, and it would have taken a lot of pressure
off her supervisor who had to ferry her around an awful lot. (Anita, 34, emphasis
added)
Unusually, this extract challenges the assumption that mobility is a duty as well as a right, and.
the expression ‘ferry her around’ positions the student as passive and helpless in her failure to
participate in ‘driving culture’. This was the only statement in which the possibility was raised
that mobility should be the responsibility, at least in part, of the institution rather than the
individual student. As Urry (1999: 12) puts it:
Not to drive and not to have a car is to fail to participate fully in western
societies...The car is never simply a means of transport. To possess a car and to be
able to drive it are crucially significant rights...
This hints at a general assumption which underlies discourses of professional ‘flexibility’ and
mobility. The assumption is that individuals will manifest certain types of mobility as a matter
of course, and that these can be co-opted for the purposes of optimising their usefulness to the
labour market.
The SC students had relatively short journeys to the campus and the majority of their placements,
and from the students’ perspective these journeys were generally unproblematic. This raises the
interesting question of how journeys are conceptualised, and suggests that those taking less than
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about 20 minutes are almost disregarded, whilst journeys taking more than 20 minutes become
spaces in their own right:
I come in from [X], it's about half-an-hour in the mornings, and about 20 minutes
when it's not busy, [that's driving], I have to drive in every day and drive back.
(Doreen 11)
I travel to.[X]..every day... it's not too bad, about an hour-and-a-half drive. (Joanne,
14)
…I do at least 12,000 miles a year, to [X] and back, for relatives, so I'm used to long
journeys. (Helen, 30)
These three extracts illustrate how long car journeys have become the norm, not calling for
protest or further comment. The three journeys here are respectively 16, 54 and 439 miles (onroad distance), and demonstrate varying degrees of what Adams (1999) calls ‘hypermobility’.
Although the third extract refers to journeys performed for reasons not directly connected with
nurse education, it establishes that this level of mobility can be seen as both a right and a duty
(Urry 2001b: 238), and is self-reproducing, as the extract demonstrates. Once one becomes ‘used
to’ the long drive, or rail journey, it is easy to extend it further. The car is especially seductive in
this respect as it extends the capabilities, or the ‘grasp’, of the body (Merleau-Ponty 1962; Urry
1998; Kelly 2000).
The issue here is that nurse education institutions are able to demand this embodied and enhanced
mobility by virtue of their proximity relationship with a certain space (e.g. Highland Region).
Their proximity relationship with the region is not simply one of ‘location’, but their
incorporation within networks of hospitals, community health centres and so on. These are
known to the institution and vice-versa. Mapped on to this relationship, however, is an official
discourse which requires a certain aggregate time on placement for each student. This discourse
is not spatially-specific, and thus travel times and snowbound roads do not often figure within it.
Significantly, however, Peach (UKCC 1999: 33), notes that ‘difficulties with travelling to and
from practice placements’ continue to be a significant cause of attrition for nursing students. The
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evidence from this study is that these difficulties are not a result of individual circumstances but
are symptomatic of an underlying spatial paradigm in which mobility is taken for granted and is
experienced as desirable in its own right. This paradigm has been brought into question by
environmentalists (Wackernagel & Rees 1996), and Adams (1999) specifically addresses the
question of the long-term sustainability of this trend. In the case of the HC students and their
institutional context, there are, at least in the short-term, few alternatives, given the shortage of
placement opportunities in the immediate area of their campus, but future recruitment and
retention policies may have to take more account of the difficulties highlighted here.
The Journey as space in its own right
Apart from extending the ‘grasp’ or reach of the body, one of the other reasons that car travel is
so seductive is that it provides a high-quality personal space, free from interruptions (mobile
phones excepted), with comfortable seats, controlled temperature and usually some form of audio
entertainment (Urry 1999). Responsibility for controlling the car is delegated largely to the
cognitive unconscious (Lakoff & Johnson 1999), and the actions of driving rarely intrude on
consciousness except in circumstances such as a driving test or a ‘breakdown’ situation (Dreyfus
& Dreyfus 1986; 1999: Eraut 2001). Time spent travelling in cars is perceived as unavoidable
and can only be colonised by work in certain ways, such as having a conversation but not by
typing or reading. For drivers, and to some extent passengers, possession of the space of the car,
and of the space opened up by the car, is therefore at a high level.
Because of the distances, and therefore the time, involved in road journeys in the Highlands, this
was an important time-space in its own right for those participants required to travel. In this
case, time and space were connected – one was not so useful without the other, as in the case of
bus journeys:
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…even near [placements] can be an hour or two's trip away, so sometimes you take
your articles and read them on the bus, at the beginning stages of formulating your
essay
(Q: So the journey is that sometimes useful study time?)
Sometimes, taking the train would be of more benefit, because when you're in the
early stages of writing your article or essay you could use the train as a table and it
would be stable enough to do that, whereas on the bus there is just no space to do
anything like that... (Naomi, 6/7)
Naomi had previously described a certain way of spreading out her materials for essays at home,
and would clearly like to be able to do things similarly on the train. As with colonisation of the
home, colonisation of the journey by academic work appears to be an efficient use of ‘wasted’
time. The spatial problems which prevent this efficient use are related to the terrain and to
transport policy in the first instance (winding roads, few train services), and to lack of study time
overall, a problem made worse by the need for long journeys. The tutor from HC described the
competing pressures for this time/space:
[My enjoyment of the journey]...depends how I'm doing it, if I'm driving alone, not
always, it can be alright, some good thinking time, the students get very wise to this
and say ‘If you're coming this week it must be Thursday and it turns out when I get
there... they want a lift back, that's fine, it gives me an extra couple of hours with
them sometimes, which is very worthwhile...long journeys alone, I do sometimes
take tapes and use that time, it's not always possible, I'm not sure that it's a good idea
to have your attention divided, particularly if it's dark... (Anita 31/32)
The students also found that journeys, even relatively short ones (c.20-30 min.) were useful
opportunities for discussion:
If possible I do give people lifts, for the company, it saves them messing around with
buses...(Helen 29)
I take someone else in, and it's quite useful to talk to another student in the car,
because we can reflect on what happened the day before, and what's going to happen
today...(N25)
The difference between the social setting of the shared journey and the social spaces of the
campus lies in the one-to-one interaction which becomes possible in the confines of the car.
There are negative associations to consider as well, as one of the participants (a nurse-mentor) in
May et al.’s research pointed out:
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I find I’m talking as I’m driving all day which is physically and mentally shattering
as well as dangerous. I also find that there is no time, when you have a student, to
change into another gear and wind down for a few moments...
(May et al. 1997: 320)
The use of the ‘change...gear’ metaphor is significant in linking the physical activity of driving to
the social activity of dealing with students. The giving of undivided attention is potentially vital
both in driving and to the maintenance of a student-centred approach to mentoring – albeit that
these require different ‘gears’ from the person performing these actions.
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Summary
In this chapter I argue that nursing students form a unique group within the communities of
higher education in which they find themselves under Project 2000. One of the most prevalent
metaphorical conceptualisation of these activities was that of the journey, and that the physicalspatial activity which students undertook in the course of performing the activities reinforced this
metaphorical conception. Analysis of metaphors used by the students related them to
proximity, mobility and possession, the three elements of the PMP framework. The proximity of
nurse students to the institution and to each other is significant in terms of mutual support and
identification as a group. Conversely, the distance between the two locations in the study had
interesting effects on both sets of students, who each tended to see the other site as more desirable
or interesting than their own. There was a perceived asymmetrical relationship of power between
the two sites which caused some resentment at times. Finally, physical journeys were seen to
have effects on the process of becoming a nurse, which were not always recognised by the
institution. In the next chapter, I continue to focus on the interview material in the context of
some specific ‘contested spaces’ within the world of the nursing students.
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Chapter 7-Contested spaces
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Of course it’s rather gruesome eating in a strange kitchen. There’s no-one about whom you
know. In your own kitchen it’s quite different. You have your own seat which you occupy
all the time...
What was the capacity of an average kitchen? He had once seen the figure. Two thousand
two hundred, he thought. This one was larger than average...
(Isaac Asimov, The Caves of Steel)
Introduction
IN this chapter, I refer to ‘contested spaces’, because it is the contestation or ‘friction’ around
spaces which renders them visible and brings them into discourse. The spaces are the home, the
library (including computer laboratories) and the lecture theatre. I will discuss these both
generically and with reference to specific examples, since my argument will be that spatial
interactions around these concepts are both contingent and subject to institutional constraints and
strategies, More fundamentally, the roles played by specific types of spaces are less important to
the studying and learning activities of the students than the spatial whole formed by their
conjunction, and the PMP framework will again prove useful in demonstrating this.
Home is where the photocopies are?
In the discussion of the PMP framework, I used the concept of ‘home’ in a representation of the
basic proximity-mobility-possession structure, which, in its simplest form, is analogous to home
- going home – at home. ‘Home’ is a good example of a contested spatial concept (Edwards &
Usher 2000: 34-35; Bordo et al. 1998) and I use it cautiously here. Within earlier writing on
spatiality, the notion of ‘home’ is a central theme in Bachelard’s The Poetics of Space, (Bachelard
1969; Best 1995:182). Bachelard explores the poetic linkage between space(s) and thought,
which are also Heidegger’s fundamental concerns in Building Dwelling Thinking (Heidegger
1993a). With both writers there are strong links between the housed body and the self (Malpas
1999: 176). For Irigaray, it is the unspoken desire, within this male-dominated discourse, to
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return to a ‘maternal’ origin which she problematises (Irigaray 1993; Brennan 1993, ch.1 & p.88
ff.; Rose 1993:108), and concepts of ‘mothering’ were certainly present in the interview data.
Nevertheless, the ideas of ‘home’ or ‘dwelling’ carry multiple connotations, some of which are
conflictual (Stone 1996), and their meanings cannot be reduced to singular or binary essences.
Feminist critics such as Rose (1993) have problematised ‘home’ as, for example, the site of
domestic violence, or in the context of technology, as constructed around a gendered notion of
‘family’ (Wajcman 1991: 110). Recent trends in tele-working, and the continued exploitation of
‘home-workers’ in the garment and other trades, have brought the boundaries between ‘home’
and ‘work’ into question (Wajcman 1991; Castells 1996; Edwards & Usher 2000), and for
students, the boundary between home as home, and home as study-space, continues to be
problematic, especially in on-line & distance learning (Twining 2001). In this chapter, I examine
some of the empirical material relating to concepts of ‘home’ and its boundaries, and discuss
what these data might tell us about the spatiality of ‘home’ for nursing students.
The basic requirement for studying at home is ‘personal space’, which involves both control over
spaces within the home and of the times when it might be available. The initial questions in the
interview schedule were in fact about this control of domestic space. Private, undisturbed
personal space was seen as a highly desirable commodity:
I live in a flat with one other person, and we have a Landlady who comes and goes,
so it's very quiet which I like, the other person, she's just finishing a one-year course
...or something like that, but she's only in for about three months and then she's off
so I have really long periods of time on my own which is great. I have been lucky in
that way, in that it has been so quiet. (Karen, 7)
The student in the above extract was single and therefore had to make minimal compromises to
create a suitable space for studying. What the extract emphasises is the importance of patterns in
the spatio-temporal activity of (other) actors for the maintenance of personal space and quality
study time. As with much of the material here, this hints at an underlying spatial paradigm
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which constructs studying as a solitary activity. Other students had to use other means to achieve
the same ends:
I usually study quite early in the morning before anybody gets up, so that I can
spend some time with my family, my husband’s at home quite a lot during the day,
and then I have a room that I study in quite a lot. I don't tend to study much at
University, because it's too far away for a start and I travel with other people, for me
it's not really conducive to studying, there's too many people coming and going, you
get too easily distracted by chatting to people (Susan, 1/2)
The spatial paradigm which begins to emerge here is constructed around a number of problematic
points. Firstly, the space(s) of the University were not seen as conducive to studying. This was
particularly marked in the smaller buildings of HC, where the library had little in the way of quiet
space. At SC there were carrels in the library, and various other rooms which could be used for
study, but the participants did not use them regularly. None of the participants stated that they
did all their studying at the University (HC or SC), and all the participants claimed to do most of
it at home. The advantages of studying at home are often balanced by the need to create spaces
and times for that purpose, and these are often in short supply.
This leads into the second point. Studying and family (or other group) activities are seen to be
incompatible, because of the perceived need for spatio-temporal isolation, but there is an
unspoken institutional assumption that this colonisation of the domestic by the academic is
acceptable, and forms part of being a student. Howard (2001: 35) reports that domestic tensions
and relationship difficulties are exacerbated by the high academic workload imposed on students
under Project 2000, and Lauder & Cuthbertson (1998) comment on the financial problems which
contribute to these tensions and difficulties. As the above extract demonstrates, there was
considerable pressure on students with families to ‘make room’ (spatially and temporally) for
study at home. Possession of domestic space was thus contested between student, family (if any)
and institution. This does not necessarily mean that students disliked studying at home, but it
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does reflect an assumption that the colonisation of domestic time and space for this purpose is
acceptable.
The third point relates to the emergence of ad hoc arrangements for addressing these problems.
In the above extract, the participant’s home was about 80 km from the university, too distant for
frequent visits. Travelling with others, however, (in a car-sharing arrangement), provided a
useful discussion opportunity which compensated for the lack of social time and space on-campus
and at home:
Q: How about the journey itself? Is that useful in terms of talking to people about the
work?
Definitely. There's things been discussed in that car... when we've been going into
our exam, we came out and said ‘if you hadn't said that I wouldn't have known that
in the exam’. That means every time we've had an exam we have been talking for an
hour before we got there... (Susan, 12)
The colonisation of domestic space and the lack of on-campus study space are both symptomatic
of a spatial paradigm based on the metaphor of the journey, where these and other study-related
problems are seen as ‘obstacles to be overcome’. In the example above, the physical journey is
itself a way of overcoming an obstacle, which in itself reinforces the dominance of the paradigm.
This use of the journey as a study-space is predicated, obviously, on the privacy and co-presence
provided by the ‘private car’ a phrase which sums up the special role of the car as a moving
space. The key factor in its usefulness is the parallel movement of the metaphorical and physical
journey, and the structural commonalities of both. As Strathern (2000) observes, understanding,
like travelling, does not proceed at an even and predictable pace, but moves forward in fits and
starts. The understanding process of learners does not map easily on to the modular timetable,
just as flows of traffic are chaotic and can be halted by relatively minor incidents. In this case,
understanding is facilitated, albeit indirectly, by a specific type of journey.
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From several of the extracts, there is a sense that that the availability of personal space is in a
constant state of flux, over longer or shorter cycles. Sometimes these cycles are seasonal:
What I do is, it's quite interesting, in the winter it's too cold to study upstairs, so in
the winter I study in the kitchen, and carry everything I need in a blue carrier box,
and in the summer I study upstairs where I have my own space …It's better, but I
couldn't work up there in the winter because I would freeze to death (laughs) so it's
quite nice when spring comes, to change venue, to move study space (Doreen, 4/5)
The materiality of buildings and the negotiations around the division of domestic space are a
familiar theme in studies of adult learners (Morgan-Klein 2003) There are clearly questions
about gender here, but for this study, the important issue was about individuals having power
over space, as an aspect of possession. The power to have undisturbed spatial arrangements was
highly valued, and several students referred to the importance of their papers, books etc. not
being moved around in their absence:
I stay by myself, so I've got no interruptions at home, I'm single with no children so
things can be left! (Lynne, 8/9)
This is both a power/control issue and a spatial issue. In terms of students’ information sources
for assignments, information was often spatially arranged on the bed or the floor and it was this
(analogue) spatial arrangement which was remembered, rather than the information being
(digitally) ‘listed’ as text, e.g. in a plan or outline (Bateson 1973: 252). The essay is not just about
information, but about acquiring a particular academic ‘voice’ (Read et al. 2001). In the nurse
student situation, there is however an emphasis on factual content which predominates over
finding one’s voice, and the students reported that the scientific idiom demanded of them was
particularly impersonal.
Another example of the importance of spatial arrangements in marshalling information is given in
this extract, in which a student discusses the library:
What really annoys me, when you are looking for journal articles, students put them
anywhere at all, they don't put them back in the correct order in the correct box and
you can go searching through stuff that is in the library but you've got to go raking
for it, so it's in the wrong year somewhere, and I think that's inconsiderate, I really
do. (Terry, 6)
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There was an emerging relationship between the physical distribution of documents and the
conceptual distribution of ideas within an essay, as one participant described:
…I've got a table, it can be a small diameter table or a long table, it doesn't matter, as
long as I can see my papers, I put my papers in particular piles, and just looking at
them will trigger off what I want to say, so as I go from each section, I tend to use
that as a triggering response and then I take that article as I’m going to refer to it, jot
it down as the reference. It's a continuous cycle kind of thing…
(Q:... so that the layout of the stuff on the table is important for you?)
Yes, very important for me, it's like a triggering response. (Naomi, 1)
Possession, as the absence of spatial interference from others, and proximity are linked here by
the embodied concepts of the mind as container for ideas (Lakoff & Johnson 1999: 240), and the
study space as container for documents, both of which need to be ordered in a certain way for
effective functioning. For the student, the home is thus part of the spatial whole which enables
learning activity. It is not merely a shelter or store-room, but is a part of the thought process
itself.
In the next extract, the function of the home as part of such a ‘spatial whole’ was problematic
because the student was concerned about the spatial autonomy of other family members:
That's why I prefer to work at the University instead of studying at home, that's why
[the library] closing at 7 o'clock hinders me, because I try to work at home but my
son is playing his CD, I'm trying to get on, the phone’s going, I need peace and
quiet to concentrate, it has to be quiet…
(Q: Would you use the labs for studying if they were more comfortable and there
was room to spread out...?)
I think I would, sort of like a plush area, where you could spread out books and
things ... that would be a good idea, because with the with the library shutting at 7, I
find it hard to go home and study, I can't tell my son to stop playing, he needs his
time. (Terry, 20/22)
This extract illustrates the conflictual demands of ‘home’, as a space for family interaction and as
a space for studying. It also emphasises how the relationship of one (domestic) space to another
(institutional) space is a product of activities and interactions which are beyond the immediate
concern of both. Thus, the student’s son (above) was present at home in the evenings because of
his conventional working hours, whilst the opening hours of the library were determined in part
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by the demands and work/play patterns of the ‘traditional students’ (and its staff) who could more
easily socialise in the evenings and thus tended to vacate the library by 7 p.m.
