Utilising a Bourdieusian lens to explore emerging health visitor practice education experiences within the context of the Health Visitor Implementation Plan

Abstract

The Health Visitor Implementation Plan (HVIP) (DH, 2011a) changed the recruitment criteria for health visiting and the way health visitor (HV) practice placements were supported. Several universities offered accelerated '2+1' programmes, where a graduate with a health related degree obtained accreditation of prior learning and completed pre-registration nurse training in two rather than three years. This was then followed by a one-year post-registration Health Visitor programme. This widening of recruitment afforded a unique opportunity to explore the experiences of 2+1 HV students, practice teachers (PTs) and mentors, and emerging practice education models within the context of the HVIP. Findings are considered through the lens of Bourdieu’s theory of practice. The study adopted an interpretive phenomenological design to gain a deeper understanding of the experiences of students, PTs and mentors. In-depth semistructured conversational interviews were undertaken with four HV 2+1 students, two PTs and two mentors. Interviews were recorded, transcribed and analysed using Interpretative Phenomenological Analysis. Findings viewed through a Bourdieusian lens indicate that policy change in the form of the HVIP affected the structure of the social field, resulting in a period of transition when some participants had difficulty adapting to the changed social context. Long arm models of practice education added to the complexity of the PT role, including the additional responsibility of overseeing numerous students and mentors. Mentors reported feeling under pressure, exacerbated by working in inexperienced teams; and frustration that their contribution to the HVIP was disregarded, compounded by a lack of opportunity for professional progression. Students undertaking different routes into nursing are affected by extrinsic views and this affects evolving habitus and enculturation. When students’ prior experience is valued, this strengthens the students’ perception of their ‘field’ position. Placement changes, particularly during consolidation, can be detrimental as they affect habitus formation and student learning and impact upon assessment processes. The research offers new insights into health visiting practice education and the impact of policy change on practice settings. The findings have implications outside health visiting in the current context of changes to nurse education and the introduction of the new NMC (2018b) standards for student supervision and assessment. New knowledge is offered with regards to the significance of transition periods, changing roles, and the potential impact upon the provision of student practice placements and those who support them. Recommendations are made for further areas of research, practice placement providers and HEIs.