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Response to: ‘The writing experiences of a group of student nurses: a phenomenological study’ by D. Whitehead (2002) Journal of Advanced Nursing 38(5), 498–506.

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  2. Response to: ‘The writing experiences of a group of student nurses: a phenomenological study’ by D. Whitehead (2002) Journal of Advanced Nursing 38(5), 498–506.

I was delighted to read Whitehead's study, as it fills a gap in our knowledge of the nursing literature. It points the way for enhancing nursing education by revealing student nurses' experiences with academic writing, and concludes that nurses should cultivate their interests in and acquire the skills of academic writing. However, two points should be addressed: (1) the basic question of why nurses need to write; and (2) some shortcomings in Whitehead's research methods.

Why do nurses need to write?

The reasons are both personal and professional. In his paper, Whitehead addresses the professional needs, but ignores the individual's personal needs. In the nursing profession academic writing serves as a means for us to communicate, exchange viewpoints and share research findings. Academic writing is an indispensable tool in the pursuit of professionalism and academic excellence, and it is the best means for disseminating nursing knowledge efficiently, documenting nursing practice reliably, and developing empirical research-based nursing care. Academic writing in nursing can be grouped into three areas: how to write effectively, how to plan curricula appropriately, and how to conduct relevant research. The focus of Whitehead's paper is found in the intersection of these three areas.

Nurses also need to write for personal reasons. This is the point that Whitehead overlooks. Writing encourages nurses to reflect on and revisit important experiences and events. Writing is an effective tool for self-help (Wright & Chung 2001) and has been considered a means to self-understanding (Greenhalgh 1999). Writing helps mediate the relationship between the self and lived experience (Ray 1998), and allows us to share private events, express feelings and share intimate thoughts (Balk 2000). Writing about a traumatic experience can increase a writer's well-being and protect immune functions (Joplin 2000). Therefore, nurses should consider the process of writing as providing an effective means of reconstructing their identity (Chan in press), and the therapeutic effects of writing should be examined (Chan 2002).

Shortcomings of Whitehead's study

The most important shortcoming is the fact that the ontology and epistemology of the phenomenological approach are not adequately defined or justified in nursing studies. Readers may fail to understand the philosophical roots and assumptions of such an approach to inquiry. Further, some of the author's arguments are contradictory. For instance, in the methodological section, the author states his belief that phenomenological meaning should emerge as ‘a result of co-creation between researcher and researched subjects.’ Yet in the data collection section, the author states that it was not considered necessary to interview the students more than once (and each interview lasted only 45 minutes). The author claims that his phenomenological approach values human experience and the process of co-construction. But can a sole, structured interview of such short duration, conducted in an artificial setting, achieve such purposes?

Other than checking the results with participants, what other measures were employed to ensure the trustworthiness of this study? What percentage of students responded to each theme (out of a total of five themes)? What potential personal biases on the part of the author might have influenced data analysis and interpretation? What are the commonalities and differences between the author and the participants, in regard to his five themes? There is a lack of critical self-reflection in this paper. Indeed, the author himself does not acknowledge the limitations of his research design (e.g. sampling bias, absence of a control group, lack of pre- and post-academic writing comparison, and lack of analysis of differences of gender, class, and commitment to nursing among the respondents). All of these intervening variables must influence the results, and a critical challenge of this study must be made accordingly.

Conclusion

In conclusion, there are limitations to this study that must be appreciated. Nevertheless, Whitehead's paper can still be appreciated for stimulating us to rethink why we need to write, and for insights it provides on how to conduct a phenomenological study in a rigorous manner.

References

  1. Top of page
  2. Response to: ‘The writing experiences of a group of student nurses: a phenomenological study’ by D. Whitehead (2002) Journal of Advanced Nursing 38(5), 498–506.
  • Balk D.E. (2000) A letter about my mother. Death Studies 24(4), 352357.
  • Chan C.Y.Z. (2002) Poetry writing: a therapeutic means for the social work doctoral student in the process of study. Journal of Poetry Therapy 16(1), in press.
  • Chan C.Y.Z. (2002) From cooking soup to writing papers: a journey through gender, society and self. Journal of International Women's Studies 4, 93106.
  • Greenhalgh T. (1999) Writing as therapy. British Medical Journal 319(7205), 270271.
  • Joplin J. (2000) The therapeutic benefits of expressive writing. Academy of Management Executive 14(2), 124–125.
  • Ray R.E. (1998) Feminist readings of older women's life stories. Journal of Aging Studies 12, 117127.
  • Wright J. & Chung M.C. (2001) Mastery or mystery? Therapeutic writing: a review of the literature. British Journal of Guidance and Counselling 29(3), 277291.