The above participant’s mobility, in being able to drive to the library, was also a contributory
factor in the possession relationship. Urry (2001b; 2002) suggests that the concept of home, or at
least the distinction between ‘home and away’ is problematised by increased mobility. In Urry’s
words, the distinction ‘loses its organisational and ideological power’ (2001b:4) . The PMP
framework, however, suggests that increased mobility brings with it changes in proximity and
possession. i.e. increased mobility brings more things within one’s range of concerns and
causes greater importance to be attached to the possession of particular spaces. Being frequently
away from home, or even frequently moving home, are symptomatic of hypermobility (Adams
1999) and actually serve to reinforce the importance of home as part of the home/away binary.
As Cairncross (2001: 5) observes, the advent of new forms of ICT may enable people (at least,
those with sufficient financial and social capital) to have homes where they want to, not where
their employment compels them to live. Urry is right to observe that ‘cultures imply and
necessitate diverse and extensive forms of mobility’ (Urry 2001B: 238) but the aspects of
mobility which arise from the data in previous chapters indicate that mobility is, in this context at
least, as much to do with maintaining a stable home (life) as with problematising it. The culture
of extensive commuting is the reverse of the nomadic lifestyle. In the examples given in the
discussion of the journey, the three students involved were covering considerable distances
because they wished to keep their homes in place, not because they wanted to enter the world of
the ‘digital nomad’ (Urry 2000: n.p.)
The idea of ‘returning home’ thus appears to be a significant aspect of mobility for the
participants, and the following extract gives a sense of the continual displacements to which HC
students were subjected:
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Yes, I'm up at Wick at the moment, I was supposed to be in Inverness the last time,
but I ended up in Tain instead, it's about an hour on the same road north, I've been to
Drumnadrochit, Tain, Wick twice and Inverness the other times, I have been away
quite a lot and I find that quite hard, I find it quite hard to study away from home.
(Joanne, 7)
‘Home’ thus acquired importance as a study-space because it could be separated from other, less
controllable spaces, as in these extracts:
If I tried to deal with [administrative work] at home I would never get any writing
done. I have to demarcate different spaces for writing and for dealing with other
things. (Peter, 7)
...I probably do more at home than anywhere else...I’m in the fairly fortunate
position at (HC) of not sharing an office with anyone, so I have a room there with a
lock on the door, that’s helpful, but I tend to use that a bit less than you might
expect because it’s not free from interruptions - people coming to the door,
telephone...so I’d use that rather less...home is preferable, but there are problems
with that too. (Anita, 1/2)
‘Home’ thus fulfils a vital role in the spatial processes of learning for the students. Boltanski &
Thévenot (1999) point to the importance of stable objects in helping actors to deal with
uncertainty, and it is this relationship which emerges from the interviews. The learning process
is a balance between order and chaos (Weick & Westley 1996), and conflicts played out at home
disturb this balance. The institutional role should be to restore the right balance, and the next
section looks at a space which contributes to this role, that of the library.
The heterotopic library
The library continues to be a significant space for nursing students, as it is for students in general.
Although the impact of ICT shows up in the data as involving the colonisation of domestic space
and a feeling of being drawn into a ‘wired world’, the library remains the main information
source. The gradual re-allocation of resources from traditional paper-based knowledge-stores to
electronic databases, however, puts the students into a transitional mode, in which they are
neither fully home-based and independent of the institution, nor fully dependent on being present
in the institution to gather material. Previous work on adult learners in higher education
(Schuller et al. 1999) suggests that this is not purely an ICT issue, but relates to more general
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spatial and temporal constraints, e.g. library opening hours and availability of photocopiers.
One student was particularly concerned with these matters:
I do most of [my studying] in the [SC] library, in the carrels upstairs…
(Q: And does that give you any particular problems?)
Opening times, because when the main body of the students are away home, times
are cut back in the library, 9-7 and 5 o'clock on a Friday and only in the mornings on
weekends, so we’re disadvantaged that way especially if we’re on placements.
(Terry, 1)
Not all students found the hours problematic, which itself creates a dilemma, since the library has
to balance its own budgetary and staffing requirements with these diverse needs.
As a space with diverse functions and clientele, the library is thus in some senses ‘heterotopic’
(Foucault 1986, see also Gregory 1994; Soja 1996). In Relph’s words:
Heterotopia is...pluralistic, chaotic, designed in detail yet lacking universal
foundations or principles, continually changing, linked by centerless flows of
information; it is artificial, and marked by deep social inequalities. (Relph 1991,
cited in Gregory 1994: 151)
The main purpose of describing a space as ‘heterotopic’ is to reveal some of the complexities
which pervade any such space. The library conforms to all of the above criteria. It has a wide
range of purposes and functions which, at this institution, are subsumed under the general heading
of ‘Information Services’. Its purposes are defined both by policymakers and by its users, who
are diverse and ‘generally chaotic’ in that their actions are not temporally co-ordinated, either
with each other or with the institution (i.e. they do not always work 9-5, Monday-Friday, or
exclusively on-line). The following extract offers an alternative interpretation of the library’s
availability:
(Q: What do you think about the library as a place to work?)
Generally it's OK, I tend to come through at the weekend, especially in term time, a
Sunday is really quite good because it's quiet, and so you can get on with things, you
can get access to computers, and the photocopiers, articles, during the week
especially, in term-time everybody is in looking for the same information, so I tend
to come through at weekends when it’s quieter. (Lynne, 2)
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This extract highlights the inequalities of access which have long been the subject of complaints
from part-time and other non-traditional students (Schuller et al.1999; Gray 2000). At one level
this is a resource issue, but at the level of spatiality, the library is not yet fully understood as a
space with its own complex interactions within the larger space of the university.
The chaotic patterns of activity in the library are well summed up in this extract:
…there’s a tendency not to use the library [for studying] because there's lots of toing and fro-ing, and there's a tendency if they're all doing an essay, for them all to be
in there, it's more like a social event, so you will say ‘how’re you getting on’ and
anything interesting rather than sit down and study…I do tend to come across here to
print out stuff, but not a huge amount of study, usually it's in my own flat in the halls
or on placement…
(Q: The fact that you tend to bump into people in the library, and socialise with
them, is that useful in itself apart from the fact that it distracts from your studying?)
Sometimes, sometimes not, if you’re at the same stage when everybody is trying to
find information, it's useful, you can ask ‘what have you found?’ But when you're at
the stage where you just want to read, you just want to study, and somebody comes
up to you, it can be quite distracting and not always very useful. Depends what stage
you're at, if you're at the information gathering stage it's quite handy because
everybody else is at the same stage. (Wanda, 1/2/3)
The issue of noise and distraction in the library was thus raised in contradictory ways:
...I can't think in the library, there's too many distractions...noise, telephones, people,
other students coming in, people talk, it's very distracting...(Doreen, 2/3)
- if there's anybody I know in there [the library] we tend to talk instead of studying,
what's happening on the ward or about the essay or whatever...(Wanda, 1)
One conclusion might be that there is a need for separate social spaces in which students can
simply chat and engage in informal learning, or alternatively that the conception of the library as
a quiet space for study is wrong and that it should function as a social space. The library in
question (HC) might be considered as too small, and an ideal library might combine quiet spaces
with social areas.
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Whatever the function of the library as social space, it has an organising function in relation to
information, and another example of the importance of spatial stability in marshalling information
is given in the next extract in which a student discusses problems encountered in the library:
What really annoys me, when you are looking for journal articles, students put them
anywhere at all, they don't put them back in the correct order in the correct box and
you can go searching through stuff that is in the library but you've got to go raking
for it, so it's in the wrong year somewhere, and I think that's inconsiderate, I really
do… (Terry, 6)
This participant also had a part-time job, so that his time on-campus was severely limited, and the
extract points to the extent to which possession, whether of home-spaces or institutional spaces,
is related to stability, or being able to find things in the same place on repeated visits. Regular
users of the library learn its geography through embodied movement and this pre-conscious
embodied learning supports their conscious deployment of information. This requires time, and
as the following passage reminds us, there are alternatives to the University library which open up
other times and spaces to studying:
The public library here is fantastic, they are open until eight any evening, and four
on a Saturday…it's really great now, they are open till about eight at night, they've
got this scheme whereby if you're any sort of a student you can get on to the Internet
free, so that they all sort of know me because I've been going there for two years…I
do use the university sometimes, possibly if I was travelling myself I would use it
more but I travel as a group,, it doesn't work, it's just not suitable. We do sometimes
stay for an afternoon...But I can't really relax even then, you're trying to deal with
three other people at the same time, so I can't really take time to deal with the things
that I'm trying to think about, whereas at the public library, I can take time to think
about what I'm doing. (Susan, 6)
Again, this indicates that proximity (knowing that there is a public library), mobility (being able
to reach it) and possession (being able to use it without distraction) are fundamental to the
analysis of competing spatial requirements.
Comparing the two campuses, the library facilities at HC were often perceived as inferior to those
at SC:
From what we can gather, their library down there [SC] is a lot better than our
library, because every book we look for is ‘[SC] only’...our library is quite bad, a lot
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of the stuff is old, they tell us not to use books more than five years old, and most of
our books are 1989, 1991, when there's ninety of you all looking for the same books
and someone keeps them... (Christine, 45)
This was also an issue in relation to essay-writing, but the issue here is the comparison between
HC and SC in which the marginal status of HC, in the perceptions of its students, is reinforced by
the proximity of a remote ‘parent’ institution. This gave rise to discontent that their sense of
possession of the university as a whole was being diluted, and that only some of the potential
benefits of sharing facilities were being realised. A similar frustration with books being held at
HC was, however, expressed by SC students, reinforcing the idea that it was the proximity
relation, as much as the actual availability of books, which was the source of the problem.
Similarly, the flow of information into HC, both electronically or in the form of requested books,
journals and other paper sources, was seen as being rather slow. Book requests, for example,
generally took about a fortnight. This contrasts with the relatively good accessibility of
Inverness from Central Scotland, with average journey times by train or car being about 3-4 hrs.
There was, therefore, a discrepancy between possible and actual speeds of document delivery,
again reinforcing notions of peripherality
Computer labs: programmed to self-instruct?
The University computer laboratories are ‘heterotopic’ in similar ways to the library, and are
related to it within the Department of ‘Information Services’. Its population is also fluid,
reflecting cycles of assessment, e-mail correspondences, job-hunts and a variety of other
connections. Within Relph’s definition (in Gregory 1994: 151), it is clearly artificial, and even
its designation as a laboratory codes it in terms of positivist science. It has elements of postoffice, library, games arcade and sometimes even dormitory. Furthermore, it embodies the
dichotomy between individualism and collectivity within ICT identified by McKie (1996).
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McKie argues that ICT, both in advertising and in a wider theoretical discourse, is paradoxically
depicted as potentially enabling entrepreneurialism and creativity for the individual whilst at the
same time promoting a collective, democratic spirit freed from the constraints of time /space.
These two potentialities are not necessarily incompatible, of course, and the computer lab is an
example of where individuality and collectivity come together, perhaps accidentally, in the form
of casual peer support. But the need for such support reflects inequalities in computer literacy,
computer access and spatial provision found throughout the university system. These
inequalities surface in the following extract, where the student complained that, although she used
a computer at home, when she attempted to use University computers:
...I found it totally unsatisfactory, because there was again too much noise,
distraction and less of a quiet space to think things out if you made errors - too many
people trying to correct things, which just adds to the stress of it all - I'm not
computer-literate...I feel more safe using one at home than in the computer labs
across here...I'm still a bit frightened of computers (Doreen, 7)
‘Peer support’ thus shades into harassment, an example of the ways in which spaces are ‘striated’
(Deleuze & Guattari 1980) by the complex power-relations which over-write them. This was not
merely a question of personal security but more a feeling of unease at being seen to be
uncomfortable with unfamiliar, quirky computers in an environment where others were perceived
as highly competent, a sentiment which was echoed in the following extract.
this is the first time I've ever used a computer, for any length of time and I feel more
safe using one at home as opposed to in the computer labs across here before I got it,
so that's basically what I use it for, just writing my essays… (Lynne, 8/9)
There were also comments about the slowness of data transfers or searches from the HC
computers. Hyperbolic claims that space has been conquered or abolished, and that we live in
an age of simultaneity (Plumb 1999), perhaps cause these delays to be particularly irksome to the
students, in the same way as the slow delivery of book requests discussed above gives rise to
frustration: so near, yet so far.
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The libraries and their related computer laboratories form a complex spatial assemblage which
extends across both sites. The frustrations and problems experienced by students at these sites
are probably little different in principle to those experienced elsewhere, and if one was in search
of ‘best practice’, it would be useful to undertake comparative studies across other sites. My
original intuition, however, had been that space involved an affective dimension which could not
be captured by observation. In a library, one could be irritated or elated, puzzled or confident,
distracted or focused without any obvious, outward sign. Knowing what a sample of students
felt whilst in the library would not reveal all possible modes of being-in-the-library, but two
possible ways of improving the library and computer laboratory system were connected to the
proximity and mobility of information and the achievement of possession. The former represents
the achievement of order, stability and transparency, whilst the latter represents the creation of
opportunities for chance meetings, conversations and informal learning.
Lectures and seminars: sitting in the same seat?
The stereotypical spatial situation within the University is that of the lecture hall or lecture
theatre, and the related situation of the seminar room. Although the ‘didactic’ lecture might be
seen as incompatible with adult-learning principles (Badger et al. 2001), the combination of large
student cohorts, limited staff numbers and shortages of suitable rooms meant that lectures were a
regular feature of the student experience for the students in the study (see May et al. 1997,
appendix E4 for a related case study). At HC, the specific rooms which were used gave rise to a
number of problems:
... A lot of the evaluations have said that the rooms are not really designed for the
size of group, we’re usually either in the Rec[reation] hall or in the lecture theatre,
and the acoustics are very bad, the seating is very bad, voices don't carry it all in the
lecture theatre, and if the teacher does not have a loud voice, you can't hear a thing,
you have to sit in the front row so there have been complaints about that and the Rec.
hall is even worse because it's like a club room... But it's purely the size of our class,
because there’s 90 people in our class, we could do with one of those amphitheatre
sort of lecture theatres (Christine, 40)
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One way of approaching these problems is through a phenomenon which can be observed in
most educational settings, the tendency of people to sit in the same seats on successive occasions.
As a student, I have done this regularly. Students appear to be (and, in my case, were) more
comfortable, both physically and emotionally, in certain seats than in others. This would appear
to be a topic for observational methods and/or quantitative analysis11 but, as with essay-writing,
the topic emerged from the data rather than being part of the research design, and thus was not a
specific focus of the study. This illustrates the importance of spatiality as a way of re-examining
common pedagogical issues. The question here is whether there is an underlying phenomenon.
The extracts cited below provide some evidence that there is.
This student gives practical reasons for sitting in the same seat on successive occasions:
Yes, I'm one of those people who habitually sit in the same place...
(Q: Do you feel more comfortable doing that?)
Yes, I wear glasses, and when there's a lot of background noise, I can't hear that
well, my hearing is normal, but you don't always pick it up, and there is one lecturer
who is very, very soft, and everyone is aware of the problem, although it's very
frustrating, they are aware of it, but there is not much that you can do except being
frustrated and understanding at the time. (Naomi, 18/19)
There is a comparison to be made here between the problem of missing library books, and the
problem of soft-voiced lecturers mentioned in the above extract. In both cases desired
information is within the range of concerns of the participant concerned (proximity relationship),
but a mobility problem (an unreachable book, a voice which does not carry over distance)
intervenes, with the result that the participant experiences loss of possession of the space in
question. There are technological solutions (e.g. sound reinforcement systems) to this particular
problem, but spatial analysis of the situation leads to a more fundamental appreciation of the
problem. The next extract also highlights the relationship between spatial and pedagogical issues:
11
see Horne (1999) for extensive methodological discussion and spatial analysis of the classroom environment on
this basis
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There are small rooms, but they can't always get the class booked up, if you think
about it, there's 90 of us, if you go into to groups of 10 they haven't always got the
teachers, we understand it's difficult for them but it's not really conducive to good
lectures, great if you’ve got a teacher with a good voice and if you’re interested, but
you notice if it's quiet and it's not a very interesting lecture, people in the back are
going ‘chat chat’ and it’s even worse... (Christine, 41)
Here, attention is drawn to the institutional compromises which necessitate the spatial
co-presence of large numbers of students, and the student stratification which is produced by
something as subtle as a variation in the speaking ability of the lecturer. This was confirmed by
the next extract, which suggested that sitting in the same seat was:
A social thing, definitely a social thing, although for me, I prefer sitting at the front
so that I can see what's going on, I find at the back that some speakers are quite quiet
spoken, and you can't hear them at the back, there were a few lectures in first year
where I was running late, a bit later than usual, and I ended up sitting at the back, I
couldn't hear hardly anything they were saying, people at that time were incredibly
rude and speaking in front of you, and I felt like saying ‘I just can't hear what's going
on’. (Doreen, 38)
This illustrates that possession can be highly differentiated across a relatively small space, but is
not simply a question of social interactions or power-relationships. Both of these are selfevidently part of what is happening here, but spatial factors such as the room acoustics and the
availability of seats in particular areas of the room are another part, and it is the interplay between
all of these, and individual circumstances, such as the temporal problem of ‘running late’, which
construct the overall sense of possession for the participant. ‘Running late’ is a good example of
a contributory circumstance because it emphasises the temporal aspect of possession. Lefebvre
(1991; 2004) draws attention to the ways in which the rhythms of everyday life condition
responses to spaces. In this case, the rhythm of arriving early in order to get a specific seat is
interrupted, leading to a reduction in the student’s sense of possession.
