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The development of personal empowerment : a qualitative study of the experience of master’s nursing student Chow, Linda Jane Hong 1992

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THE DEVELOPMENT OF PERSONAL EMPOWERMENT: A QUALITATIVE STUDY OFTHE EXPERIENCE OF MASTER'S NURSING STUDENTbyLINDA JANE HONG CHOWB.Sc.N. The University of Toronto, 1972A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTSFOR THE DEGREE OF MASTER OF SCIENCE IN NURSINGinTHE FACULTY OF GRADUATE STUDIESThe School of NursingWe accept this thesis as conformingto the_required standardTHE UNIVERSITY OF BRITISH COLUMBIAOctober, 1992© Linda Jane Hong Chow, 1992In presenting this thesis in partial fulfilment of the requirements for an advanceddegree at the University of British Columbia, I agree that the Library shall make itfreely available for reference and study. I further agree that permission for extensivecopying of this thesis for scholarly purposes may be granted by the head of mydepartment or by his or her representatives. It is understood that copying orpublication of this thesis for financial gain shall not be allowed without my writtenpermission.(Signature)Department of  A/z/yeiL/4/ The University of British ColumbiaVancouver, CanadaDate  &..,& _ /c7, /99.2..DE-6 (2/88)iiABSTRACTThe development of personal empowerment in nursing students isthought to be a critical element not only in the promotion of a positivepersonal and professional self-image among graduate nurses, but also inthe advancement of the nursing profession. This study was designed toexplore and describe the experiences of master's nursing students withthe aim of adding to the knowledge and understanding of the developmentof personal empowerment in graduate level nursing education. Thequalitative method of ethnography was used to conduct this study.Data were collected through formal interviews, informalinterviews, and observations of master's nursing students within thesettings related to teaching/learning experiences. The majority of thedata were collected through 27 semi-structured interviews that wereconducted with 13 informants. Ten of these informants were full-time,currently-enrolled students, and three of the informants were full-timestudents who had graduated from the program with the past year. Datacollection and analysis were conducted simultaneously. The process ofdata analysis gave rise to themes that were clarified and validated bythe informants and gave direction to the construction of the informants'accounts of their experiences.All of the students described themselves as having been personallyempowered, to varying degrees, as a result of their experiences in themaster's nursing program. They perceived that they had acquiredknowledge and skills that would contribute to the achievement of theirprofessional goals. Further, by being successful in the program, theyhad developed a positive self-concept that was associated with a senseiiiof being able to take control under difficult circumstances and overcomeadversity. However, most of the informant also perceived that the levelto which they had been empowered was limited by the excessive pain ofsome of their experiences in the program. Often, these negativeexperiences tended to overshadow the more positive experiences and tocolor the students' perceptions of their experiences as master's nursingstudents in a negative way.The data revealed that the development of personal empowerment is,ultimately, the result of a collaborative effort between and amongmaster's nursing students and nursing faculty. First, students,themselves, have the capacity to promote their own sense of personalempowerment through constructive adaptive strategies directed towardacquiring knowledge and skills and toward coping with adversity. Thesestrategies often necessitate reflection on personal beliefs, values, andassumptions; they often require a shift in students' perceptions of selfin relation to the experience of being a master's nursing student.Second, supportive peer relationships, build on mutual trust andrespect, are important in promoting both professional and personalgrowth. And third, the nursing faculty play a critical role instructuring learning experiences and fostering collegial, caringrelationships that nurture the students' development of personalempowerment. The research findings have implications for nursingeducation and nursing research such that the development of personalempowerment in nursing education will be enhanced.ivTABLE OF CONTENTSABSTRACT  	 iiTABLE OF CONTENTS  	 ivACKNOWLEDGEMENTS 	 viiCHAPTER ONE: INTRODUCTION  	 1Background to the Problem  	 1Statement of the Problem and Purpose  	 5Significance of the Study  	 6Scientific Significance  	 6Practical Significance  	 6Definition of Terms  	 6Personal empowerment  	 6Master's nursing student  	 7Educational process  	 7Assumptions  	 7Limitations  	 7Introduction to Methodological Approach  	 8Organization of the Thesis  	 9Summary  	 10CHAPTER TWO: REVIEW OF THE LITERATURE  	 11Introduction  	 11Theoretical Context  	 11Personal Empowerment  	 11Powerlessness in the Nursing Profession  	 15Powerlessness in Nursing Education  	 17Empowerment in Nursing Education  	 19Undergraduate Nursing Education  	 20Graduate Level Education  	 25Graduate Nursing Education  	 27Returning Registered Nurse Students  	 30Summary  	 31CHAPTER THREE: METHODOLOGY  	 33Introduction  	 33Selection of the Informants  	 33Criteria for Selection  	 33Selection Procedures  	 34Characteristics of the Informants  	 35Data Collection Procedures  	 38Formal Interviews  	 39Informal Interviews  	 41Participant Observation  	 41Data Analysis  	 44Reliability and Validity  	 44Ethical Considerations  	 47Summary 	  48CHAPTER FOUR: FINDINGS  	 50Introduction  	 50The Dream Versus the Reality  	 51Experiencing the Reality  	 55The Work of Being an MSN Student  	 55Trying to Learn  	 56Keeping up  	 56Meeting personal learning needs  	 59Looking for constructive feedback  	 61Trying to Measure Up  	 65Hitting a moving target  	 65Meeting personal expectations  	 69Comparing one's self with others  	 69Changes Over Time  	 72The Interdependence of Being an MSN Student  	 75Relating with the Faculty  	 75Conditional respect  	 76Unintentional indifference  	 84Relating With Other Students  	 91Doing group work: a matter of trust andrespect  	 91An exclusive fellowship  	 93Changes Over Time  	 96The Art of Being an MSN Student 	 100Getting the Information 	  100Finding Their Way Around 	 105Learning the Language 	 106Deliberate Accomodation 	  107Playing by the rules 	 107Playing the game 	 109Changes Over Time 	 111Summary 	 112Responding to the Impact 	 113The Impact: Losing Control 	 113Shaking the Foundations 	 113Transition into the student role 	  114The challenge to professional beliefs, values,and assumptions 	 115The threat to self-esteem 	 116The Pervasive Pressure of School 	  124The Threat to Physical and Emotional Well-Being	 126The Response: Regaining Control 	 128The Passage of Time 	 130Manoeuvering for Survival 	 130The Perceptual Shift 	 132Redefining priorities 	 132A shift in locus of control 	 134Finding meaning 	 136viPersonal Empowerment 	 137Personal Empowerment as an Outcome 	 137Professional growth 	 138Personal growth 	 139Personal Empowerment as a Process 	 140Summary 	 145Chapter Summary 	 146CHAPTER FIVE: DISCUSSION OF FINDINGS 	 149Introduction 	 149The Dream Versus the Reality 	 150Experiencing the Reality 	 153The Work of Being an MSN Student 	 153Trying to Learn 	 153Trying to Measure Up 	 158The Interdependence of Being an MSN Student 	 162Relating with the faculty 	 162Relating with other students 	 168The Art of Being an MSN Student 	 170Summary 	 176Responding to the Impact 	 177The Impact: Losing Control 	 177Shaking the foundations 	 177The pervasive pressure of school 	 180The threat to physical and emotional well-being .	 182The Response: Regaining Control 	 184Personal Empowerment 	 188Personal empowerment as an outcome 	 188Personal empowerment as a process 	 190Chapter Summary 	 192CHAPTER SIX: SUMMARY, CONCLUSIONS, AND IMPLICATIONS FOR NURSING	 195Summary 	 195Conclusions 	 199Implications for Nursing Education 	 203Implications for Nursing Research 	 205REFERENCES 208APPENDICES 	Appendix A:Appendix B:Appendix C:Appendix D:223Sample Interview Questions 	 233Proposed Observations 	 224Letter to the Informants 	 225Informant Consent Form 	 227viiACKNOWLEDGEMENTSForemost, I wish to thank the members of my Thesis Committee:Professor Sally Thorne, Professor Elaine Carty, and Professor GloriaJoachim. Their patience and their caring enhanced my personal growth;their expertise and their guidance enhanced by professional growth.Second, my sincere thanks to all of the master's nursing students whoparticipated in my study. Their willingness to share their experiencesmade my experience a meaningful one. Third, I wish to express my loveand gratitude to my family and friends who were always there for me:Mom, Dad, Peter, Susie, Jane, Anne, Denise, and Ethel. A specialacknowledgement to Mary with whom I shared many late evenings debatingand critiquing ideas and theories. And a special acknowledgement toRuth with whom I shared a unique bond that was build on helping eachother to understand self, to grow from our experiences in the program,and to discover the many meanings of life. Finally, I wish toacknowledge Mitsy who was at my side throughout my experience in themaster's nursing program and who waited until I was done before leaving.1CHAPTER ONEINTRODUCTIONIt has been suggested that a critical focus for nursing educationin Canada today is the development of graduate nursing programs(Baumgart & Larsen, 1988; Kerr, 1988). There are currently 11 Canadiannursing programs at the master's degree level, and doctoral programshave recently become a reality. These programs have the goal ofpreparing nurses for leadership roles in advanced clinical nursingpractice, nursing research, teaching, and administration (Baumgart &Larsen). Students entering a graduate nursing program expect that theireducational experiences will enable them to acquire the knowledge,skills, and self-concept that will empower them to reach their goals asnursing leaders. This study sought to describe the experience ofmaster's nursing students and to provide an understanding of thedevelopment of personal empowerment within the context of theireducational experiences.Background to the ProblemEmpowerment has been conceptualized as both a process and anoutcome (Gibson, 1991). As an outcome, empowerment encompasses positiveself-concept, self-efficacy (Gibson), and optimism about one's abilityto achieve desired ends (Kosowski et al., 1990). The individual who isempowered possesses an understanding and appreciation of personalstrengths and abilities, a sense of hope and direction, recognition ofthe social, cultural, economic, and political conditions that contributeto powerlessness, and the energy to act in creative and constructiveways (Mason, Costello-Nickitas, Scanlan, & Magnuson, 1991). Empowerment2has transactional and synergistic dimensions in which the empowerment ofone individual generates empowerment in others (Montisano-Marchi, 1984).Personal empowerment of nurses is believed to be vital not onlyfor the individual nurses, but also for the growth, development, andempowerment of the profession of nursing (Copp, 1989; Mason et al.,1990). There is abundant literature that articulates the powerlessnessof the nursing profession in influencing the health care system (Jenny,1990; Mason et al.; Stevens, 1983), in improving practice conditions(Martin, 1990; Mason et al.), and in speaking effectively on behalf ofclients (Weis & Schank, 1991; Zerwekh, 1990). The public image of thenursing profession and the felt experience of nurses as powerless isthought to contribute to a lack of unity within the profession, burnout,failure on the part of nurses to demonstrate commitment to theprofession, failure to attract prospective students into the nursingprofession, and the current nursing shortage (Hegyvary, 1990; Martin).The notion of empowerment in nurses is particularly relevant inview of the perceived inadequate and declining state of health caredelivery (Tanner, 1990b) which has been called the "moral failure of thepatriarchy" (Watson, 1990, p. 62). It has been suggested that thevalues underlying contemporary health care policy are oriented towardthe values of the medical profession and that this technological, cure-oriented perspective has failed to address the social conditions such aspoverty, pollution, and homelessness that contribute to disease (Tanner,1990b; Watson). It is believed that this perspective has contributed toa failure to devote adequate financial resources and research effortstoward the major health problems of the future that are projected to be3related to an aging population and chronic illness (Maraldo & Solomon,1987). Further, it has contributed to a failure to respond to societaldemands for a focus on health promotion and illness prevention (Maraldo& Solomon; Moccia, 1990). It is thought that the profession of nursingnot only has the opportunity, but also the obligation to take aleadership role in shaping the future of health care delivery (Tanner,1990b; Welch, 1987). However, the proactivist stance required tofulfill this role is dependent on the collective ability of the nursesto realize and wield their power; it is dependent on the collectiveefforts of empowered nurses (Kosowksi et al, 1990; Mason et al, 1991;Stevens, 1983).Nursing education plays a critical role in the development ofprofessional attitudes, values, and behaviors in nursing students and,consequently, in the reinforcement of nurses as powerless individuals orin the development of personal empowerment in nurses (Martin, 1990).Leading nurse educators are calling for a curriculum revolution becauseof the perceived role of nursing education in creating and maintainingpowerlessness in nursing students (Griffith & Bakanaukas, 1983; Pitts,1985). Bevis (1988) asserts that the proposed changes in nursingeducation arising from the curriculum revolution must ultimately affectthe liberation and empowerment of nursing students."Nursing eats its young" (Meissner, 1984, p. 52) is a graphicphrase that describes the perceived experience of students as theyundergo the process of nursing education (Hedin, 1989; Martin, 1988).This phrase speaks to overt and covert practices in nursing educationthat are thought to arise from the inequitable power relationships4between students and faculty and that are thought to undermine thestudents' self-confidence, produce unnecessarily high levels of stress,and interfere with the students' achievement of educational goals(Allen, 1990; Klaich, 1990; Meissner; Parkin, 1989; Pitts, 1985; Stone &Goodwin, 1988). Additionally, the nursing student who is a graduatestudent must deal not only with the frustration, stress, and threats toself-esteem that are said to be inherent in the graduate studentexperience (Rimmer, Lammert & McClain, 1982; Taylor, 1975) but, often,must also deal with the adjustments and changes related to returning toschool as a registered nurse student or after many years away from theacademic community (Perry, 1986).In 1990, there were 847 students enrolled in master's levelnursing programs in Canada (Statistics Canada, 1991). This number isexpected to increase significantly with the continuing implementation ofbaccalaureate entry-to-practice standards in nursing throughout thecountry. However, little research has been done in the area of graduatenursing education (Allemang & Cahoon, 1987; Stinson, Field, &Thibaudeau, 1988). In view of the potential leadership roles that willbe assumed by graduates of master's nursing programs and in view of thetransactional nature of empowerment, a study of the development ofpersonal empowerment in master's level nursing students may yieldinformation that will have a significant influence on the personal self-image of nurses and the professional image of nursing. Recent nursingliterature describes nursing education as oppressive and, therefore,contributing to an identity of personal and professional powerlessnessin nurses. These claims underscore the need to explore the educational5practices in nursing education that may be perceived by students asempowering or demoralizing - educational practices that are challengingor threatening, constructive or destructive, and caring or uncaring.Statement of the Problem and PurposeThe problem that this study addressed was the lack of knowledgeabout the development of personal empowerment in the educationalexperience of master's nursing students. Explicating this experience istimely in view of the proposed curriculum revolution in nursingeducation and may contribute to the body of knowledge about how nursingeducation can best meet the learning needs of students and prepareempowered practitioners. The literature supports the notion that thedevelopment of personal empowerment in nursing students may besignificant in the development and progress of the nursing profession.No studies could be found that addressed the notion of personalempowerment in nursing education. Therefore, the purpose of this studywas to describe the development of personal empowerment in theexperience of master's nursing students. The research questions thatthis study addressed were as follows:1. What are the elements of the educational process that master'snursing students have experienced that contribute to the development ofpersonal empowerment?2. What are the elements of the educational process that master'snursing students have experienced that inhibited or prevented thedevelopment of personal empowerment?3. What are the elements of the educational process that themaster's nursing student suggest be implemented to enhance the6development of personal empowerment?4. What consequences have the experiences of master's nursingstudent had on their personal and profession identity?Significance of the StudyScientific SignificanceThe results of this study will provide information about thedevelopment of personal empowerment in the experience of master'snursing students and contribute to the existing body of knowledge aboutthe experiences of students at the graduate level in nursing education.Moreover, they may provide a basis for the generation of further relatedresearch on the experiences of master's nursing students, or research onthe notion of personal empowerment in nursing education, or on both.Practical Significance The information arising from the data generated by the informantscould assist nurse educators to understand and respond to some of theeducational practices in master's level nursing education that areidentified as facilitating or inhibiting the development of personalempowerment. From the student perspective, a description of theexperiences of students enrolled in a master's nursing program couldprovide a basis on which students might validate and build on their ownexperiences toward a higher level of empowerment.Definition of TermsPersonal empowerment A state in which an individual experiences a sense of personalpower in being able to achieve desired ends and influence lifeexperiences. This state is facilitated by the acquision of the7knowledge, skills, and self-concept specific to the goals and aims ofthe individual.Master's nursing student For the purpose of this study, a full-time student who is eithercurrently enrolled in the first or second year of first level graduatestudies in nursing, or who, as a full-time student, graduated within thepast year.Educational processFor the purpose of this study, the planned and unplanned, student-generated and teacher-generated experiences in learning that pertain tothe progress of the student toward the achievement of a master's degreein nursing.AssumptionsFor the purpose of this study, the following assumptions weremade:1. Master's level nursing students are able to articulate theirperception of personal empowerment and their personal experiences inrelation to its development.2. Personal empowerment is a phenomenon that can be facilitatedor hampered by the educational process in master's level nursingeducation.3. Personal empowerment is a phenomenon that can have ansignificant positive impact on both the personal and professionalidentity of master's nursing students.LimitationsThe limitations of the study were as follows:81. The sample is limited to masters nursing students in oneCanadian university and thus can not be generalized to otherpopulations.2. Informants may distort data in view of their position ascurrently-enrolled students in the master's nursing program. Thispotential problem is discussed in the section on reliability andvalidity.3. This researcher may distort interpretation of data in view ofher position as a currently-enrolled master's nursing student. Thispotential problem is addressed in the section on data collectionprocedures.Introduction to Methodological ApproachA qualitative research design was used to study the development ofpersonal empowerment in the experience of master's nursing students.This design is appropriate when "virtually nothing seems known about atopic or phenomenon" (Munhall, 1990, p. 164) as was the case in thisstudy. Qualitative research designs are intended to result in anunderstanding and interpretation of experiences from the perspective ofthe informants (Field & Morse, 1985). Oiler (1982) adds that nursing,as a profession, respects the individual as the creator of a personalreality and, consequently, it was appropriate to use a qualitativeapproach that was consistent with this philosophical position. Incontrast to quantitative methods, there is no attempt to place controlsupon the phenomenon being studied, nor is the aim to determine causal ormeasurable relationships among variables (Field & Morse).More specifically, the theoretical perspective that guided the9research methods was ethnography. Because the researcher was a memberof the cultural group being studied, the participant-observer stancethat is consistent with ethnography seemed to be particularlyappropriate. Ethnographic methods require first-hand contact with thepeople and the setting concerned and participation in the group (Ornery,1988). Instead of collecting data about people, the ethnographer seeksto learn from people, to be taught by them (Spradley, 1979, p. 4).Rosenthal (1989) notes the suitability of ethnographic methods instudying nursing education because of the emphasis on process and thestrength of ethnographic methods in yielding a description of thetotality of a situation. Ethnographic methods in data collection, asdescribed by Aamodt (1982), can focus on either the emic or the eticperspective or both. In this study, the emic perspective was theprimary focus; that is, the ideas, beliefs, and knowledge of theinformants that were expressed verbally as they talked about what theyknew and did. The etic perspective, that is, the observable patterns,objects, and events in the setting, was a secondary focus that was usedto generate questions and to validate data arising from the emicperspective. Ornery warns against the exclusive adherence to either theemic or etic perspective due to potential loss of data. The combinedemic and etic approach used in this study contributed to thecomprehensiveness of data and added to its richness and depth.Organization of the ThesisIn this first chapter, introductory information about the study ofthe develpment of personal empowerment in master's nursing students hasbeen presented. This information included the background to the10problem, problem statement, research questions, purpose, significance,assumptions, limitations, and research method. Chapter Two presents theliterature that provided the theoretical context for this study as wellas an overview of research- and non-research-based literature that isrelevant to master's level nursing education. Chapter Three providesspecific details about the ethnographic research methods used in thisstudy. The fourth chapter provides a descriptive account of theinformants' experiences as master's nursing students. Chapter Fivepresents a discussion of these accounts in relation to literature thatwas described in Chapter Two as well as other relevant literature. Thesixth chapter includes a summary of the study, conclusions, andimplications for nursing education and nursing research.SummaryThe study of personal empowerment in nursing education is timelyin view of the current and potential status of the nursing professionwithin the health care delivery system. The focus on master's nursingstudents is particularly relevant in view of the expected leadershiproles in nursing that will be assumed by these graduates. Moreover,shifting philosophical perspectives in nursing education support thenotion of personal empowerment in nurisng education. This chapter hasdescribed the foundational perspectives for the study of personalempowerment in the experience of master's nursing students.1 1CHAPTER TWOREVIEW OF THE LITERATUREIntroductionThere is little in the nursing literature that addresses theconcept of personal empowerment or even the broader notion ofempowerment. It is only recently that nurse educators have begun tovisualize personal empowerment of students as a consequence of nursingeducation and what this might mean to the profession of nursing. Thus,it is necessary to begin this review of the literature by placing theconcept of personal empowerment into the context of current theoriesabout nursing education and nursing as a profession.The research-based literature that follows the theoretical contextpertains to the educational experience of masters level nursing studentsin their roles as masters students, nursing students, and registerednurse students. Therefore, four bodies of literature relating toundergraduate nursing education, graduate level education, graduatenursing education, and registered nurse students will be reviewed. Thisreview is limited to those bodies of literature that shed light onaspects of the development or lack of development of personalempowerment. Educational experiences that are perceived as satisfying,that fulfill personal and professional expectations, that enhance self-esteem, that increase competencies, and that facilitate learning areexperiences that are thought to be empowering (Beeman, 1988).Theoretical ContextPersonal Empowerment The notion of empowerment is linked most frequently with12discussion of preventative social and community intervention (Kieffer,1984). There have been numerous studies that have reported socialphenomena such as helplessness, alienation, powerlessness, socialimpotence, feelings of loss of control, and sense of meaninglessnessthat have been experienced by individuals in cultures that are"disadvantaged," "deprived," or "underprivileged" (Kieffer). However,even out of the most socially, culturally, politically, and economicallyoppressive conditions, individuals have been able to take control oftheir lives (Kieffer). This process by which individuals have been ableto develop personal empowerment has become a theoretical perspective forsocial scientists in working with individuals, groups, and communities.Empowerment, as a process, is a mechanism by which individuals,organizations, and communities "gain mastery over their lives"(Rappaport, 1984, p. 3). Inherent in the notion of personal empowermentis the belief that individuals have the right to define their own needsand to act on that understanding (Lord & Farlow, 1990). Individuals whoare empowered experience a sense of control that may encompasspsychological, spiritual, interpersonal, economic, and/or politicalrealms (Rappaport). Empowerment entails true collaboration, the sharingof power, and acting on the assumption that competencies are present orpossible "given niches and opportunities" (Rappaport, p. 4). There is afocus on the individual's strengths and capacities instead ofdeficiencies (Lord & Farlow). Power is not viewed as a limited resourcebut rather a resource that can be shared and, through this sharing,become self-generating (Montisano-Marchi, 1984).Rappaport (1984, p. 3) states that empowerment is more easily13defined by its absence: powerlessness, learned helplessness,alienation, and sense of loss of control over one's own life. Thecounterpoint to empowerment is powerlessness in which an individualexperiences a sense of being unable to determine the occurrence ofoutcomes through personal behaviors (Kieffer, 1984). Powerlessnessarises out of conditions of oppression, enslavement, and domination inwhich individuals become trapped as victims (Pinderhughes, 1983). It isreinforced by social institutions and, therefore, empowermentnecessitates an understanding of the historical, sociocultural, andpolitical roots of powerlessness, and the options for action to escapeconditions of oppression (Kieffer; Lord & Farlow, 1990).Individuals who have developed personal empowerment do not viewthemselves as having more power but rather as feeling more powerful(Kieffer, 1984). They are transformed in the ways in which they relatein social systems; they become proactive rather than reactive; there isa shift in the way in which they perceive themselves, others, and events(Kieffer; Lord & Farlow, 1990). Although the development of personalempowerment is an individual effort, it can be nourished by significantothers and through collective efforts (Kieffer). Most often, there is asignificant individual who inspires, supports, or facilitates thedevelopment of personal empowerment (Lord & Farlow). Individuals whoare in a position of power guide and facilitate the empowerment ofothers rather than intentionally or unintentionally cultivating adependence in order to enhance their own self-esteem and status(Pinderhughes, 1983). They view their role as supporting thecapabilities of others in taking control and responsibility for their14own lives (Lord & Farlow). Empowerment occurs only to the extent towhich those with power allow it to take place (Hess, 1984).Gibson (1991) offers a conceptualization of empowerment that flowsfrom her examination of the attributes, characteristics, and uses of theconcept. Personal empowerment is a quality or property that anindividual possesses as a result of the process of empowerment.Empowerment, as a process, is defined as "a social process ofrecognizing, promoting, and enhancing people's abilities to meet theirown needs, solve their own problems, and mobilize the necessaryresources in order to feel in control of their own lives" (p. 359).Gibson's empowerment model is composed of the client domain, the nursingdomain, and the interaction between client and nurse. The client who isin a situation where actual or potential loss of power is experiencedhas feelings of distrust, alienation, hopelessness, or