Use of Analogy by Public Health Nurses in Problem Solving for Individual Consultations in Japan: A Multiple Case Study

Masako Kageyama,Atsuko Taguchi,Satoko Nagata,Kathy Magilvy,Taeko Shimazu

doi:10.4236/ojn.2017.73028

Abstract

Aim: Nurses must develop good problem-solving skills (PSS) to work in the complex health care environment. This study explored PHNs’ use of analogy in PSS development. The purposes of the study were to clarify how PSS developed in one area (i.e., mental health) could be applied to another area (i.e., maternal health) and whether new PSS could develop in response to PSS gained in another area. Methods: A multiple case study was conducted using interviews. We interviewed 27 consultations from eight Japanese PHNs who consulted in mental health departments before transferring to maternal health departments. The data on how PHNs applied PSS in the selection, mapping, evaluation, and learning stages of the analogy process were extracted from transcribed interviewed data and compared. Results: PHNs provided 59 PSS used in 27 consultations. All PHNs applied past mental health PSS to solve new problems in maternal health. They tended to select past PSS based on structural similarity and to apply PSS via low-level abstraction in serious situations or preventively to avoid causing the current situation to worsen. Notably, PHNs developed maternal health PSS by using past mental health PSS; these new PSS were derived through analogy from various failures and successes. Conclusions: PSS developed in one area can be applied in another area, and new PSS can develop through applying these previous PSS. Identification of structural similarities and preventive analogies must be included in nursing education, especially for nurses working in public health fields.

Highlights

Current rapid social change and the highly complex health care environment indicate a need for nurses to develop good problem-solving skills (PSS) in complex situations [1]
public health nurses (PHN)—and all nurses working in the community—must develop high-level PSS to deal with these unfamiliar problems
Regarding the second level of the case unit, twenty-seven maternal health consultations were reported by the eight PHNs, Figure 2

Summary

Introduction

Current rapid social change and the highly complex health care environment indicate a need for nurses to develop good problem-solving skills (PSS) in complex situations [1]. PHNs—and all nurses working in the community—must develop high-level PSS to deal with these unfamiliar problems. These skills need to be incorporated into nursing education and practiced to produce students with flexibility and competence in problem-solving. “problem-solving” and “critical thinking” are often used interchangeably [2] [3] Both are the focus of problem-based learning (PBL), a prominent student-centered approach in nursing education [4] [5]. Analogy has been examined in a variety of fields and is recognized as a key concept of relational reasoning, which holds an increasingly important place in educational practice [9]

Objectives

Methods

Results

Discussion

Conclusion