Another element of possession which also relates to student identity) is the taking of notes
(Badger et al. 2001) and this example come from SC:
the lecture theatres were OK except for the MacRobert which we had to use two or
three times, I felt sorry for the external lecturers walking in because they walked out
onto a stage basically, and 180 people were spread out in this massive arena, it was
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just a waste of time, there was nowhere to take notes…trying to write, it was just a
waste of time. (Terry, 34)
Note –taking is an important activity, not only for its recording function, but because it helps to
reinforce the relationship of proximity between student and institutional space by helping to bring
the content of the lecture into the range of one’s concerns (Badger et al. 2001). Note-taking also
a contributes to possession, as a dialogical relationship between lecturer and students. Bakhtin’s
concepts of polyvocality and positionality might be useful ways of relating acts of speech or
writing to spatiality (Holloway & Kneale 2000). Note-taking disrupts the notion that the lecture
is a purely didactic process in which information flows unidirectionally, because the notes will
resurface in essays, examination responses or in seminar discussion. The participant’s frustration
at not being able to take notes due to spatial constraints repositions him within the the narrative of
the lecture, where his notes would normally be part of an ongoing dialogue. The space
effectively silences him, and although the proximity relationship holds (everyone is within the
relevant range of concerns), there is a mobility problem in terms of the lecturers’ (in)ability to act
over distance and the related (in)ability of the students to respond over distance.
The following statement reflects the way in which the neutrality of spaces is challenged by
bringing them into discourse via the research interview:
If we get lectures in the lecture theatre, that's fine, that's a good room, but sometimes
we have to go to other rooms which aren't so suitable, but I haven't really considered
the building in terms of problems... (Andy, 23)
Even here, the attribution of quality to rooms (‘good’ or ‘aren’t so suitable’) implies that, even in
the absence of specific consideration, spaces are still seen as making a contribution to the overall
success or otherwise of the learning process. The next extract paints a similar picture:
I would view it [HC] as kind of minimally functional, that’s about all it is...it's a little
bit claustrophobic when all 102 students are about, but it's minimally functional, it
doesn't feel like a prison, it's actually quite nice and light and reasonably spacious, it
doesn't feel. .. the lecture theatre feels a little claustrophobic because there are too
many bodies in it, the rest of it is OK. (Doreen, 29)
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The physical characteristics of the space could also constrain the ways in which students
positioned themselves:
We used to sit along the walkway between the two halves [of the lecture room], you
get a bit more legroom that way, some of the other people in the group were tall, and
we like the legroom... It's close enough to hear what the lecturer was saying and also
see the screens as well. (Terry, 38)
The use of the first-person plural here indicates the strong group cohesion which was as much a
part of the same-seat phenomenon as individual preference. Furthermore, as a group with some
social science knowledge, the students were well aware that they were developing habitual
patterns of seating behaviour:
Yes we all do, yes we do, we jokingly say that we're institutionalised, we sometimes
just ...for the fun of it, just change seats, it's usually if, sometimes certain people are
travelling and they opt not to come to some of the lectures, so you would move seats
if they weren't there sometimes, but we do have a tendency to sit in the same seats
most of the time. (Lynne, 37)
This self-deprecation reflected the sense of guilt felt by some of the participants in the pursuit of
the desired seating arrangements, and the next extract shows one participant attempting to
overcome this:
I just feel as a person that I've made it part of my thing to try to go across to speak to
other people because I'm trying to train myself to be with people who don't
particularly want to be with me, because they've got their own group . The thing is,
it is all divided up into groups now, And if you don't try to make an effort go over to
other people you don't learn anything from other people, that's one aspect of it, and
they don't get to know you as a person so prejudices can build up. I don't like it
when groups get into cosy wee niches, and nobody challenges... it can be a bit
stressful…They might feel I've got some kind of ulterior motive, but I do think that
if you communicate with other people you learn more from them. (Joanne, 21,
emphasis added)
This extract highlights one of the problems which can arise with small groups, whether sociallycontingent or tutor-instigated. The ‘cosy wee niches’ have two opposing functions for the
students. They provide mutual support for their members, and they discourage non-members
who make communicative demands, as above. The ‘niche’ is a spatial metaphor which suggests
hiding and shelter. The group is in possession of its niche and resists attempts to invade it:
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I like to go down the front because I can hear better, you're not asked so many
questions...we tend to [go to the same seats each time] but not because it's our space,
it's just that you get down the front as quick as you can, but we don't mind which
side at the front, so long as it's the front. ..there have been nasty looks at people who
have got down the front before us, not nasty but, you know...’oh no I won't be able to
hear anything’. (Lynne, 43)
This quotation highlights that possession is negotiated. The disclaimer (‘not because it’s our
space’) indicates that there are explicit spatial issues for the students. The first-person plural
indicates that group cohesion is reinforced by the necessity, under a logic of possession, to be at
the front in order to hear properly. The acoustic qualities of the room and the variable
presentation skills of lecturers contribute to a feeling of being-at-home in the front, where
problems are minimised. Furthermore, the above statement points to spatially-differentiated
perceptions of tutors’ attitudes:
It is the way it happens for a lot of the lectures, there are a lot of mature students at
the front, and there are some of the younger students in the middle, but there is
always the same group at the back, which has been noted (laughs). There are always
comments about it, ‘there are seats down the front, you know!’ They think that if
you go down the front you are going to be asked questions, but you're not actually, if
you go down the front you are not asked as many questions as if you go down the
back, but I like to go at the front because I can hear better (Lynne, 42)
This points to there being a differentiated sense of possession between sub-groups within the
same course cohort. The ‘same group at the back’ territorialises their ‘patch’ in opposition to the
mature students at the front. This is not an overt conflict, but an inevitable effect of the
interaction of proximity, mobility and possession as it plays out over a specific space. Students
feel more or less engaged with the activity of the lecture , more or less able to communicate with
the tutor, and more or less comfortable with their own situation within the space.
Their spatiality cannot, therefore, be addressed under a single heading, but must be considered
along the three dimensions of proximity (one’s range of concerns) mobility (action over distance)
and possession (at-homeness}. Even in a perfect auditorium, there would be a similar playingout of the spatial dynamics of the group. The embodiment of the participants renders the group
interaction spatial.
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If concepts of ‘group dynamics’ are often weakened by the absence of spatial thinking, the
meaning of a particular space, in this case a lecture theatre, is clearly constructed by social
interactions and institutional rules, tacit or otherwise. Its performance in that role, however, is
constrained by physical 'stuff', such as the acoustic properties of the walls and ceiling. These are,
in turn, the product of socially-determined knowledges, such as architecture and building
technology (Markus 1993) and the physical properties of materials. Institutions are financially
constrained and are in most cases unable to optimise their physical spaces to suit diverse
individual requirements, an increasing problem in terms of disabled access and mobility. What
emerges from the data is that important pedagogical issues, such as the responsiveness of students
to questions during tutorial sessions, are affected by material parameters of spaces such as
acoustics, sight-lines, the type of seating or the room temperature, or even the quality of the
journey which the students make on the way to the session. These parameters, whilst important
in themselves, also illustrate the inter-relationship of proximity, mobility and possession.
An example of the difficulties involved in rationally planning spaces was the attempted provision
of social space for the HC students by the University, which had set up a student common room
equipped with a television, video recorder, stereo and vending machines. According to the
participants, it was rarely used, and the reason given for the room's unpopularity was that it
'lacked atmosphere', due partly to the small numbers of students free to use it at any given time,
and in contrast to the hospital canteen in the main building. Its emptiness was seen as giving
rise to feelings of insecurity, and as it was physically separate from the staff common room, it
gave rise to few opportunities to mix informally with tutors, or hospital staff. Atmospheres,
however, can be cyclical, altering according to the ebb and flow of activity. One participant,
who was involved with evening classes, contradicted the above ‘reading’ of the room:
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It can be quite relaxing , quite productive to go in there after about 6 p.m., when it's
more relaxed...there are security staff around, it doesn't feel threatening in any way.
(Anita, 17)
In contrast to the lecture room situation, in which practical elements like the acoustics played a
major part in its usefulness, or otherwise, the less formal common room depended, almost by
definition, on its level of occupancy to establish an enjoyable atmosphere. There are interesting
comparisons with the library, which I discuss in Chapter 7. The library has a ‘gathering’
function of its own, due to the necessity of borrowing books or copying journal articles, and is
thus constructed as a social space by students, even although there are constraints and even
penalties for doing so.
Unlike the physics students described by Nespor (1994), the nursing students did not have spaces
regularly given over to study groups, a feature of the ‘café society’ common to many US
campuses:
At Berkeley because it is such a big campus, there tended to be large numbers of
cafes very close to the campus, and we tended to have group discussions in there,
although sometimes the acoustics weren't always helpful. But the coffee was always
excellent. (Peter, 39)
The role of informal spaces in the formation of communities of practice has been noted by
Wenger (1998), and such spaces were a feature almost entirely lacking at HC, and in short supply
at SC, especially during term time. The role of informal spaces parallels the role of social skills
in enabling the sharing of tacit knowledge which would otherwise not be available to students.
Recent research in organisational learning has shown that conversation within firms is the
medium for many significant exchanges of knowledge (Grant et al. 2001). This can only happen
if the spatial arrangements of the organisation make it possible to have conversations. Recently,
for example, Fiat has introduced simultaneous coffee breaks for its employees at one of its car
plants, in order to facilitate conversation and work-team interaction, providing seating around
coffee machines and stopping the production line at break times rather than running it
continuously. This, according to management, has proved to be a useful innovation in terms of
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communication about production problems12.
12
Personal visit to Fiat, Montecassino, 29/05/03
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Summary
The purpose of this section has been to trace some of the complex interactions between
proximity, mobility and possession in three of the spatial settings experienced by nursing student.
It has shown how the embodied spatiality of the participants makes a difference to the way that
they experience home, the library and the placement. These are not neutral containers for
activity but interact with the process of becoming a nurse in ways which are both subtle and
complex. What emerges is the part which each element of the PMP framework plays in the
students’ spatial relationships.
The conclusion here is that the spaces of the university are, perhaps, necessarily heterotopic if
they are to perform their function properly. Achieving this heterotopic character is not solely a
question of rational planning, because too much of what constitutes spatiality is contingent and
individual. This does not mean that spatiality can be neglected, however, because, as has been
shown, that there are negative pedagogical consequences of ignoring the basic qualities of spaces,
such as sightlines, acoustics, seating arrangements and ventilation.
The PMP framework is one possible way of analysing the student experience of spatiality in order
to explore these consequences, and the next chapter looks at the consequences for the nursing
students of another area of spatial experience, that of the placement.
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Chapter 8-Placements
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“…It is possible for a terrestrial to leave the City at any of numerous exits and strike out
across country to Spacetown, where no barrier will stop him.”
(Isaac Asimov, The Caves of Steel)
Introduction
GIVEN the importance of the placement to nurse education, which I discussed in the literature
review (May et al. 1997: 241-253; 263-265), it would be surprising if students had not raised a
number of issues around it. May et al. (1997: xii) define the placement as:
Community-based or clinical settings in which the student is placed for experiential
learning purposes.
The intention of the placement is to integrate theory and practice, and to begin the important
process of professional socialisation (Quinn 2000: 418). As I will show, it is perceived by the
students to fulfil these functions, sometimes at the cost of great personal effort. The placement,
considered spatially, is different from the lecture or essay-writing as a learning experience. The
placement is a world into which the student is ‘thrown’, (Heidegger 1962: 236) meaning that it is
always already ‘up and running’ when the student arrives (and, of course, it continues to be so
after her departure). As a space, or set of spaces, its significance can be explored using the PMP
framework. ‘Placement’ is a term which combines spatial and temporal meanings, and can be
regarded as a time-space in which both meanings are present, if not always equally visible.
The Placement and proximity
In the placement setting, the student is widening her ‘range of concerns’. She is brought into a
proximity relationship with previously unfamiliar objects and others. This need not be the case
in every placement, and May et al. (1997: 295) draw attention to the benefits of continuity where
students have been able to return to a previous placement. Students, thrown into these pre-
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existing situations, then ‘dwell’ in (and on) the placement, but the term ‘dwell’ has a special
significance here, as I will explain, based on Heidegger’s use of the term (Heidegger: 1993a).
This significance is not merely an arcane philosophical digression, but can be linked to the nature
of nursing itself, and is thus relevant to the experience of the students which I discuss here.
Young (2000: 194) argues that there are two forms of dwelling in Heidegger. First, there is an
essential form of dwelling which ‘...is entirely independent of any feeling or experience’.
In this sense dwelling is ‘ek-sistence’ itself, and ‘[t]his quality one possesses regardless of
whether one feels at home or alienated in one’s world’. There is also an ordinary sense of
dwelling, which is the sense under discussion here, and in this sense ‘dwelling preserves...[i]n this
way, that mortals nurse and nurture the things that grow and specially construct [i.e. ‘build’]
things that do not grow’ (Heidegger 1993a: 353). Building and dwelling are, then, as Heidegger
tells us, intimately related. Building grows out of the dwelling which makes it possible, but at
the same time also shelters that dwelling (Heidegger 1993a: 361-362). ‘Building’ here, as
Heidegger makes clear, is not to be thought of as the mere erecting of houses, but, in its
etymological roots, as related to the Greek tiktõ, to bring forth or produce’ (ibid). Both types of
things, those which grow and those which are constructed, are in this sense ‘grown’, or ‘brought
forth’ by mortals.
I might characterise dwelling, then, as a way of being t/here (Dasein) out of which something
grows and is sheltered by that which does not grow. ‘Growth’ here is not the unlimited (and also
metaphorical) growth beloved of economists but an organic, cyclical growth which is limited by
the essence of that which grows. A rose grows, but only within the limits of being a rose.
‘Growth’ as I use it here is not the increasing magnitude of some thing or quantity. Nursing
students ‘grow’ as they gain experience on placements, but remain within the limits of nursing.
By ‘limits’ here, I mean conceptual limits, not limits of performance or quality. A nursing
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student would not suddenly emerge from a placement as an expert car mechanic, although an
individual student might hypothetically decide that she had reached the limits of her growth as a
nurse and decide that she would rather be such a mechanic. As the introduction to a website
(RIPG 2002) offering seminars on personal growth puts it:
Our mission is to empower individuals to discover, enhance, and develop inherent
skills and mechanisms that enable them to triumph over life's challenges and
experience multidimensional growth of the body, mind, and human spirit. (emphasis
added)
The keywords here are ‘individual’ and ‘inherent’, meaning ‘inherent within the individual’.
Neither of these apply to the type of growth which Heidegger wishes us to read into ‘dwelling’.
Here, growth is inherent in a way of dwelling, not in those who dwell. This is not to deny the
idea that persons can grow individually, but to argue that the form of growth, as dwelling, which I
am discussing here is not experienced as such, but is a phenomenon which can be reached
through the study of experience.
Heidegger’s example is, predictably perhaps, the peasant farmhouse in the Black Forest, which
has evolved, been built or grown in tandem with a particular way of life, one which is responsive
to the seasons and to the cycles of everyday life. At first this ‘Black Forest kitsch’, as Borgmann
(1996) calls it, seems to bear little resemblance to the 21st century hospital, with its management
systems and complex machinery. The point, however, is that nursing practice constitutes,
according to Benner, precisely the reverse of this ‘commodified health care system that focuses
on technical procedures and economics’ (Benner 2000: 297-298). In Benner’s view, nursing
practice ‘blossoms forth’ or ‘unfolds’ from the health care system, but does not embody its
techno-rationalistic assumptions. The health care system may, however, function to maintain
and support nursing practice, and a large part of Chiarella’s study of the legal and professional
status of nurses (Chiarella 2002) is devoted to questioning this relationship of nursing to the
wider context in which it practices. My aim here is to show that a different metaphorical
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conceptualisation of the relationship can have real consequences for an understanding of
spatiality in general and the spatial experiences of nursing students in particular.
In the case of the Black Forest farmhouse, Heidegger comes to the phenomenon of dwelling by
thinking through his experience of the farmhouse and its historical location. He considers its
roof ‘whose proper slope bears up under the burden of snow’ and its other homely features, which
contribute to its ‘fitness for practice’. The latter phrase is not Heidegger’s but is the title of a
recent report on nurse education (UKCC 1999). The house is fit for the practices of Black
Foresters, just as the placement should be fit for the practices of nursing students. The essence of
‘placement’ thus lies in nurturing and building the practice of nursing. In the next section, I
examine the practical realisation of this ideal.
Disappointments and rearrangements
The situation regarding placements for SC students was relatively simple, given the relatively
high population density of the area and the presence of sizeable small towns in addition to Stirling
(and its Royal Infirmary) itself. Conversely, HC had one major hospital (Raigmore) as an acute
care centre. Although, as one of the participants puts it, Raigmore constituted a ‘huge resource’
in terms of placement opportunities, there was sometimes a feeling that the area did not have
enough of the kind of ‘busy’ urban hospitals traditionally associated with nurse training:
(Q: Do you think that's an advantage that Highland campus has, because you can go
to these placements in Wick or wherever?)
It depends, I did my training in Birmingham, among six huge hospitals, some of the
placements you go on in Highland, you don't really do a lot, I know it you've got to
do your basic nursing and that's important, but if you're doing six weeks of…if that's
supposed to be your elderly care, and if you are six weeks in a nursing home, where
no one has really anything but basic care, it’s six weeks where you feel that you're
missing opportunities because elderly care down in Stirling may have a far larger
range of conditions, possibly, I would assume so… (Helen, 69, emphasis added)
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This desire for a more intense learning experience in a ‘traditional’ nursing environment is
consistent with the research carried out by Heslop et al. (2001) into the perceptions of pregraduation nursing students in Australia, although Tierney (1998: 82) notes that, in the profession
generally, ‘community [nursing] has been emphasised increasingly over time’. It is also
consistent with a desire to be closely involved in team work, a desire which was expressed by
several of the participants. Remote settings reduced the sense of intra-professional proximity
and ‘collective competence’ (Boreham et al. 2000) imparted by teamwork, and the sense of
‘autonomy in clinical decision-making’ which Chiarella (2002: 212) sees as central to the redefinition of its role sought by nursing as a whole. The lack of decision-making opportunities
and autonomy in remote areas is counter-intuitive, since it would seem obvious that settings in
which decisions had to be made ‘on the spot’ would lead to an increased sense of autonomy for
the students concerned (Chiarella 2002: 9) The low population density of the area, however,
meant that much of the nurses’ time was spent in travelling and in what some saw as routine
‘maintenance’ work. As with most of the issues here, this created risks and opportunities, as the
next two extracts illustrate:
I went with the nurse at Torridon...we had one lady to go and see for the whole day, I
know they don't like to call them social visits, but it was really just pop in and make
sure she was all right...do you need an H-reg. [nursing grade] nurse to do that? Fair
enough on another day she had a chap who is doing home dialysis in the middle of
nowhere, and she was going in and checking on his sight and making sure he was all
right, that was OK but I didn't notice anything that needed... Maybe to coordinate...maybe someone to go to if you're worried, that if you were out of your
depth there was something, but I thought they could probably get away with... I
know that sounds terrible but... (Helen, 71, emphasis added))
The language used here contrasts with that in the extract below, which points to the opportunities
which Highland region provides for the type of expanded nursing role discussed by Magennis
(1999; see also Land et al. 1996). In the above extract, the ‘whole day’ is spent ‘just [to] pop in’
on a patient for a ‘social visit’, leading to a sense of frustration about the need not just to be
identified as a nurse, but to practice nursing. Again, this resonates with Chiarella’s (2002)
concern to problematise the legal and professional status of nursing and the spatially-located
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negotiations of power which accompany any such re-positioning (Magennis 1999: 35). An
attenuated sense of proximity and a differentiated sense of mobility, of acting over long distances,
is developed in the above extract by the experience of being ‘in the middle of nowhere’ as
opposed to the archetypal nursing environment, the ‘huge hospital[s]’ mentioned in the extract
above. A similar experience of attenuation can, however, have different interpretations, as the
next extract suggests:
(Q; So do you have a sense yourself of it being too quiet up here?)