self-blame(Kieffer, 1984). The empowering response is initiated when a particularsymbolic or emotionally significant episode threatens the individual'spride, sense of connectedness to others, or self-reliance, and elicitsfeelings of outrage or a sense of confrontation (Kieffer). The nurseacts to enable the individual to become empowered through the roles ofhelper, supporter, counsellor, educator, resource consultant, resourcemobilizer, facilitator, enabler, and advocate. The relationship betweenthe client and nurse is characterized by trust, empathy, participatorydecision-making, mutual goal-setting, co-operation, negotiation, andlegitimatizing. The client who is empowered achieves a sense of self-determination, self-efficacy, sense of control, motivation, self-development, learning, growth, sense of mastery, sense of connectedness,15improved quality of life, better health, and a sense of social justice.In contrast to the notion of powerlessness, empowerment is a moredifficult concept to define because it takes on a different form indifferent people and contexts (Rappaport, 1984). It can be aninternalized attitude, or it may be understood as an observable behavior(Rappaport). Ultimately, the development of personal empowerment is asubjective experience that is best articulated by those who have beenempowered (Kieffer, 1984).Powerlessness in the Nursing Profession It has been suggested that the roots of powerlessness in thenursing profession lie in the patriarchal nature of the health caredelivery system and in the fact that nursing is a woman-dominatedprofession (Stevens, 1983). Lovell (1980) claims that the medicalprofession is acting in its own best interest in maintaining a dominantposition in the health care delivery system by preventing therealization of the power potential of other health care disciplines suchas nursing. Through its focus on cure, the medical profession acts todevalue the contribution of nursing and is, in fact, controlling anddiminishing the professional image of nursing (Lovell, p. 75). The factthat much of what nurses do is not visible to society compounds theproblem (Wolf, 1989). Ashley (1980) adds that, although on the surfacenurses are praised for their care-orientation, "medical ideology . . .negates the very existence of nursing as a separate and valid professionwith much of value to offer society, a service that goes beyond meretreatment of disease to the provision of needed care for the health ofpeople" (p. 20) and instead keeps nurses "subjugated, powerless, and16politically impotent" (p. 13).Nurses have been described as an oppressed group which lacksautonomy, control, and status within the patriarchal health caredelivery system and who demonstrate this through self-hatred, awe ofauthority, resistance to change, avoidance of initiative, and internalconflict (Fagin & Maraldo, 1988; Jenny, 1990; Roberts, 1983). Accordingto Freire (1970), the behavior of an oppressed group is based on anattempt to internalize the behavior, norms, and values of the dominantgroup in society in order to become equally successful and powerful.Nurses who adopt the technological, cure-oriented stance of the dominantmedical profession are often rewarded by being given leadershippositions within the profession of nursing (Roberts). However, thesenurses not only demonstrate a dependence on the profession of medicineand a self-hatred toward themselves as nurses, they also promote thisattitude among other nurses through their positions of power (Roberts).Roberts calls this a form of horizontal violence in which nurses areengaged in confrontation with other nurses rather than their oppressors.These nursing leaders who function from a position of dependence withrespect to the medical profession and a position of authority withrespect to the nursing profession have been described as "queen bees"(Staines, Tavris, & Jayaratne, 1974, p. 45) who hoard their knowledgeand skills, who resist making any changes in the system which promotedand supports their position as leaders, and who perpetuate theoppression of nurses through their own controlling behavior and bydevaluing what the dominant group devalues (Roberts). Caring, which hasbeen called the essence of nursing (Barnum, 1987), is perceived as an17inherent feminine quality (Reverby, 1987) and, therefore, not adequatelyvalued or practiced (Tanner, 1990a; Wolf, 1989). Intuition, which hasbeen defined as "understanding without rationale" (Benner & Tanner,1987, p. 23), is not given legitimacy by the fact-oriented medicalprofession and, therefore, not by nurses (Miller & Rew, 1989). It hasbeen suggested that it is unlikely that nursing can develop further as aprofession and have a significant impact on the health care deliverysystem until nurses cease to oppress each other (Ashley, 1980; Klaich,1990; Rosenfeld, 1986).Powerlessness in Nursing Education It has been argued that educational practices in nursing fail topromote the development of a positive professional image in students(Hammer & Tufts, 1985) and, in fact, socialize nurses to "subordinatethemselves and their ethical commitments to the authority of physicians"(Noddings, 1990, p. 406). Having been denied power and control innursing and in education, faculty tend to exert power over students byplacing them in submissive roles and utilizing manipulative strategiesto maintain authority (deTornyay, 1977). Faculty do not foster studentindependence, creativity, sensitivity, and self-motivated learning; theymake students feel threatened, powerless, and incompetent (Griffith &Bakanauskas, 1983).The notion of students as an oppressed group lends impetus to thecurriculum revolution. Freire (1970) describes the "banking" concept ofeducation in which the education of students is under the control ofteachers who make deposits of information into the minds of thepassively accepting students. Students learn, directly and indirectly,18to submit to the dominant group--the teachers--and are manipulated intothinking, feeling, and behaving in accordance with the wishes of theiroppressors. Education is a one way process, and the inequitable powerrelationship between teachers and students is explicit.Instead of being nurtured, nursing students are judged andoverwhelmed with unrealistic study loads and unrealistic expectations bynurse educators (Meissner, 1986). Students learn to compromise theirstandards and learning suffers as teachers fail to devise teachingmethods that promote self-motivated learning and generic thinking skills(Holbert & Abraham, 1988). By imposing predetermined learningobjectives, the previous educational and life experiences of studentsare negated and the individual learning needs of students are ignored(Hedin, 1989; Pitts, 1985). Students quickly learn that their ownbeliefs and values are less significant that those of others who holdpositions of power (Pitts).deTornyay (1977) states that traditional nursing students nolonger exist and that nursing education is failing to address the issueof diversity in students who have different life experiences and values.It has been suggested that the power held by nurse educators and anunreasonable focus on grading and evaluation requires students toconform and to devise manipulative strategies to survive the educationalprocess (Diekelmann, 1990). Students lose freedom and humanity bybecoming a product (Pitts) and, ultimately, become compliant andobedient but dependent, angry, and unthinking practitioners (Allan,1990; Hedin & Donovan, 1989). The message is conveyed to students thatthere is only one right answer to questions, only one right way to do19things, and creativity is stifled (deTornyay, 1988). The oppression ofnursing students leads to a sense of powerlessness and a sense of angerthat interferes with the learning process and leads to a loss ofcommitment to the profession of nursing (Hedin & Donovan; Munhall,1988).Empowerment in Nursing EducationEmpowerment in nursing education calls for a more democraticlearning environment that empowers students to acquire and analyzeinformation on their own (Allen, 1990). This process of empowerment ofnursing students necessitates a more egalitarian relationship betweenteachers and students, recognition and affirmation of the knowledge,capacities and past experiences of students, permission to create andexplore, and explication of the moral foundations of nursing and healthcare issues (deTornyay, 1988; Hedin, 1989). Learning becomes meaningfulfor every individual and students are empowered through an awarenessthat meanings and answers lie within them and they need not depend onothers to tell them what to think and do (Hedin & Donovan, 1989).Empowerment in nursing education entails the deliberatebuilding of self-esteem through respect and caring, encouragement,interest, and trust (Martin, 1990; Zerwekh, 1990). It occurs throughexperiences in which students develop a sense of connectedness withother students and faculty; it occurs when students are guided toincrease their sense of control through affirming feedback, clearexpectations, appropriate responsibilities, strong role models,opportunities to make choices, and opportunity to risk failure and togrow from the experience (Zerwekh). Emphasis is placed on learning how20to learn and transferring learning from one situation to another(Martin). It means helping students to develop the knowledge and skillsthat will equip them to function as independent, critically-thinkingpractitioners who will be able to fulfill the mandate conferred on theprofession of nursing (Martin). Students who are empowered come to seethemselves as participants and creators of their worlds (Hedin &Donovan, 1989).Undergraduate Nursing EducationResearch that reflects the educational experiences ofundergraduate nursing students describes some of the problems in nursingeducation as well as proposed solutions. It should be noted that whilemost studies are quantitative in nature, some of the more recent studiesare qualitative and thus capture the students' perceptions of theireducational experience.Beck and Srivastava (1991) studied the perceived level and sourcesof stress in baccalaureate nursing students. Their findings revealedthat students experienced relatively high levels of stress throughoutall years of the program and that the items ranked highest as sources ofstress included workload, exams/grades, lack of free time, lack oftimely feedback, difficulty with patient responsibilities, andrelationships with faculty. Although experiences with patients wereseen as stressful, relationships with patients were also seen as themost satisfying experiences. The authors noted strong evidence ofnegative feelings of inadequacy, frustration, and discouragement withthe program. In view of the students' perception of the faculty asnonsupportive, the authors recommended exploration of strategies to21improve student-faculty relationships. Beck and Srivastava were alsointerested in the finding that the students' greatest uncertainty wasabout the choice of nursing as a career and about university educationfor nurses. They theorized that these feelings of ambivalence mayinfluence the students' motivation to learn and their commitment to theprofession of nursing. The authors speculated that the students'feelings might reflect the struggles that the profession of nursing isexperiencing in establishing a positive self-image.The study by Beck and Srivastava confirmed the findings of earlierstudies by Zujewskyj and Davis (1985) and MacMaster (1979) in which thesources of highest stress identified by baccalaureate nursing studentswere academic workload, the clinical instructor, and clinicalevaluation. These authors pointed out that these elements, which areintended to promote learning, seem to have the opposite effect as wellas undermining the students' self-esteem. The theme of threat to self-esteem was echoed in Pagana's (1988) study of baccalaureate nursingstudents' perceptions of their initial clinical experience. Althoughstudents tended to perceive their experience as challenging rather thanthreatening, content analysis yielded six themes of threat includingpersonal inadequacy, fear of making errors, uncertainty, the clinicalinstructor, being scared, and fear of failure. Kleehammer, Hart, andKeck (1990) similarly reported fear of making mistakes as anxiety-producing in the clinical area among third and fourth year baccalaureatenursing students. The major theme from content analysis of their datawas that the students' anxiety was increased in the clinical setting bytheir perception of faculty as being nonsupportive.22Ramsborg and Holloway (1987) reported a high level of congruenceamong faculty, student, and graduate perceptions of positive andnegative learning experiences. The most positive learning experienceswere situations in which students mastered a new skill or technique, hadan instructor who was supportive and enhanced feelings of confidence,were given appropriate levels of independence in learning and practice,and were able to engage in open dialogue with faculty and peers.Negative learning experiences were those perceived as damaging to self-concept such as condescending comments by instructors in the presence ofothers, lack of positive feedback, insensitivity to the student'sindividual needs, lack of support when problems arose, and berating astudent's judgment.There have been numerous nursing studies that report thecharacteristics of effective clinical teachers. Windsor (1987) reportedthat the instructor was the most important variable in the students'perception of their clinical experience. Bergman and Gaitskill (1990)found a high degree of congruence between faculty and students in theiridentification of important characteristics of clinical teachers. Bothgroups regarded the student-instructor relationship to be more importantthan the instructor's professional competence. The highest ratedcharacteristics were: conveys confidence in and respect for students,is well informed and able to communicate, encourages students to feelfree to ask questions and ask for help, is objective and fair inevaluations, shows genuine interest in patients and their care, and ishonest and direct with students. These findings confirmed earlierfindings by Mogan and Knox (1983). A later study by Mogan and Knox23(1987) that was subsequently replicated by Nehring (1990) showed that,although being a good role model was the most significant characteristicof clinical teachers, two of the other most critical characteristicswere encouraging mutual respect and providing support and encouragement.Flagler, Loper-Powers, and Spitzer (1988) surveyed baccalaureatenursing students to determine clinical teaching behaviors that wereperceived as most important in promoting their self-confidence. Thefindings showed that these behaviors included showing confidence in thestudent, being accepting of questions, and giving positivereinforcement. Students perceived evaluation as least confidence-producing, possibly because of its threatening implications. Theyperceived receiving no feedback or only negative feedback and beingcriticized in the presence of others as destructive to their self-esteem. Thus, students found that teachers who created an atmospherethat was conducive to learning were most helpful in promoting feelingsof confidence. This study confirmed Kushnir's (1986) findingsconcerning the high levels of stress produced by the teacher'sevaluative role and their perception that the teacher's primarily rolewas an evaluator rather than a facilitator.Theis (1988) investigated baccalaureate nursing students'perceptions of unethical teaching behaviors. Using the AmericanAssociation of University Professor's Statement on Professional Ethicsas a conceptual framework, Theis separated the students' statements intothe categories of respect for persons, justice, and beneficence. Shefound the large number of student reports related to faculty disrespectand insensitivity most troublesome and noted the profound impact that24nursing teachers can have on students' self-image.Vaughan (1990) surveyed nursing students' preferred teachingmethods and found that they preferred student-centered participatorymethods rather than teacher-centered methods such as lecturing. Hewarned that failure to consider the students' preferred teaching methodsmight result in long-term negative attitudes toward learning.Two qualitative studies described the undergraduate nursingeducation experience from the perspective of caring student-teacherencounters. In the first study, the teachers' professional caringbehaviors included "professional competence, genuine concern, positivepersonality, and professional commitment" and formed the basis for arelationship that resulted in the student responses of "sense ofacceptance and self-worth, personal and professional growth andmotivation, appreciation and role modeling, and long-term gratitude andrespect" (Halldorsdottir, 1990, p. 98). Conversely, an uncaringstudent-teacher encounter was characterized by the teachers' "lack ofprofessional competence, lack of concern for students, demand forcontrol and power," and destructive behavior such as "manipulation ofstudents, disrespect, ignoring, and ridiculing students" (p. 103). Therelationship with students was characterized by "lack of trust anddistance" which led to student responses of "puzzlement, anger, thinkingabout leaving the program, turning to supportive others, and long-lasting negative feelings about the experience" (pp. 104-105).Halldorsdottir concluded with the words of one student who expressed theidea that learning requires the freedom to learn and that teachingrequires an understanding of how to allow that freedom.25In the second study, Miller, Haber, and Byrne (1990) describedstudents' perceptions of a caring teaching-learning interaction as onein which support and a concern for the student both personally andacademically is implicit throughout the interaction. The teacher is"nonjudgmental, respectful, patient, available, dependable, flexible,supportive, open, warm, and genuine. She is available, protective,nurturing, and empowers the student through enabling students toautonomously reach their personal and academic potential" (p. 129). Thefaculty's perceptions were similar to the students but included "actingas a role model, providing a nonjudgmental climate of support,validating the students feelings and self-worth, and enabling studentsto move toward personal and professional autonomy" (p. 130). Themes oftrust, sharing, and respect were inherent in caring teaching-learningencounters.Bradby (1990) presented a qualitative study that described theexperience of undergraduate nursing students as they were socializedinto the student nurse role. Although the students were eventually ableto develop a professional identity, it was not without feelings ofconfusion and being overwhelmed, perceiving that their identity had beendivested, and having to become "egocentric in order to find a sense ofreality" (p. 1224). The author noted that high self-esteem and lowanxiety levels were associated with an easier transition into thestudent nurse role.Graduate Level EducationBoth the research and anecdotal literature articulate the negativeeffects of graduate level education on the students' experiences as26learners. Taylor (1975) provided insight into the graduate studentexperience in an article based on a review of essays submitted bystudents about their lives in graduate school. Taylor was profoundlystruck by the overwhelming theme of loss of self-esteem expressed by thestudents. "From social scientist to performing artist to law student,all feel that they barely hold themselves together under the pressure.For the most part, graduate school is seen as a demeaning process, onethat is set up to test the student deliberately or perhaps do more thanjust test - but to subject the student to rigors of deprivation" (p.36).Mechanic's (1962) highly-regarded study of the experiences ofmaster's and doctoral students as they prepare for departmental writtenexaminations vividly portrayed the self-doubt, self-degradation, andanxiety experienced by these students. The students' lack of knowledgeabout the graduate student experience led to feelings of uncertaintyabout self and, consequently, a continuous process of comparison withthe behavior, efforts, and performance of other students--a processwhich was both reassuring and, in itself, stress-producing.Other research attests to the high level of stress experienced bygraduate students regardless of the program (Butler, 1972; Clark &Rieker, 1986; Firth, 1986; Goplerud, 1980; Heins, Fahey, & Leiden, 1984;Khanna & Khanna, 1990; Lloyd & Gartrell, 1983). Graduate studentsperceive stress to be associated with academic expectations (Butler;Clark & Rieker; Firth; Goplerud; Heins et al.; Khanna & Khanna; Lloyd &Gartrell), personal expectations (Clark & Rieker; Khanna & Khanna),instructional processes (Butler; Clark & Rieker; Firth; Katz & Hartnett,271976; Khanna & Khanna), time constraints (Butler; Clark & Rieker; Heinset al.; Katz & Hartnett; Khanna & Khanna; Lloyd & Gartrell),relationships with faculty (Heins et al.; Katz & Hartnett; Khanna &Khanna; Lloyd & Gartrell), and disruptive influences of graduateeducation on personal life (Firth; Khanna & Khanna). Responses tostress were cognitive, such as lack of concentration (Khanna & Khanna);emotional, such as feelings of inadequacy, feelings of powerlessness,frustration, anxiety, and depression (Butler; Firth; Goplerud; Katz &Hartnett; Khanna & Khanna; Lloyd & Gartrell); and somatic, such asweight fluctuations, GI tract problems, headaches, and fatigue(Goplerud; Khanna & Khanna).The literature also reveals information about factors that hinderor enhance the educational process such as effective characteristics ofthe teacher (Butler, 1972; Khanna & Khanna, 1990), changes ininstructional processes or workload (Butler; Goplerud, 1980; Khanna &Khanna), increased participation of students in the learning process(Butler), an orientation to the school (Rimmer et al., 1982), academiccounselling (Goplerud; Rimmer et al.), opportunities to develop asupport network (Butler; Goplerud; Rimmer et al.), and stress managementcounselling (Khanna & Khanna).Graduate Nursing EducationThere is little research in the area of graduate nursingeducation, and this lack has been identified as a major concern inCanada (Allemang & Cahoon, 1986). Mancini, Lavecchia, and Clegg (1983)found that course requirements were the major cause of stress ingraduate nursing students. They noted that faculty members' awareness28of stressors in students' lives and approaches to diminish stress mayfacilitate learning. Stressors that are within the control of facultyinclude coordination of assignment due dates, scheduled breaks inclassroom routines, emphasis on meeting individual learning goals ratherthat student competition, judicious use of positive reinforcement, andavoidance of unexpected changes in scheduling and assignment due dates(p. 333).Klaich (1990) studied the graduate nursing student role using atransition framework and a qualitative approach. The focus of the studywas the influence of master's level nursing education on the developmentof the students' professional self-image. The findings extracted fromin-depth interviews with the participants showed that the participantsperceived positive changes in cognitive skills, acquisition of a broaderperspective of the nursing profession, and the development of asupportive network of peers. However, the educational process was alsoperceived as disruptive to the students' personal self-image andpersonal life, and the students also perceived that changes in theirlives were not valued by significant others or by society in general.Klaich stressed the pivotal role that can be played by nursing facultyin enhancing the personal self-image of students. She stated that apositive self-image in each nurse is a prerequisite for a strongprofessional image and, ultimately, for a strong image of nursing as aprofession.Van Dongen (1988) provided a description of the life experience ofthe first-year doctoral nursing student in her phenomenological study.Van Dongen described the significant impact of beginning doctoral29studies on the development of a "life experience pattern of high stress,restriction of nondoctoral activities, intense focusing of energies,tendency to egocentric behaviour" (p. 23). Students experiencedmultiple losses and changes including losses of self-esteem, status,income, social and recreational activities, free time, sense of securityand predictability, changes in interpersonal relationships within thefamily, and allocation of time. Stressors were related to academicrequirements and produced a feeling of vulnerability and a threat toself-concept. Stress was manifested through physical and behavioralsymptoms and managed by the students through the use of personal copingmeasures and the use of situational supports. A significant sustainingfactor was the students' strong commitment to achieving a doctoraleducation and their perception that rewards associated with thisachievement were more meaningful than the sacrifices and hardshipsassociated with the educational process.Appleton (1990) conducted a phenomenological study of the meaningand experience of caring during doctoral education in nursing. Caringwas conceptualized as a personal, relational, situational, andenvironmental phenomenon. The personal dimension related to caring foroneself; the relational dimension related to caring that occurred amongstudents and among students and faculty; the situational dimensionrelated to caring that arose from teaching-learning experiences andassociated school activities; and the environmental dimension related tothe breakdown of hierarchies, sufficient time to express and engage in aprocess of caring, and suitable surroundings that allowed and fosteredexpressions of caring. Appleton emphasized that freedom was a critical30aspect of caring relationships and caring in education encompassedfreedom to learn. Although Appleton's study was limited to only twoparticipants, it reinforced the notion of caring in nursing education asa prerequiste to the achievement of students' educational goals.Returning Registered Nurse StudentsMaster's nursing students are most often registered nurses with anundergraduate degree in nursing (Stinson, Field, & Thibaudeau, 1988) andwho may have had work experience in nursing prior to enrolling in amaster's nursing program. They may fit the profile of the "reentrywoman" who is reentering higher education after an absence of more thanfour years (Perry, 1986) or the "mature RN learner" who must fulfillmultiple roles as an adult student (Green, 1987). Therefore, becausemaster's nursing students often enter programs with educational and workbackgrounds in nursing, with a personal lifestyle that is complex, andwith a lack of recent familiarity with the demands of scholarship, theyare thought to have unique educational concerns and learning needs.Rendon (1988) studied the effects of returning to school onregistered nurse students. Rendon noted that, among the stresses anddissatisfactions most often reported by students, two significant areaswere feelings of being overwhelmed by academic responsibilities and theperception that they were not respected by faculty in regard to theirprevious knowledge and accomplishments. The major finding of the studywas that students with predominantly compliant trends evidenced thehighest congruence to the student role (p. 176). Rendon questioned thedesirability of compliance as a personality feature in student nurseswhen this quality is antithetical to an autonomous professional nursing31role. While recognizing that it is possible that individuals with morecompliant personalities may be more attracted to the nursing profession,Rendon recommended further study into whether nursing faculty valuecompliance and possibly reinforce this trait in nursing students.Lee (1987) reported that the predominant stressor for returningregistered nurse students was inadequate instruction. Although she didnot provide information about the nature of the students' perceptions ofinadequate instruction, Lee questioned if modes of instruction forregistered nurse students fail to meet their adult learning needs.Beeman (1988) found that registered nurse students did perceive thattheir baccalaureate nursing program was meeting their adult educationneeds. She noted that students favored independence in learning,required much support from the educational environment in order to makethe transition into the student role, preferred learning that could beapplied to specific problems, and found repetitious learning to be aninhibiting factor in achieving personal educational goals. Beeman notedthe wide variation found within the student population studied andadvocated for the individual assessment of each student if students'learning goals are to be met.SummaryThe literature strongly suggests that the nursing professionsuffers from a negative self-image and social image that contributes toa condition of powerlessness. Theories of oppression provide aperspective for the development of this state of powerlessness in boththe profession of nursing and in nursing education.The literature offers the opinion that the educational practices32in master's level programs and nursing programs often lead toexperiences and learning that are not desired or intended. Thesepractices may produce high levels of stress and low self-esteem thatinterfere with learning, create negative impressions of learning, andfail to develop the personal self-image and professional competenciesthat contribute to the development of personal empowerment. Althoughthe majority of the literature has a negative orientation, there is somethat addresses positive aspects of the teaching-learning process andpositive learning experiences. The primacy of the student-teacherrelationship is evident throughout the literature.Although there is literature that addresses theoreticalperspectives about the nature of personal empowerment, there is scantliterature that specifically addresses personal empowerment in nursingeducation, and none could be found that was research-based. Few studiescould be found that addressed the experience of master's nursingstudents from the students' perspective, and no studies could be foundthat spoke specifically to the development of personal empowerment inthe experience of master's nursing students. These deficits underscorethe necessity of researching this phenomenon.33CHAPTER THREEMETHODOLOGYIntroductionIn this chapter, the research process, as it was guided by theethnographic approach to qualtitative research, is described.Specifically, the following areas are addressed: the selection ofinformants, data collection procedures, data analysis, reliability andvalidity, and