The 'health promotional' role of a pre-registration student cohort in the UK: a grounded-theory study

Abstract

With the proposed syllabus changes of the United Kingdom's (UK) 'Project 2000' curriculum, came the promise that pre-registration nursing students would benefit from a greater emphasis on 'health promotion' than had previously been the case (UKCC 1986, R CN 1988). The structural changes to this curriculum were designed, in part, to prepare the student for a more prominent and broader health-promotional role, in both their clinical and theoretical activities. The revised Making a Difference curriculum has recently sought to reinforce this (NHSE 1999). This grounded-theory study, undertaken at the authors' previous university, gathered the views and insights of a group of these students (10 students in all), in relation to their perceived and actual health promotion role. The students were in the last phases of the Project 2000 curriculum, as theMaking a Difference curriculum was being phased in. The findings of this study were designed to see if the changes, proposed throughout the Project 2000 curriculum, had had their intended impact on this particular group of students. Several categories emerged from the data. The core category became 'seeking out and making sense of health promotion theory and its application to practice'. In addition, five other fully developed categories emerged. These were: 'conceptualising health promotion', 'health promotion in the curriculum', 'health promotion in practice', 'role models in health promotion' and 'health promotion in a future context'. The study's findings demonstrated that these students, despite the promises of a revised curriculum, were still being inadequately prepared for a constructive and broad health promotional role. It showed, instead, that these students had continued to be prepared for and exposed to a limited and limiting 'health education' role. When applied to the findings of similar studies (i.e. Gott O'Brien 1990, Lask et al. 1994), prior to the Project 2000 reform, it appears that little has changed for the students in this study. This state of affairs was reflected in both the student's theoretical and clinical placement settings.