In some respects...I have to temper myself down, because having come from theatre
[nursing], it's very upbeat, which has big adrenalin rushes, you've got to be on your
toes, you’ve got to know what you're doing, so from that kind of a rush, dash, getthings-done kind of thing, and then coming into an environment where it's more than
just gaining your patients’ sense of confidence in a very short space of time, to
gaining your patients' confidence over a longer period of time, developing the
relationship, bringing them in as a whole person, you are saying, ‘oh well, you are
here, you are this age, you are in for your appendix, this is what we are going to do’,
you are looking at a bigger area of a person, so it is good in that sense, because you
do appreciate people as individuals, as if they had a life before, whereas I don't know
how much that has been taking in to consideration in a larger hospital in a larger
city, so you would have that benefit, although it would be nice to have both sides of
it, but I don't think it would happen, I'm not sure if it would exactly happen...
(Naomi, 37, emphasis added)
Firstly, here, the participant is ‘coming into an environment’, implying a conception of a bounded
region distinguishable from other regions, into which patients are brought. The spatiality of the
Highlands is being experienced as a different form of proximity, a different range of concerns
from the spatiality of the city and the hospital where Naomi was trained. Significantly, all her
previous training (which had been outside the UK) had been within the spatial confines of one
hospital, including various placements to specialist departments. The extract contains significant
contrasts between ‘short space of time’ , ‘bigger area of a person’ and ‘larger hospital in a larger
city’, and these expressions – two spatial metaphors and one spatial comparison – map readily on
to the idea that there are two different senses of proximity involved, two different spatialities
experienced before and after coming to Highland region.
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Going on a placement was thus a more significant issue at HC because of the geographical
distances involved, and this spatial dispersion of students contributes to their senses of mobility
and possession:
I see it [journey to Skye placement] as a bit of an adventure...there wasn't time to
socialise, we were scattered around...we each went to different parts of the island...I
didn't keep in touch [with anyone on-campus]... (Andy, 22)
Andy was the only male participant from HC, whose characterisation of the placement as ‘a bit of
an adventure’ provides support for the view that autonomy was a gender issue. More complex
feelings about mobility were, however, expressed by a female participant:
That was ludicrously ridiculous beyond words, sending a single parent with two
children to Kyle of Lochalsh...leaving home at 6:30 in the morning, thinking ‘what
are you doing, silly woman, get a life’, but having done it, there were lots of positive
things came out of it, and it was a huge learning curve, and staying in bed and
breakfast was brilliant, but masses of organisation and planning, getting your
children looked after, pack them off, pack their week's things, ‘when have they got
piano? When have they got ballet?’ Lots of planning, you needed amazing
organisational skills, but once you had done it, what a sense of achievement!
(Doreen, 34)
Two intersecting concerns flow from this extract. On the one hand, institutional circumstances
dictate an inconvenient, and in some ways even dangerous, relocation. On the other hand, this
creates an opportunity for study time and freedom from distraction, and ‘a sense of achievement’
for the student. This sense of achievement occurs at the intersection between two roles, those of
parent and nursing student.
Urry (2001a; 2001b) suggests not only that the right to mobility has become enshrined in
contemporary citizenship, but also that this right carries with it duties of mobility. Thus, we seek
the technological means to commute long distances to work, and complain if these are not up to
our expectations, but we are also encouraged to seek work at increasing distances from home by
discourses of flexibility (Edwards 1997; Gray & Morgan-Klein 2000). The PMP framework a
possible basis for this paradox. Increasing proximity, as an increase in that which is in one’s
range of concerns, is an effect of media saturation (Thompson 1995), in that there are few places
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left beyond the horizon of personal knowledge. This in turn increases the desire for mobility,
which in turn increases our sense of proximity, further accelerating the process, as both Urry
(2002) and Adams (1999) have noted. Fear of the unknown is increasingly unknown. It needs to
be emphasised that these processes are not unique to the early 21st century but have historical
precedents (Cavalli-Sforza et al.1995).
This perhaps explains the relative reluctance of the HC students to complain about the burden of
mobility which is imposed on them by the local structure of nurse education, although their
responses also suggest that travel time can be sometimes be enjoyable and may provide
opportunities for learning. The mobility and flexibility implied in Chiarella’s five identity stories
(Chiarella 2002) is thus acted out in the embodied experiences of the students.
Albertsen & Diken (2001) point to immobility as the necessary corollary of mobility, and for
many of the participants in the study, the specific form of professional mobility required by the
placement system resulted in periods of personal immobility, in which they found themselves
restricted by shift patterns or work rosters, and were at the same time unable to study due to
deficiencies in their accommodation, for example the lack of desks in tourist ‘bed & breakfast’
establishments. The point here is again the contingent nature of the learning context that the
institutional requirement for placements creates, with little formal recognition of the
consequences for students. Mobility and possession are thus bound up with the question of
power-relations.
In the same vein, another student emphatically expressed her dissatisfaction with aspects of the
new and more varied role towards which current nursing policy was directed (Warner 1998) :
...the common foundation course, it was appalling, just ridiculous, I spent six weeks
on a health promotion placement... As far as I'm concerned, it had nothing to do
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with nursing... ... it would be good if there were beds because that would mean
there might be a chance of a patient being there. (Joanna, 35)
This confirms a finding of May et al. (1997: 297), one of whose respondents commented:
Health promotion...folk get sick of it, you are bombarded with health promotion in
the first 6 months, people are not interested you know, I want to be a nurse, I want to
look after sick people.
The issue here revolves around nursing students’ expectations that they will be involved in caring
for patients. Nursing is predicated here on a strong sense of proximity (having patients within
the range of nursing concerns), a restricted sense of mobility (nursing operating over short
distances) and a strong sense of possession of specific types of setting (acute hospitals). This is
not to criticise these expectations but to show that they involve issues of spatiality which can be
explored via the PMP framework.
The Highland experience was not, therefore one which suited all the students equally. The spatial
differentiation between Highland region and other areas could sometimes lead to quite strong
expressions of loyalty, or, in terms of the PMP framework, a strong sense of possession towards
the Highlands:
I want to stay in the Highlands, we're living in Nairn, I'd be quite happy to commute
and do something like that, that doesn't bother me at all as long as I could get home,
but a lot of the girls are going to go down south and get other places, Edinburgh,
Dundee or Glasgow and Southampton, places like that, because I was teasing them
about ‘all of you get trained up here and then go down there, down south and not
give the advantage to up here’, but it was said half in jest (Helen, 72, emphasis
added)
One of the purposes of Project 2000 was to stimulate reflection on the wider social context of
nursing (UKCC 1986) but as the earlier extracts showed, the spatiality traditionally experienced
by nursing students works against this by helping to maintain a group identity (‘the girls’) centred
on collaborative activity within restricted or restrictive settings.
The need for a combination of nurturance and re-siting in order to build nursing practice proved
more problematic when the long distances involved in HC placements were taken into account.
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In the case of the next participant’s placement, the arrangements for contact with tutors during the
placement period bore out the desire of the students to demonstrate their autonomy as much as
possible:
Initially, I discussed with my personal tutor, because I was quite confident and that
kind of thing, ‘if I have any problems, I will telephone you’, because I knew there
were a lot of girls who didn't have that kind of confidence and I didn't want to waste
her time…yes, if there was a problem it would be relevant, but if there wasn't a
problem, someone else could do with your help more than myself and there was a
personal side to going away, and... my personal tutor was very good and she phoned
me up and said ‘are you O K ?’ a very short phone call, but very relevant, it really
backed me up, it wasn't a problem, she trusted me enough to understand what I
meant by it, so... (Naomi, 23)
Having been ‘quite confident’ in this (earlier) placement, the lack of regular contact (caused
partly by the unplanned absence of a fellow student who was due to share accommodation).in the
second placement was highly problematic:
I had to have a placement that was quite far away, and I was by myself, and it was
very lonely, horrible, there was no contact, although some of the staff you could
speak to, but you couldn't speak to [anyone else], so you had like contact deprivation
almost, you had four walls and you're bouncing off them, all you've got to do is your
essay to concentrate on, you can only do that for so many hours without becoming
nutty (laughs)… (Naomi, 24)
Two points emerge from these extracts. Firstly, despite the attention given to supervisory
arrangements in Project 2000 (May et al. 1997), the difficulties involved in providing equal
amounts of supervision for all students in all placements mean that the students in the study were
not always provided with as much support as they would have liked. The placement, in this case,
is sensed by the student to be at the furthest extreme of proximity to the university, being only
just within its range of concerns.
There are conflicts here between the desire for autonomy, the desire to be mutually supportive
and the desire to be supported. It is not the physical distance between the placement and the
institution so much as the quantity and quality of the time/space that the tutor is able to allocate
(or which the student solicits) which determines the degree of proximity. In the first case
(above) the quality of the relationship is apparently high and ‘a very short phone call’ is
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quantitatively sufficient to maintain the mutual proximity of student and institution. In terms of
mobility here, it is not just the student who is highly mobile. Rather, the institution maintains its
proximity by caring for the student at a distance.
In terms of the academic role which the student has to maintain whilst on placement, the role of
the essay in relation to placements is paradoxical. Whilst May et al. (1997: 348) report that the
need to be working on essays or other assignments can be unhelpful to students on placement, as
it distracts them from the practical learning experience, the stories told here were more complex.
In the extract above, the essay functions as a distraction from the stresses of a lonely placement,
but only to a limited extent. In the earlier discussion of the essay-writing process, this particular
student reported that the spatial arrangement of information was an important issue for her. In
the placement situation her preferred spatial arrangement was more difficult to achieve, due to
other issues around the nature of the accommodation and its spatial arrangements:
When I've been away, it's always been B&B [bed &breakfast] accommodation, there
is just this feeling that it's not entirely your own space, because you're living in
somebody else's house, and it's not your chosen surroundings...so far I haven't had
television in my room, but there has been television in my B&B, and it's been a
distraction. I am actually staying in halls [of residence] in Wick this time instead of
a B&B and I'm finding that better, because they've got the set-up, when you're in
somebody else's house...you don't often have a desk, whereas this one has and it's a
bit more equipped for students, so it's a bit better this time round...whereas in halls
everybody shares, so it's a bit more like it's your territory… (Wanda, 8. 9, 10)
Again, the extract highlights the need for student accommodation to be fit for its purpose, but it
also emphasises the importance of possession as a power relationship, the sense (or lack) of
control over a space, or of having one’s own ‘territory’. Student rooms in halls of residence form
such a territory. The essential characteristic is that the space conforms to the expectations of
those who dwell in it, in other words that it is fit for its purpose. In the extract above, there is a
sense of reduced possession because the participant is having to study in a space which is geared
towards relaxation and transient occupation. The next extract also reveals that ‘fitness for
purpose’ is linked to gaining a sense of possession.
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It depends on the placement. When I was up in Wick, it was a health promotion
placement, and I took all my books up with me, I even took my word processor, and
I did a lot of work, I didn't want to communicate with anybody, I just shut the door,
the accommodation at Wick was very good, it was purpose-built for the nursing
staff, we had our own space and shared showers and so on, but at this place I've just
been so tired at the end of the day that after the first week I thought, there's no way
I'm going to study, I'm not finished till half-past eight at night, I don't get back till
quarter to nine and by the time I've had something to eat, you just don't feel like it,
there's no point, you're just not taking anything in...(Susan, 35)
The workload of the placement sometimes meant that students were unable to focus on study in
general and on essays in particular during their off-duty time. On the other hand, the placement
provided opportunities for some students, usually those with children, to spend extra time
studying and writing, since they were relieved of their domestic workload. This is the converse
of the problematisation of ‘home’ as a study space, and one of the unexpected benefits of the
placement here is the relative luxury (for students with families) of being looked after in bed &
breakfast accommodation – no bed-making, cooking or washing up (see extract Doreen, 34
above). This was not a unique experience, as the student-tutor pointed out:
Yes, they do sometimes [enjoy it], to get some quiet evenings and time to be entirely
a student, for a few weeks and not to have to worry about shopping and picking up
the kids...(Anita, 37)
This is an experience often appreciated by mature students:
it [American exchange year] was an opportunity to get away from domestic
commitments for a while and do nothing but be a student… (Peter, 20)
The change of domestic environment enabled an intensity of study not otherwise attainable, thus
highlighting the constraints which often render ‘home’ a contested space for students.
...I went to a motel for the weekend once just to finish a big paper – loved that, a sort
of caffeine binge and an escape from domestication. A portable existence, no
washing up or DIY. So the space acted to keep out distractions and focus the
work...(Peter, 22)
This might be an example of a gendered spatiality, but it also illustrates that studying as an
activity is both portable and conditional on having a certain relationship to the available space(s).
I stress ‘available’ here because the institution was perceived to have a casual attitude towards
finding accommodation for students on placement::
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…really it is finding accommodation that's the big problem, because in the winter a
lot of the places are closed down and in the summer all the prices are horrendous and
you're working early shifts and things and a lot of the B&Bs [bed & breakfasts] you
don't get any breakfast until 8 o’clock or whatever, so yes you can [find that a
problem]… (Helen, 22)
sometimes people can go and tell you to stay in a certain place, but the whole thing
is a bit shambolic… (Susan, 34)
Given the marketing of the Scottish Highlands as a tourist destination, and its low population
density, the problems identified above might be expected. It provides more evidence, however,
that mobility, this time in terms of a mobility of accommodation, is expected of the students as a
duty rather than being seen by the institution as part of its duty of care towards its students, as the
following extract shows
It doesn't create a problem[with domestic arrangements], because I'm pretty
pragmatic about these sort of things, but it does annoy me that I've had to go away,
because I should have had a placement at home, but there weren't enough placements
so five of us got moved to the outlying district, so there could be an element of
annoyance there, but it doesn't create particular difficulties for me with my home
life, because my family are behind me...everybody has difficulties, but it's not
particularly because I'm away. (Susan, 30)
In turn, this can be seen as expressive of the ‘nurse as domestic worker’ story which, as Chiarella
(2002: 98-100) shows, resulted in poor living conditions and a harsh disciplinary regime for many
nurses until relatively recently. As an experience of spatiality, accommodation problems can
generate a diminished sense of possession. Paradoxically, the experience of tourist
accommodation can also generate a heightened sense of possession through the ‘luxury’ of relief
from domestic chores and responsibilities. This, however, is contingent on the geographical
uniqueness of the Highland region, rather than a planned benefit organised as a matter of course.
The attitude of the institution to placements was thus a factor in students’ sense of possession of
the placement space itself, whilst this, and the high level of student mobility, reflect both the
‘autonomous professional’ self-image of nursing discussed by Chiarella (2002: 168-172.) and the
‘ministering angel’ image which in her view has frequently resulted in poor pay and conditions
for nurses (ibid: 246), as the next extract suggests:
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For me personally, the overwhelming impression I get is that they're [tutors] far too
busy, and it's just the usual thing that you don't want to appear incompetent or a
nuisance, or particularly annoying, or rocking the boat, or [to be] pestering them, so
I just feel I've got to be confident enough to ride this out for myself… (Susan, 39,
emphasis added)
This returns once again to the importance of spatial metaphors in constructing nursing student
identity. The nautical metaphors here (‘rocking the boat’; ‘ride this [storm] out’) convey the
tension between group solidarity and individual resilience. Lakoff & Johnson point out that
groups of metaphors are frequently used to promote inconsistent sets of ideas or worldviews
(1999: 248; 345; 555).. As the participant makes clear, this desire not to appear ‘incompetent...’
is ‘the usual thing’, as indeed it was for all the participants who expressed a view on the topic.
This suggests that the notion of ‘dwelling’ might be a useful foil for the pervasive metaphor of
the journey through which the education process is conceptualised in everyday discourse.
Students want to ‘dwell’ in the placement and elsewhere but are frequently frustrated by material
constraints such as the type of accommodation which is available to them or the need to perform
other work, such as essay-writing, at the same time. These constraints, and the action which is
required to overcome them, are seen as themselves part of the pragmatic approach and compliant
attitude expected of nurses, and are therefore not the subject of major protest. This neglect of the
embodied spatiality of the participants by the institution is not a deliberate act, nor is it due purely
to its limited financial resources. What I am suggesting here is that it is partially a consequence
of operating under the paradigm of education-as-a-journey, rather than the paradigm of dwelling.
I cannot, of course, claim that this is the sole cause of discontent amongst nursing students, nor
can I claim that such a paradigm shift would be easy to accomplish.
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Summary
The above extracts suggest that the type of spatially-dispersed nursing activity practised in
Highland Region requires specific educational and policy emphases in order to maximise its
benefits for nurses and their clients. These emphases might include better support and
communication during placements, and more attention to the non-clinical aspects of nursing
during both C.F.P. and branch programmes. The intentions of Project 2000, as set out by the
UKCC (1986; 1987) and as modified in subsequent publications (UKCC 1999; DoH 1999), were
to broaden the scope of nursing activity and to expand its range of settings. As Cuthbertson
comments,
Project 2000...has always had its detractors, established as it was under an
unprecedented burden of criticism and negativity (Cuthbertson 1996: 1)
This level of negativity clearly continues in certain respects, although changes have been made,
partly as a result of these and similar criticisms. The evidence suggests that spatiality is a more
important aspect of nursing than has hitherto been acknowledged. None of Chiarella’s five
‘stories’ about nurse identity (Chiarella 2002: 23) is directly linked to a spatial location, and yet
in the three examples above we have seen that the size and location of the campus, the presence
or absence of acute hospital settings and the opportunity to be involved in direct patient care have
a significant role in identity formation. This is not to say that the examples given here point to
generalisable conclusions about identity, as there are counter-examples for all of them, even
within the sample used in the current study. What the examples show is that the experience of
spatiality is complex and cannot be reduced to a set of measurements. The next stage in the
exploration involves a further teasing-out of the relationship between the participants’
experiences of spatiality, which emerge from the data, and the PMP framework, which is
intended to clarify the meaning of those experiences. In Chapter 8 I move from consideration of
spatiality in settings which are overtly spatial, to examples of learning activities which are less
obviously so. The use of spatial metaphors, which has surfaced from time to time in this chapter,
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will be more closely examined, and the importance of embodied spatiality as a factor in learning
activity will be re-emphasised.