ethical considerations.Selection of the InformantsConsistent with qualitative methods, the informants for this studywere selected based on their willingness and ability to speak to thephenomenon under study. This type of theoretical sampling makes use ofthe notion that individuals who have experienced the phenomenon are themost legitimate and accurate source of information (Oiler, 1982; Ornery,1983; Sandelowski, Davis, & Harris, 1989). The researcher selectedinformants until theoretical saturation was achieved and no new data wasfound that would add to the understanding of the phenomenon (Morse,1989). These sampling methods were used to provide depth and breadth tothe knowledge about the phenomenon of personal empowerment in master'snursing students and to ensure the representativeness of the informants'accounts (Morse). Although the sample size could not be predetermined,the researcher estimated that between six and ten participants would besufficient to extract the full meaning of the phenomenon and achievetheoretical saturation.Criteria for Selection The informants for this study were selected based on their34willingness and ability to share their experiences as master's nursingstudents. All of the informants were either currently enrolled in firstor second year studies in a master's nursing program, or had graduatedwithin the past year. Only students who were enrolled on a full-timebasis were selected because it was felt that the experience of part-timestudents would be qualitatively different.Selection Procedures Approval to conduct the study was obtained from the University ofBritish Columbia Screening Committee for Research Involving HumanSubjects. The names of all currently enrolled full-time students in themaster's nursing program were obtained from the School of Nursing. Anintroductory letter (Appendix C), which included an overview of study,was placed in thirteen students' personal mailboxes in the graduatenursing student lounge. Five of the seven second year students whoseparticipation was solicited responded that they were interested inparticipating in the study; five of the six first year studentsexpressed the same interest. These ten students were contacted bytelephone by the researcher to provide further information about thestudy, to answer any questions, and to make arrangement for the firstinterview. The ten informants met the selection criteria and wereenthusiastic about sharing their experiences as master's nursingstudents. The researcher was able to contact two of the three studentswho chose not to participate. These two students indicated that theychose to not participate because they felt vulnerable in their positionas students who were still currently enrolled in the master's nursingprogram.35Data collection and analysis were conducted simultaneously in thefirst half of the school year. It became apparent that, although thefive first year students were able to speak about their experiences inthe first semester and the five second year students were able to speakabout their experiences in the first three semesters, there were noinformants who were able to give accounts of their experiences from thebeginning of the fourth semester until the end of the master's nursingprogram. Consequently, it was determined that additional informantsshould be invited to participate in the study. A list of students whohad graduated from the program within the past year was obtained fromthe Graduate Student Adivsor. Three graduates were contacted bytelephone and expressed a willingness to participate.Characteristics of the InformantsA total of thirteen students participated in the study. All ofthe informants were female and currently resided in the metropolitanarea. Six of the informants had moved to the province from anotherprovince in order to study nursing at the master's degree level. Threeof the informants had moved to the city from another location within theprovince, and the remaining four informants had resided in the citybefore entering the master's nursing program.The informants ranged in age from 26 years to 58 years with anaverage of 35 years of age. Eight of the students were single, and theremaining five were either married or divorced. Of the five latterstudents, three had at least one child.The average number of years between graduation from anundergraduate nursing program to enrollment in the master's nursing36program was approximately seven years with the longest period being 16years and the shortest period being four months. Four of the informantsobtained their baccalaureate degree from the same university at whichthis study was conducted.The most recent work experience for two of the informants was inteaching nursing at the community college level. Two of the informantshad most recently held administrative nursing positions. Three of theinformants were most recently employed in public health or communitynursing positions. The remaining six informants had most recently beenemployed in staff nurse positions.Two of the informants had selected administration as theirfunctional stream; five had selected the teaching stream; and six hadselected the clinical nurse specialist stream.The following description of the master's nursing program, atwhich this study was conducted, provides the context for understandingthe informants' experiences as master's nursing students. Much of thefollowing information was obtained from two sources: The 1991/92University calendar and the 1991/92 University program planning andadvising information guide.The university is located on the outskirts of a large Canadiancity and has an annual enrollment of approximately 39,000 students, ofwhich, approximately 5,000 are graduate students. The School of Nursingis located centrally on campus and conveniently adjacent to a medicalsciences library. The School, which offers programs at thebaccalaureate, master's, and doctoral levels, is on the third floor of auniversity-affiliated hospital. Classrooms, laboratories, the business37office, the faculty members' offices, student lounges, and computerfacilities are all located on the third floor. Students are assigned totheir own study carrel and given an individual mailbox in the graduatestudent lounge. There is also an area in the lounge with chairs andsofas where the students can socialize and discuss school-relatedmatters on an informal basis.The program, which leads to a Master of Science in Nursing degree(MSN), consists of 34 credits of required course work. This course workincludes: five core nursing courses; one graduate level statisticscourse; two courses in one of the three functional streams of clinicalnurse specialization, teaching, or administration; and one support orelective course in the teaching stream. In addition to the course work,every study is required to complete either a thesis or directed studycourse for six credits.Learning experiences take place in the classroom, in small seminargroups, and in selected clinical facilities. There are approximately 40full-time and 100 part-time students enrolled in the program. Althougha few full-time students are able to complete the program within twoyears, the large majority of the full-time students require two and ahalf years or more. The students have created three semi-formalmechanisms to share information and experiences, to provide support toeach other, and to plan and organize social activities. Thesemechanisms include the MSN Network meetings, the MSN newsletter, and a"buddy" system for new students. Recently, students have also organizedwine and cheese parties to promote informal interaction with facultymembers.38In addition to the director of the School of Nursing, there areapproximately 68 members of the academic staff including professors,adjunct professors, and clinical associates. Of this number, there areapproximately seven faculty members on the graduate nursing teachingteam who guide the students' learning experiences in the classroom.These faculty members, as well as other members of the academic staff,may also serve as seminar leaders, as members on thesis committees, asadvisors to students who have elected to complete a directed studycourse, or as preceptors for students in the clinical area. One facultymember serves as a graduate nursing student advisor.The faculty organize and conduct an orientation day for themaster's nursing students during the week that precedes the beginning ofthe academic year. There are no examinations in the nursing courseswith the exception of the oral comprehensive examination for studentswho have elected to complete a directed study course. Instead, studentsare assigned grades on written assignments which they refer to as" papers." Some assignments are completed by small groups of studentswho are all subsequently assigned the same grade. However, most of theassignments are completed individually by the students. There areusually two to five assignments in each course.Data Collection ProceduresEthnographic data collection methods that were used includedsemi-structured interviews, informal interviews, and participantobservation (Lipson, 1989). Each method contributed to the completenessof data in order to faithfully describe the phenomenon of personalempowerment in master's nursing students.39Formal Interviews Open-ended, semi-structured interviews were conducted thatallowed the interview to take the directions informed by the keyinformants' responses within a range that was appropriate to the study(Field & Morse, 1985). Trigger questions, based on the researchquestions and the review of the literature, were used to provide a guideto the parameters of the study (Appendix A). This method of datacollection was appropriate because rich and diverse data were desirableand the free expression of thoughts and feelings was not inhibited (May,1989).Interviews took place at a mutually convenient time in a naturalsetting or a setting of each informant's choice (Rosenbaum, 1988). Inmost instances, these interviews took place in the informants'residence. Several interviews took place in the researcher's residence;two took place at the School of Nursing; one took place in a quietrestaurant setting. Interviews were audiotaped and transcribed verbatimto capture the experience in the informants' own words (Sandelowski etal., 1989). Demographic information was gathered from each keyinformant in order to describe the essential characteristics of thesample (Germain, 1986, p. 156).It was recognized that the researcher must use herself and soundinterviewing techniques in order to develop a trusting relationship witheach informant and, thus, elicit the most candid data (Lipson, 1989).Most of the informants were eager to disclose their thoughts andfeelings about their experiences as master's nursing students. Many ofthe informants expressed their appreciation for the opportunity to share40their experiences. Field notes were recorded as soon as possiblefollowing each interview to capture the context of the verbal dataprovided by each informant (Lipson).Ethnographic data collection methods allowed for flexibility suchthat revisions could be made in interview questions as new data arosefrom both interviews and observations (Germain, 1986). As the studyprogressed, a second interview was conducted to focus on and exploreareas that require elaboration or confirmation (May, 1989). Datacollection continued until theoretical saturation was reached and no newdata were elicited (Catanzaro & Olshansky, 1988).Eight informants were interviewed on two occasions. Two of theoriginal group of ten informants were interviewed on only one occasion.In the first instance, the informant temporarily withdrew from the studyin response to an academic crisis. This informant returned toparticipate in a third interview that was conducted with six of theinformants to validate the entirety of the thematic descriptions thatemerged from the data analysis. In the second instance, the informantwas not interviewed on a second occasion because of the timing of thefirst interview and because theoretical saturation had been reached.The three informants who had graduated from the master's nursing programwere interviewed on only one occasion. The purpose of those interviewswas to compare and contrast the perspective and experience of theseinformants with those who were still enrolled in the program. Further,because the third interviews were conducted late in the academic year,data were collected from second year students that confirmed thegraduates' experiences and validated the themes relevant to experiences41in the last section of the master's nursing program.Informal InterviewsIt was recognized that informal interviews with the key informantsmight occur due to the presence of both the researcher and informants inthe same university settings. These interviews were recorded in writingwith the consent of the key informants as soon as possible after theinterviews to add to the completeness of data.Other members of the masters nursing student group were alsosources of data. Data that arose from informal conversations withindividuals or groups could not be ignored. These data were recorded infield notes and assessed for their utility in the generation ofinterview questions with the key informants.Participant ObservationParticipant observation means participation of the researcher inthe activities and in the settings in which the group being studiedcarry out their daily activities; it includes observation of theseactivities and settings (Appendix B) (Germain, 1986). In this study,the settings were locations within the school of nursing such asclassrooms, the student lounge, and the cafeteria. Direct observationof the behavior of master's nursing students yielded data that validatedand added to the data provided in interviews by key informants.Discrepancies between the observed data and interview data weredescribed, assessed, and explained through further data gathering anddata analysis (Germain).Ethnography recognizes that behavior is context-related and aimsto capture that context in detail (Germain, 1986). Thus, the physical42characteristics of the settings and artifacts within the settingprovided contextual data for understanding the data collected throughinterviews and observation of behavior (Ornery, 1988). In the beginning,broad observations were made; ongoing analysis of data guided theresearcher to more specific and selected observations to explore orconfirm previous data (Germain; Ornery). Data obtained throughparticipant-observation were recorded in dated field notes during theevent in an inconspicuous manner or as soon after the observations aspossible (Germain).As a participant in the group under study, this researcherrecognized the dilemmas that were inherent in this position. Doingresearch in one's own culture may elicit emotional responses when facedwith ideas, beliefs, values, and behavior that are contrary to one's ownor may interfere with data collection and analysis (Field, 1989; Lipson,1989). Thus, a journal was maintained by the researcher to recordpersonal experiences in the research process in order to recognize theinfluence of personal biases and feelings on the study (Lipson, p. 71).The journal contained personal reactions to each formal interviewsituation and thoughts on how the interview and informant might havebeen influenced by the researcher; it contained thoughts on what wasbeing observed or attended to in order to determine the presence ofpreconceived ideas, personal issues, and biases (Lipson). It was alsoused to record questions, ideas, preliminary perceptions, mistakes thathad been made, problems that arose, reactions to the research process,decisions about the research process, and personal feelings about thedata that had been collected (Catanzaro, 1988; Ornery, 1988; Spradley,431979). A second problem that arises in doing fieldwork in one's ownculture is that the researcher may assume to be familiar with the fieldand feel too comfortable with the group to be studied (Field, 1989).Significant data may be ignored or misinterpreted under thesecircumstances (Field). The researcher's thesis committee was asked toassist in providing objectivity in this respect.A specific problem that occured during the course of datacollection was related to the researcher's overinvolvement with one ofthe informants. This informant was experiencing an academic crisis and,consequently, the interview process generated intense emotionalreactions and personal pain. The researcher's personal and professionaltendency to empathize and care for this informant resulted in theprovision of counselling and emotional support. Consultation was soughtfrom the researcher's thesis chairman in relation to the implications ofthis overinvolvement with the informant. Further, as could be expected,this informant's perspective was decidedly negative. Therefore, theinformant's perceptions have been included in the study, but only withcare to avoid uncritically accepting the perspective of this informantand jeopardizing the credibility of the findings. Ultimately, althoughthis informant had the most negative perspective of the experience ofbeing a master's nursing student, data analysis revealed that several ofthe other informants' perspectives approached the same level ofnegativity. Consultation with others and awareness of the implicationsof "contaminated data" (Robinson & Thorne, 1988, p. 73) have beenidentified as appropriate strategies to manage problems associated withoverinvolvment with research participants (Watson, Irwin, & Michalske,441991; Wilde, 1992).Data AnalysisCollection of data and preliminary data analysis proceededsimultaneously, The following steps to analysis of the verbatimtranscripts were guided by Giorgi's (1975) method of data analysis.1. Each transcript was read in its entirety to achieve a sense ofthe whole.2. Meaning units were extracted from each transcript by notingnatural transitions in meaning.3. Meaning units from each transcript were compared andcontrasted with each other and in relation to the whole in order toeliminate redundancies. Simultaneously, the meaning units wereclarified or elaborated upon.4. Through the processes of synthesis and integration, essentialmeaning units were organized into clusters of themes.5. An exhaustive descriptive account of the phenomenon understudy was written using verbatim quotes related to these themes.Reliability and ValidityMeasures used to ensure reliability and validity in qualitativeresearch are distinctly different than those measures used inquantitative research. The naturalistic-qualitative paradigm of inquiryseeks to explicate meaning, views each human experience as unique, andrecognizes that qualitative research processes are not intended to bereplicated (Sandelowski, 1986). Sandelowski's four criteria ofcredibility, fittingness, auditability, and confirmability to achieverigor in qualitative studies were adopted by this researcher.45First, internal validity in quantitative research is analogous tothe notion of credibility in qualitative studies. Credibility isachieved when the description of an experience is presented sofaithfully that people having that experience would recognize theexperience as their own, or when others would recognize the experienceafter having read the description. Credibility is enhanced when theresearcher is able to describe personal behaviors and experiences inrelation to the behavior and experiences of the informants. The use ofa personal journal and the recording of field notes, as described in thesection on data collection, served to promote credibility. Data werechecked with the informants at several levels, from the use ofreflecting or rephrasing to ensure accurate interpretation of what wasbeing said during interviews, to verifying the validity of the resultsof ongoing data analysis, and to verifying the validity of finalthematic descriptions and conclusions (Catanzaro, 1988). Observationsof student behavior in the informants' natural settings were validatedor discomfirmed by the key informants (Aamodt, 1982). A panel, in theform of thesis advisors, verified the construction of the analysis(Catanzaro). And finally, verbatim quotes related to each theme wereincluded in the final descriptive account of the informants' experiencesto enhance credibility.Second, external validity in quantitative study refers to thecontrol of the study such that representativeness and generalizabilityare ensured. However, because the goals of qualitative methods are notconsistent with the goals of quantitative research, the criterion offittingness is applied instead of external validity. Fittingness refers46to the fit of findings "into contexts outside the study situation" andwhen the study's audience "views its findings as meaningful andapplicable in terms of their own experience" (p. 32). In this study,fittingness was promoted through the use of data collection proceduresin which repeated and intensive interviews were conducted with theinformants (Sandelowski et al., 1989). As evidenced by thecharacteristics of the informants, there was diversity in the samplesuch that the informants' experiences would be representative of theexperiences of the master's student nurse group (Aamodt, 1982). Acontinuous process of comparing the results of various levels ofanalysis to the data was maintained. The possibility that informantswould control presentation of data for personal reasons was monitoredthrough comparison of data with other informants and with theliterature, and through determination of the stability of the informantsresponses to similar questions (Brink, 1989; Woods & Catanzaro, 1988).Specifically, the intense negativity of many of the informants wasinterpreted with caution. Sampling continued until theoreticalsaturation was achieved and no new variations in the data were elicited(Catanzaro & Olshansky, 1988).Third, reliability in qualitative research, which refers torepeatability of a study, is analogous to auditability in qualitativeresearch. Qualitative research recognizes that each human experience isunique and that variations in experience, rather than similarities, aresought. The goal of qualitative research is not repeatability butrather auditability, in which another researcher can readily follow thedecision trail used by the investigator and would arrive at similar, but47not contradictory, conclusions. The decisions made by this researcherwere recorded in the researcher's personal journal and have beendescribed in the research report in order to achieve auditability.Fourth, objectivity in quantitative studies is similar toconfirmability in qualitative studies and is promoted through theachievement of credibility, fittingness, and auditability. Thedescription of the background to the problem and the theoretic contextreflect information about the researcher's personal perspective aboutthe development of personal empowerment. This information was bracketedin order to avoid bias in the study (Sandelowski et al., 1989).Bracketing is the conscious setting aside of one's preconceptions(Knaack, 1984). In addition, because of the researcher's currentposition as a student in the master's nursing program, the nature ofpersonal experiences, made explicit in the personal journal, wasrecorded and examined for their potential influence on data collectionand analysis. Consultation with thesis committee members was sought tomanage problems that potentially threated the confirmability of thestudy's findings.Ethical ConsiderationsWritten consent (Appendix C) was obtained from all participantsbefore interviewing took place This consent indicated that theinterviews would be audio-taped, that the tapes would be transcribedverbatim for the purposes of analysis, and that sections of thetranscribed data may appear in written form in the final product. Theconsent also indicated that the informants could refuse to answerquestions, stop the interview at any time, and that tapes would be48erased when the study was completed (Field & Morse, 1985). Measures toprotect anonymity were communicated on the consent form.Specific precautions were taken to protect the informants' rightsin view of the fact that the thesis committee members might have adirect relationship with the informants. Potential informants wereinformed of the identity of this researcher's thesis committee membersprior to volunteering to become an informant. Because of possible voicerecognition, committee members had access to the transcripts but not tothe audiotapes. Transcripts were modified if there were data that mightsuggest the identity of informants, or the identity of specific facultymembers or courses. Data that were collected in informal interviewswith master's nursing students, other than the key informants, were usedonly to provide structural questions for interviews with key informants.Data that might suggest the identity of the student did not form thebasis for structural questions. Observations of the activities ofmaster's nursing students and settings served as contextual data andthese data in the research report were modified to protect the identityof students.Informants were informed that, although the findings might haveimplications for educational practices in master's nursing programs,potential benefits might be experienced only by future classes ofmaster's nursing students. However, the informants might benefit fromhaving the opportunity to express their thoughts and feelings with anattentive listener.SummaryThis chapter has described the methods used to conduct the study49of the development of personal empowerment from the perspective ofmaster's nursing students. The selection of informants, data collectionprocedures, data analysis procedures, reliability and validity, andethical considerations were described.A total of 13 students participated in 27 interviews which was theprimary method of data collection. Data collected through the use ofinformal interviews and observation of students in a variety of settingswere used to formulate questions and to clarify and validate theexperiences of the informants. Analysis of the data resulted in theidentification of relevant themes that depicted the development ofpersonal empowerment in the experience of master's nursing students. Inthe next chapter, the findings of this study will be presented.50CHAPTER FOURFINDINGSIntroductionThis chapter presents the results of the analysis of datagenerated from interviews with the informants. Although each informantrecounted the experience of being a master's nursing student withuniquely personal details, it was evident that all of the informantswere relating a descriptive account of their experiences as well aschronicling a process of responding to the impact of these experiences.In the chapter's first section, which is entitled, "the dream versus thereality," the informants' hopes and dreams, relative to theirprofessional nursing goals and to their experiences as master's nursingstudents, will be discussed. In the second section, "experiencing thereality," the informants' descriptive accounts of their experiences arerecounted. The three significant components in this second sectioninclude the work, the interdependence, and the art of being an MSNstudent. Within each component, there are common themes representingthe shared reality of the informants' experiences. In the thirdsection, the informants described these experiences as occurring withinthe context of an ongoing process of "responding to the impact" of theirexperiences. The three facets of this process include losing control,regaining control, and personal empowerment. Again, each facet of thisprocess is characterized by common themes that emerged from theinformants' accounts.The findings of this study are, therefore, organized to reflectthe informants' dreams, the three descriptive components of the51informants' experiences, and the three facets of the process ofresponding to the impact of these experiences. The essence of eachtheme within each component and each facet is explicated. Verbatimexcerpts from the informants' narratives serve to illustrate andvalidate the researcher's portrayal of the informants' experiences. Theletters, "I" and "R" correspond to the informants' accounts and theresearcher's questions respectively.The excerpts are candid and, often, intensely emotionaldisclosures that speak to the profound personal significance of theinformants' experiences as master's nursing students. For many of theinformants, the interview process was a kind of cathartic experience.Thus, as will be seen, although the informants recounted positiveexperiences in the master's program, there are decidedly strong negativeovertones in their accounts. It appeared as if the informants felt aneed to talk in detail about their negative perceptions and to conveythe profound impact of these experiences.All of the informants made the decision to enter into the master'snursing program in order to move toward realizing their professionalnursing goals. The informants' experiences as master's nursing studentsare significant in relation to these goals. Therefore, the firstsection of this chapter describes the informants' professionalaspirations and sets the scene for the informants' experiences with thereality of being master's nursing students.The Dream Versus the RealityAll of the informants had a vision of professional goals that theyhoped to attain upon completing the master's nursing program. These52dreams were, therefore, the impetus for entering the program, and insome way, they were all based on a commitment to the profession ofnursing. As one informant said, "My choice to come and do nursing was acalculated well thought-out decision. Nursing is my love." Theinformants believed that they had the potential to make a difference innursing. The knowledge, skills, and attitudes that they would acquirein a master's nursing program would move them toward realizing theirdreams. The following accounts are examples of these dreams . .I: When I was a staff nurse, I found that my closest resourceperson was someone who was in administration . . . I heard thatshe was incompetent as a clinician . . . she was either off atmeetings or, you know, in her office, or just wasn't there for thestaff nurse. I saw a big need for the staff nurse to have someonewho had the clinical expertise, had the time and, I guess, themotivation to help the staff nurse as well as the patients ineducation--on-going education in a very specific area. Since Iwanted to combine this with going back to school, the best optionI saw was to do a clinical nurse specialist education.I: I thought that if I want to put a dint in [this area ofnursing] and influence some changes, so to speak, I was going toneed to get to a level where I could have some impact. . . . And Irealized that there was so much I didn't know about what'shappening politically and otherwise that might impact on [my areaof nursing]. I became very aware of what I didn't know, and so Idecided that I needed to apply.As they entered the program, the informants experienced a mixtureof excitement and anxiety. They realized that they had the opportunityto move toward their dreams, but that they were also putting themselvesinto a vulnerable position that would be characterized by challenge.I: I thought, "My God, this is going to be a lot of work and myGod, what have I gotten myself into? I must be crazy. I could bemaking money, and I was foolish to do this, and I don't really53think I can do this." All those kinds of self-doubts. At thesame time, talk to myself and say, "You got here because it wasmeant to be, and that's what you want. You want this bad enoughand, therefore, you will succeed. Even if it takes you ten years,you will get through this program (laugh)." So initially, I guessit was the excitement to be accepted and the challenge of it.I: We all worked very hard to get into the master's program. Wedid a lot of stuff to make it even possible for us to be here.And we were all giddy and happy and really positive. . . . Butit's intimidating because now you're in with a very knowledgeableand well-educated group who have obviously all come with the samescholastic achievement that you did. . . . You're now with a wholebunch of driven people who all work at the same pace as you. It'sthat equality that's frightening and intimidating because justdoing the work is not going to get you through anymore.Despite some anxiety, the informants also expected to have theresources to meet the challenge. They expected to be able to depend onthemselves--their own intellectual abilities, coping skills, self-discipline, and work ethic. They expected to be able to depend onothers to support and to share in their dreams. They expected to havethe physical resources available that would facilitate their learning.And they expected that their learning experiences would provide theknowledge and skills that would help them to realize their dreams.I: All the courses were what I wanted to get out of a program,and I planned that. I looked at this program, and I thought that,yeah, I really want to learn these things. I could really relateto the way the program was laid out and what I wanted.I: My vision was that in grad school, there was going to be somesort of camaraderie and an open-door kind of policy where theprofs would say, "My door is open. If you have any questions,come to me and I will try to help you out. I'm here for you as aresource person, and I'm going to be a facilitator for yourlearning." That was my vision--that they would be there toprovide a greater outline, a structure for the learning because wewould be working toward a mutual goal.I: I thought it should prepare you to think at a high, abstract,54nonjudgmental, open-perspective way. I thought it should give youa solid foundation in the stream that you want to go in, and itshould prepare you to do research. . . . I thought it shouldprepare you to be a leader in the profession, and I thought itshould prepare you for a PhD program.Most of the informants were taken aback by how quickly some oftheir perceptions of the MSN experience changed. Based on some of theirearliest experiences in the program, they became wary of the prospectthat their expectations might not be met, and a few of the informantsperceived that their dreams were threatened by the possibility of notsuccessfully completing the program.I: I think the whole tone of the [orientation] day changed whenwe got the pretest. It was before Labour Day weekend. I thoughtI had one more weekend without homework before I set into this fortwo years, and that was just destroyed. I thought it was not avery welcoming, friendly thing to do--to hand out a pretest duringorientation and expect it--typed, two copies, and handed in. Ijust thought it was terrible. . . . I left feeling like it'salready begun; we haven't even got our feet wet, and it wasn'tthat welcoming or friendly. It was cold. . . . It was just reallyformal. The faculty just sort of stood up and introducedthemselves and sat down. . . . It was cold.I: It was the first assignment--the first mark that we got back..	 . Whoomp! First thing we get back, most, who used to get90's, had below 70's. The mark carried the message. It justkilled everyone. . . . I was really pleased at the beginning whenthey told us that we were an elite group. Then we got slashedwhen the elite group all got 60 on our papers, and I thought,"Hum, we're elite but stupid. Well, that's good." . . . It wasnot nice to devastate on the first assignment. One can devastateon maybe the second or third, but save it for a while. . . . Sothis big decision to finally come and to lay one's eggs in thisplace and then to have this happen, right off the bat, was like,"Whoa-oh. I made the wrong decision here."In summary, the informants made a decision to pursue a master's in55nursing degree primarily because they perceived that they would be moreprepared to accomplish their professional goals. They felt a commitmentto nursing as well as a sense that they would be able to achieve theobjectives of the program. One informant stated, "People don't movehalf-way across the country, give up a job, leave their family, andbecome a student again without being serious about the program andfeeling like they can do it." However, early experiences in the programled most of the informants to suspect that their expectations ofthemselves and of the program would not be met, and some perceived thattheir dream might be threatened by the reality of being a master'snursing student. The next section describes this reality.Experiencing the RealityThe Work of Being an MSN Student The work of being a master's nursing student was a significantfocus of all of the interviews. When informants were asked to identifythe types of work in which they were engaged, their responses wereuniformly simple and straightforward. For instance, one typicalresponse was . .I: You go to class, you go to the library, you photocopy, you tryto learn how to use your computer ... you do a lot of study groupmeetings. You read forever. . . . Write papers. Lots of papers--lots of long papers. Group process (laugh). You do a lot ofgroup processing.This informant described many of the tasks involved in the work ofbeing a master's nursing student. In performing these tasks, theinformants hoped to achieve the goals of doing the work. These goals56were learning and achieving. Although the tasks seemed simple andstraightforward, trying to learn and trying to achieve were infinitelymore complex and challenging.Trying to LearnFor all of the informants, the primary reason for entering amaster's nursing program was in order to learn and thus, to realizetheir dreams. Consequently, it was important to the informants thatthey make the most of their opportunity to acquire the knowledge andskills that would be consistent with their individual learning needs.Keeping UD.In attempting to fulfill the requirements of the course work, theinformants perceived that they were continuously straining to keep up.There were three characteristics of the work which accounted for thechallenge of keeping up--the quantity of the work, the pace at which thework had to be generated, and the quality of the work expected.First, all of the informants spoke of the quantity of the work asbeing very heavy and difficult to manage. They perceived that there wassometimes an overwhelming amount of work involved in preparing to writetheir papers and in the actual writing of these papers.I: It's a lot of work. It's a lot of reading, a lot ofassignments. . . . It seems like you eat, breath, and sleep it.But you know, from September to December 1st, I don't think therewas a day I didn't do homework. . . . There were days when I woulddo it from five in the morning to two in the morning.I: In October, things build up, and you think that November won'tbe that bad because we'll all have the group paper in, and that'sthe heaviest. But I think that November was the heaviest by far.I felt like I was constantly on the computer. I was keeping upwith the readings, but I didn't get some of them done in November.I tried, but I thought, "It's just not my priority. I have to use57my brain for something else."I: I'm used to working six or seven days a week and working untilI go to bed, and that's okay because I love doing it. But Godknows, the last few weeks have been hell. And there just isn'tenough hours in the day. . . . There just isn't enough hoursunless I don't want to sleep, and I'm not about to give that up.It's my one luxury.I: The assignments were so outrageously monstrous. They were sohuge. You had to produce every single bit of knowledge that youhad learned in the previous four or six weeks or whatever--toreproduce it, to regurgitate it--every single thing onto thisassignment. Can't we just use the sampling technique that welearned? Going through every single little itty-bitty bit ofknowledge, I thought, was so unrealistic, tedious and, you know,like, what's the point? It made learning tedious.Second, the informants described the workload as heavy and, attimes, overwhelming in terms of the pace at which they had to work.Most of the informants perceived that there was inadequate planning,coordination, and collaboration among the members of the graduatenursing teaching team in relation to the number of assignments and theirdue dates.I: First semester was a whirlwind. It just happened so fast. Itwas like being on a treadmill and spitting out essays, so youdidn't have time to sit and think about anything. It just had tohappen.I: I don't even know if the profs talk to each other. I mean, dothey know how many papers we have to write the first term? . . .it's an incredible number of deadlines to meet. And I thinkthat's worn me down. There's 11 or 13 papers to write in 12weeks, and for the first few weeks, having nothing. It would havebeen better if it had been spread out. That's the only thing thatI keep coming back to. Everything is due at the same time, andall the organization in the world can't get around that. You canbe organized and work your butt off, and it doesn't matter becausethey're all due at the same time.I: There was a time in October that I thought that, if I liveduntil November the 9th, that I can live through anything because58we had like four assignments and one presentation due in twoweeks. . . . It was like two weeks that I thought, "Lord, if I getthrough this, I'll get through anything."Third, compounding the challenges of the quantity of work and thepace of the work was the challenge of academic scholarship. Theinformants were not advocating that the standards of scholarship shouldbe lowered but, rather, that there should be recognition that they didnot necessarily enter the program with the knowledge and skills thatseemed to be required of them in their earliest learning experiences--either because they had never been learned or because the informant hadbeen absent from an academic setting for a prolonged period. Moreover,the informants perceived that there was a great deal of pressure toacquire this knowledge and skills as quickly as possible.I: The program was very unwilling to meet me where I was at. Itwasn't able to say, "Well, this is where you're at, and this isgoing to be how we're going to help you get to where you want tobe."I: . . . writing a paper in a group . . . writing skills . .articulating my thoughts based on critical thinking . . .responding when my ideas are challenged. . . . I'm getting alittle frustrated . . . they want those skills now. And I'mfinding--well, that's not realistic. If we haven't been shown orif we haven't had the opportunity to develop them, how do theyexpect us to get them?I: "Go out and write a belief paper." Pardon me? "Go out andwrite a belief paper about nursing (laugh)." First of all, atthis point, we don't know the difference between beliefs, values,and assumptions (laugh). And we're going to get marked on this?I: You come in with this great pressure from them to upgrade yourwriting skills. . . . It was enough to give you writer's block.59However, despite the informants' perception of an apparentlyunmanageable workload, all of the informants perceived that they werelearning.I: I'm enjoying the assignments. Like [thisdifficult and a hell of a lot of work--beyondexpectations, but I'm learning a lot from it.assignment], as horrible as it is in terms ofunderstanding the course as a result of doingvalue of it.course] is extremelyanybody'sThis [othertime, I'mit, so I can see theI: We're being challenged, and it's draining. I'm just so tiredall the time, but it's a good kind of tired. It's, "I got a lotout of that and I thought about a lot of thing." So it's allgood--draining, but good.Meeting personal learning needs.Although all of the informants described the course work as beinginstrumental in helping them to meet some of their learning needs, theyalso expressed dissatisfaction with the extent to which their learningexperiences contributed to meeting individual learning needs. Many ofthe informants perceived that many aspects of the nursing program wereaimed at a group that was erroneously assumed to be homogenous and thus,failed to recognize the existing diversity of individual learning needs.For many of these informants, the problem was a lack of choicewithin the structure of the program or within specific courses. Evenwhen there appeared to be choices, the informants perceived that it wasactually a case of manipulated non-choice. Thus, what the program orthe course had to offer was not necessarily congruent with theinformants' individual learning needs.60I: There's a great deal of control in first year . . . much morecontrol and structure within that first year. Here's what youneed to know, here are your papers, here's this, here's that.I: There are choices but within a very controlled structure.Like in this course, you had a choice of which topic to sign upfor, but really, what is the choice? Is that really a choice?Your choices are very limited choices.I: I personally found it a very frustrating experience in firstyear. I think that it was largely that I came into the programwith some sense that I was going to learn things relevant to mystream. And the courses in first year couldn't have been furtheraway from what I perceived to be preparing me for it.I: I wanted to come out of this two-year program with a bit morecomfort in verbally expressing my thoughts--also with the securityof knowing that my thoughts and opinions will be challenged, butI've experienced this over the last two years, and I've survivedin a sort of more supportive environment. It was going to be hardbut the group was going to help me. .	 . That was my ideal. I'vebeen robbed. That part of my education can't be brought back.The informants described some of their more positive learningexperiences as ones in which they were able to fulfill individuallearning needs, interests, or goals.I: I was really happy with [that course] because we could do anindependent paper. I designed and produced a paper based on [mywork background]. I loved that assignment. It allowed me tolearn more about [the required course content], but I was able toput it into a context that was familiar to me for a change.I: In [this course], we take a concept, and we do some reading onit. And then, we take it back to the practice setting. You know,what your idea is about this concept from your own personalexperience. Everybody gets an opportunity to sort of make theircomments, and then we relate it back to the theory or what's knownabout the concept. That, to me, is a really good forum for groupdiscussion. And I can see the practical use of doing a lot ofresearch and reading about a concept.61More troublesome for some of the informants was their perceptionthat the resources were lacking to assist them in the process oflearning. The emphasis seemed to be on the product, and littleattention was given to the process of producing the product.I: The research proposal--it just seemed like this was supposedto come out of the blue or something. . . . the feasibility ofideas . . . research question . . . method . . . tools. . . . Likeall of that stuff is just supposed to amazingly fall out of thesky it seems.I: You have to help the person . . . give them direction as tohow to go about meeting their learning needs incorporating theirlearning style and building on their learning style. You canlearn to learn better. . . . It's only now in second year that Iknow, "This is the way I think, and it gives me difficulty inputting things together," and I know that's normal. I don't havea learning deficiency.I: . . . didn't help you to identify what your learning needswere in that course. The expectation was that, somehow, you wouldjust be able to identify them--just pick them out of the air. . .. To me, they were saying, "You're going to base all this on whatyour learning needs are," but I was too intimidated to say, "Idon't know what the heck my learning needs are."I: For this assignment, I had to come up with this idea on myown, and there was absolutely no structure for coming up with thatidea. It just took weeks, and it was something that I struggledwith for a long time, and I guess that imposed a high demand onme. It was a demand that hadn't been made of me before. It wasvery painful coming up with it. Struggling with it and, you know,feeling the pressure of, "I have to get this idea."Looking for constructive feedback.Part of the learning process was contingent on the informantsbeing able to learn from previous mistakes or to build on strengths.Consequently, the informants perceived getting constructive feedback ascrucial in assisting them to learn. Many of the informants' experiences62in relation to getting constructive feedback were positive in that thefeedback clearly conveyed what had been done well, what could beimproved and, often, suggestions as to how to improve. Some of theinformants described this feedback as "an effective combination ofpraise and criticism," "helpful in pointing out what the gaps in myknowledge or conceptualization were," and "sometimes painful, but alwaysmade me think more and work harder." However, almost every informantspoke of problems in obtaining constructive feedback.One of the problems was the inadequate amount of feedback. Manyof the informants perceived that some faculty members were not takingthe time or putting the effort into reading assignments carefully andthen commenting in a constructive manner.I: I had a real problem with putting my guts and my blood and mysoul into a paper and not getting decent feedback. I had a greatproblem with that . . . I really believe that if you're going togive a student feedback, it has to be something that she can use.And there was only a very small handful of professors thatactually put the effort into giving feedback.I: Some of them . . . I thought, this person bothered to read mypaper and bothered to think as she was reading my paper. Theothers were more disappointing in that there wasn't anything tobuild on. . . . I remember being really afraid to write the nextpaper--getting back no feedback, bad feedback, no constructivefeedback. No note saying, "Come and see me. Let's work out yourconcern." I felt like I was cut off. "You tried dear. Too bad.Let's see your next paper. Maybe the next one will be alright."A second problem was in the timing of feedback. The informantsstated that they had difficulty in coping with the uncertaintyassociated with not knowing how well they were progressing. Moreover,many of the informants perceived that the only feedback they got was63from their papers.I: There's such a level of uncertainty. We don't know if we'reon the right track half the time, and your success depends onbeing on the right track. We didn't have any idea of how we stooduntil mid-November. . . . the only mark we had back was from thefirst paper. . . . If you'd done alright on that paper, you hadthat to carry you. But when you were sitting there with a lowmark, you start thinking, "What do I do now? What happens if Idon't get a good mark on the next paper?" You have thatuncertainty and anxiety about what you're doing. You kind of haveto have something to keep people going throughout.I: Going for so long without having any feedback about how wewere doing, was very stressful. I felt that the only feedbackthat really mattered were your marks--not that we got any feedbacknecessarily in any other form. No-one ever saying verbally howyou were doing. So you had to wait for eight weeks to get anymarks back, and it was hard to be in such a tenuous position.A third problem was the vague generality of the feedback. Often,the informants had difficulty in understanding the faculty member'scomments and the implications of the comments in terms of makingchanges. They often found it necessary to speak to faculty members on aone-to-one basis in order to clarify written feedback on assignments.I: They were very short comments. It was sort of like she didn'thave a lot of time to read the paper, and she just said, "Thisisn't clear, this isn't clear." And that means nothing to me.And I sort of thought, "For me who wrote the paper, it was clearin my mind, so I'm not sure why it's not clear to you. If ithadn't been clear to me, I would have written something else.Obviously, to say it's unclear is useless." So I went to her, andI discussed with her for half an hour, and now I know what shemeant. But I did need to go and talk to her about it.I: You get a mark, and you have no idea where that mark camefrom. It's sort of, was it pulled out of a hat, or did I do wellon this part of the paper and not so well on this part? Like it'sa summative statement and one mark. You want something that youcan concretely pick up and do something to make a change.64I: There wasn't anything that you could say, "Okay, these are mystrengths. This is my foundation. I can build from here." It'sall, "Do better here, do better there, needs more work." Itwasn't anything that you could latch on to and say, "This is whatI do well and go from there." . . . When professors wereconstructive, it was like a blinding light. When things wereconstructive and positive, it was really helpful and encouraging.And fourth, some informants had difficulty in dealing with whatthey perceived as a preponderance of negative feedback. There waslittle or no recognition of what had been done well or of learning thathad occurred pursuant to previous learning experiences.I: The feedback that I've had so far has been to say, "You're notdoing this and you're not doing this. You're not doing it right.. . You're not accomplishing what you should be accomplishing."I: There was so much negative feedback that I don't know how wegot the mark we did. . . . At the end of the paper, there was atoken remark saying, "Overall, quite well done," and then justsort of thrash whatever else you had in there. . . . negativecomments on every page and things slashed out.I: If you're expecting a person to have a logical and consistentargument, when they succeed in doing that, and if you've beencritical of them for not doing that, then there should be somerecognition of that success. If I looked at what was missing fromthe comments, I could say it would seem that I've improved inthese areas, but there was then a whole new set of negativecomments. I found that very, very difficult to cope with. Fromwhat I know about motivation theory, one needs to blend praise andreward with criticism. Criticism can be very constructive ifgiven in a constructive way, and I didn't find it constructive.Trying to learn was, therefore, characterized by work thatchallenged the informants' ability to keep up and that, at times, wasperceived as being inconsistent with individual learning needs. Theinformants described problems in obtaining feedback from the faculty65that would be constructive in promoting learning. Furthermore, theyperceived that there was inadequate guidance and support to engage inthe process of learning. A common thread running through theinformants' accounts was a sense of frustration with the process oftrying to learn.Trying to Measure UDAlthough they were inescapably entwined, there was a distinctionbetween trying to learn and trying to measure up. According to theinformants, it was not enough to just learn--there also had to be anevaluation of that learning. Trying to measure up refers to theinformants' attempts to measure up to certain evaluative standards. Thecriteria for this evaluation were based on standards set by faculty, theinformants' personal standards of achievement, and the standards set byfellow students. These standards were most often in terms of marks butcould also be in terms of other work-related standards such as the speedwith which work was completed or the length of papers.Hitting a moving target.Achieving the standards set by the faculty was perceived by manyof the informants as being an elusive goal--like trying to hit a movingtarget. The rules or criteria for achieving desirable grades wereunknown, ambiguous, or subject to randomly being changed with or withoutthe knowledge of the informants.I: It became clear to me, over time, that the evaluation systemwas somewhere out there in the nebula. If you happened to hit it,you were lucky. And if you didn't happen to hit it, it had verylittle to do with the objectives that were laid out for us.66Although the informants knew the truth to be otherwise, some ofthem expressed doubt that first-class grades were ever given out.I: It appears that "A's" aren't given out, and it would take atruly exceptional paper--truly exceptional. . . . You walk into aclass and you're told, "You had good marks in the past. Don'texpect them here. This won't be happening. You won't be gettingthose good marks. We don't give them out unless it's a totallyexceptional paper." It's like, if they're not going to give themto us, then what does one have to do to excel? Like you wouldhave to spend all your time on one course which would be thedetriment of other courses, and it would be a 24 hour job. Youwould not have a life.Most of the informants identified lack of clarity in therequirements of the assignments as being problematic. They perceivedthat it was difficult to achieve high grades when the expectations forthe assignments were confusing or when the assignments appeared to begraded on criteria that were not explicit.I: There was a lot of vagueness in what they asked for in ourpapers, and you found yourself asking, "Considering the paperitself is a difficult endeavor, couldn't we at least know what isexpected?" That vagueness and the unknown adds more stress to it.You could flunk on the basis of you haven't met the terms of theagreement because you weren't agreeing on the same thing.I: I don't think that you have to be spoonfed but, at the sametime, there were parts that I didn't do on the assignment becauseI didn't know that it was expected of us. We got the assignmentback, and it said, "You were supposed to do this," and you lookedat the assignment, and nowhere does it say that you're supposed todo that. . . . I thought the expectations were unclear and, like,I don't know why they did that. I don't know what they weretrying to prove by doing that. It was just so frustrating . . .it's like why are they doing things this way? I've already gotenough things going on. I've already got enough stress.I: I would have expected that there would have been moredirection as to what this assignment is all about, you know,rather than leaving it all to your interpretation and then saying67if your interpretation was right or not right according to themark that you got. Like why set somebody up for failure? Why notstate, "Here are some true guidelines," and just like give alittle more clarity to the process?As well as unclear expectations, some of the informants statedthat achieving desired grades was an elusive goal because some studentswere in an unfair, advantageous position.I: It sort of bothered me that so many people got extensions ontheir papers. . . . some people presented and then handed in theirpaper, and other people handed in their paper and then presented.. . . It just seemed a little bit--not unfair, but it just seemedlike you almost got rewarded for handing your paper in late.I: Sometimes, there are discrepancies that aren't fair. . . .When you chose a particular topic, the workload isn't alwaysequal. I don't want to sound like they didn't work as hardbecause they obviously did, but the workload was different becausethe topics are different. I don't think there was any allowancefor that difference.Some of the informants perceived that there were other factorsoperating which made achieving desirable grades not totally within thecontrol of the informants. Such factors might include the whim of theteacher or perceived administrative requirements.I: It may be great work, but . . . if I like it, I'll give you an"A", and if I don't like it, you won't get an "A".I: There's this "A" thing where some people have to get "A's" tostay in the program. That just blew me away. I think it's aterrible pressure to put on people that they have to get these"A's", but it looks like they give them to them. Someone who issitting at a 78 that needs an "A" to stay, they give them the twomarks, and that's not fair to the person who got 79 and probablydeserved the "A".I: I think that the end result of every course is a few high68"A's", a few low "A's", a heck of a lot just below an "A", and afew below that. And if there's some assignment where everybodydoes well . . . and the marks are really high, you will see themarks on the second assignment be a wider range to balance themout. You don't always have control. It's hidden. I saw thathappen in maybe three different courses. There's something goingon here beyond our control. I remember saying to one prof thatthey don't bell the marks here, and she said, "We don't?"Some of the informants also thought that the workload was so heavythat it was difficult to find the time to devote to each assignment thatwould reflect their best effort. Consequently, achieving desired gradeswas more difficult.I: I have no idea how to get an "A" on an assignment. . . . Inundergrad, you did extra work. But you can't work more now. .I'm not even meeting the minimum with the time that's beenallotted for everything. So as far as doing extra to get that"A", I can not see where that time is going to come from. Causeif I'm already spending all my time doing homework and not gettingit all done, then I can't imagine getting an "A".I: I'm getting everything done. Not to the extent--it's not aswell-written--some of the things as I'd like them to be. Like thelast three school days, we've had three things due. And the firstthing due, I was happy with. It was well written. The next thingwas--it was okay, I could live with it, and the thing I'm actuallyhanding in today, I'm not terribly happy with, and it's justbecause there wasn't enough--there wasn't enough hours in the dayto do the amount of work on it that I wanted to do.And finally, some students perceived that the faculty in themaster's nursing program had inconsistent expectations in matters inwhich the expectations should be uniform among all faculty members.I: They all have different ideas. APA. I could scream. Everytime we handed in a paper, the same thing kept coming up at theend. It was such a stupid thing. The reference sheet--does itneed to be double-spaced or single-spaced. I mean, we hand one69in, get it back, this is wrong, it should have been single-spaced.Changed it for the next paper, get it back, this is wrong, itshould have been double-spaced. And this went back and forth forfour or five times, and we all got sick of this and said, "Wouldyou people please all get together and decide what you wantbecause you don't all want the same thing."I: There was very definitely for me, with all the teacherswithout exception, a very definite prescribed way of writing anassignment. This was different from one instructor to another--their writing expectations, their style expectations, theircontent expectations. There were all really different.Meeting personal expectations.The second standard by which informants measured their achievementwas in relation to personal expectations. Informants had expectationsof the grades that they should be able to achieve usually based onprevious experiences as learners.I: I came in with very high marks from undergrad. . . . It's hardto adjust when you're used to getting 90's, and you start gettinglow 80's and high 70's. It was hard to see such a drop in marksinitially. . . . Anytime I didn't get 80, I was disappointed. . .. I was never afraid of failing. I just wanted to get my minimum.I had the cutoff of 80.I: In telling myself the lowest mark that I could live with, Isort of set myself up for a fall, and I won't do that again. . . .I was an "A" student, and I can see that, if I'm going to be a "B"student, I can sort of live with it. It's not going to be an easytransition to go down, but I think I'll be able to do it.Comparing one's self with others.The third standard by which the informants measured theirachievement was the group norm. Informants either discretely askedother selected students or heard, through the grapevine, what marksother students had received on a given assignment or how other students70were progressing with papers or with their thesis.I: You ask yourself, "Where do I fit in? Am I doing okay?" Youhave to use your peers to get a sense of that. We do the work andlearn, but you want to know how you're doing. You have to feellike you're normal.I: It's a comparative process--comparing where you are to others.. . . You're looking at where you are at--where you are workwisein terms of getting it done and in comparison to marks to see ifyou're in the same ballpark. You're an independent student butwithin a student body. There's a population of you. .	 . a bodyof students who are working toward the same goal, and to measurehow you're doing, it's almost like normative referencing--makingsure that you're where you think you should be. You reinforceyour own self-concept by comparing yourself to others in theclass. . . . I had one close friend, and our marks were prettysimilar. I thought that if our marks were about the same, then Idid fine. If there was a wide discrepancy, then I would questionwhat happened.Some informants gained comfort in this process of comparison.I: Once I realized that the marks weren't in the 90's . . . thenI felt comfortable. . . . They were about 10% less and that's thenorm. . . . That was about where my marks were, so I realized thatI was still doing okay.I: This process of comparing has been reassuring for the mostpart. It's important for me to know that I'm measuring up to thepeople that I'm going to have to compete with--not in a negativesense--in life, jobs, and things like that. That I can do it.Not that I'm on top, but that I'm in the ballpark.Other informants found this process oppressive. There was adiscomforting sense of pressure to do as well or better than others.I: You want to know that you're not doing worse than everyone.But when you ask everybody what they got, and they all did betterthan you. . . . Somebody has to make the lowest marks, and I don'tknow if I am; I haven't asked enough people. But it can be71depressing.I: I get tired of talking about my thesis. "When are you goingto graduate? Are you going to be done by March?" I think we puta lot of pressure on each other. "How far are you? Have you gonethrough Ethics yet?" Sometimes, it seems to be the one and onlytopic of conversation.Some informants also perceived that some fellow students comparedtheir marks or other measures of achievement with their peers for thepurpose of promoting their own self-esteem at the expense of others. Asense of competition was created rather than a sense of collaboration.I: The rumor mill has it that our full-time class has been verycompetitive, and I have to agree with that. I think that, attimes, it was very competitive with marks--at least among thefull-times. Like, "What'd you get? What'd you get?"I: Within the class, we have people who want to do the best andwant to know how everybody else is doing, so they can know thatthey're doing better than everybody else. That's competition, andthat's very real in our class.Interestingly, of the three class years from which the informants wereselected, only informants from one class year experienced a sense ofdestructive competition. The informants from the other two class yearsfound competition to be minimal.I: I don't think my class was competitive because we needed eachother. We were such a small group that we needed the support. Weweren't going to do anything to jeopardize that source of support.I: It wasn't that you got 90, and I got an 80, and I've got towork harder, and I'm not going to tell you "X" and "Y". That's noway of doing it, and we've come too far for that kind ofcraziness, I think. . . . It's not conducive to one's person butcertainly not conducive to teamwork and helping one another.72Thus, having to measure up to evaluative standards put a differentcomplexion on the process of learning. The informants experienced thepressure of trying to meet the evaluative standards of the faculty,their own standards, and the standards established by their fellowstudents. In many instances, the informants discovered that it was aformidable task to meet these standards. Moveover, some of theinformants experienced a destructive kind of competition that arose fromthe demands of trying to measure up.Changes Over TimeMost of the informants who had completed the first year of theprogram experienced positive changes in the work. Not only was theworkload lighter, but they perceived that it fulfilled more of theirpersonal learning needs. The informants were able to direct more timeand energy into studies related to their chosen functional stream.Moreover, the thesis, on which they were working, originated from apersonal interest in specific research questions. Consequently, theinformants felt that they had more control over their learningexperiences and opportunity for personal creativity.I: I think there's less time pressure. Maybe the same amount ofstress as last year but less time pressure. Last year, we onlyhad two days to think about this stress and hand it in and on tothe next one.I: In second year, workload was less in terms of pumping outpapers and that sort of thing. You're not pulled in a hundreddifferent directions. . . . It went to a different level. Morecreative, perhaps. . . . In first year, they say, "Here are therungs to your ladder. You're going to have to put on the sides,but here are the rungs, and here's how they fit together." Insecond year, they say, "Now you can put on your own sides and73place that ladder wherever you want it."Even though there was a decrease in the quantity of work and thepace at which work had to be generated, the second year of the programwas characterized by the unrelenting tension of doing research andcompleting a thesis. The informants perceived that, although the thesisprocess was a valuable, and in many ways, satisfying learningexperience, there were obstacles, and the informants did not always feelthat they were in control of the process.I: The proposal goes back and forth, back and forth. What hasbeen deleted in one meeting gets reintroduced in the proposal twoor three meetings later. It's extremely discomforting. . . . Ifelt fear. I was afraid that I wasn't going to be able to dothis. I was afraid that I was not going to meet my own personalagenda to get out of here and get to work.I: At times, it's a picky process of writing, and somethingpasses one reading, and they find fault with it, and it's more onstyle. I think it has to be scholarly and linked, but everyonewrites a bit differently. I think it should still look like yourwriting when you're done and not theirs (laugh). At times, Ithink we're rewriting sentences to rewrite sentences.The most common characteristic of the thesis was that it was anomnipresent force in the informants' psychological environment.I: This year, I feel like I have this--I wouldn't say black cloudhanging over my head. I have a cumulus cloud hanging over myhead--fluffy and white--and that's my thesis--just sitting thereall the time. You don't know whether it's going to darken withrain and fall on you or whether the sun's going to come out. . .You know the cloud is going to move off eventually, but it'sthere. Last year, it seems that there were little black clouds,and every time you handed a paper in, a cloud went away. Youdon't have that this year. You're always under pressure this year.... Last year, it was more pressure-release, pressure-release. .74. . Now, it's always there. It's a process. It's got its ups anddowns--its sunshine and its rain--really gruelling at times,really rewarding at times. . . . You take one step at a time, andyou have these hurdles, and with each little hurdle, you have toreward yourself. It's a process. . . . You don't get a break. Idon't think you ever quit thinking about it.Most of the informants became more comfortable with trying tomeasure up. They realized that the evaluation of their work wouldprobably be within a specific range. However, they never took it forgranted that they would be able to maintain their level of achievement--there was always a sense of insecurity.I: I wanted to get 75 on my papers and stuff. Once I was getting75's for the most part, then I knew I was doing okay. . . . But Idon't know that I ever felt more relaxed about the marks.I: When I started getting papers back, I realized that I wasdoing okay, and I think more than anything, it made me feel that Ihadn't made the wrong decision to come to graduate school. It wassort of a tightrope that you walked because I never assumed that Iwould do that well again. . . . I never took for granted that Iwas going to do well on a paper.In summary, the work of being an MSN student was demanding both interms of trying to learn and trying to measure up. The informantsperceived that they were being asked to produce a great deal of work,that might or might not meet individual learning needs, within a shortperiod of time, and at a high level. Moreover, support and guidance,including feedback from the faculty, were perceived as often beingdeficient in promoting the process of learning. As if trying to learnwas not enough, there was also an evaluative component to the work ofbeing an MSN student. The informants experienced the pressure of75meeting the standards established by the faculty, their personalstandards of achievement, and the standards set by fellow students.Often, the informants had to lower their expectations of themselves, andsome of the informants suffered the effects of the unhealthy competitionthat existed in one of the classes. Over time, there were some changesin the characteristics of the work, but it continued to be demanding interms of both trying to learn and trying to measure up. However,despite the demands of the work of being an MSN student, all of theinformants perceived that they were learning knowledge and skills thatwould be useful in their future professional nursing roles. In the nextcomponent of experiencing the reality of being a master's nursingstudent, the nature of the informants' significant relationships will bedescribed.The Interdependence of Being an MSN StudentThe informants identified two groups who were the most influentialin shaping their experiences as master's nursing students. These werethe faculty in the master's nursing program and the informants' fellowstudents. These two groups were seen as being critical in relation tothe informants' professional and personal growth. Although a mutuallysupportive, interdependent relationship was sought with each group, theinformants did not always experience this type of relationship.Relating With the Faculty It would be unfair and not representative of the informants'accounts to characterize all of their experiences in relating with thefaculty in the master's nursing program as painful or negative. Manyexperiences contributed significantly to the informants' professional76and personal growth. These experiences are recounted throughout thefollowing construction of the informants' accounts.However, almost every informant had reservations about endorsingthe nature of the student-faculty relationship. This reservation maynot seem to be unusual in view of expected likes and dislikes that occurwithin two groups of individuals. However, the degree of personal painand negative emotion experienced by the informants was unusually intenseand enduring. The themes of, "conditional respect" and "unintentionalindifference," which reflect that personal pain and negative emotion,are explored here.Conditional respect.A sense of conditional respect was one feature of the relationshipbetween many of the informants and the faculty. The informantsperceived that mutual, unconditional respect was absent in theirrelationships with faculty.The informants felt unreserved respect for the faculty in terms ofthe knowledge and expertise that the faculty brought to nursing andnursing education.I: On the whole, I think I have a lot of respect for thetremendous amount of knowledge and expertise that they bring tonursing. I think that developed over time. Initially, I thinkthat you're only looking at how they teach or mark your papers.But now I can step back and say, "Yes, I do respect them."I: She makes you think, she leads a seminar, she sits back, andlets the group talk. she interjects, she paraphrases beyondbelief. She can . . . somebody in class says something, she getsthe essence of what they said in two lines and says it right backwhich makes everybody think, "Yeah, that's what she said" andthat's even at a higher level when she gave it back. . . . Likeyou always knew that she was listening to everything that wasbeing said. . . . Sitting back and watching her--most of the time,77you think, "Wow--boy, I hope I can do that someday."I: It's like a seminar setting. The professor is very open todialogue. The way she conducts the class is different from mostof the other professors. She relies on our input to conduct theclass. And she will guide us and keep us on track. She has us doa little sort of checkpoint--a little assessment in our own headsabout our experience with that particular topic and everyone ismade to feel that it's valid, that it's okay to be different.I: I have great respect for her because of her teaching abilityand she is just . . . she takes very abstract things and she makesthem very easy to understand.However, some of the informants had less respect for the facultyas teachers and expressed dissatisfaction with the faculty's ability tolead classes in a graduate level seminar format.I: I thought that class dealt too much with looking at concretethings as opposed to it being a seminar course, and shouldn't webe looking at a more conceptual or abstract level? Like whyregurgitate everything? Why not discuss it and make applicationsfrom it?I: I often didn't sense that the teacher was leading the class inthe way that she should be. It's like, do they know learningtheory? Do they know what their philosophy of teaching is? Dothey know what the course objectives are? Are they putting thatall together?I: A seminar group should be a blending process of informationthat they give us and the information that we bring from ourexperiences. If they have the group process abilities--which theyappear to lack--then this blending would occur. . . . Thisinstructor had a very traditional approach to instruction. Shestood up in front of the class, and she gave a lecture. Shedidn't encourage a whole lot of participation, and when she did,she didn't seem to have to ability to get it out of us--to get usto participate. So there was lots of times when people justdidn't speak, and it was a very uncomfortable situation.The informants expected differences of opinion and philosophical78positions to exist naturally in an academic setting. However, afundamental lack of respect between some faculty members could readilybe detected by the informants and was problematic in terms of theexample being set for professional working relationships.I: I couldn't believe how this prof won't work with that prof. .. . I've heard a lot about making sure that you find people foryour committee who are compatible. I know that it's allpolitical, and that occurs in any workplace but, I mean, somepeople can't stand each other, and you get caught in the middle ofthese people who are both trying to be in control and who don'twant to listen to each other or compromise.I: There's more than just a difference in opinion about things.There's something going on. I saw [two faculty members] in [agroup setting], and one of them was saying something, and theother one almost turned her back like, "What are you saying andwho really cares?"I: . . . obvious to me that there is conflict between variousmembers of the faculty. It's between individuals and not justbetween the individual's ideas. That's unfortunate, and I thinkthat students pick up on it very quickly. It's not very healthy.The credibility of both parties comes into question, and it's hardto see them as role models for how to work together.The informants were most distressed by their perception of thelack of respect shown toward them by the faculty. There were multipleproblems in relating with the faculty that led to this perception. Tobegin with, the informants perceived that the knowledge and expertisethat they had acquired from their professional practice and educationalexperiences was ignored or negated. In some instances, the facultymember appeared to deliberately discourage students from discussingclassroom topics in the context of their personal experiences.I: I couldn't believe that people at the graduate level--faculty79at the graduate level would treat me like I was some kind of kid.It's like I didn't have a history. It's like I hadn't doneanything before.I: I had one instructor, and I mentioned the role that I hadplayed in my last job and that you were really seen as a resourcein the community. And she said, "Well, in your case, it wasprobably an oddity." And it kind of detracted--it negated myexperience. Dismissed it.I: There doesn't seem to be a recognition in the school that youare a competent person before you come in.R: At the beginning of each course though, we would go around andintroduce ourselves and describe our background. They did ask usabout our background.I: They asked us, but they didn't hear. . . . We heard eachother, but I don't get the sense that the instructors heard. . . .It's like they went through a textbook, and it said, "Now when youstart a class, you do A, B, and C." And it was like they did A,check it off, they did B, check it off, they did C, check it off.And now, "Let's get on with what I have to do with this class."Many of the informants also perceived that they were not respected fortheir contributions in class, especially when they expressed an opinionthat differed from that of a faculty member. As one informant stated,"Your participation is expected but not valued."I: Why can't our thoughts be validated and given, "Oh, that's areally good point but," . . . It's almost like somebody is barkingat you and not respecting your thoughts. . . . I found that reallysad because school should be somewhere where you can learn, whereyour ideas can be expressed. But it's obvious that, sometimes,that's not what happens.I: Within three weeks of that course, people were shutting up,one by one. No one was challenging what was being said anymore.It was sad. No-one spoke up.R: Why did that happen?I: Because they kept being told, "No, you're not right. No,that's not how it is. This is how it is." There wasn't any kindof "That's an interesting point; why don't you explain it to me?"It was, "That may be what you believe now, but this is what you'regoing to believe from now on." . . . Remember [two fellowstudents] at first? Wind and fire in them. And in the end,80people shut up. The spirit was gone. I'll never forget.Some of the informants perceived that the failure on the part of somefaculty members to make use of the knowledge that the informants broughtfrom their previous educational and work experiences contributed to lessproductive learning experiences in the classroom.I: The teacher would sit there and read her notes and never takeher eyes off the paper. The assumption was made that we knewnothing about the topic, and the purpose of the class was to teachus. That people had some pertinent previous knowledge andexperience, was never acknowledged. And this was supposed to be aseminar group for goodness sakes. It was just so demoralizing.R: . . . could you characterize that as a lack of mutual respect?I: Yes. I guess I find that really difficult.R: Is that too strong?I: It's not really. It's just that it's a really sad statement.. . . There should be more respect, and I'm thinking, respect forstudents--if things were more personal, and faculty knew thestudents better--where they came from and what they're capable ofand what they can contribute, and if that was shared more. Insome classes when that happens, the learning that can take placefrom your fellow students is tremendous. There's so much there.Not all of the informants perceived the classroom interactions in anegative way. Some of the informants described a refreshing opennessand receptivity to diverse ideas. Further, some of the informantsoffered a different explanation for some fellow students' perceptionsthat their participation was expected but not valued.I: I like the group even though it's too big to be perfect. ButI do like the open discussion that people can say what they want--that they can be at total opposite ends and that's okay and that'srespected.I: I believe that we can still express our opinion even though81there is a right answer at hand. I don't think there's going tobe any punitive measures should our opinions differ greatly fromthe teachers at this point. . . . Right now, you're allowed to askquestions and say, "This isn't possible," or, "I can't believe youcan actually use this."I: I think that course was the best course in the program. Ithink it was structured to make you think. I think we had anexcellent group. Our group just seemed to build off--you know,thrive off each other--build off each other. We did thinking. Wethought about it out of class, in class. The teacher made usthink. She let us do our own thinking as a group.I: I find that that prof . . . I think there may have been methodto her madness. It seemed like she wasn't particularly receptiveto another opinion and didn't seem to like to be challenged. ButI think it was more, "Don't challenge me unless you can give methe details of it. If you can't back it up, don't challenge me."I think that she gave the wrath of God to everybody and, yet, Isaw people challenge her who could back themselves up, and thatwas fair game. She was delighted by the intellectual pursuit.But if you didn't have it, it was, "Don't bother me."I: [The professor] talks to us in a forum that I feel sherespects us as individuals with intelligence and she wants tochallenge us--not a challenge to trip us up--it's a challenge tomake us think and to become critical thinkers. I think she'strying to help us to learn.According to many informants, another way in which the facultydemonstrated their lack of respect for the opinion of students was thefaculty's lack of response to teacher and course evaluations completedby the students. The informants described instances in which teachingbehaviors or course content had not been altered despite long-standingcritical feedback from students.I: I filled out the evaluation forms thinking, "This isn't reallygoing to make a lot of difference." Even if we all say the samething, I can't see a lot changing in some of these courses. I'vetalked to people who have said the same thing for years, andthey've made the same comments, and nothing's changed. So youwonder if it's worth filling them out. They know what they're82going to do, and they're going to do this, and that's that.There were several instances in which the faculty did respond to thestudents' suggestions about curriculum changes. These changes did notgo unnoticed by the informants.I: I see that [the professor] has made some changes in the way[that course] is taught. I think she was actually listening to usand it's nice to know that someone is listening.I: I don't think that they should change things just becausewe're expressing a concern or complaint--not that we don't havesome legitimate concerns and complaints. But it's nice to seethat some people are trying to make things better. Like I knowthat [the professor] tried to get [a situation] changed, and itdidn't work out. But at least she responded to our suggestion andtried.Some informants also perceived that respect was too dependent on thegrades achieved by students. They stated that students who were able toachieve the higher grades were treated differently.I: They look at you and say, "Look at all the stupid people whohave been riding 60," and people treat you differently--in adifferent light. . . . You can tell who got what marks by the waythe teacher addresses people and whether they're regarded ordisregarded.I: They favor the people with the highest marks. . . . Theprofessors get more excited when they're talking to those peoplein class. The people who are making the best marks are usuallythe most articulate and have the broadest knowledge base, sothey're the ones who are saying the creative things in class. Sothe professors are lighting up in response to them and giving themthe positive feedback. And it just perpetuates itself.I: Like this person is not going to respect me unless I make an"A" on this, and I felt that very strongly with the faculty--thenursing faculty. We know that they're going to respect us if wedo well and get good marks. . . . It doesn't matter if they don't83like us, but they have to learn to accept us for who we are andwhere we're at. . . . like the professor that I had in [a non-nursing graduate level course]. He really wanted us to all dowell at our own level. He was never judgmental. Like he didn'tseem to convey, "Well, she's not an "A" student." He acceptedwhere I was at and was interested in me doing the best that Icould. . . . I never got that sense of empathy from the nursingprofs--that extra sense of empathy.I: .	 . one person, in particular, in the group who set thestandard for the professor, and nobody else could live up to thisstandard that this person had set. And in a way, the rest of uswere all looked down upon and just were not up to snuff.The most compelling of the informants' narratives reflected situationsin which the inequality of the student-faculty relationship was evident.One informant stated that, at times, the faculty abused their positionof authority--"In many situations, they pulled rank on us."I: I went through one experience with one teacher in class whereshe literally yelled at me. You know, I decided that she washaving a hypoglycemic reaction because there was no other way toexplain it. I mean, if I took it personally, I would haveshrivelled up and died. I mean, she literally yelled and screamedat me, and I don't think that was necessary. Maybe I caught herat a bad moment, but she let me have it. I don't think thatshould happen to any student, under any circumstances. Ever!I: I was pulled into the office and told, "That's not theappropriate dress." That made me feel like a teenager; that Iwasn't bright enough to know how to dress before I went outside myroom. I've always prided myself in the way that I look. I'm not ahigh-fashion person, but I like to think that I'm dressedappropriately wherever I go. If I want to dress the way that Idress, that's my responsibility. The image I project is my own.I: There was some mix-up in the communication. Well, theprofessor came in the next day, and she was furious. She was justfurious at us and made us feel like school kids. I certainlyphoned her afterwards and apologized to her because I felt that,yes, we had inconvenienced her. But on the other hand, we didn'tneed to be treated like school kids. She basically took away ourdecision-making about whether we would have a tutorial or notbecause we were going to meet for every tutorial from here on in.You had to show up.84I: .	 . you know, to go into somebody's office and they'refiling--they pull out their nail file while you're talking tothem. Or they don't bother to turn their head when you're leavingto say, "Good-bye." It's kind of a little slap in the face whenthey can't be bothered to turn their head to say, "Good-bye," orthey're still flipping through their papers. I mean, you are aperson in that office--regardless of whether you are a student oryou are their superior, you are a person.Unintentional indifference.Some of the most painful experiences, which the informantsrecounted, were in relation to the indifference that they sensed fromthe faculty. They perceived that there was a general lack of caringabout them as unique individuals. The informants acknowledged theacademic community imposed multiple demands on the faculty's time andenergy, but as one informant said, "Most of them, I feel like I'm takingup their time because they're so busy."I: We did hear that there's a hundred and sixty people in thisprogram. That's a lot for faculty, but that's a problem that hasto be addressed by administration. And if it's a detriment to thestudents and to the faculty, they why is it happening? I thinkthat at the master's level, there should be time for each student.I: They're not rewarded for doing a good job teaching. They'rerewarded for their research and their publications, and theyreward each other for that. People who do the research and havethe publications are the ones who have the status. They don't getrewarded for teaching or being with students.Although the informants acknowledged that the indifferencedemonstrated by the faculty was most likely unintentional, the pain thatthe informants experienced could not be denied. Many informants feltthat the faculty made little effort to know them as individuals and that85they were merely faces in the crowd.I: We're talking about a two year relationship. I don't thinkthat you can spend that kind of time with people and not developrelationships; somehow, that's not happening here.I: She never once acknowledged anybody by their name in class thewhole semester. . . . She did not do that all semester. She knewour names. . . . And I thought, "Why don't you acknowledge us byour names in class?" I found that really disturbing. I don'tknow, but it really ate at me. . . . It just really bothered me.I: . . . caring, I find, is when the teacher is supportive,treats you with . . . trust, treats you with respect and dignity,and values who you are, values your past experience, values yourknowledge. And sort of cares about you in a broader contextbeyond the nursing role, the student role. And I would say thatthey care to some degree, but I didn't really feel that a lot ofthem got to know me to value me.As described previously, many of the informants perceived thattheir individual learning needs were not met. The informants perceivedthat a major reason for this deficiency was because the faculty did notmake any effort to know them as individuals and, therefore, were unawareof the informants' unique learning needs.I: There needs to be a sense of recognition of the individual . .. with different needs, different abilities. And I'm sure thatit's very difficult for an instructor, but in graduate educationwith small numbers, I think that this could be realized--knowingyou as an individual. We don't come to this with definedcommonalities among us. We couldn't be more diverse.I: We're at a graduate level. We have all identified why we'rehere, what we want to do with it. How can we go into a programthat's going to give us a kind of blanket education and expectthat we're going to be able to go out there and do it? I agreethat we need fundamental courses--everyone of us. But I thinkthat somewhere in there, there has to be more dialogue. There are20 or 30 students in a class, and if you don't have any dialogue,then there is no way that you're going to know the individual86learning needs of the students, let alone address them.Many of the informants were disturbed by their perception that theonly feedback that they received was in the form of marks or writtencomments on assignments. Giving verbal feedback that would support theinformants through the learning process seldom occurred, yet it wasclearly a significant and meaningful validation to the informants whenthe faculty took the time and made the effort to do this.I: I went to talk to [a faculty member] about the possibility ofbeing on my thesis committee, and she said, "Well, you're a strongstudent," and I thought, "I am?" I remember thinking, "Oh,really?" I was really surprised. I remember that making my wholeweekend to know that she thought that. I think that was one ofthe few times that I had ever gotten verbal feedback before.I: I get good feedback when it's solicited.solicited, then it's not provided. It has toAnd I don't know that there's really anythingIt's just that, every now and then, it's niceyou positive feedback when it's unsolicited.If it's notcome from me first.wrong with that.to have someone giveMany of the informants described the faculty's lack of sensitivityto the rigors of student life and to the sense of vulnerability that theinformants experienced in the student role. When some of the facultydid demonstrate this kind of sensitivity, the informants perceived that," someone out there is aware of what we're going through and canunderstand that it's not easy," or "that professor could reallyunderstand the student condition and the frustration and uncertainty andanxiety." However, many of the informants perceived that either thefaculty were ignorant of the students' situation, or the faculty were87aware and didn't care.I: There is no sensitivity or . . . even a realization by ourprofessors that we are going through this tremendous, unsettlingprocess when we become a graduate student. And so there's nonurturing going on; you're out there in the cold.I: We had three papers due this week, and we were supposed tohave done some reading for class. There was just no way. And wesort of had mentioned this to her, and half way through the class,she said, "You people--you're just not giving me any feedback. Ineed you people to start talking to me." And we were all justdrained, and it was sort of, "We need you to understand just alittle bit more than that. You have to understand that we're justa bit tired." I wanted her to be a little more understanding.I: I don't remember having a conversation with anybody on facultyabout how I'm doing with school. No one said, "It's okay ifyou're feeling this way, people usually do," or, "The first partis really tough, but it gets better." . . . They don't try toanticipate what students are going through or what the peak timesare for high stress. I'm sure that they're aware because theywere students at one point. . . . Where is the compassion?Many of the informants also perceived that some of the faculty didnot care enough about them as learners to put their best effort intofulfilling their teaching responsibilities. It was not that the facultywere deliberately intent on making the learning process difficult andunpleasant; it was perhaps more that the faculty were not going to takepains to facilitate the learning process. In the following narratives,it is evident that although faculty members may have perceived thattheir actions would have a beneficial effect, the informants perceivedthese actions or lack of action as inhibiting the learning process.I: A lot of the other instructors, I get the impression that . .. they feel that students are going to have to go to hell and backbefore they get their master's. Or they're thinking tothemselves, "When I went to graduate school, we had 16,00088courses, and I had to go to school barefoot through the snow, soyou're going to have to too."I: I mean, to give a reading list from 1985, I don't feel that'sgood enough. And not that I want to be spoonfed; I don't thinkthat you can go far with that attitude. But I think that readinglists are important. And I know that it's kind of like go outthere and do it yourself. We're all doing that anyway, so I don'tthink that it's much of a problem if we got a decent reading list.I: I like the idea that some teachers had the readings ready forus. I don't think that at the master's level that there'sanything to be gained by making us look for them in the library.R: Maybe to teach us to be independent?I: It's not teaching us to be independent. It's just teaching usthat you're a low-life student. . . . We're going to beindependent enough--doing our thesis, doing lit reviews for ourpapers over and above our readings. There's no way you can gothrough this without knowing how to use the library. . . . I thinkthat, if it's important enough to read, and they have one in theirlittle drawer, they could arrange it so we could all have it. . .. The ones who had the readings ready because they had themthemselves and who share them with us are treating us like adults.The informants clearly respected those faculty members who went out oftheir way to enhance learning.I: I really like this professor. She's so flexible in helping usto get what we want out of the course. Like she goes out of herway. . . . We were all having some problems with writing and solike, she comes to class and she's got ten articles xeroxed foreach of us on writing skills. Some of it was kind of finickystuff like on the use of the comma, but she did go out of her wayfor us.I: I just found her very approachable and she always made timefor me even when she was really busy. If I was confused aboutsomething that had been brought up in class, and I had reread thematerial, I could go to her and say, "Look, I'm not sure about[this concept]," or "I'm a little confused about what [this]means." And she was very good at taking time to explain it and togive you references that would help.The following narratives address the distance that most of the89informants perceived existed between themselves and the faculty. Theinformants perceived that there were no mechanisms established by thefaculty to create and maintain collegial relationships.I: I think there needs to be a little more informal dialoguebetween the faculty and the students. There seems to be a wall--almost a class distinction. And that's destructive and it'scounterproductive, and it doesn't foster positive workingrelationships. . . . It's a bit labour-intensive, but if theprofessors could have done just a really brief interview with eachstudent. Just a one-to-one interview to try to get to know them abit, their background, what they want to get out of the course. Ithink that would help to break the barrier that seems to be there.I: I would like sort of an informal--perhaps see something set upas an informal discussion thing-- say, three weeks into theprogram or something. "Okay, we're available, come and see us.We're going to be in this room at such and such a time and talkabout problems or issues that have come up. How is your courseload? Do things need to be adjusted? Is one assignmentconflicting with another? Are you finding this? Are you findingthat? Is there any input?"One informant's experience with a personal crisis is a sadcommentary on the distance that the informant perceived between herselfand the faculty.I: My mother had a heart attack when I was in first semester. Atthat point, I wanted to go home, but I felt that I couldn't gohome because I felt that I would lose the whole term. There wasreally no-one to go to with that sort of information. I feltthere would be no support for that kind of information. . . .Before I came to school, everyone talked to me about nurturing. Ididn't have any nurturing at the School of Nursing, and I thinkthat's a common experience.Some of the informants' most positive interactions with thefaculty occurred in situations in which the informants perceived that90they were able to relate to the faculty in a collegial way rather thanin a student-teacher mode. Although the following accounts describefaculty's members actions that may seem relatively minor, they clearlyhad a significant positive impact on the informants.I: I felt better about the professors who were a little bit lessstandoffish. It's small, but one of the professors, at the end ofher course, invited us over for coffee and dessert. And that wasa nice touch.I: Last year, when we were introducing ourselves twenty times, Iremember one teacher sharing something of herself and I reallyappreciated that. She told us [some personal things aboutherself] and that was really important at the time. Now it sticksout even more. I don't know why.I: I would be sitting there in her office and talking about anassignment or something. But we would sit there and talk aboutideas too. Like I had this idea about the model or nursing as aprofession. And we would sit there and talk about other stuffbesides just the assignment. And she was always so accepting andopen and listened to my ideas.I: Like [this professor] has a magnificent sense of humor andthat's not something that is generally well known. She's a gem.I feel like I can say anything to her. And like, we called her onFriday--out study group--and we were a bit off-the-wall and off-the-cuff in what we were saying. And she was wonderful on thephone. You know, kibuttzing around.The accounts of the informants' relationships with the master'snursing faculty demonstrate a wide diversity in their perceptions ofthese experiences. Clearly, there were numerous positive experiencesand many of the informants described instances of collegial and caringinteractions. However, the informants narratives also clearly reflecthow troubled most of them were about the distance in the relationshipbetween themselves and the faculty. This distance was understandable in91view of the informants' perception of the indifference shown toward themby faculty and the absence of mutual respect. The informants perceivedthat they were not valued as unique individuals, that they were nottreated as colleagues, and that they were not accepted as they were.Moreover, the informants felt that they could not always depend on thefaculty to have their best interests at heart. There were repeatedrequests for more dialogue with the faculty in order that moreeffective, collaborative relationships might be developed. One of theinformants described how the distance in the student-facultyrelationship persisted even up to the time of her graduation .I: When we graduated, there wasn't anything after we graduatedexcept what the MSN students had put together. As I understandit, even previous graduations, the faculty don't put on a tea oranything after the ceremony. . . . And I thought that was reallytelling.Relating With Other Students In contrast to the informants' experiences in relating with thefaculty, almost every informant described experiences in relating withfellow students in a positive way. A bond developed among the studentsbased initially on common needs and shared goals. From this arosemutual respect and trust and, ultimately, a sense of interdependence.Doing group work: a matter of trust and respect.Group work played an instrumental role in the development of anawareness of mutual dependence and a sense of community among theinformants. Initially, many of the informants experienced a certainamount of trepidation in engaging in this group work. As individuals92who were accustomed to achieving on their own or being in control, theynow were forced to trust others and to respect the opinions of others inorder that a common goal might be achieved. Despite the fact that therewere some painful moments, most of the informants perceived that theyhad learned a great deal both personally and professionally.I: It shook me. Like I don't know that I like to have control,but it was like, "Let me be the editor, let me have one read ofthis before we hand it in." But when I did the second paper, Ididn't have that need. I basically left it to another person inthe group. I decided that I'd gotten to know that person. I knewthat person would do a good job. I guess it's a sense of trustwith a peer that I knew that I didn't need that sort of control.I: Three people have different writing styles, three differentways of thinking about things. It was sort of painful in thebeginning, but I noticed about halfway through the paper, we werefeeling a little bit more at ease. .	 . You had to get used tothe process and try and feel comfortable that, sometimes, yourideas are not going to be included or, sometimes, you may havebeen working on something for ten hours, and you're still not at aconsensus. . . . I've learned that if I really believe insomething strongly, try and hold on to it and rationalize throughwhy I feel that way. And back myself up. And I've learned tochallenge the other two members.I: I had a wonderful group to work with, and not that we agreedabout everything, not that we had the same ideas, but that we justworked really, really well together. We listened to each other,and we were supportive of each other. We were able to get thetask done, and we could rely on each other to have done the workthat we were supposed to have done and stuff like that.Not every experience with group work was positive. In fact, forseveral of the informants, it resulted in a threat to their self-esteem.In these instances, it was clear that trust and respect did not existeven though the group was able to achieve on an academic level.I: I wasn't validated. It wasn't, "I know what you mean, but I93don't think that's important here." It wasn't even that.Usually, I was just ignored. My comments were ignored. I feltlike I wasn't even there. It made me start doubting myself. . . .I felt like they thought that I was stupid, and I wasn't doing agood job, and why was I in the group?I: I gained confidence, but I also got a few scars during theprocess. One person in the group--it's not that she says, "Well,that's interesting" and respects it. . . . I was gettingfrustrated because she couldn't appreciate my perspective on somethings. It was obvious that it had to be her way or no way.An exclusive fellowship.The most significant features of the relationship that theinformants experienced with their fellow students were a sense ofempathy and a sense of caring. They recognized each other'svulnerability and could identify with each other's joy and anguish.Most of the informants identified the support that they shared withtheir fellow students as the most positive aspect of their experience asmaster's nursing students.I: People are very supportive with each other. We all seem to begoing through the same thing, and everyone's always asking me howI'm doing, and I'm always asking other people how they're doing. .. . People really do care.I: Without the other students, I don't think that I ever wouldhave survived the first term. . . . We were a real needy group. ..	 We boosted each other up through telephone conversations andlunch and just talking about our frustrations and things that hadworked for different people. And I found that very helpful.I: I think the relationships that I've developed with my fellowstudents have really contributed to me, as a person, becausethey're reassuring you that you're okay--that you're anintelligent person, that you're worth listening to, that you maynot always be right, but that's okay.94The relationships that the informants had with their fellowstudents were based on a shared language and shared experiences.Therefore it was difficult for the informants to find the same level ofempathy and understanding from even family and friends. Being amaster's nursing student resulted in entrance into an exclusivefellowship.I: You can't discuss it with the general population or yourboyfriend or your husband because they don't understand thelanguage.I: I was trying to tell this person that I used to work withabout what it's like here, and it was hard. I kept using people'snames, and she had no idea who they were. And I would talk aboutdoing some assignment, and she just couldn't appreciate how hardit was. . . . I mean, I think she could understand on some level,but it wasn't like talking to someone who's been through it.The informants described sharing their experiences with theirfellow students to validate perceptions, to justify reactions, or tovent feelings. The trust that characterized the relationships that theinformants had with their fellow students is apparent.I: There are other people in the class that I trust enough and Ifeel comfortable enough with to sit down and say, "Oh, I didn'tenjoy today's class," or "That really bugged me," and I know thatthey would give me some good feedback on that.I: I asked one of my classmates after class. I said, "Do youthink I was getting too heated in class? What did you think of mypoint?" And they said, "No, no, I think your point was good." . .. I think that the people that I trust as a support, they wouldtell me the truth.I: I complain. For me, that's therapy--if I can sit down and getit off my chest with a group of people that I trust. We just tear[the faculty members] apart. We talk about her hair, the moles on95her face. Did you see what she wore today? Not say a positivething if our lives depended on it.Many of the informants spoke about the significance of therelationship between first and second year students. The first yearstudents were able to turn to students who had already gone through theexperience for advice and support. In turn, the second year studentsexperienced an altruistic sense of satisfaction from providing thatsupport and sharing what they had learned.I: It's been a real value to get to talk to people in second yearto see that they've survived--to see that they still have a senseof humor. They have a life and all those things.I: I think we were in awe in October and November about how calmyou guys were. . . . Most people would take the time to beavailable, and the buddy system was available . . . just to talkto someone about what your experience was, and that was reallyhelpful. All of you were really good at empathizing . . . givingadvice and reassurance. There was a lot of camaraderie.I: Second year's relationship with first year is big . . . beinga [buddy] or talking to them in grad lounge. You become veryimportant to them. By you sharing and trying to help them, itmakes you feel good, and it makes it a more positive experience.You put your arm around them and say, "How's it going? This is arough week." It made me feel better about myself and the wholeprocess if I could help someone else.The informants perceived that they had predominately positiverelationships with their fellow students. In doing group work, theinformants usually experienced a sense of respect and trust as well aslearning to work with each other toward a common goal. Moreover, theinformants depended on each other for support and caring. In sharingtheir joyful and painful experiences, a lasting bond was created. A96sense of instinctive empathy existed because the informants sharedexperiences that would not readily be understood by persons who had notexperienced the reality of being an MSN student.Changes Over TimeAs the informants progressed through the program, there were somechanges in the relationships with the faculty and with fellow students.Relationships with faculty tended to become more positive, and thosewith fellow students continued to be positive, but a more selectivesupport network was developed.Most of the informants who were engaged in the thesis processperceived that they had a close, collaborative, and effectiverelationship with the faculty members who sat on their thesiscommittees. This was primarily because many of the informants wentthrough a deliberate process of selecting individuals for theircommittee whom they perceived as meeting both their personal needs andacademic learning needs.I: I need somebody who has a sense of humor. I don't really knowif that's my top priority, but I'll need somebody who will supportme. I can accept criticism, but I need to hear positives first.I need someone to give me reassurance because this is the firsttime I'm going to go through this. I'm not so concerned withfinding someone who knows the content, but I'll look for someonewho knows the method and someone who's available. I have to makesure they have time.I: I liked them and had respect for them and thought that I couldwork with them. I wanted them to be supportive of me through it.I knew that they would challenge me. I trusted that they wouldchallenge me to the level that I could achieve.For most of the informants, experiences with their thesis97committee were positive and satisfying.I:	 The committee was very supportive--extremely supportive inwhat I was trying to do and how I was trying to write. Theypushed things. They didn't push me necessarily, but they pushedthings so that when I was on a roll, they would be there, and theywould bend over backwards to be there with my writing. They keptto their word in terms of a time line. They were good with theirsuggestions--very good. I never had the sense that I had to do ittheir way. I felt that they were both accomplished people.That's one of the purposes of having a thesis committee--they'vegone through the process. Let's learn from them. I trusted them.I trusted them implicitly. I had the utmost faith in them.Relationships with faculty who were not on the informants' thesiscommittees also tended to be more positive because many informants feltmore confident about their progress through the program. Moreover, theywere usually more comfortable with faculty they had learned withpreviously because they were less intensely involved with them and hadestablished a reputation for being able to succeed in the program.I: I see a big difference this year and maybe because they knowyou, they know you've done okay to get to where you're at. Theyknow you've got your head screwed on right and you're on the righttrack and you're going to make it. . . . So they treat youdifferently. Now they're concentrating on a whole bunch of newpeople, and you're no longer in their psychological environment.You're out there in their hull somewhere. Therefore, they treatyou more human or something. . . . Maybe I treat them differentlytoo because they're no longer in my psychological environment.I: There were times when I thought, "This is ridiculous. We'rebeing treated as if we don't have a brain in our heads" kind ofthing in first year but not necessarily in second year. And Ithink that may, in part, have been my own feelings of insecurity.In the preceding narratives, it is interesting that the informants point98out that the faculty may not necessarily have changed but, rather, thatthere were other factors operating within the informants that changedtheir perceptions of the faculty. Nonetheless, it is noteworthy thatthe first informant refers to the faculty treating her in a more humanway because it reinforces the notion that respect from the faculty wasdependent on the informants' ability to demonstrate academic competence.The informants' relationships with their fellow students changedin that almost all of the informants developed their own smaller supportgroup that was selected from the class population. Althoughrelationships with the other class members remained friendly andsupportive, it was with the smaller support group that the informantstended to share more of their more intimate experiences and to share ingetting the work done. These smaller groups were usually formed by theend of the first semester of the program and, in some instances,resulted in distinct, readily recognizable cliques.I: You have your support system by second semester some time.These are the people that you really trust and want to spend timewith and who think the same as you. And those are the ones thatbecome your friends for life.I: I have the people that I talk to most--the ones that I turn towhen I'm stuck on a paper or bogged down or drowning. . . . Ifsomeone finds an article that might help someone else, then she'llshare it with the other person .... It's not that I wouldn't dothat with other people in the class, but you know more about whatyour closest friends are doing.To summarize, the relationships that the informants sought wereinterdependent ones that would be characterized by mutual respect,trust, sharing, and caring. In so many instances, the informants and99faculty did not get to know each other well enough for theserelationship qualities to develop. There was a certain distance betweenthe informants and the faculty that appeared to be based on a state oninequitable roles. Emotional tones of anger and regret were evident inthe informants' narratives. One informant, somewhat defiantly, stated,"They can demand authority and be authoritative, but it doesn't meanthat I have to respect them". Another informant said about theindifference in the student-faculty relationship, "If only they caredmore. I'll always wonder what could have been if they had cared more."Fortunately, more productive and positive working relationships tendedto develop between the informants and the faculty in the second year ofthe program. This change occurred partly because the informantscarefully selected faculty members to be on their thesis committees.However, as several informants noted, perceptions of the faculty changedover time as the informants gained more confidence in their abilities.This increased confidence apparently allowed the informants to perceivethe faculty in a less threatened and, perhaps, more objective manner.The relationships that the informants had with their peers wereinitially built on need. They needed their peers both to get the workdone and to have an emotionally supportive network. As time progressed,a bond, based on shared experiences, was maintained among the informantsand their fellow students even though each informant developed a smallersupportive network with whom they developed the most intimaterelationships. Thus, the relationships that the informants shared withtheir fellow students were ones that were characterized by connectionand a sense of community; they were the ones that were characterized by100respect, trust, sharing, and caring.In the next component of experiencing the reality of being an MSNstudent, the art of being an MSN student will be explored. Learning howto function as a master's nursing student was important in both gettingthe work done and relating to others.The Art of Being an MSN Student The art of being an MSN student refers to the knowledge, skills,and attitudes that would enable the informants to most effectively andsuccessfully negotiate the educational system and, ultimately, earntheir degrees. Thus, fulfilling the role of master's nursing studentmeant that the informants had to know and practice the behaviors thatwere the most productive in terms of getting the work done. Moreover,it meant that, for the most part, they had to know and practice thebehaviors that were most likely to be approved of, valued, and rewardedby their fellow students and the faculty.Getting the InformationBeginning the master's nursing program was often a chaotic andoverwhelming experience for the informants. It was crucial for theinformants to obtain information that would allow them to function mostcomfortably and effectively as master's nursing students. The followingexcerpt illustrates one informant's initial experiences in becoming amaster's nursing student . . .I: It was so confusing. . . . This person in the office was suchan absolute haven of knowledge and comfort. She knew all ournames the first day, and I'm thinking, ". . . I barely even knowmy name today" . . . just feeling so lost. . . . I don't know ifincompetent is the right word but just intimidated. . . . It was101overwhelming. I just had no idea of what was going on.One source of information was the faculty. In many instances,written or verbal information obtained from the faculty was beneficial.However, the informants also cited many instances in which the quantityor quality of the information was deficient in assisting the informantsto function capably in the master's student role.I: I think that we should have been told to have a computerbefore coming