Response to Chan's critique

Whilst I welcome any critical debate, I feel that many of Chan's comments are somewhat misplaced, inaccurate and contradictory. Most of the comments made appear to reflect a personal agenda that does not arise from the findings of my study.

I do not dispute that academic writing can reflect personal as well as professional qualities. Contrary to Chan's suggestion, however, I have neither ‘ignored’ nor ‘overlooked’ the personal aspects of an academic writing process: these simply never emerged in the data collected. The students in the sample alluded only to professional issues, and not to personal ones. Although I hesitate to do so, I draw the conclusion that perhaps students tend to associate the demands and rigour of an academic writing style less with the familiarity of a personal writing style, and more with the professional requirements of academic educational institutions. That said, I would contend that research findings are best confined to discussing the actual findings, rather than exploring ideas that do not emerge.

Chan's comments leave me with the impression that she has inadvertently used my article as a vehicle to defend her own preference for an academic writing style, as well as to promote her own recent publications on this subject. If Chan requires confirmation of my interest in and acceptance of personal, creative, therapeutic and reflective styles of writing, I should point her to other articles (Whitehead 1999, Whitehead 2000). Of value, however, is the fact that Chan highlights a pertinent area for further investigation – that of personal vs. professional orientation in academic writing.

With regard to Chan's other comments on methodological aspects of my study, there are several points to clarify. Firstly, her point about its ontological and epistemological ‘shortcomings’ appears to be directed at all phenomenological studies in nursing. Does Chan therefore see the shortcomings of my study as reflecting the state of phenomenology in nursing? If so, why would Chan expect my study to be any different to all the other phenomenological studies in nursing which, in her view, are ‘not adequately defined or justified’? I am unsure if Chan's comments do not really underlie the tension that she feels between the research practices of social work and nursing.

My second point is to challenge Chan's contention that ‘co-creation, co-construction and valuing the human experience’ can only result between the researcher and the researched if more than one interview takes place with each individual. Chan's generalization contradicts much of the literature on phenomenological process. To this end I had cited the supporting literature of Wimpenny & Gass (2000). The duration of interviews is irrelevant. In my study, all the student interviews came to a natural end after somewhere between 45 and 60 minutes of discussion. In each case the interviews – which were unstructured and not structured, as Chan stated incorrectly – had ended when students had stated that they had nothing further to add. If they had wished to elaborate further the interviews would have lasted longer. I would question the validity of re-interviewing sample participants if they have already stated that they have nothing more to add.

Other methodological points that Chan makes appear to reflect personal preferences about what she herself would wish to see in any phenomenological account, namely detailed description of the methodological process and quantification of the method and data. I consider that the necessary methodological considerations were highlighted adequately in my article. Given the word limit attached to publishing research in academic journals, it simply is not possible to offer a detailed account of every methodological intricacy and nuance, nor to explore every facet of the collected data. For instance, I do not feel that it was necessary for my article to give a detailed account of all of the pitfalls of using the chosen research design. There is plenty of critical literature that covers this already. And, in terms of the point about quantification raised earlier, why does Chan want to have the percentage of students responding to each theme, the inclusion of a control group, and to analyse gender and class differences as ‘intervening variables’? Surely this is not the intention of phenomenological research.

I wish to thank Chan for taking the time to offer her critique, and for the opportunity for me to respond and to challenge many of her points. And, of course, I thank Chan for her ‘delighted’ acknowledgement that my study fills a knowledge gap in the nursing literature and for ‘stimulating us to rethink why we need to write’. That is exactly what I set out to accomplish through this study.

References

  1. Top of page
  2. Response to: ‘The writing experiences of a group of student nurses: a phenomenological study’ by D. Whitehead (2002) Journal of Advanced Nursing 38(5), 498–506.
  • Whitehead D. (1999) Should it really matter if you don't like our style? Nursing Standard 13, 29.
  • Whitehead D. (2000) Academic writing. Professional Nurse 16, 849852.
  • Wimpenny P. & Gass J. (2000) Interviewing in phenomenology and grounded theory: is there a difference? Journal of Advanced Nursing 31, 14851492.