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Chapter 9-Spatial metaphors in nurse
education
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He was being driven back. Against his will he was forced to turn his thoughts into
the City, and since last night he dared not. Certain questions battered at his
conscious mind...he didn’t want to face the answers
(Isaac Asimov, The Caves of Steel)
Introduction
Previous chapters have described the PMP framework which has acted as a heuristic framework
for some of the spatial issues which affect nurse education in the context of the two sites specific
to the current study. In this chapter I will use the framework as a basis for discussion of two
aspects of nursing student experience which are spatially significant, but which are less site–
specific. The first aspect is the problem of self-directed learning vs. structured or teacher-led
learning, and the related tension between individual and collective forms of learning, and the
second aspect is essay-production. These do not appear to be directly connected, since the first
item concerns ‘a fundamental principle of adult learning’ (Jarvis et al. 1998: 78), whilst the
second concerns a means of assessment. I will argue in this chapter that both are related to the
ways in which students experience space, and that lack of attention to these contingent spatialities
has a negative effect on students’ experience of the learning process. What I cannot do here is
demonstrate links between the spatial issues and specific learning outcomes. The findings which
I report here are, however, consistent with those of other studies of student experience under
Project 2000 and are relevant to some of the changes which have recently been made or
recommended as a result of those studies (RCN 2003b).
Self-directed–learning: journey without a pause?
In what follows, I discuss the concept of self-direction and what it means for the students, with
the aim of bringing out its spatial, rather than pedagogical (or andragogical) significance. The
contextual use of language will prove to be an important part of the evidence for the spatial
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experience of self-direction and the other issues to be discussed. To introduce this section, here
is a participant statement which raised the issue of ‘direction’:
You're not used to school any more, you've been living in a different world, even
some of the girls who've just left school were finding it totally different to
their...how they were at school, and yet they're all self directed now at school, in the
5th & 6th year, aren't they? ...they were saying,’ Well, we don't know how to go
about it, where do you start?’ so I mean if, OK, I've learned things on my own that
I've wanted to learn , but it's still nice to know where to get started...(Christine, 76)
This dissonance between perceptions of the school experience and perceptions of teaching and
learning in higher education introduces an important metaphorical construction, that of ‘learning
as a journey’. The key phrase here is ‘where to get started’. This is such a deeply embedded
spatial metaphor that it is hardly recognisable as such. The idea of self-direction is based on a
similar spatial metaphor – learning as a journey, requiring navigational skills and a location from
which to begin. The advent of modularity, self-direction and other ‘flexible’ (Edwards 1997;
Morgan-Klein & Gray 2000; Edwards & Clarke 2002) modes of learning has altered the nature of
the journey. There is no longer a recognisable ‘Class of '99’ with whom one can complete the
journey through university. As the data reveal, students sometimes form groups around
individual course modules but these are transient and disrupted by family commitments or the
placement process.
Earlier literature on self-direction in adult learning (SDL) draws on humanistic psychology (see
e.g. Rogers 1994; Quinn 2000: 51; Tennant 1997) and would not appear to be overly concerned
with spatiality. Rather, in a reflection of the discursive regime of 1950s America, humanistic
psychology is concerned to emphasise the potential autonomy of the individual in relation to
society (Law & Rubenson 1988). The essence of SDL does not lie in its content or in the
instructional method, but in the locus of control of the learning (Quinn 2000: 52). In true SDL,
control of content, pedagogy and assessment would all lie with the learner. Furthermore, as
Edwards (2000: 39) indicates, the ‘learning needs’ of individuals, which are supposed to drive
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their (self-directed) learning activities, are themselves products of discursive regimes. In this
view, learner autonomy is an illusion, as the qualities called-for in the lifelong learner are in fact
symptoms of, amongst other things, the externalisation of costs under the regime of justification
of industry (Boltanski & Thévenot 1991: 203). Humanistic principles of adult learning,
however, attribute importance to individual ways of experiencing phenomena. The learners
under discussion here are self-directed in some, but not all, senses, of the term. Clearly their
education is neither ‘compulsory [n]or universal’, the two criteria which Jarvis et al. (1998: 77)
see as definitive of education other than ‘adult education’. It is, however, compulsory in the sense
that they cannot pursue their chosen careers as nurses without some form of it. They are
therefore ‘self-directed’ (in terms of career path) into a process where they are ‘other-directed’ (in
terms of the structure of their professional education) and then, from time to time, ‘self-directed’
in relation to the performance of various learning-related activities.
The notion of self-direction, however, is itself a spatial metaphor. As I discussed above, it draws
on the ‘learning-as-journey’ schema (Lakoff & Johnson 1999: 193). The self is conceptualised
as an object which can steer itself along a path. This is, of course, what embodied humans do in
negotiating their environment. Because the metaphor is so deeply embedded in the educational
process, the student experience is conditioned by the metaphor, and the learning experience can
suffer through institutional ways of thinking which often draw on contradictory philosophical
paradigms (Lakoff & Johnson 1999: 546). What I wish to show here is that within educational
discourse, self-direction is both a spatial metaphor and a spatial problematic.
The participants’ perceptions, according to the data, are of being ‘in’ the University or college in
order to be ‘guided’ by its ‘structure’. Whilst there was a certain amount of choice involved in
the nursing courses under discussion, this was largely limited to choice of branch specialisms
(Adult, Mental health, Learning Disabilities or Paediatric) or of modules within branches.
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Otherwise, students perceived themselves as having little control over course content and a very
limited amount of control (via staff-student groups and course evaluation forms) over pedagogical
and assessment issues. May et al. (1997: 268) found that considerable efforts were being made
to make the educational process ‘student centred’ in the institutions which they evaluated, but the
issue here is the spatiality of self-direction, which is not synonymous with student-centredness.
In this context, ‘self-direction’ meant that students were expected to exercise initiative in terms of
collaborative working and in terms of locating information for essays and other assignments.
Thus, self-direction meant, for them, the absence of constant supervision or clear structure for
learning activity. May et al. (1997: 337) report, however, that the students in their study made:
[l]inks between formative feedback and self-directed learning, i.e. their tacit
acceptance of their responsibility to be self-directing.
In view of the increasing professional autonomy of nurses and the related use of the research
evidence base to support practice, the ability to learn without supervision and to locate
appropriate materials is clearly important. What is less clear is the relation between individual
learning and assessment, and group support or collaborative working, with students unsure where
collaboration ended and plagiarism began. Thus, the stress on self-directed learning combined
with encouragement to form study-groups sometimes led to confusion:
There's been a lot of bitching about the academic side, but then when they're asked
about it they [students] won't say [anything]. Now I will say - nicely - ‘I'm getting
really confused about this essay because one nurse says one thing and one says
another’...I don't say ‘Oh, so-and-so told me this,’ I don't try and cause trouble...and
so long as you don't go ranting and raving people are alright...there is a bit of ‘Oh
well, it is self-based learning... but you still need guidelines... (Lynne, 75, emphasis
added)
[B]eing among nursing students all the time can be both an advantage and a
disadvantage. You can talk to each other about essays, we didn't at first because
people thought it was against the rules, but we soon learned, now we have some
really good discussions on essays, but other times you feel you're getting pushed in
the wrong direction. I sometimes feel you're sat in groups and felt that the person
who was the loudest has pushed everybody into his or her way of thinking. (Lynne,
38, emphasis added)
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Thus, whilst group-learning and mutual support were encouraged, students detected that there
seemed to be an underlying conflict between the processes required to produce autonomous
learners and those required to produce collective outcomes. On the one hand, the university
espouses a culture of individuality, in terms of its assessment criteria. On the other hand, as
Boreham et al. (2000) have suggested, nursing and other healthcare professions require cultures
of ‘collective competence’ in which the team is more significant than the individual. Whilst
participants were conscious of the need to function effectively in teams, their perceptions were
that the institution did little to encourage awareness of team process as distinct from individual
outcome.
My purpose here is to explore the spatialities which feed into this conflict. The repetition of
‘pushed’ in the extract above is an interesting example of a metaphor derived directly from the
embodied world of action, with ideas, ways of thinking, or the self as its object (Lakoff &
Johnson 1999: 240). Ideas, in this metaphorical schema, can be ‘kicked around’ or ‘thrown out’
or ‘picked up’, whilst, in a continuation of the journey metaphor, one can be ‘pushed in the wrong
direction’ in terms of one’s thinking. Ideas are also conceptualised as a fluid body:
we have a bantering session where we discuss what we found and what we hadn't
found and ‘what do you think of this’ sort of thing, so we are also learning from that,
but it is also very confusing, because some people will go really in depth into
something, whereas other people will just skim the surface… (Naomi, 14, emphasis
added)
The surface/depth metaphor has a long history in adult education, following the work of Marton,
Entwhistle and others (Marton et al. 1997) which suggested that it was possible to distinguish
‘deep’ and ‘surface’ approaches to student learning. Indeed, May et al. refer to this research in
their discussion of the effects of assessment methods on the learning of Project 2000 students
(May et al. 1997: 343).
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As Haggis (2002; see also Atherton 2003) has suggested, the deep/surface distinction is overly
simplistic and is of limited application, but the pervasiveness of the metaphor is such that it is
easily understood and resonates with a wider cross-section of the educational community than, for
example, the related, but now obscure, distinction between ‘sylbs’ and ‘sylfs’ (Parlett & King
1971). Moreover, as with many such binary distinctions, it has an evaluative function
(Michelson 1998), as can be read off from the opposition between ‘really...’ and ‘...just’ in the
above extract13. The relevance of this to the present discussion is that the deep/surface distinction
is effectively a continuation of the journey metaphor. In the above extract, some participants are
prepared to journey further (or deeper) into the knowledge-field (or forest) than others who wish
to remain on the edge (or surface). This is an additional source of confusion for students who are
already caught between the devil of sedimented practice and the deep blue sea of the evidence
base. Knowledge is experienced spatially here, as something to which one can be in greater or
lesser degrees of proximity.
The next extract also employs the common spatial metaphor of ideas-as–objects to illustrate a
point about the need for navigation through the system:
it [staff nurse course] also allows me to see where the tutors are actually going, with
their education, because at first I was very confused, and I was thinking, now why
are they teaching all this stuff? They were like, putting everything into boxes, and I
thought about it for quite a while, because I was quite confused as to why they were
putting things into boxes, because I was thinking, realistically nursing is not about
boxes, it comprises a whole picture... After coming out of CFP, you’re putting
everything into practice, and they're taking you through that stage, and I started a
year ahead of them in my thinking, so I had to withdraw myself right back, to be
able to pass everything that they were giving us, and now I've kicked into the stages
of building up the blocks and getting a nice big wall with every block in place.
(Naomi, 32/33, emphasis added)
This passage uses a rich selection of spatial metaphors to make its point – the journey, the box or
block and the wall, but with the overall visual metaphors (nursing as ‘a whole picture’, ‘a nice big
13
It is also worth noting that the origins of cognitive learning style typologies lie in the spatial-orientation
experiments of Witkin (1972), performed in the late 1940’s and early 1950’s. Witkin’s spatial-orientation research
has been largely discredited in its original field of perceptual psychology (Jones 2000) yet the notions of field
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wall’) counter-balancing the structural separation of knowledge into discrete units. Because
there was insufficient pre-course information, the ‘boxes’ could not be brought into a proximity
relation with the student – they were beyond her range of concerns and thus could not be
understood as a Heideggerian ‘region’ (Young 2000) or ‘referential totality’. The ‘whole picture’
is built up from the physical metaphors of ‘taking you through’, being ‘ahead’,
‘withdraw[ing]...right back’ and ‘kicking into...building up’. In other words, it is a visual
representation of a journey, during which events happen and companions fall behind. There is an
expressed desire for navigational aids, or landmarks, to help in the initial stages, corresponding to
the participant’s experience of arriving at HC for the first time:
... I remember my first day, and I remember the first person I spoke to, I was
standing there, and I thought to myself everyone is feeling the same way as I am, so
I reassured myself in that fashion, and then we had second years who took us around
and pointed out particular areas of interest, so although it was too much to take in
the first day, because you're so hyped-up and everything, as you absorb the
information and it became like long-term memory, so you could take in further
information and be at ease with what you started with, although when you first
started its you're like OOOH, all uptight and tense and everything, and then you got
over that, that went into long-term memory, you take on the next... Like a loaf of
bread, you're cutting it up and as you're going through it, you become more and
more comfortable with the new ways that you have got to do things
but...familiarising yourself. (Naomi, 21, emphasis added)
The need for navigation and the gradual unfolding of spatial understanding parallel the unfolding
of understanding of the tutors’ strategy in the previous extract, and yet another metaphor of
division (‘a loaf of bread’) is used to make the same point as the ‘blocks’ metaphor.
The above extracts represent a recurring theme in the data, that of initial disorientation on
entering a space (or, more accurately a collection of spaces) followed by a process of
familiarisation, acculturation or, in some cases, increasing discomfort (or dis-ease?) over time.
This is not the same as ‘de-familiarisation’, since there may be parallel processes of increasing
spatial familiarity combined with social alienation or increasing discomfort. Possession is thus a
dependence & independence, and their descendents, continue to influence the theory (if not the practice) of adult
education.
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way in which spaces are differentiated from each other as individuals and groups move through
them on journeys or dwell in them.
Almost by definition, self-directed learning takes place outside traditional institutions (Jarvis et
al. 1998: 79). The use of the term for activity occurring within institutions is thus misleading,
but the principles extracted from early research have been transferred into these settings. As I
noted at the beginning of this section, these principles have been absorbed into the rhetoric of
enterprise and lifelong learning, an unsurprising move since pioneers such as Knowles and
Maslow were known for giving motivational seminars to business audiences (Wilson 1972).
Again, my purpose here is to show that spatiality is a relevant factor in any consideration of selfdirected learning. The individual is ‘thrown’ with others into the institution and its spaces and is
thus always already confronted with social situations. There is a complex interaction between
individual, social situation and space in relation to the metaphorical and spatial idea of the
university as a structure for ‘guiding’ learners, as this extract demonstrates:
…even although the university isn't structured as such, you've got the formalisation
of going to lectures…people are teaching you, you go to the library…to support
what you’ve supposedly been taught, in the classroom, so there's more control there,
whereas outside it’s more... autonomous in a way, in that it's up to you to do it, but
it's less formal, I don't know if it's to do with my age, and the way that I was taught,
but I do prefer a more structured teaching environment, rather than just ‘Oh well you
can go to a class if you want to, if you don't want to then you don't have to’, I find I
learn better if someone gives me structure, as opposed to it not being . . . So I
prefer it in the classroom… (Lynne, 17, emphasis added)
Self-direction was thus seen by this student as contrary to her perception of the function of the
University, a theme which had previously emerged with non-nursing students on a part-time
degree programme. There, the feeling of the students was that self-direction had to follow an
initial structured phase of learning, preferably in a classroom or other defined space. In
discussing the metaphor of access to HE as ‘climbing over a wall’, one of the students pointed out
that once one had climbed the wall, and reached the other side, it provided ‘something to lean on’.
The conflict here is a proximity issue, because in order to be within the range of concerns of the
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students, and thus be in proximity to them, the university has to play a large part in defining those
concerns. The structuring and legitimating effect, or the civil regime of justification which the
university system provides, is needed in order to keep it within the proximity of the students.
The above discussion of the experience of self-direction in the context of nurse education has
problematised the ways in which spatiality and spatial metaphors interact in the experience of
participants in self-directed learning, and the metaphor of the journey was again shown to be
important to this spatial experience. This is not to say that self-directed learning is in itself
problematic, but to say that spatiality, and the PMP framework, provide a way of exploring
concepts such as self-directed learning from a different perspective. In the next section, I will
move on to discuss the spatiality of essay-writing within the context of nursing student
assessment, again using the PMP framework as an analytical tool.
The essay – bringing it all back home?
In nurse education, the essay as assessment method has featured in the critical literature (May &
Domokos 1992, May et al. 1997) following the introduction of Project 2000 and the consequent
shift towards academic assessment practices. The use of the essay as assessment method reflects
a trend towards evidence-based or research-based practice and the need to assess ‘higher levels of
cognitive functioning, such as application, analysis, synthesis and evaluation’ (Quinn 2000: 207;
p.565) with a related desire on the part of teaching staff to encourage students to access and
critique the relevant literature. The essay does not at first seem to involve spatial issues, being a
literary form, although as such it can be regarded as a kind of space (Blanchot 1989) and
therefore as a way of arranging ideas, As such, its production involves spatial activities, both
physical and metaphorical, even for the solitary thinker in her study, and it is this aspect of the
essay which makes it of interest here. Urry refers to ‘the notion that academic and political
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writing can itself be conceived of as a journey’ (Urry, 2001b: 240), thus situating the essay within
sociological discourses of mobility and proximity. In the interviews, participants were asked
where they wrote their essays and how they went about the process of gathering relevant
information. Whilst methods varied from student to student, the process centred on two main
features. Firstly, the participants described space-time patterns of collecting and assembling
data, centred around the library: and secondly they described their writing techniques, which
often involved access to, and familiarity with, computers,
…what I tend to do is gather the material in the library, then take it home in note
form and type it up at home. (Terry, 7a)
This is the process in its simplest form -collect, condense and construct. The above extract was
from one of the students who made most use of ICT at home, and who found it useful:
...a lot of journal articles, especially nursing journals, are on the Web, I can access
that from home and also from the University. Psych-info [an electronic database]
and things like that are pretty good. (Terry, 5)
The availability of material on the Web has not yet eliminated the need for library visits,
however, even for the more advanced users of ICT. Even if all the necessary materials were to
be made available on-line, the collection process would still be required, albeit within a different
set of spatial ‘co-ordinates’. Brickell (1993), in discussing the design principles of on-line
learning environments, shows that these spatial and ‘navigational’ metaphors are essential to their
function. The essay-writing process is thus one in which the student gains proximity to the
materials, exercises mobility in accessing them, and takes possession of their essential content. I
will now look at each of these elements in turn, with reference to the interview material which
refers to the essay-writing process.