here. In the second term, I wrote those 13 papers,and I had to have them done a week ahead of time, so I could getthem to the typist. . . . Many times, when the paper had to be inon a certain day, I was at the typist at 7 o'clock in the morningto make the revisions. I never knew how long the paper was goingto be. It was really stressful.I: They should explain what this program is all about. . . .We're never given any direction with that. . . . It came down tothey wanted to make us think and to reason things through and tologically organize that in the context of each course. And at thetime, I had no idea. It wouldn't have been so anxiety-producingif I had known that back then.I: I didn't find we really got a lot of insight into thedifference between a thesis and a major paper. It seems likealmost a given that you're going to do a thesis. . . . And I thinkthe school lacks some organization on the thesis process. There'sone handout that sort of says, "Do this, do that," but there couldbe a lot more explained for you. . . . That it is a process withstepping stones and hoops you go through and, then, when you're init, you wouldn't feel like you were the only one having someholdup or problem. You wouldn't feel so isolated.Because the informants perceived that accurate and timelyinformation could not always be obtained from faculty, the informantsturned to other students. They were able to learn a great deal fromeach other by sharing information and experiences. Sometimes, the102informants learned by talking directly with other students. At othertimes, they acquired information "through the grapevine" or by "tappinginto the rumor mill"--that is, hearing information or about otherstudents' experiences secondhand.I: I think you learn a lot from just sitting in the grad loungeand talking to other people. You might be talking to people inyour class or someone from second year. . . . You hear thingsabout how certain professors want things or how to go aboutgetting a paper done or where you can find things.I: They were a tremendous resource. Somebody had found anarticle or found this out, and somebody knew something or someonehad done something similar. . . . Like a lot of us were juststarting out with computers, and there was a lot of sharing ofknowledge from one person to another.The information obtained from other students might or might not beaccurate, and the informants had to consider the source of theinformation. Inaccurate information could result in undermining thecredibility of faculty as well as undermining the self-confidence of theinformants.I: They said that second year was going to be a breeze (laugh).Well, let me tell you. . . . That was really destructive. Here'severybody saying, "It's a breeze. No problem." I completelypooped out, and that really compounded the destructiveness of it.I: A lot of the information from student to student isundermining, and you don't realize this. Someone has come outwith this impression about this teacher and, now, that's what'sspreading. That's not the impression that I got about the her,but that's what I heard. There's a tremendous rumor mill. . . .You try and stay away from the negative stuff, but you can caughtup in it when you're feeling down or you're feeling pressured.That type of thing can have a horrendous effect on people and itcan wash over the whole room and you can see it. . . . I thinkit's undermining. It's not intentional. They're trying toprotect their fellow students, but it works the opposite.103I: You have to take it with a grain of salt because it's onlytheir perception anyway. You don't learn that until you get toknow people and know where they're coming from. Like this personexaggerates all the time. There's a bit here, and this is what Imight need to know, but the rest is just attention-seeking orblown out of proportion or whatever. I sift out what ismeaningful for me and let the rest go.Interestingly, many of the experiences that the informants shared withtheir fellow students involved negative experiences. Positive andjoyful experiences tended to shared within the informants' smaller, moreintimate support group. The stories that one might hear in the gradlounge tended to be negative.I: It might be an unwritten underlying rule that we don't talkabout our good experiences. We don't hear a lot about them. Whenpeople did really great on a paper and got a really good mark--like, "I really felt good about that paper, and it really all cametogether for me," they don't say it. I guess you don't want tolook like a braggart. I mean, this course was an excellentexperience . . . the group paper . . . our group process,everything. It just went so well. And I know that wasn't thecase for the rest of the class. I think our group felt prettygood about it, and we felt good about the classroom experience aswell. . . . We talked ourselves about how good we felt. . . . Wedidn't share our good experience with the rest of the class.R: Would you share that kind of thing with first year students?I: Oh yes.R: But you would hesitate to with your peers?I: Uh-um. Maybe they had a different experience, and I don'twant to conflict with that. I would do it with next year's classthough.It was difficult to ignore or avoid listening to the negative orpainful experiences of other students. One informant said, "They'rehorror stories. It's like an accident on the side of the road. Youdon't want to look but you always do." Hearing the horror stories could104have both positive and negative consequences.I: In a way sometimes, it was a validation that it's not just me;other people are having difficulty too. Other times, it was, "Ohmy God. What am I doing in a craphole like this where there'ssuch a lack of respect and a lack of caring?" In that way, it wasa real downer.I: Sometimes, I'm glad that it wasn't me. I know that soundsselfish . . . but it's just that I'm finding this tough, and ifsomeone else is having a worse time, then I feel fortunate thatthings aren't that bad for me yet.It is significant that many of the "horror stories" were in relation tostudents difficulties with the thesis process. Although most of theinformants had positive relationships with their thesis committee, somewere not so fortunate. In the following narrative, one informantaccounts for the interest in stories about the thesis process and echoeswhat was said in a previous narrative about the attention paid to"horror stories" when one feels vulnerable and uncertain.I: I've heard lots of stories about how the thesis process hasbeen horrendous for some people. I think that some people'sproblems are their own fault because they don't conceptualize wellor can't write well. But I think that the way that some peoplehave been treated--they end up firing people from their committeebecause the committee has put them through hell. . . . It's sortof like the committee is toying with them or, maybe, the committeeis incompetent. Anyway, here we are in this situation where wehave no idea of what we're doing because we've never done itbefore, and this is the biggest thing that we've probably done inour lives--well, at least in terms of an academic, scholarly kindof thing. I mean, we think that every word that falls out oftheir mouth is a pearl, and it's devastating when we find out thatthey're not. . .	 So anything that I can find out about what notto do . . .105Finding Their Wav AroundThe informants also had to become familiar with the physicallayout of the school of nursing and the university, and the location ofresources. Some had to refamiliarize themselves with the library systemand, in some cases, the informants had to become familiar with a newcity.You go down these hallways and you find out they're dead-ends and you feel like a rat in a maze. You can't find anythingand then they tell you to go to the office to talk to thesecretary and you can't find the office. . . . have to go and getkeys and you have to find key control, and that's over on thenorth side of the campus--or is the west? . . . You're gettingused to where things are at the university, and at the same time,you also have to find your way around the city--Just knowing thebus schedule and where a drug store is. . . . I think I spent thefirst month finding out what was where.I: You have to find clinical placement, but you don't know whatthe resources are or who the important contact people might be. .. . Not having been in the library for a while, I was amazed atthe machines--the computers that they have now.Sometimes, once the informants found the resources, they weredisappointed with them. Many of them found that it was often difficultand frustrating to try to obtain the written resources necessary forlearning in the library.I: The old WY's in Woodward need some work. It's a mess. It'sfalling apart. It's not nursing's fault, but the WY's are a mess.I: When I go to the library, I photocopy (laugh). Or else Ispend hours searching for a book that isn't there. In fact, Ihave been quite disappointed with the library. . . . When I lookat some of the materials there and the lack of materials--likethey'll have one or two copies for the size of the nursing106department. That is totally ridiculous. And some of the newereditions of books are not available at all. There won't be onecopy in there, and their reserve section is minute.There was also some disappointment with the classrooms which wereinadequate in providing the optimal environment for learning. Often,the classroom were too small to accommodate the number of students.I: It's supposed to be a seminar, but there's too many people tobe a really true seminar. And in one of the classes, there's somany people that people can't even sit around the table, and theyend up in the second row. I've ended up in the second row, andit's like you're not even in the room.Learning the Language Another aspect of the art of being a master's nursing student waslearning and using the language consistent with the MSN student role.The informants found themselves using words and phrases that had notbeen a natural part of their personal or professional lives. Usingcertain words and phrases that had a special or exclusive meaning to theinformants was a significant part of fitting in.I: I found that when you start off in a graduate program, it'salmost like talking a different language. I remember going toclass and not being able to contribute one word to theconversation and thinking that perhaps I was in way over my head.I: That came with the courses, didn't it? Like models andconcepts. We could probably use simpler words, but it's more funto use words like, "explicate, congruent." They really explainwell what I mean. . . . I didn't use them before, but I didn'tthink like that before either. . . . I think we take the languagefor granted now.I: You don't talk about the idea, you talk about the notion.Things are in your psychological environment or she's a positive107force or we've entered into a critical period. We don't state ourthoughts, we articulate them. . . . I wonder if we'll ever talknormal again.Deliberate AccommodationThere were unwritten rules about how to behave as a master'snursing student. Certain kinds of behavior were more likely to beapproved of, valued, or rewarded by both faculty and peers. Learningthese behaviors involved listening and watching carefully.I: You develop very good listening skills because a lot of theinformation is there if you listen to all the comments.I: You have to play the system. It doesn't take long to find outthat, if you want to make it, you have to be aware of the signals.Playing by the rules.Playing by the rules was an important part of creating andmaintaining the right image and not drawing negative attention fromeither faculty or fellow student. The following transcript excerptsillustrate some of these rules . .I: I probably censor what I say in class because I can be prettyoff-the-wall at times . . . class clown and all that. Well, itdoesn't seem to be something that most people want to hear in theclass. . . . I worry about the way I dress because everybody is sowell-dressed--master's level--there's a lot less jeans around.I: I'm actually sitting back and listening to people andformulating my ideas and opinions from a distance, instead ofjumping in, which is a new thing for me. I'm really weighing whatI say because you can't just speak--it must be critical andintelligent.I: In class, you really want to pay attention. That's realimportant so you don't repeat what somebody has already said.108There's nothing worse than being redundant. But really try andadd to the discussion as much as you can and, maybe, even askquestions out loud.I: Be on time for classes. Go to class (laugh). Everybody goesto class. You don't miss class. If you're sick, phone in.With respect to fellow students specifically, playing by the ruleshelped the informants to fit in so that they could take advantage of thesupport that the student group offered. Moreover, the image projectedby all the students was an important consideration when the informantsdeveloped their more select and intimate support group.I: You listen to the horror stories, and you're horrified back,even if you don't feel that way. You listen and go along . . .I: You can be different but not too different. . . . It's okay tobe yourself, but you want to be normal at the same time. Youdon't want to be on the outside looking in.I: The first term establishes your reputation, and the ones thatyou choose after that are the ones that you get to know morepersonally. . . . The way that I projected myself . . . in firstyear has never changed. And the ones that I thought were off-the-wall in first term are still off-the-wall. . . . First impressionsare long lasting in the student body. I made sure I foundpositive people to hang around with. We call all bitch, but thebottom line is that we're all positive people.One behavior that guaranteed a negative reaction from fellowstudents was "brown-nosing." The informants looked down on behaviorthat was intended to develop a special and advantageous relationshipwith the faculty. This might involve flattery, fake hero-worship, orobvious obsequious behavior.I: I don't know how they can do it. I mean, they're almost109bowing and scraping and being so nice and agreeable and sweet.Like you know that they're just such manipulative fakes.I: Being a brown-noser will not win you a lot of brownie points.It might with the professor but not among your fellow students. .. . There's a line. If you cross that line, you're brown-nosing.. . . If you go and see the prof every five minutes, then I sortof question what's happening.I: It's their body language in class--the way they sit, the waythey look like they brown-nose the prof, and the minute she turnsher back, they're rolling their eyes. That bugs me.A second behavior that was frowned upon was being obviously competitive.I: Every time she asked a question, it was geared toward what shewanted to know about an assignment. She never asked a questionother than that, and that was competitiveness. . . . I always gotthe feeling that it didn't matter if she was learning anything, itwas the assignments. Get them done and tell everyone what you got. . . . really oppressive and not respectful of people.I: She had to make sure that everybody knew what her marks were.And she would ask you what you got, and then pretend that she wasso happy for you. She was just happy because she beat you. . . .I never got the sense that she wanted to share anything. . . . Shewas just so . . actually, it was kind of sad.Playing the game.All of the informants described a constellation of behaviors thatthey referred to as, "playing the game." These behaviors were based oncalculated decisions and directed toward creating and maintaining themost advantageous position possible in relating with the faculty. Thisposition was one in which conflict could be avoided with facultymembers, and the informants' behavior would be rewarded. As oneinformant stated, "You have to find out what they want and give it tothem." Most of the informants believed that playing the game was a110natural phenomenon consistent with fulfilling the student role. Forsome informants, the purpose of playing the game was to "get through theprogram." For others, it was a way of getting the highest grades.I: I play the game, but I think that's indigenous to the studentrole. Whether we need to play the game or not, I'm not in aposition to test the professor. She says, "Don't. That's wrong."I think it would be stupid to pursue the topic in light of thehistory of the course.I: I think everyone does it to a certain degree. . . . I don'tthink I'm a total game-player, but I'm not so stupid that I'mgoing to jeopardize my degree. I'm going to be true to myself,but there are times that I will play the game. If there's cuesbeing given out, and you choose to ignore them, then that'sstupidity.I: Certain people want certain things. . . . They all have theirown thing, so it's sort of jumping through the hoops for eachperson, and they all have different hoops that they want you todo, so it's finding out what their little niche is.I: I've started to learn to play the upper academic game. . . . Isquash my opinion a bit more than I used to. My whole linguisticperformance--I call it being a linguistic chameleon--is probablyaltered to meet the needs of the people that teach me--the way Italk, what I say, what I don't say. . . . I'm not pushing limitsas much as I used to. . . . I feel that I need to protect myself alittle bit more than I used to. . . . I don't know if that can beconsidered negative or positive because if you don't do it, you'renot going to get anywhere. You're selling out which, to me, isnegative. But at the same time, it's positive because it will getme to where I can do what I want to do.The informants perceived that playing by the rules and playing thegame were necessary because, ultimately, the faculty held the upperhand. They were the ones in a position of power, and they could rewardor punish the informants.I: They're the ones who have the power. Are they going to takethe power and oppress us? If we don't call in sick, are they111going to think that's horrible, or are they going to treat us likeadults?R: You're saying that if there wasn't so much inequality in thepower structure, we wouldn't be doing this as much?I: Precisely. We would know what our expectations are for ownbehavior, and we would feel that they were reasonable. We wouldlive by them.I: I guess it comes down to you don't have total control.They're going to pass you or fail you. They're going to give you79 or 80--a "B" or an "A".Changes Over TimeAs the informants progressed through the program, they became morefamiliar with the knowledge and more accomplished with the skills thatwere associated with the art of being a student. All of the informantsperceived that getting the information, finding their way around, andlearning the language were valued activities, regardless of whether theywere beginning or ending their experience as master's nursing students.In contrast, the informants, over time, varied in the extent to whichthey practiced the skills related to deliberate accommodation. Some ofthe informants perceived that deliberate accommodation made them feelmore in control of the MSN experience; others perceived that itcontributed to a sense of losing control. The changes in how informantsplayed by the rules and played the game will be discussed in the thirdsection of this chapter.When the informants entered the master's nursing program, it wasimportant for them to learn the art of being a master's nursing student;that is, to learn the knowledge and skills that would enable them tofulfill the role of a master's nursing student and to negotiate theacademic system. This meant that they needed to get useful information,112they had to learn their way around, and they had to learn the language.Moreover, they had to learn the skills involved in deliberateaccommodation in which they made decisions to behave in ways that wouldcreate the most functional relationships with faculty and with fellowstudents. By playing by the rules and playing the game, the informants,at least initially, perceived that they would be most likely to becomfortable and successful in completing the program.SummaryIt is clear that the reality of being a master's nursing studentwas a complex experience that, at the least, presented a tremendouschallenge to the informants. None of the informants anticipated thatdoing the work would be easy, but many of them were surprised by theextent to which their personal resources were stretched in trying tolearn and trying to measure up. Some of the informants suggested thatthey did not receive adequate support and guidance from the faculty inorder to accomplish the work of being an MSN student. This wasconfirmed in the discussion in which the informants describedrelationships with the faculty that were characterized by conditionalrespect and unintentional indifference. Many of the informantsconcluded that the faculty did not always facilitate the learningprocess and, in fact, often inhibited it. They repeatedly asked formore personal, more collegial, and more caring relationships with thefaculty. In contrast, the informants usually experienced positive,interdependent relationship with their fellow students, in which theysupported each other emotionally and also in getting the work done. Inresponse to the need to successfully accomplish the work of being a113master's nursing student and in order to develop and maintain the mostfunctional relationships with faculty and fellow students, theinformants learned the art of being an MSN student. This meant learningthe knowledge and skills consistent with the master's student role andpracticing the behaviors that would most likely be approved of, valued,and rewarded by faculty and fellow students. The activities in the artof being an MSN student were generally perceived as being useful and,sometimes, as vital in assisting the informants to negotiate their waythrough the master's nursing program efficiently and effectively.Responding to the ImpactThe Impact: Losing Control In response to the reality of being a master's nursing student,all of the informants experienced a feeling of disequilibrium--a senseof not being in control of their experience as master's nursingstudents. One informant said, "Being a student is not fun. It's verypainful--not knowing what I'm doing or where I'm going--feeling out ofcontrol." Most of the informants did not experience a loss of controlto this degree; there was a wide variation. But in many cases, thedisequilibrium that the informants experienced resulted in a loss ofcontrol that was intense or sustained or both.Shaking the Foundations All of the informants realized that the experience of being amaster's nursing student would change them in their professionalidentity and in their personal identity. This process of change wouldinvolve a loss of security consistent with a change in self—concept. Itwould mean questioning previously held beliefs, values, and assumptions.114As one informant said, "There's this whole sort of pulling the rug outfrom under you that affects every aspect of your life." Although mostof the informants anticipated change and loss, they were not preparedfor the depth to which their foundations would be shaken.Transition into the student role.In making the decision to enter into a master's nursing program,many of the informants experienced losses and changes. For most of theinformant, there was loss of status and credibility associated with aprior professional role, changes in financial and living circumstances,and disruptions in interpersonal relationships.I: I not only had to make the transition to being a student, butI also had moved to a different province, moved to a differentcity, left my family and friends. . . . It definitely shook mypersonal life. . . . I was in a new home, and I couldn't even comehome from school to a secure foundation. It was shaky because Ididn't even know all the ins and outs of where I was living.I: First year was a real adjustment. I had to cope with so manychanges and losses . . . I think it was almost a process ofgrieving for what you'd left behind when you came in. . . . Beingback in a full-time student situation, after not having been astudent for [more than 10 years], was very difficulty. I thinkyou lose your sense of meaning because you don't have a job. . . .There's really not much credibility for your decision-making here.I left a position where I had a lot of responsibility and a lot ofaccountability, and people really consulted me. When you're ingraduate school, that doesn't happen. . . . I basically walkedinto the school like a blank slate. I found that very difficult .. . it was sort like trying to establish a new identity in a newsituation. Basically, no-one knows you, no-one knows what you'vedone. I think more than anything, I found that really difficult.I felt extremely affected by it.Leaving behind a secure background as a respected professionalpractitioner was often more difficult when the faculty appeared to115ignore or assign little value to the knowledge and skills that theinformants had acquired in their educational and working experiences.It was devastating to many of the informants that there seemed to be solittle regard for what they had already been able to accomplish.I: The past experience of students isn't particularly valued inany way. It's, "Okay, you've done that. Put it on the shelf." Ithink that's where a lot of the lack of self-confidence comes in.The challenge to Professional beliefs. values. and assumptions.The informants recounted how the program challenged theirprofessional beliefs, values, and assumptions. With the exposure to newideas, new perspectives, and new knowledge, they underwent a process ofquestioning their previous notions about nursing. Although it was anexhilarating challenge, and they derived a great deal of satisfactionfrom the process, many of the informants found it somewhatdisconcerting.I: All of a sudden, the things that you believed and that you didare challenged. . . . You start breaking down bits and pieces, andyou sort of question everything and challenge everything. And Ithink that's part of the critical thinking process. . . . You wereforced to try and justify what it was that you believed aboutnursing and why. . . . And suddenly, it's very frightening, andthe strength that you drew from in being good or competent at whatyou had been doing is suddenly pulled out from under you. You'vedone it yourself. You've pulled the rug from under yourselfbecause you've done all this introspective thinking.I: . . . a lot of things that I thought I knew, and the way thatwe're sort of learning things or thinking about things, I had toreally question whether or not that's how I felt anymore. Forright now, I would say that it's more upsetting than it issoothing. A lot of my ideas are getting changed.I: I went in to learn what I didn't know which threw me into a116panic. "Oh my God, I'm back here to learn, and I'm finding outhow much I don't know. Even those things I thought I did know, Idon't know anymore." So the whole structure of my knowledge baseand even my clinical base started to get ripped away.The threat to self-esteem.Although the informants perceived the questioning of professionalbeliefs, values, and assumptions as challenging, they perceived thequestioning of personal beliefs and values as threatening. All of theinformants described experiences which lead them to question themselvesand, ultimately, resulted in a threat to the informants' self-esteem.The most profound impact that the informants' experiences asmaster's nursing students had was on their self-confidence. All of theinformants recounted experiences in their belief in themselves ascompetent individuals was shaken.I: I was at the point where there was total vulnerability. As aperson, you feel that you get to [my age], and you've been able tosurvive in the world quite well. And somebody has the ability orthe program or the stress of the program has the ability to reallyknock down that self-confidence.I: The joy was gone from my eyes. I was really just walkingaround looking terrible, feeling terrible, had lots of doubts inmy mind. I thought I should be able to do this. I've gottenthrough everything else, and it's never been this tough. It did anumber on my self-confidence. I'm a strong believer that the onlyway that you can learn is if you trust in yourself that you can doit, that you're an intelligent individual, that if you work hardenough that you can make anything happen. And when someone takesthat away from you, it makes you question your ability.Some of the informants expressed self-doubt about being able tokeep up with the workload--doing the amount of work required, within thespecified time period, and at the level demanded. Not keeping up meant117that there would be more work later on and therefore more pressure inrelation to succeeding in the program. Moreover, it was difficult forthe informants to feel a sense of accomplishment because there was notime to reflect on what had been learned.I: . . . "My God, I really don't what the hell that person istalking about." Thinking, "Oh my God, I'd better go home and readten more articles because I don't know what they're talkingabout." And there's a sense of, "Oh my God, I have to keep up. Ihave to get through."I: I worry about flunking, and I think that's realistic. There'sjust a huge workload, and it scares me that despite my efforts . .. my great fear is flunking.I: I remember handing in an assignment on a Monday and having anexam on the Wednesday and not even having studied for the exam. Imean, I've never done that in my life--walk into an exam and nothaving opened a book. I mean, talk about stressful. And you knowthat in the end, that's going to have a cannonball effect with howyou do, so it puts more pressure on you later on.I: You get one thing done, and it doesn't even feel like anaccomplishment. You've got to move on to the next one.While struggling with keeping up with the workload, some of theinformants felt intimidated by the level of scholarship that they wereexpected to demonstrate. The informants perceived that the faculty didnot know what competencies the informants had brought with them into theprogram. Moreover, even if the faculty did know, it did not appear thatthe faculty were always able or willing to nurture the informants'growth. These circumstances perpetuated the informants' feelings ofself-doubt.I: It seemed to me that the discussions in class were way beyondwhere I was. And I had a lot of difficulty in understanding and118feeling intimidated because I didn't understand and feeling asthough I should be understanding. Thinking, "Well, I can't ask aquestion because everybody else understands it, so obviously,there's something wrong with