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The study investigates student verbal activities in six small discussion groups. A total of 18 registered nurse graduate students from two schools participated. The content for their discussion was based on three nursing practice situations that focused on adult medical-surgical nursing

The components that served as basic units of analysis for the data were four types of pedagogical move that characterized the verbal interplay of the students. [These include structuring, soliciting, responding and reacting. Within each pedagogical move four categories of meanings are identified. These categories include substantive-discipline, method of inquiry (nursing process), substantive-logical and digresion.]

The descriptive data suggest that the discussion pattern was characterized by a high proportion of cyclical reacting moves. The referential base for much of the substantive-discipline meanings was the patient's disease processes, with discipline referenced content primarily in nursing, pathology, and psychology. The general character for the nursing process suggests frequent use of the assessment phase and minimal use of the remaining four phases, especially the nursing diagnosis and evaluation phases. Additionally, the collection of assessment data was guided by a perceptual emphasis on the pathophysiological manifestations of the patient.

These data replicate earlier reports on the frequency with which students verbalize empirical meanings of fact-stating and explaining more often than either evaluative or analytic meanings.

The findings support current concern with one of the major challenges still facing nursing, that of shifting from disease centred nursing to patient centred nursing. The aim of the shift is to encourage wholism in the nursing care of patients and avoid reducing nursing inquiry to only one discipline perspective, attainment of a balanced perspective for the nursing activities discussed by the students in this study was not evident.