The essay is generally regarded as a summative assessment method, meaning that it marks the
culmination of a process rather than (as in formative assessment) being part of a continuous
process. There are three points to make before I begin to explore the essay-writing process in the
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interview material. The first is that, although the essay has only recently gained a role in nurseeducation, it emerges from the data as being problematic in the context of nursing practice.
Secondly, it is an assessment method still widely used in other disciplines, and hence the
discussion here may be of interest outside the context of nurse education. Thirdly, the term as
used here also applies to forms of written assignment, such as research reviews, which the
students regarded as being essay-like in form and in terms of the methods used in producing
them. The purpose of the discussion here is thus to relate the essential elements of the process to
the participants’ experience of spatiality. The following extract gives a sense of this:
A normal pattern when I’m doing an essay [would be to] start collecting research
and material, this is probably a bit naughty but I... I tend not to read it and assess it
as I go along, but leave it all to the end and then I do the reading, I was talking to
another student today, and he was saying the same, I'm a slow reader, the reading
thing is very laborious and also the concentration thing... Writing things down, then
assessing it, analysing it, deciding what you're doing, I used to do about four drafts,
whereas now I'm down to about two, doing one [essay] is just such a learning
experience I think, and it makes a difference if you're enjoying the subject, if you
know the subject, it's just writing it up, tidy it up, and thinking about the layout, what
you're trying to say and structure and all that… (Karen, 52, emphasis added)
The ‘materials’ in this context need not be confined to written texts, but can also include the
results of informal learning, such as discussion with other students. Whilst this is what might be
expected in a ‘community of practice’ (Wenger 1998), there are additional issues which make the
situation more complicated. As I discussed in relation to self-direction, students were often
confused about the difference between group collaboration and individual assessment, with
resultant problems during the essay writing process:
It's [student group] completely not structured, but I think students inevitably talk
about what's on the agenda for today, and essay questions always bring up a flurry of
thoughts and actually lead to more anxiety than less...
everybody seems to have different ideas about how to go about it, it tends to make
people anxious and just talk about college when we're here. (Doreen, 13/14)
[I] put in an essay, is it going to pass, is it going to fail? Stuff like that, especially
because this is new to me, it’s 17 years since I studied, any serious studying…
(Lynne, 21)
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The second extract reflects the anxiety commonly felt by mature students returning to education
(Wakeford 1994), an anxiety which arises as a result of (amongst other things) comparisons with
the perceived abilities of others. These comparisons are relevant to issues of possession, since
being in a space with others results in varying degrees of knowledge about the abilities and
techniques of the other, leading to corresponding attributions of power and influence over the
space, a phenomenon most marked in the library and computer lab.
As with the question of self-direction, there were issues over the provision of ‘navigational aids’
to the essay-writing process
Yes, I think it would be good to have, not group tutorials, but discussions about the
essays which were coming up to see if we were going in the right direction, because
a lot of people have said they thought they were going in the right direction and they
have followed the guidelines and when they've done the essay they’ve been told ‘no,
you have not tackled it the way we wanted it’ but they have followed the guidelines,
the guidelines are very vague and it's very easy to get yourself off on a tangent…
(Helen, 39)
The process is again conceptualised metaphorically as a journey where one can go ‘off on a
tangent’ and thus end up at the wrong (conceptual) destination. It is another example of the
tension between the collective ‘we’ and the individual as the unit which is assessed, and the
tension between form and content which characterises the essay as an assessment method. One
of the students recalled an occasion when a tutor had told her that her essay would have received
an ‘A’ but for its introduction not conforming to the set format, which reduced it to a ‘C’. This is
in agreement with the finding of May et al. (1997: 339) that students found marking inconsistent
and frustrating, but more importantly, it reveals a problem with the spatially-derived
metaphorical schema which drives the essay process. Moves towards greater use of formative
rather than summative assessment in the theoretical component of nurse education (Howard
2001) are an acknowledgement that different metaphors may be required in future.
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The spatiality of the essay is not exhausted by metaphorical analysis of the overall process. In
terms of students’ information sources, which frequently consisted of piles of photocopies and
books, information is spatially arranged and remembered, rather than being ‘listed’ in some linear
way as text. Thus, as one participant put it::
…I've got a table, it can be a small diameter table or a long table, it doesn't matter, as
long as I can see my papers, I put my papers in particular piles, and just looking at
them will trigger off what I want to say, so as I go from each section, I tend to use
that as a triggering response and then I take that article as I’m going to refer to it, jot
it down as the reference. It's a continuous cycle kind of thing…
(Q: That's interesting, so that the layout of the stuff on the table is important for
you?)
Yes, very important for me, it's like a triggering response. (Naomi, 1)
At home, I do like to spread out, it's more visual, I like to see it as it builds, as it
were, my bed is covered with all the stuff that’s in the first draft, and the table is
covered with all the stuff that isn't in yet, just chaos, but organised chaos… (Karen,
56)
There are several interesting points in these statements. Material is gathered (in the physical
form of notes or photocopies) in one place and transferred to another. A parallel process takes
place metaphorically, in that ideas are gathered together, sifted, compared (‘weighed-up’) and
finally formed into an argument. Information is seen here as the base ingredient which the essay,
through the student’s prior understanding, transforms into knowledge:
...if I’ve found the information that I’m looking for, it’s a feeling of relief for
knowing that I’m on the right track for writing an essay, if I’ve found the right
information or I’ve found good information, you know, that’s just a feeling of ‘Oh,
good, now I know what I’m doing’. It’s not relief at getting away from the place
[SC], it’s just relief at getting information... (Lynne, 28, emphasis added)
The essay-writing process is characterised as a journey from uncertainty (‘where is the
information?’) to certainty (‘I’m on the right track’). The following table (figure 5, overleaf)
summarises the situation:
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Figure 5: The Essay-writing process as a journey
Essay
Spatiality
Uncertainty
Source
Uncertainty over
finding
information
Uncertainty over
which way to go
with it
Uncertainty over
its reception
Library, IT lab,
www,
tutors, students
Essay structure
Feedback
Question or
Quest schema
What will I look for?
What am I concerned with here?
Element of PMP
framework
proximity
Which path will I follow?
How will I get to my destination?
mobility
What will I find when I get there?
Will my quest end in a good or a bad
place?
possession
This is, of course, a structuralist view of the essay-writing process which draws upon the work of
Propp (1968) on folk-tales or of Lévi-Strauss (1964) on myth. A different interpretation is given
by Holloway & Kneale (2000: 74-75) who suggest that the work of Bakhtin provides a way of
relating space and spatiality to the dialogical situation of self and other. In this view, the essay is
not a closed text but is both open to its socio-cultural context and ‘polyvocal’, that is, it speaks
not only in the voice of its author but in the voices of, for example, the research communities
which inform it. To the extent that it is addressed to another (the course tutor or examiner), it
also speaks in the voice of that other, that is, it reflects back the language which calls it forth. In
doing so, it sets up a spatial relationship between the participants in a dialogical situation. The
essay-writing students are literally placing themselves in the community of nursing, through their
adoption of its own specific voice within language.
Neither Holloway & Kneale (2000), nor Bakhtin himself in the original work upon which they
draw (Bakhtin 1981; 1984a; 1984b; 1994), explore this spatial relationship in detail, since its
make-up depends by their own definition on the particular dialogical situation which sets it up.
In the context of this study, however, the data suggest that the essay-writing process is
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experienced by the participants as both a metaphorical journey and a real spatial journey
(Library/web - home/lab - tutor). Bakhtinian theory supports this, suggesting that the essay has
‘positionality’ (Holloway & Kneale 2000: 77), in other words it ‘voices’ the spatial relationships
between the participants in the dialogue (or, more accurately, ‘polylogue’). Next, it is necessary
to examine the data more closely to see how these relationships might reveal themselves, and how
the PMP framework might contribute to a fuller understanding of their importance.
The following extract gives a sense of the contradictory spatial practices which can arise in the
essay-writing process:
There's a tendency not to use the library because there's lots of to-ing and fro-ing,
and there's a tendency if they're all doing an essay, for them all to be in there, it's
more like a social event, so you will say ‘how’re you getting on’ and anything
interesting rather than sit down and study… (Wanda, 2, emphasis added)
Previous discussion of the spatiality of the library emphasised this paradoxical combination of
roles, but the interesting point here is the third-person characterisation of the others as ‘they’,
which is unique to this section of the interview. Elsewhere the participant refers to others in the
first person plural (‘we are quite a large group’: Wanda, 6). This reflects the perceived
dichotomy between the essay-writing process as a solitary activity (the traditional ‘writer in a
garret’) and as the outcome of dialogue and social interaction. The specific element of the PMP
framework which is visible here is that of (dis)possession – the occupation of the library by others
results in the participant being dispossessed of her share in the communal space. This can, of
course, work both ways, and other students might appreciate the chance of meeting others and
thus of increasing their possession of the library.
This individual/collective dichotomy was reinforced by the problem of gathering the correct
materials:
...as soon as the lectures are there, there's about four or five people who go
immediately to the library and take out four books, of the books that were
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mentioned, so they've got the four books, and nobody else can get them, and all right
the teachers have put them on short term loan and... but everybody needs them at
the same time... (Susan, 17)
The journey thus begins with a struggle over limited resources, but in terms of the polyvocality of
the essay, the information which speaks in or through the essay is being drawn from sources
which are less than optimum:
...but the other annoying thing is...you look a book up, and there is nothing that great
but you think ‘I'll have this one’, and you go to the library and she'll say ‘Oh, it's
there’, but you'll go to the shelves and it's not there and she'll say ‘oh someone's
taken it’, that's really annoying, that someone's taken them, in fact they've stolen
them. That's really annoying, but I mean, they just can't keep buying books all the
time. (Susan, 17)
In terms of proximity, even the less desirable information is within the range of concerns of the
participant, but beyond her reach. The starting-point of the journey is thus rendered problematic,
and the voices of the essay will speak differently.
It might be argued that this is merely a way of re-describing problems of resources and access to
information which affect the majority of students in Higher Education and elsewhere. Why
should this be seen as a spatial, rather than a problem of economics or management? The two
approaches are not, of course, opposed in this way, and what I am suggesting here is that
spatiality provides a way of understanding both rhetorical strategies and material problem,
because the same spatial conceptualisations which underlie the essay process are also underlying
assumptions of the education system itself.
Students are metaphorically described as ‘going through the system’, ‘making progress towards
their degrees’ and so on. They make a journey which begins with them walking into the
University and ends with them walking offstage at a graduation ceremony. This is set within the
cultural conception of life-as-a-journey which is so prevalent in Western thought (Lakoff &
Johnson 1999: 193-194). The problem with the journey schema in this context is that it positions
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students as travellers and thus their problems with the library, for instance, become ‘failure to
overcome obstacles’ rather than ‘experiencing a lack of materials’.
This metaphorical conceptualisation, however, can only be seen as such if it can be opposed to
some alternative paradigm. That paradigm might be provided by Heidegger’s thinking around
the topic of ‘dwelling’ which I used earlier to build up the concept of possession. ‘Dwelling’
does not simply weld space and time together, but as the human expression of Zeitraum, timespace, provides an opening out of which time and space can both be experienced. ‘Dwelling’ is
not something which comes to an end or has a beginning. Rather, it is that out of which
something temporal and spatial, such as a journey, can emerge and subsequently re-enter. The
essence of dwelling is to free something into its essence, to build (Heidegger, 1993a: 349-351).
To construct something, whether a building or an essay, is to free it from the earth, to bring it into
a world. Heidegger’s language in the essay from which this thinking comes forth is poetic,
almost lyrical – ‘earth is the serving bearer...’ but a wider reading takes the concept of earth to
mean the undifferentiated ‘stuff’ out of which the (human) world is ‘built’ and ‘maintained’
(Inwood 1999: 50-51). Maintenance is required because earth and world are in continual
struggle, and ‘dwelling’ is the site of that struggle. Thus, the activity of essay-writing is an
attempt to build meaning, or knowledge, out of undifferentiated ‘information’ Books on a shelf
or text on a web-page are inert objects, which only acquire worldly significance as equipment
when used by someone as tools and materials for some purpose. The essay, as a purposeful
construction, shelters and gathers the thought of its multiple voices and writers.
The aim of this further excursion into Heidegger’s writing has been to show that to conceptualise
essay-writing as a journey is to miss its significance as an activity which maintains a certain way
of being-in, or dwelling-in, the-world. As such, I am not setting up an opposition, or a hierarchy,
between the two conceptualisations. Breathing, for example, is related to air, but the two are
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neither opposites nor do they form a hierarchy. From a linguistic perspective, they cannot be
compared, since one is an activity and the other is a mixture of gases. But by breathing air from
the earth we can continue to dwell in the world.
A simpler version of the above argument might, therefore, be to posit essay-writing as a site of
struggle rather than as a journey towards closure, just as a building-site can be a site of
maintenance rather than a journey towards a new house or school. The pedagogical implications
of this might be, for instance, that essays are never regarded as finished but instead become
works-in-progress, around which dialogue continually takes place. An extension of the buildingsite metaphor also points to the need for the constant availability of materials via the web to
replace the haphazard availability of library books. Essay-writing thus contributes to the
spatiality of nursing students, and a spatial model of essay-writing would address the proximity
of information, the mobility of information acquisition and the (dis)possession of institutional
space which results from the process.
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Summary
I have suggested in this chapter that two disparate educational activities are experienced spatially
by nurse students. Self-direction, as distinct from notions of student-centredness, and as limited
by its institutional context, is problematised because it conflicts with the students’ desire for
structure and guidance. The metaphor of the journey encourages educators to over-value learner
autonomy, when the ends of the educational process might be better served by acknowledging
and supporting the gradual acquisition of the spatial sense of possession which enables autonomy.
In terms of the early professional learning of probationary nurses, or other professionals such as
teachers, this process of gaining possession is not well understood (Kirpal 2003), largely because
the learning-as-a-journey metaphor encourages the university-work transition to be seen as a line
or clear boundary rather than as the vaguely defined process of gaining possession which is
suggested by the material here.
Essay-writing is similarly affected by the metaphor of the journey and can be connected, via the
metaphor, to the PMP framework. It involves activities such as ‘gathering material’ which are
simultaneously physical and metaphorical, and the obstacles which arise in the physical realm are
also obstacles to the cognitive activity of ‘assembling’ the essay.
I also argued that a Bakhtinian approach which saw texts as ‘polyvocal’ and ‘dialogical’ can be
used to relate essays and other written assignment tasks to the PMP framework, by situating the
essay in the context of a community with its own voice within language. Finally, I discussed how
Heidegger’s conception of dwelling might provide an alternative way of thinking through the
student experience in order to overcome the limitations of the journey metaphor.
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In the concluding chapter, I will expand on the findings of the study and discuss how the
application of the PMP framework to spatial situations might enhance our understanding of
them. I shall also suggest alternative ways in which this research might have been conducted,
and will speculate on how it might contribute to future work in the field.
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Chapter 10-Conclusions
He paused a long moment and said, “Yes, it is quite interesting, and now I can form
a consistent whole of the data.” (Isaac Asimov, The Caves of Steel)
Introduction: forming a whole
The objective of this chapter is, as the epigraph suggests, to form a consistent whole from the data
and the theoretical framework which has been used to make sense of it. I attempt to form this
‘whole’ into a set of conclusions, and I also examine whether the study could have been done
differently, its strengths and weaknesses, and what I have learned from doing it. Finally, I will
argue that the study has produced answers to its research questions, and that these are a useful
contribution to the field of social research, particularly the kind of ‘phronetic’ social research
advocated by Flyvbjerg (2001). That is, it does not attempt to provide epistemic knowledge, in
the sense of generalised scientific ‘facts’ about phenomena. Neither does it attempt to provide
technical ‘know-how’ about the performance of tasks. Rather, it provides what Flyvbjerg calls
‘practical wisdom’ derived from, and applicable to, one specific set of spatio-temporal
circumstances. Although the concept of practical wisdom includes an element of intuitive
judgement, it also incorporates detailed examination of circumstantial evidence.
As Flyvbjerg suggests, phronetic research takes account of the complexity of human life and its
embeddedness in a material world. Embodiment is thus an essential element of the study, and I
argued that it is meaningless to explore ‘spatiality’ in the context of student experience (or any
other context) unless it is taken to mean ‘embodied spatiality’. Using this as a starting point, I
developed a theoretical framework, based on the interlocking concepts of proximity, mobility and
possession. I argued that these can be used to make sense of the issues and practices which
emerge from various forms of data. Spatiality thus represents the collective effects of being-inspace for embodied human beings. This is not to say that there are no imaginary spatialities, for
as Anderson (1983) suggests, even nations are imagined spaces, but my argument has been that
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spaces mediate activity and interaction, and that this mediation generates a sense of spatiality in a
complex reciprocal relationship between individuals, groups and cultures.
The proximity-mobility-possession (PMP) framework suggested here does not constitute a
‘theory of space’, but rather, it suggests what the pre-conditions for being able to apprehend, or to
‘grasp’ space(s) might be (Lefebvre 1991: 40). In other words, it enables the rather fuzzy concept
of space to be discussed with greater precision and insight. In describing a house, we might use
the word ‘big’, but if we unpack this by specifying the architectural style, the number of rooms,
the floor area and ceiling height andits distance from the road, we begin to grasp it in its
materiality spatiality. In this way, the three-dimensional PMP framework was helpful in
analysing the interview data, but the question here is whether it can be re-used elsewhere. Within
the concept of phronetic research, the framework, as a sense-making device, is a tool for use
within located and bounded situations. Other users of the tool may come to different
conclusions, or produce different answers to different questions, but the essential form of the tool
should remain the same. As Burden (1998: 17) puts it, describing a similar small-scale study:
the value of this methodology...relates to its ability to focus in detail on a small but
significant facet of a broad and complex social setting. While it may be argued that
such detailed examination prevents replication and extrapolation to the wider
population, this kind of study has the potential to contribute exemplars of social
action to the institutional setting.
These ‘exemplars’, or patterns, of social activity are, in this case, underlying spatial assumptions,
metaphors and practices which influence, but cannot predict, behaviours. These assumptions
apply as much to the researcher as to the researched, and I have argued that this is not a ‘pure’
phenomenological study in the Husserlian sense, in that I am unavoidably bringing both
theoretical and personal assumptions to bear on the material. The study is about foregrounding
these assumptions and their impact on the lives of the students concerned. In itself it has little or
no predictive value, but the perceived importance of predictive value is itself symptomatic of a set
of assumptions about the rule-governed nature of reality and the appropriateness of particular
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research methodologies (Flyvbjerg 2001). The concepts developed here have proved to be useful
in understanding the spatiality of other research situations e.g. in organisational learning and the
early professional development of teachers. Equally, some existing studies of nursing student
experience refer implicitly to some of the spatial issues raised here, and those which draw on
empirical evidence from nursing students support my conclusions about the ways in which their
experience is problematic, particularly in relation to placements. Using the framework to reexamine existing research thus confirms its value as a sense-making tool.
Proximity, Mobility and Possession
I have shown above that the proximity-mobility-possession framework (PMP) is a useful way of
approaching empirical data concerning space & spatiality. As Soja (1996) points out, there are
references to at least 90 different ‘species’ of space in Lefebvre’s The Production of Space
(1991), some of which are in common use, such as physical-, social-, personal-, mental-, literaryand cyber- space. This unmanageable heterogeneity of spaces, in my view, is best understood
through the use of the PMP framework, although there is an argument, which I have touched
upon above, that being able to ‘manage’ something implies a certain way of looking at the world,
a techno-rationalistic paradigm characterised by Heidegger (1993b) as ‘enframing’ (Gestell).
Conversely, if the meanings of all these spaces are incommensurable, for example if there is
nothing in common between physical space and literary space, then why call them ‘spaces’?
This is where Husserlian ideas about essences were useful in thinking about what the essence(s)
of space might be, or whether there is an underlying framework which enables us to have a
conception of space which can equally well handle the school playground (physical space), James
Joyce’s Ulysses (literary space) and the internet (cyberspace)? The framework which has been
developed here can do this.
The table below (figure 6) demonstrates some possible parallels:
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Figure 6: The PMP Framework and types of space
Proximity
Mobility
Possession
Playground (physical School, shops, busy
road, parents, teachers
space)
Disabled access,
crowding, timetabling
Identification with
characters,
situatedness of text (in
Dublin; in historical
context)
Awareness of
interesting websites
Literacy (ability to
move around in text)
Text as cross-cultural
object
Teacher/pupil
relations, smoking
area, bullying
Feeling at home
within text, using text
as basis for other
writing
Computer literacy,
access to
hardware/software
Own website,
prominence in search
engine results
Ulysses (literary
space)
Internet
(cyberspace)
It is noticeable that the parallels between these spatial types themselves depend partly on the use
of spatial metaphors. The discussion of spatial metaphor and the work of Lakoff & Johnson
(1999) and others (Merleau-Ponty 1962; Gibson 1979; Sanders 1999; Kelly 2000) suggests that
the embodiment of spatiality is the key to understanding why it has such a basic role in both
mundane action and language. To construct a typology without attempting to understand this
basic role in more depth risks the ‘unmanageable heterogeneity’ to which I referred above. As
Lakoff & Johnson (1999) have suggested, cognitive activity is inseparable from embodied
activity, and is connected to it via embodied metaphors. Although the evidence from this study
does not relate directly to cognitive activity, it supports their views about the importance of
embodied spatiality as a basis for the manipulation of ideas (as in the metaphor I have just used).
The use of spatial metaphors can be shown to have physical-spatial consequences. The notion
of self-direction in the metaphorical space of learning becomes problematic when students are
disorientated in physical space. Gathering material for essays is stressful because, like gathering
fruit, the best examples are sometimes hard to reach. Yet students are not supposed to be spoonfed because that would position them as baby-like and helpless. The point here is that
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consideration of the metaphors used to communicate ideas can reveal entire schemas,
metaphorical domains which determine how we think and therefore how we act.
Learning should not, then, be seen as a purely cognitive activity, which happens to, or is
performed by, a disembodied mind. Both in a practical and a conceptual sense, learning is
inseparable from spatiality and embodiment (Michelson 1998). Jarvis et al. (1998: 27) point out
that certain forms of learning can be performed satisfactorily using a behaviourist model. Their
example is, fortuitously, the ‘square-bashing’ by which military recruits learn drills and
disciplines. This is a prime example of learning which is entirely predicated on spatial
arrangements and embodied activity, but it is not part of the adult education ‘repertoire’. More
relevant models of learning style, such as the ‘deep/surface’ distinction, or ‘field dependence/
independence’ depend on spatial metaphors for their explanatory power, as I have argued above,
but do not in themselves address the issue of the spatiality of learning. The conclusion which can
be drawn from the current study, however, is that the embodied spatiality of the student affects
the performance of activities related to learning. This is not the same as saying that spatiality
affects learning outcomes, which is not a question within the scope of the present study, because
it would have been necessary to have an a priori concept of spatiality, and probably a longitudinal
study, in order to establish whether this is the case. Such an a priori concept was not available,
but the framework proposed here goes some way towards providing one. For ethical and
practical reasons, it would be difficult to set up an experimental study which compared the
learning outcomes of two or more groups using different spatial models (Moore et al. 2003).
The present study gives a certain amount of support to the idea, based on the differing experience
of students across two campuses, that spatialities affect the experience of learning, but that is not
the same as affecting learning outcomes.
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Current educational research in different contexts does not provide answers to these questions.
For example, Blatchford et al. (2003), in a comprehensive re-assessment of school class-size
research, make no reference at all to the spatial aspects of the classroom, yet Horne’s (1999)
unpublished research suggests that spatial factors may be significant variables in determining
learning outcomes in relation to class-size. The present study provides evidence for spatial
effects which warrant further research. In the discussion of the research questions below, I discuss
how the spatial agenda might be taken forward in the context of nurse education. Firstly,
however, I critically examine possible objections and alternatives to the way in which the study
was conceived and executed.
Objections and alternatives
The four main features of the study are that it takes ‘spatiality’ to be worth investigating, it used a
theoretical framework based on the concepts of proximity, mobility and possession, it focused on
the experience of nursing students, and it used qualitative, interview-based methods to obtain
data. It is, however, important to consider what the alternatives might have been. I have already
discussed the reasons for choosing to focus on the experience of nursing students, so will
concentrate here on the theoretical framework and the methods used to collect data.
The objection can be raised that the analytical framework used here is imposed on the data rather
than being grounded in it. This can be answered in two ways. Firstly, there is a sense in which
any research project imposes a framework on the data by virtue of asking a particular question
about it, or indeed by virtue of defining something as ‘data’ in the first place. The question for
this study was a question about the experience of spatiality amongst a specific group of students,
and even in a general sense this involves several assumptions about the nature of experience and
the nature of space, in addition to assumptions about what it means to be a ‘student’. Deriving
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additional themes from the data can, of course confound these assumptions but only via a process
of interpretation which itself involves assumptions about meaning.
Secondly, the framework is a heuristic device which provides a basis for interpretations of the
data. There might well be other possible ways of analysing spatial experience, but the criteria
for using insights derived from these alternative methods will also be different. To use an
analogy, a chef, a food technologist and an environmental campaigner might regard the same
bowl of soup in three distinctive ways. The chef sees combinations of flavours, the food
technologist sees production methods and storage characteristics and the environmentalist sees an
endangered species14. Each imposes a pre-existing framework on to the ‘data’, and each analysis
contributes to a field of knowledge about the dish without negating the contribution of the others.
Bell (1992), for example, proposes a framework for the study of social phenomena based on the
concept of embodied ritual, which might have served instead of the framework used here.
Equally, a framework based on the construction of gender might have produced interesting
results. Thus, the proximity-mobility-possession framework which I use here contributes to a
field of knowledge about student experience without excluding the possibility of alternative
modes of analysis. A further insight here is that temporality and spatiality are interwoven, and had
I started from a temporal perspective, space would have unavoidably opened up alongside it. The
choice of spatiality as a topic was a fortuitous one and, along with temporality, it remains a rich
and complex source for further work.
Equally, the study has been concerned with the spatial practices of a small but vital part of
society, rather than theories of space, which have arisen in physics, mathematics or philosophy.
Nor has it been concerned with images and symbols of space, a task which has been addressed by
Markus (1993) in relation to built space. It has argued, however, that the dominant
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conceptualisations of space to which Lefebvre (1991) refers are related to some of the
assumptions which underlie current educational practice. The dominant assumptions amongst
these are that space and spaces are homogenous, neutral containers of activity and that their
manifestations as spatiality are not important objects of study.
Lefebvre (1991) has argued against this spatial neglect, and another approach to the framework
would have been to use Lefebvre’s distinction between spatial practice, representations of space
and representational spaces. (Lefebvre 1991:39; see also Soja 1996).
The notion of a
trialectical relationship between these three terms, the perceived, conceived and lived, is itself an
interesting theoretical move, overcoming as it does the limits of binary approaches to power and
space.
Lefebvre suggests (1991: 38-39) that ‘the spatial practice of a society is revealed through
the deciphering of its space’. Whilst this is what I attempt in the current study, there are
questions as to how far this repeats the detached ‘view from nowhere’ (to use Nagel’s (1989)
phrase) which is critiqued by Haraway (1995). Lefebvre further argues that representational
space is ‘space as directly lived through its associated images and symbols’. Thus, in medieval
Christian societies, the images of Heaven and Hell, the cosmology which maintained those
images and the sacred architecture of churches and cathedrals formed a whole within which a
certain set of spatial practices made sense. These spaces were themselves not the result of
representations, whereas under capitalism, representations of space are, as conceptualised space,
‘…the dominant space in any society (or mode of production)’. Thus cities are shaped by a
planning process based on a set of technical conditions and aesthetic judgements which in turn
depend on a specific mode of production. Lefebvre points out that it is not his intention to create
an abstract model of spatiality, but to find a way of grasping the ‘concrete’ (1991: 40). His work
14
See Morgan (1993) for another illustrated example of this.
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certainly offers a rich source of spatial insights, some of which are applicable to the issues under
consideration here15.
Doreen Massey (1992) has also pointed to some of the political (in the widest sense) tensions
resulting from the neglect of the spatial in favour of the temporal and the social, which she argues
is the result of both a false binarism in separating the two, and a gendered denigration of the
‘chaotic’ materiality of the spatial (Paechter 2003). The results of the study support this view,
although it has not attempted to focus specifically on the gender implications of spatiality.
Spatiality is, however, messy, paradoxical and cannot be tidily ‘optimised’. A library may be too
overcrowded for one student and too quiet for another, resulting in loss of useful working time for
both of them. A long journey to work can be constructed as ‘heroic’ or ‘insane’ or ‘normal’.
Nor can space be ‘tidied-up’ by pretending that it has been abolished, as is the logic of the trend
towards on-line education in its various forms. The world-wide web has increased the chaos of
the spatial, bringing multiple worlds to the desk-top. This is creative chaos, and the point of
Massey’s argument is that, in one sense, this is what spaces are for. In this spirit, the current
study thus attempts to reconcile the elements of Lefebvre’s triadic model and, in producing the
PMP framework, to suggest a useful way of continuing to explore spatiality in the emancipatory
spirit which underpins his work (Lefebvre 1995: 238) and which also underpins much nursing
research (Francis 2000).
In terms of the research method, one conclusion of the study is that spatiality need not be an
explicit element within discourse in order for it to be an important element in the underlying
experience. I am assuming here that there is such a thing as an underlying experience-of-action,
even although its meaning may well be constituted as such by the discursive act itself. The fact
15
There is also a view, represented by Blum & Nast (1996: 559) that Lefebvre follows Lacan in building
‘heterosexism’ into his trialectical model, which parallels Lacan’s ‘real, imaginary and symbolic registers of
subjectivity’. This may or may not be the case, but it does not invalidate Lefebvre’s contribution to spatial thought.
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that an action may be described in a number of different ways does not mean that it has no
existence outside of those descriptions, merely that its meaning has no existence outside
linguistic descriptions (Searle 1995).
Consequently, conversations about experiences of activity
are the most accessible way of developing shared meanings (Davis & Harré 1990). Furthermore,
the experience of embodiment, even although it may itself be differentiated, forms a basis for the
understanding and analysis of such shared meanings.
The question is whether the same outcomes, in terms of student-related issues, could have been
generated differently. The answer is probably ‘yes’, as many of the issues raised by students
might have been elicited by questionnaire-based research of the type often used to evaluate
courses or other institutional activities. In fact, research of this type was carried out (for a
different purpose) at an early stage in the project (Gray 2000), and helped to frame some of the
questions in the interview schedule. Questionnaires, however, cannot substitute for the depth of a
conversation. This itself is a spatial issue – questionnaires are generally completed in the
absence of the researcher, who therefore ‘loses’ possession of the space in which they are
completed, subject to distractions. The social frame of the interview situation generates
different senses of possession for researcher and researched, but these are, at least in principle,
accessible to the researcher.
Moreover, interviews have the advantage that participants can reflect on their intentions in
performing particular actions. Conversely, interviews are artificial situations whose direction is
inevitably skewed by the researcher, even if there is a sufficient degree of ‘participatory
consciousness’ (Hesushius 1994) for the interviewee to be able to ‘own’ her contribution. Some
researchers (Hormuth 1990; Kesby 1999; Edwards & Clarke 2002) have used methods other than
direct interview in similar projects. These have involved graphical media, such as autophotography, token-based diagrams or hand-drawn maps to elicit participants’ sense(s) of space
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in relation to specific issues. I did not feel that these methods would deliver sufficiently finegrained information for my purposes, and that there would be at least as much, and probably
more, uncertainty over the interpretation of photographs or maps as there was in the interpretation
of texts. Additionally, as a novice researcher, I was apprehensive about approaching students at
all, and felt that requests to draw maps, keep diaries or take photographs would add to the burden
which I was imposing, a view confirmed by other researchers who have experimented with these
methods (e.g. Clarke 2004). This is not to say that such methods are of no use, and with
hindsight, a method such as map-drawing might have been valuable.
Does the study answer its research questions?
Figure 7 sets out the research questions which were first posed in Chapter 1 (p.14):
Figure 7: The Research Questions revisited
Question
Reason for asking
What is meant by ‘spatiality’?
Own interest
What is meant by spatiality in
the context of nurse
education?
Attempt to cross disciplinary
boundaries, reinforcing and
deepening analysis of previous
research in field
Desire to enhance student
experience, lack of attention to
spatiality in nursing literature
How does spatiality affect
lives of nursing students?
Body of knowledge to which
study might contribute
Theories of space
Theories of space, nursing
literature
Literature of student
experience within nursing
literature
The first question seeks the meaning of spatiality. Has this small-scale study of an apparently
specialised aspect of spatiality led to an enhanced understanding of this elusive concept?
I
have argued that spatiality, as the human way of experiencing space and spaces, comprises three
elements or dimensions, all of which relate in some way to embodiment. My central argument
here has been that spatiality is part of what it means to be human, in the same way in which
sexuality, identity and other relational concepts are parts of being human. Not only does
219
spatiality interact with other relational concepts, however, it also provides the means to think
about them and the terrain on which they are enacted.
By stressing embodiment as a necessary precondition for experiencing spatiality, I also
acknowledge the existence of a physical reality (‘earth’, to use Heidegger’s term) which grounds
and supports embodiment, but distinguish it from ‘world’. ‘Worlds’ are networks of meaningful
relationships, and humans are beings-in-the-world, and in order to function, or even just to be-in
the world, the following three elements are essential. The first element is proximity, which
establishes the possibility of distance. Proximity can describe the networked characteristics of
experience, as a measure of the intensity of a network relation. Proximity also provides a way to
move beyond ideas of ‘inside’ or ‘outside’ in relation to institutions. The second element is
mobility, which is the possibility of action over distance enabling distance to have meaning in
terms of action. The third is possession, which is the product of engaging with space over time,
and is an interpretation of affective relationships to the space(s) set up by proximity and mobility.
Mobility is important in providing a means of understanding some of the socio-economic
assumptions which go towards establishing a spatial paradigm. Using Boltanski & Thévenot’s
(1991;1999) model of ‘regimes of justification’, and the work of Urry (1999; 2000; 2001a; 2001b;
2002) and Adams (1999) on mobility, I argued that some very strong assumptions are embedded
in our everyday understandings of mobility. These understandings are themselves indicative of
power-relations which the spatial paradigm helps to reproduce. Specifically, institutional
assumptions about individual mobility have tended to ignore issues of, for example, gender, age
and ability, although the latter is increasingly a concern under the provisions of the Disability
Discrimination Act16
Parenting, for example, is a major constraint on mobility which appears to
be largely ignored by institutions, yet it has a significant impact on the learning experience for
16
The Disability Discrimination Act 1995 (DDA) is extended to education from September 2002
following amendments introduced by the Special Educational Needs and Disability Act 2001.
220
those involved, as the study revealed. The term ‘learning environment’ has increasingly been
used to describe software, such as WebCT, which provides access to various content, discussion
and assessment resources on-line, and there are few discussions of learning environment from the
point of view of embodied spatiality. Notable exceptions are Gordon et al. (2000) and Nespor
(1994) and there has been subsequent work which begins to take account of the realities of spatial
existence (e.g. Clayton & Forton 2001; Holloway 2001; Clarke et al. 2002). Previous writers
have tended to conceptualise this ‘environment’ as constituted by the interplay of power and
identity issues in a ‘spaceless’ situation.
Possession offered another set of insights into the spatiality of the learning process. By
‘possession’ I intend to convey a sense of ‘being-at-home’ in a situation, a sense which can, of
course, be a negative one, since spaces can generate a sense of dispossession as well as
possession.
Frequently, students stated that they felt apprehensive about entering specific
spaces such as computer laboratories, because they lacked a familiarity with the equipment which
others seemingly possessed.
The labs became a site for exchanging knowledge about ICT, but
even this apparently beneficial quality of the space had a downside for those students whose time
was taken up by requests for assistance from the less-experienced. Possession here was thus a
complex interaction between knowledge, communication, altruism and curiosity. There is an
existing literature which discusses the professional socialisation of nurses, but this is generally
presented as a unidirectional process of assimilation into teams or ‘communities of practice’
(Lave & Wenger 1991). Possession complicates the idea of a homogenous community, and
provides a way of engaging with the positive and negative dynamics of socialisation and
community.
What emerges from the current research is that there is a subtle interplay, not only between issues
of power and identity, but also between power, identity and physical spatiality. This interplay is
221
not a matter of pure social construction, but social construction grounded in physical
embodiment. In the following section I discuss the second and third questions, regarding the role
of spatiality in nurse education.
Spatiality in the context of nurse education: How does spatiality affect the lives of nursing
students?
It was predicted that nursing students would be good sources of data, for reasons connected with
health-care policy and practice. This turned out to be the case, and I am extremely grateful to
the participants for providing such rich accounts of their spatial experiences. The complexity of
their relationships with spaces, however, is probably not unique. I believe that it would have
been equally productive to interview, for example, student teachers, the police, or long-distance
lorry drivers. The spatiality of newly-qualified teachers is, in fact, one focus of an on-going
study (McNally et al. 2003). It is much harder, in fact, to think of a group whose spatiality would
not have been of any interest. The participants had come to nursing with complex ‘geobiographies’, and as I argue in Chapter 5 the tendency to ignore embodiment and to focus on
‘purely’ psychological or social elements of the learning process has detracted from the
usefulness of some previous research in the area. Nursing students were a worthwhile group to
research, not only because of the richness of the data which they willingly provided, but because
of public, professional and political concerns about their recruitment and training.
The study has therefore shown how the use of spatial tools has the potential to address topical
issues within nurse education and elsewhere. Recruitment and retention rates for nursing students
and qualified nurses are a source of concern within healthcare policy discourse (RCN 2003), and
the evidence here is that specific spatial problems can influence morale. These problems include
difficulties with placements in relation to domestic circumstances, difficulties in accessing library
222
resources and even the problem of being able to hear lectures properly. The results from this
study suggest that there are also interesting connections between travel and learning. The
perception of travel as transparent and unproblematic (except under ‘breakdown conditions’)
hides the diverse roles of transport in providing group study space, space for relaxation, or in
facilitating placement opportunities in remote areas. The study shows that spaces open up for
learning in unpredictable but creative ways. Public libraries become substitutes for computer
labs. A placement becomes an ‘adventure’. A car-share is not merely a way of getting from A
to B, but affords an opportunity for group learning and the exchange of ideas. In some situations,
train travel provides study opportunities, but it is clear from the data that public transport
generally was not helpful, and that there was therefore differentiation between car owners and
others.
In respect of on-line learning and the use of ICT in nurse education, a spatial approach suggests
that on-line activity should be problematised by referring to the material circumstances of learner
engagement with ICT. Far from being de-spatialised, as suggested by the rhetoric of distance
learning enthusiasts, such learning is re-spatialised, whether into corners of bedrooms, cramped
computer labs or under-funded public libraries. Even the advent of mobile technologies, whilst
ostensibly decoupling learners from the need to be co-present in specific spaces, colonises new
spaces for learning and thus removes the possibility of creating spaces of resistance to the idea of
all-pervasive lifelong learning (Tett 2002).
Given that we are in a transitional phase as far as the adoption of ICT is concerned, its spatial
effects do not simply take the form of the ‘space-time compression’ beloved of modernist writers
such as Harvey (1989) and Giddens (1991). At the micro-level of student experience, ICT has
not yet delivered its potential benefits, because it has been added on to a traditional model of
student learning, consisting of lecture-based delivery and essay-based assessment. Indeed, it
sometimes adds to the frustrations and workloads of students, by introducing an additional set of
223
skills to be learned, skills which, at least for the students in the current study, are insufficiently
supported by institutions. The ability to act at, or over, a distance is frustrated by the location of
the technology. Students are often required to be as physically mobile in order to access ICT as
they are in accessing other forms of information. Additionally, the knowledge that ICT is ‘out
there’ creates frustration when other delivery systems, such as inter-library loans, fail to meet
student expectations. This is a dynamic and evolving situation, and it is likely that current
students will be more familiar with the technology and more likely to have personal access to it
(The Independent, 26/10/03).
There are thus several features of the nurse education process, as it is currently conceived, which
have spatial implications. In addition to those mentioned above, these include the geographical
location of the relevant institutions, the relation of nursing and midwifery departments to other
parts of the HE system, and, most obviously, the practice placement. In addition to these, there
are less obvious spatial elements in the assignment-writing process, in the implementation or
perception of self-direction and in the way that lectures are conducted. Again, the conclusion
which can be drawn from the study is that generalisations about any of these features of nurse
education need to be qualified by local knowledge. Even when such knowledge is available, and
in certain instances it has been provided by the participants in this study, the implications of
taking it into account in determining practice may be considerable. It is clearly difficult, for
example, to avoid long journeys to placements when the available settings are as widely dispersed
as they are in the Highland situation. A longitudinal study on a larger scale than this one would
be required to determine whether the spatial aspects of professional socialisation were significant
in terms of, for example, learning outcomes or student retention.
The discovery of complexity in the relationship between nursing students and the spaces in which
they learn offers, therefore, useful insights for nurse education. The study is not, however,
224
written from a nursing perspective, and is not primarily about nursing or nurse education. It has
thus been able to focus on spatiality and to relate this to wider sociological issues, such as
mobility, in a way which might not have been possible within the methodological conventions of
nursing research. It has, however, been informed by nursing research which has suggested
topics of current concern within the field. Nurse education benefits in that its practices and
assumptions have been scrutinised by a ‘professional stranger’ or ‘outsider’ (Agar 1996;
Merriam et al. 2001). The central conclusion to be drawn is that embodied spatiality matters,
and must be taken into account when considering attrition rates, student recruitment and other
pressing issues (RCN 2002). It is characteristic of nursing students, both according to the
literature and as revealed in their conversations, that they are highly motivated, flexible and
reluctant to complain. Research such as this gives them the opportunity to articulate concerns
about the process of becoming a nurse which might not otherwise be voiced publicly.
It also
shows that several of these concerns result from institutional reluctance to acknowledge that
spatiality is differentiated, whether for students or for staff. This differentiation is most marked
in terms of mobility, and the experience of mobility manifests itself in complex ways, as both a
risk and an opportunity.
Questions are, therefore, raised by the study which intersect with current policy issues around the
spatial and professional expansion of the nursing role. Within this expansion, nursing students
are experiencing dislocation, which is ‘an unfixed, diverse and contradictory phenomenon’
according to Edwards & Usher (2000: 40). They are not simply being asked to work outside the
hospital setting, which in any case has never been wholly their ‘own’ or their sole territory
(Rafferty 1996), but are being thrown into ‘[a] complex future’ (UKCC 1999: 18).
The following diagram, (figure 8, overleaf), sets out some of the issues:
225
eases
Figure 8: The complex future of healthcare – the paradoxes
More money
Health care in the future will be characterised by:
AND ...continuing relative shortage of resources
Central/regional strategy
Emphasis on prevention
Continued dominance of hospitals
AND
AND
AND
Public reliance on professionalism
More, well-educated and assertive
patients and clients
Greater demand for high tech
medicine
AND
AND
high technical competence and
‘scientific rationality’
Blurring of professional boundaries
Growing local diversity of provision and roles
Great demand for cure and palliation
Considerable emphasis on care close to home
Greater lay assertiveness
Continuing need to serve those with little
personal access to information
AND
Growing demand for complementary
approaches
AND Continuing need for ‘human’ qualities and the
time to express them
AND
Separate professional traditions, organisations
and public expectations
Continuing demands from younger people
AND
Continuation of old moral certainties
The core expectations of nurses
and midwives will be little altered
AND
New and challenging environments in which to
apply them
Nurses and midwives are not immune to
the other social changes outlined above
(Adapted from Dargie et al. 2000)
An understanding of spatiality can help to unpack some of the contradictions expressed in this
table, because spatiality, as a central theme, gathers together a range of material concerns about
the future of healthcare which would otherwise be dispersed across a range of discourses and
problem areas. The dimension of ‘proximity’ suggests ways in which awareness of new
possibilities is spatially mediated, whilst the dimension of ‘mobility’ helps to understand how the
ability to deliver or to receive services at a distance might be socially and economically
differentiated. Finally, the dimension of ‘possession’, which I have developed here, provides a
framework for understanding how the re-siting of nurses and other health care workers can
contribute to their sense of autonomy and professional identity.
226
A concrete example of this is the current (2003) controversy over the Edinburgh Royal Infirmary.
This institution was recently re-located from central Edinburgh, where it occupied a rambling
collection of Victorian and modern buildings, to a ‘purpose-built’ greenfield site on the outer
suburban fringe of the city. Complaints about the new site have ranged from bed shortages and
difficulties in navigating around the building, to the expensive and restricted parking
arrangements and poor public transport facilities (Edinburgh Evening News, 09/12/03). All these
are spatial issues, which have apparently been neglected or down-played for a variety of
economic and managerial reasons (Edinburgh Evening News, 04/12/03). Resources are not, of
course, unlimited, but a more spatially-focused approach to user needs might have enabled
resolutions of some of the issues at an earlier stage. This is not just about convenient access, but
ethical issues have also arisen, such as the proximity of women who have suffered miscarriages to
those who have successful births (Edinburgh Evening News, 27/10/03), giving rise to
considerable distress for those involved. A spatial case study of the project using the PMP
framework is, unfortunately, beyond the scope of this thesis, but would produce interesting
results.
The above discussion has dealt with the use of the PMP framework as a tool within a particular
social science tradition, that of phronetic research as described by Flyvbjerg (2001). It has shown
that the study answered its research questions, and it has also shown that what I call ‘spatial
neglect’ is an important issue in health care policy and research. In the final section, I draw the
discussion to a close.
227
Concluding the conclusions: as closure beckons, another spatial metaphor appears.
Spatiality is part of human being, and it is important for institutions not to ignore the spatial
realities of the student experience. The philosophical grounding of the concept of spatiality is
complex, and the discussion of it here is not, and could not have been, exhaustive. The central
theme of the whole study is, however, that attention to the specifics of spatiality is worthwhile in
terms of understanding important and socially useful areas such as the nursing student experience.
In a recent RCN report nurses are compared to an ‘amalgam’, a connecting substance for a
collection of functions (RCN 2003: 15). The experience of nursing students is that they
’amalgamate’ a wide range of spatial settings and situations in the course of their studies. The
journeys which they make, the knowledge-gathering processes which they use in essay writing,
the ways in which they form social groups for study purposes and their engagement with the
placements on which they are sent, all contribute to this amalgamation process.
A different process of amalgamation is at work in the production of this text. Here, as will have
become apparent, there is an attempt to reconcile two very different approaches to spatiality. The
spatiality of theory, whether it is derived from the ‘smooth and striated’ spaces of Deleuze and
Guattari (1988), or the ‘non-place’ of Augé (1995), or the ‘in/different spaces’ of Burgin (1996),
makes for fascinating reading, but is ultimately as heterotopical and chaotic as Lefebvre’s livedspace itself. This is not to say that spatial theories are useless, but rather to say that they are tools
amongst others, as is the PMP framework proposed here.
The mental map provided by the empirical research is somewhat different. As with most
students, nursing students are in constant motion, but across a very different landscape. Theirs is
a terrain of enclosed spaces, of wards, consulting rooms, libraries, cars, kitchens and halls of
228
residence. The journeys between these, in the main are journeys as means to ends rather than
objectives in themselves, unlike, perhaps, my excursions into theory. Nevertheless, the use of the
PMP framework helps to reveal many of the assumptions which underlie the educational
experience of nurses and others. The journey metaphor, which is central to the spatiality of
education as currently practiced, is predicated, for the nursing students, on the overcoming of
obstacles, in the form of (inter alia) difficult placements, crowded libraries and noisy lecture
theatres. Yet there are also spatial compensations; the Highland scenery and quality of life, the
greenery of the Stirling campus, and the companionship of long drives with colleagues.
A one-line summary of the research outcome might therefore be ‘spaces are important in nurse
education, and everywhere else’. This is, in one sense, obvious, but the evidence points to an
increasing disregard of spatial considerations in policy and practice. The controversy currently
surrounding the new Edinburgh Royal Infirmary is just one example, but there are many other
cases of what I would wish to call ‘spatial neglect’. Many of these are linked to issues around
mobility and sustainability, issues which will assume steadily greater prominence as climate
change begins to be perceived rather than conceived. The outline of nursing student spatiality
here provides a sketch map of a relatively small area, but the intention of the study is that it will
contribute to a greater understanding of the spatiality of everyday life. This is an understanding
which will become increasingly essential, in a future, which is as uncertain for nurse education as
it is for the world as a whole.
Taking a wider view of the project, the study of spatiality was itself intertwined with the spatiality
of study, a spatiality which was discontinuous, chaotic and yet creative. The postgraduate process
is one in which two forms of becoming are potentially combined. The becoming of the research
project overlaps the becoming of the researcher in a form of apprenticeship which is both
informal and highly significant. Other projects come and go within the long stretch that lies
229
between commencement and completion. These inform the final shape of the main project,
sometimes too late to make a difference. The point at which one is best placed to undertake the
study is therefore at its end. The conceptualisation of the process as a journey is only partially
useful, since there is also an element of dwelling, of haunting a particular set of spaces until
possession (perhaps as employment) is gained. The idea of dwelling holds out against closure,
which in the case of spatiality is highly appropriate. Spatiality is the basis for both closure and
openness, and as such, is an inexhaustible topic. This study cannot claim to provide a definitive
analysis of spatiality, but it has attempted to open up the study of spatiality in a useful and timely
way.
230
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Appendix One: List of nursing student
identities
Pseudonym
Anita
Personal details
Female, married, two children, mid 40’s
Andy
Doreen
Male, single, living with parents, 22
Female, single parent, two children, late 30’s,
previous university degree in music, half hour
drive from campus Age: 40
Female, married, grown-up children, early
40’s, moved to Highlands from Birmingham
area
Female, married, son with disability, daughter,
both school age. Mid 30’s
Female, single but with long-term boyfriend
living some distance away. Previous
experience as chef. Early 20’s
Female, single, living alone, mid-40’s, over
twenty years nursing experience
Female, living with partner, originally trained
as nurse in South Africa. Late 20’s
Researcher, living with partner, one son at
home (primary school), one at university
Married, two school-age children, lives about
80 km. from campus. Husband on shiftwork
Married, teenage son, previously employed as
psychiatric nurse. Age: Late 30’s
Female, single, living in hall of residence, mid
20’s
Helen
Joanne
Karen
Lynne
Naomi
Peter
Susan
Terry
Wanda
Campus & Remarks
HC – postgraduate student &
tutor
HC
HC – mental health specialism
HC
HC
SC
SC
HC
SC
HC
SC
HC
245
Appendix Two: Map of Campus locations
246
239
Appendix Three: Interview schedule
248
SPATIALITY AND NURSE EDUCATION - RESEARCH PROJECT
INTERVIEW SCHEDULE
Name:........................................................................................
.............................................Date............................interviewer......
The interview is designed to take about an hour to an hour and a half
Thanks for agreeing to participate in this project. What I'm exploring is the relationship between
people and the spaces - all the spaces - in which they learn. That could be as simple as liking a
particular classroom because it has a good view, or being worried about finding the space to study
at home . So the first question is:
1) Where do you do your studying/ university
work?.......................................................................................
................................................................................................................................................
2) Can you keep things such as books and papers there or do you have to move them around?
2) How do you feel about using that particular space?
3) Do you write there? If not, where?
3) How does your use of this space affect [others in the same household]?
4) Are there time limits on when you can use that space?
3) When you go into the university, what do you feel about the journey?
.............................................................................................................................................................
.................................................................................................................................
4) Why is that?.......................................................................................................................
...............................................................................................................................................
................................................................................................................................................
5) When you get to the Uni., what do you feel? (eg is it a relief, or are you apprehensive
etc.?)....................................................................................................................................................
..................................................................................................................................
................................................................................................................................................
6) Tell me about your class - how many people are in it? Do you have to attend seminar groups
or workshops? How many people would be in one of these?
7) Do you have a regular group which you socialise with at the University and/or on placement?
Do you socialise with students from your seminar group/class, or with a different group?
249
6) Some metaphors for the university (show card below)
I'd like you to suggest some metaphors of your own
7) Could you explain why [this metaphor] suggests itself?
8) What do you feel when you leave the University campus?
9) How do you feel about the university when you're at home?
10) Specifically as a nurse student, how do you feel about / interact with other students at
university?...........................................................................................................................................
........................................................................................................................
7) Why is that?
8) Are you involved with placements? If so, where?
9) Do you do any studying there, e.g. reading/writing, or are you involved solely in practice?
10)Do you feel different in the practice situation( e.g. more or less empowered etc?)
11) Does the placement involve extra travelling?
!2) Looking at your travel to and from the university, how would you describe the time you spend
travelling?
Section 2: Using on line learning
11) Do you use computers in the course of your studies?
12) If so, where?
13) Which of the following applications do you use:
e-mail
web searches
word processing
250
spreadsheets
databases
WebCT or other learning software
chat rooms/newsgroups
4) How does using a computer make you feel? (e.g. more in contact with other students, more
isolated, frustrated etc?)
15) How do tutors use computers in your current unit?
16) Do you feel that you would benefit from using computers in ways other than available at
present?
Highland Campus
1) How do you feel about Highland in relation to the rest of the university?
2) Does the presence of a large hospital next to the campus affect the way you feel about learning
there (eg noise of helicopters, only appropriate to do nursing, etc)
3) How much extra travelling do you have to do as a result of being based at Highland /WI
4) Does this bother you?
5) How do you feel about the size of Highland's [catchment] area - the area where you might have
to do placements?
6) Does the weather affect how you feel about learning?
251
METAPHORS FOR
THE UNIVERSITY
PRISON
MAZE
JUNGLE
RABBIT WARREN
MADHOUSE
RETREAT
POWERHOUSE
JULIE ANDREWS
HAVEN
ANTS' NEST
CLOUD
252
Areas of the campus
library
Macrobert dining
Macrobert coffee bar
Roberto's
Study areas (specify
Pathfoot dining room
Oscars
Pathfoot resource centre
Gannochy - sports (specify)
Gannochy - bar
Other area (specify)
Highland campus
Your office
Other people's office
Common room (staff/students)
Hospital canteen
Other (specify)
6) In the university, are there particular areas that you use more than others?
Thank you for taking part in this study.
253