me if I don't."I: I had done everything that I could do, and I still didn't feelthat I had learned what I was supposed to learn. I had attendedall the classes, read all the readings, had reread my notes, hadthought things through, had gone to the library, had gone to seethe professor. I had done everything that a normal person couldbe expected to do. When I went and saw the professor, I think shemeant well, but I walked out of her office, and I still had a lotof questions. I went in saying that I felt lost, but she didn'tunderstand what I was saying. . . . I finally just wrote the paperand handed it in. I felt like things were beyond my control.There was a strong relationship between scholastic grades andself-esteem. Many of the informants found themselves measuring theirself-worth based on grades. Furthermore, there was the frustration ofdealing with the notion that one could have done much better if one onlyhad more time.I: I was used to getting marks in the 90's, and I couldn'tunderstand it when my marks dropped so much. I can remembersitting outside crying with the mark that I got back from onecourse; I know now that the mark was fine. It was 79.2 orsomething but, at the time, it was like, "Wow, what's wrong?"I: [The] mark on that paper was so devastating to me. I mean, Iwalked around campus for two hours with tears dripping from myeyes. I just could not believe that I could get this kind ofmark. I found it absolutely annihilating. I won't allow thedevastation to occur again. They've done exactly what they setout to do--to knock us off our pedestal.I: I've been fighting this thing about marks all semester. It'slike, "Oh great, you got 75 or 78. Oh shoot, I could have got an80 or 82 if I had more time to put into it."Many of the informants were dismayed that their sense of self-worth119could be so dependent on their grades. However, it was easy to loseperspective when, as one informant said, "It was the only kind offeedback that they gave and the only kind that mattered to them."I: Even though, consciously, you're aware of the fact that itshouldn't--you've tried to disregard marks--somehow we are socaught up in a mark that the initial reaction is, "Oh, I only gotthis. What a dummy!" You know in your heart of hearts that itdoesn't matter. As much as I like to think that I'm not affectedby marks, I am, and I can't help it. And we all try to grow aboveit and think that we're not the one that's going to be impactedbecause of marks. I hate it. But at the same time, it's sobloody ingrained. You measure yourself by your marks. And Icannot grow out of that. If anything, it's even worse.I: I find marks very oppressive, and I've really struggled withthem. I never considered myself a mark person and then, I gotinto this program and all of a sudden, I was starting to measuremy sense of self-worth next to my marks. . . . Psychologically, Ican tell myself to put them into perspective. I'm learning a lot,and I should be measuring myself against myself. A competitionwith me and not with anybody else. But that's so hard.Experiences in relating with the faculty and with fellow studentsalso led some of the informants to doubt themselves at times ascompetent individuals. Even experiences related to the art of being anMSN student led the informants to question their own capabilities; inthe third transcript excerpt, the informant describes how misleadinginformation transmitted by a faculty member undermined her confidence.I: One day, I got torn apart in class. And although I wassaying, "Well, she's not doing this to be mean to me personally,"it was really hard to take. . . . I wonder if she feels threatenedby us? It almost seems that she wants to attack us before weattack her. I just wonder why they can't be more tactful. . . .It's really sad that I would think that way because well, I'm hereto learn. But if you get slammed down every time you talk inclass, you're not going to want to say very much.120I: I had two bad experiences with group work, but a lot of thatwas tied in with where we were at in terms of the program and mylack of sense of self-worth. I always doubted myself. I alwaysfelt, "These dynamics are happening because of me," and "Myexpectations are out to lunch," or whatever.I: For that assignment, she said, "You can do it in four or fivehours." Well, 20 hours later, you're still working on it, andyou're thinking, "Am I stupid that it's taking me 20 hours?"Some of the informants perceived that they were forced to beexcessively dependent on the faculty in order to get their work donebecause there was such uncertainty about the faculty's expectations andthe criteria for achievement. This constituted a threat to theirperception of themselves as individuals who were able to take fulfilltheir responsibilities independently.I: I found I started going to people a lot more. . . . Figuringout exactly what it is that they want seems to be the big thing,and that's been one of my biggest problems. I've gotten reallyused to going to see them to make sure I'm on the right track. Ikeep thinking that everyone is doing it, but I also wonder ifthere's something wrong with me that I'm not figuring out whatthey want.I: They were off to see the prof three times before writing asingle paper, and it wasn't just one person in the class. And Irealize that it's important to have some clarity in what you'retrying to do, but it seemed to me, "Why is this happening? Whydoes everybody feel the need to do this?" I think it gets prettydemoralizing to have to do that. I couldn't bring myself to doit. I'd feel like a total incompetent if I had to go in therethree times.I: I feel as though I'm asking too many questions, and I'mlooking for too much support. . . . I feel as though I'minadequate because I have to ask her questions or I have to lookfor support to get through. . . . I always think that when I askquestions, they're stupid questions, and I find that veryintimidating--to have to always be asking questions.121Some informants felt that they had to act in ways that wereinconsistent with personal values. In playing by the rules and playingthe game, the informants found themselves in a precarious position. Itwas a matter of finding the balance between behaving in ways that wouldenable them to achieve and fit in, and behaving in ways that would notcompromise their sense of personal integrity. Some of the informantsfound themselves close to compromising their own values.I: It was evident to me that there was definitely an instructor'spreferential way of doing something. . . . And I went along withthat for a while, and I became very frustrated because it didn'tfit with the me--the kind of person that I am.I: I've sold myself out a few times in that I'm not giving myabsolute opinion on things. I'm playing the game. I'm alteringmy response to things so I can pass. . . . One thing that I don'tlike about myself is that I'm willing--I am actually willing tochange [this] to meet the needs of the mark.R: You had to compromise a little.I: That was a major compromise.Some of the informants were dismayed at the extent to which some oftheir fellow students comprised their personal integrity. In one sense,the informants could understand the feelings of frustration ordesperation that led to what they perceived to be dishonest behavior; inanother sense, they found this behavior shocking and disappointing.I: I think there's a fair bit of dishonesty in the master'sprogram among the students. The whole first year, I never had oneother assignment to look at, but everyone knows that papers floataround graduate class like you wouldn't believe. I sort ofresented the fact, too, that people came to school and reportedclinical experiences they didn't participate in. I think it sayssomething about the person, but I also think that says somethingabout a program--that we're that desperate that we have to dothat. Maybe for some people, it was to get ahead but, for some,122it was just to get through the program.I: The assignment that I was working on was stolen off my desk. .. . I have it on file at home, and I have a hard copy so I'm notscrewed that way. But I'm a little upset that somebody did that.. . . It's just not right. . . . And somebody else--when you getyour assignment back from [this professor], she tapes it andstaples it shut--this person went in her mailbox, and it wasopened. There's something going on in our class. . . . even thegrad lounge isn't a safe place.Many of the informants perceived that they were at the mercy offorces beyond their control. Their experiences were such that theyexperienced a threat to self-determination; they perceived that theywere not in control of their own destiny. This threat was often aresult of experiences related to the work of being a student.I: You feel like you don't have control in the sense that even ifyou work really, really hard, you'll never get that "A". I runaround a lot, I spend a lot of time in the library, and all ofthat. The work is never reflected in the mark. You can work ashumanly possible, and you just aren't allowed to get there.I: Those marks represent my future. It's as simple as you needthe marks to go on, and they don't give them. . . . It eliminatesyou from the chance of going on to do a doctorate because of theextremely high average that is necessary to gain acceptance into agood school. There'll be no scholarships. I'll never be able toget that 95% necessary to get money. So basically, they'vedecided that I'm not going to get any money and I'm not going toget into a doctoral program.In some instances, the informants experienced the threat as a result oftheir experiences in relating to the faculty.I: No, I don't know that we have any choice or control sometimes.Like with this professor--she has her agenda, she has herassignments, and there's no room for any flexibility.123I: [Faculty members] are saying to me, "It's all part of theprocess," and this is the answer that I'm getting for what's goingto happen. . . . Which is saying that I have no control, and thenI just feel anxious. They're going, "It's all part of theprocess, and you just can't tell." I have my own personal agenda,and I'm getting the old patronizing, "It's all part of theprocess."And in still other instances, the threat was a result of informationthat was or was not conveyed to the informants by faculty members.I: In that course, she said that she wouldn't be handing out theoutline for like till the end of September. I'm just like,"What!" And I thought, "Well, I'm a full-time student, and I wantto make sure that I have my time managed well." I don't eventhink she told us when the assignments were due like till threeweeks into the course. I didn't like that. It made me feel alittle bit threatened. Like I like to prepare. I like to beorganized. I like to know what's going on.I: I think that when you're told as a class upfront that you'renot going to get "A's", it takes away from the desire to do well.I think that it's kind of a self-defeating prophecy that when youtell people that their marks aren't going to be good, and theyhave that kind of expectation, then people live up to thatexpectation. That philosophy, I question, in teaching and, inparticular, in adult education.As a result of their experiences as master's nursing students, theinformants perceived that their foundations had been shaken. Change,loss, challenge, and threat disrupted the informants' professional andpersonal self-concept and led to feelings of uncertainty, self-doubt,and powerlessness. However, "shaking the foundations" was only one partof the experience of losing control.124The Pervasive Pressure of School The informants described school as a pervasive presence in theirlives. Virtually every aspect of their lives was affected leading oneinformant to describe her life as, "abnormal". If the informants werenot engaged in school-related activities and responsibilities, then theywere talking about them with their family and friends, or they werethinking about them. Life revolved around school.I: It's always there. It's there in the middle of the night, andit's there first thing in the morning. It doesn't mean thatyou're always doing something. You are in the fact that it's inyour head, and you're thinking about it. But it's always there.I: There were times that I thought, "This is too overpowering.There's just too much here. I'm just pumping out papers andstressed to the nines. I have no social life. It's too all-involving, too all-encompassing."I: My husband and I agreed that one night a week, from 5 o'clockon, I wouldn't do any homework, and we'd go out. And I could notdo that the entire semester. We'd go out to a movie, but when wegot back, I'd be leafing through my books and, "Oh, I'm just goingto do a little bit of reading."Many of the informants had to make significant changes in theirlifestyle in order to accommodate the demands of the work. Thefollowing narratives illustrate the restrictive lifestyle of theinformants and the difficulty in completing some of the simplest, mostbasic activities.I: The workload. It's really high, and by that, I mean everyminute counts. . . . At this point in time, you have to concernyourself if you've got time to do your laundry.I: In November, you did well to be getting dressed and getting toclass. You could see the grooming of the class had deteriorated,125and I'm sure there wasn't an armpit shaved.I: What suffers are other components of my life that are reallyimportant to me. My physical is important; I was no longerexercising. There wasn't time. I had to give that up. . . . Myspiritual; I stopped going to church. I just didn't have thetime.A great deal of planning occurred in an attempt to accommodateboth the demands of school work and the desire to have a "normal" life.For some informants, life had to go on, and responsibilities in otherroles that they occupied, had to be fulfilled. However, despite theplanning, interpersonal relationships suffered often suffered.I: Life goes on. You can't put your life on hold to go toschool. . . . When you assume the student role, that doesn't meanthat you give up other roles. I'm still a person with multipleroles. . . . When I had to go home for Christmas, I took my thesiswith me. . . . When my girlfriend at home got married, I borroweda computer so I could work on the computer. It affects all facetsof your life, but you learn to work around it so you can still bea family member or a friend or whatever.I: I have a child who I should at least spend some time with. SoI took Friday evening off, and we went and had some wonton soup. .. . trying to organize play times to get her out of my hair so Ican get some work done. . . . I can't get rid of this child. Ihave those responsibilities. . . . trying to beat this path downto higher education and taking this child along with me . . .R: What kind of things aren't normal anymore?I: My family is here . . . and I don't see them hardly. . . . AndI'm really close to my grandmother, and she's my next doorneighbor, but I haven't seen her that much. . . . She likes for meto come and visit her, not just for ten minutes, but for an hour.And I feel time-pressured, so I know that I can't see her.126The Threat to Physical and Emotional Well-beingMany of the informants also perceived that the unrelentingpressure and stress of their experiences as master's nursing studentshad an negative impact on their physical and emotional well-being.I: By the time I got home for Christmas, my family was concerned. . . and didn't want me to come back. I didn't look well. Ididn't feel well. And I didn't know it, but I was emotionallydrained. I'd lost seven pounds, and when you weigh as little as Ido, seven pounds is a lot. I was a mess. . . . A couple of daysbefore I had to go back, I started to cry, and I said, "You know,I don't want to go back. This is not what I signed up for. Idon't want to be hurt ever like this again. I don't ever want tobe in this position again."I: There's been a whole flurry of colds and that type of thingbecause people are run-down. You see whole lifestyle changes--noexercise, drinking coffee, up all night. I drink a lot of coffee.I don't do any exercise, stay up late. Lost weight--lost tenpounds the first month. . . . People in the class were coming upto me and saying, "I don't know if I'm going to make it throughthe week without having a major breakdown. I'm on a thread."Every informant described experiences in which they felt a senseof emotional vulnerability. They experienced intense emotionalreactions to experiences which ordinarily would not have generated thesame level of emotional intensity. These emotional reactions were bothpositive and negative, but the informants were somewhat disconcerted bytheir lack of emotional self-control. Some of the informants felt likethey were on an emotional roller coaster.I: Last week, every time I turned around, I had tears in my eyes.Someone talked to me, and I would be holding back tears.I: It's frustrating. It's enjoyable. Sometimes, I've thoughtthat it's been impossible. Sometimes, I think that I can do it.At other times, I'm quite sure that I can't. Sometimes, I'm angry127at the program, I'm angry at the profs, I get angry at myself. Itjumps around depending on what week it is and what's happening.I: I felt in November that I couldn't control my emotions. Lastweek, when I didn't cry all term, all of a sudden, I just brokedown. I really don't think it was any particular incident thatcaused it. Maybe it was all the stress that had compounded, and Ijust had to have a good cry.Many of the informants experienced feelings of guilt when theytook time to engage in activities that were not related to school. Inother instances, the informants felt guilty when they compared theamount of work that they were doing with the amount that other studentswere doing. One informant characterized the experience of being amaster's nursing student as a "guilt-ridden process."I: Sometimes, it's not so much that you don't have time, but youfeel guilty if you use that time for something like that. Youfeel like you're wasting time. Like, I'll come home and waste thehour but, if I go somewhere, I feel guilty. I don't feel quite soguilty at home. It's a funny phenomenon. . . . Guilt comes fromthe idea that I'm a student, and a student has this role andshould always be working away. And you talk to some of yourclassmates, and they're doing exactly that--working all the timeand driving themselves crazy.I: . . . the assignments and program are the driving forcesbehind everything that I do in a day. My personal growth andsocialization are important too, but . . . when I'm not working, Ifeel guilty.Other emotions that the informants frequently experienced wereanger, frustration, and anxiety.I: My initial reaction was anger because of them deciding thatyou were going to be marked according to the fact that you wereall smart once and, now, you're not going to be smart.128I: The professors--some of them were really good. But sometimes,there's a real sense of anger when you look back and see how theyweren't as supportive as they could have been.I: There's this unattainableness about [getting an "A"]. I don'tknow if this sort of mirrors what the real world is going to belike; we all have to be working all the time toward making nursingbetter. And maybe, we're never going to get there, and we have tojust keep on fighting and trying all the time.I: I remember feeling really anxious--outrageously anxious--aboutgoing in and talking to a faculty member about my thesis idea. . .. The anxiety that I was feeling certainly was there because itmanifested itself in insomnia, and I had to see a psychiatrist forinsomnia.Experiencing the reality of being a master's nursing studentultimately led to a state of disequilibrium in which the informants felta lack of control. There were multiple changes, losses, challenges, andthreats. There was an inevitable change in self-concept associated withthe experience of being a master's nursing student. Unfortunately, formost of the informants, this change in self-concept resulted in a threatto their self-esteem. There was unrelenting pressure for the informantssuch that they had to make changes in lifestyle. Furthermore, theinformants' experiences created a threat to their physical and emotionalwell-being. In response to their feelings of loss of control, theinformants had to find ways to regain control. In the next facet ofresponding to the impact, the process of trying to regain control willbe described.The Rmonse: Regaining Control The process of regaining control was different for each informant.There were variations in how, when, to what degree, and for how longthey were able to regain control. The informants described a variety of129ways in which they responded to the experience of losing control. Someof these measures were more effective than others in promoting a senseof equilibrium, and the informants usually used a variety of measures atany given time. Some of the informants found it difficult to regain asense of control, or they regained control only to lose it again. Oneinformant felt that she had never been able to regain control.In many instances, the informants found that the work of being anMSN student contributed to a sense of losing control. However, thisloss of control then interfered with the informants' ability to do thiswork. A cyclical or spiraling dysfunctional pattern was sometimesestablished.I: I was doubting myself so much that I transferred my doubt ofmyself to that course, and what I did, I just avoided theassignments. Like I was paralyzed. I didn't know where to begin.I didn't understand it. I couldn't conceptualize it. And I foundmyself getting further and further behind.I: I'm not going anywhere with my thesis actually. I don't knowwhat I'm going to do about it. I keep thinking that the ideasthat I have are stupid ideas, and I don't know why I want to dothis kind of thing. . . . I just keep doubting myself, and thethesis goes nowhere . . . I'm worried if I'm ever going to getstarted on it or not. I keep putting it off.I: I went through about six weeks there with a lot of self-doubt.I couldn't make up my mind about whether to do a major paper or athesis. . . . I had this thing in my mind that I wanted to get onwith my life, and I felt that if I did a thesis, there'd be allthese hoops to jump through, I wouldn't have any control over theprocess, and I would find that very stressful and frustrating. Ididn't want to go through that anymore. I'd had enough of italready. I wanted to have a life. . . . I was paralyzed byindecision. I really felt powerless.130The Passage of TimeFor many of the informants, a sense of control was established, tosome degree, because of the passage of time. Even for informants whowere in the first year of the program, a sense of more control wasexperienced as they developed supportive relationships with their fellowstudents and became more familiar with the art of being an MSN student.Students who had progressed past the first year were able to look backat what they had accomplished and were beginning to realize that theywere moving toward completing the program.I: In September, I felt more out of control than I did inNovember because I had gotten to know a little bit more about thesystem, who you could go and talk to, which profs you can sort ofhave a little more flexibility with. . . . You know what the rulesare now, you know how to act, what the expectations are. You'remore comfortable.I: Second year was a lot better. Your level of anxiety is a lotlower. You've got courses behind you. You've made it half-way--more than half-way then. Your thesis is exciting. And you canalmost see--you're probably getting to the crest of the hill andyou know that, from then on, you're going to make it.Manoeuverinq for Survival Many of the informants used measures to regain control that wereusually only partially or temporarily effective in making them feel incontrol. However, they were effective enough that their survivalthrough the experience of being a master's nursing student would beensured.Some of the informants used defensive measures to protectthemselves from the multiple threats posed by their experiences as131master's nursing students.I: I think you blame, scapegoat all your frustration and youranger. I chose one particular instructor, and I chose to targetall my anger and frustration on this particular teacher. . . . SoI released a lot of stress where perhaps it didn't belong.I: I didn't feel I put enough emphasis on that paper. I put timeinto it and stuff . . . but I could have done more. Irationalized my discomfort with that by saying that getting mythesis done was more important.I: There was myself and three others, and there was a patterngoing on where, once a week, somebody was having a breakdown(laugh). And one week, a girl broke the cycle and she criedsooner than she was supposed to, and it was my turn next. And Isaid, "Oh no! I just had one. I don't want another one." So wetried to find humor in it. It was a difficult time, and if Ididn't maintain my sense of humor, I don't know how I would havegotten through.I: I try not to get too involved in the negative stuff because Iknow how damaging it can be. But it happens. You're vulnerabletoo. I'm as vulnerable as the next person. . . . I think if youwere to focus on the negative, you would be doing yourself a majordisservice. It's not that they're not there to focus on, but it'sjust self-defeating.Other informants took control by making a decision to persevere inthe program despite their adverse experiences as master's nursingstudents. This decision to persevere was based on their commitment tocompleting the program and realizing their professional goals. As onestudent said, "You just get on that treadmill and keep going."I: I think there are some times when I really think, "What thehell am I doing here?" But most of the time, I know that I haveto do this so that I can carry on and get on with what I reallywant to do.I: I had second thoughts about coming back after Christmas, but Ihad to. I had some doubts, but I was also committed to doing thisto become a CNS.132I: There's always self-doubt. . . . But there was more, "Well,you're still here, and you can have all the self-doubt that youwant, sweetheart, but it's not going to get you through thisprogram." Had I failed a course, it would have been difficult.That would have been extremely difficult for me, but I would havesurvived, and I would have taken that course over again. I wouldhave done something. I wouldn't have just said, "Well, I failed acourse. I'm going to leave the program." I would have done itover again because I wanted a master's.I: I had some problems with my thesis, and I shed the odd tear ortwo. And I thank God for the friends that I had to support me fora couple of days. But I just got back into it. . . . I made adecision to come here, and I'm going to make the best of it. Andbeing unhappy or sad or crying or fighting the system or givingin, is not the way to go about it. . . . I mean we all have ourmoments, but I decided that I would do my best, and if I washaving problems, I would keep working at it to do better.The Perceptual Shift Some of the informants took deliberate measures to regain controlby changing the way in which they thought about themselves, about theprogram, or about some of their negative or painful experiences. Theywere able to modify their perceptions so that even though theyexperienced a loss of control, they did not feel helpless or powerlessto make changes and regain control. The informants moved away from"deliberate accommodation" and made conscious decision about theirbehavior so that they would be in control of their experiences asmaster's nursing students rather than just reacting to some one or something in the program.Redefining priorities.Some of the informants redefined their priorities based on anexamination of what they truly valued. Instead of behaving in waysbased on the values or expectations of others, the informants decided to133behave in ways based on their personal values and expectations.For many of the informants, it was a matter of putting grades intoperspective. They were able to identify things that were more importantto them--the learning, the camaraderie with peers, a life outside ofschool, or their own personal standards.I: I had, by this time, developed the notion that I was there foran education. . . . I went there for knowledge. That was my goal.And, therefore, whether they told me I was a first-class or asecond-class, was not the reason I went back to school. . . . Igot to the point of thinking that the marks were not as importantto me anymore. I decided that what was important was thecollaboration, the sharing, and support amongst my colleagues. .. That was what nursing was all about and should be about.I: I bought into a philosophy of aim for 75, hope for an 80, andhave a life. . . . It seemed that, in the end, I would be happierwith getting an 80 and having some balance in my life than working18 more hours for one more mark.I: If you're taking someone else's values about marks, and "Ishould be getting 'A's'," and you really believe it, then you haveto rework that and believe, "I'm still a good person if I get 78."For other informants, they reconceptualized the amount of time andenergy spent on school-related activities as opposed to other aspects oftheir lives. One informant said that it was a matter of, "how schoolrelates to my life," rather than "how my life relates to school."I: I have a family . . . and a home to run. At one point in theprocess, [someone in my family] became very sick . . . and then myschooling didn't seem quite so important. . . . I had all theseother factors that were far more important to me than myschooling. At that point, I made a choice.I: I had really high expectations that I was going to do reallywell, and I'd be a wonder student. But I decided that I have toattend to me as a person and my life. . . . I see people around meand, literally, their health is suffering. It's not that school134is not important and I do want to do well and I want to learnsomething and that's why I'm here. So it's a major commitmentthat I made, but there has to be other priorities in life--healthand self first. So I think I've kind of let go a little bit, andmy stress level has come down a bit because I'm just moreaccepting of where I am and what I'm doing and what I want. . . .This program was not going to get the better of me; I was going toget the better of the program. I decided that this program wasnot going to run my life.I: You have to learn to set your priorities and take control. .. I realized how much school had control of my life. . . .worrying about getting the assignments done but jeopardizing a lotof things . I may not get done by April, but . . . I don't wantto look back and think that all I ever did for two years wasrelated to school.A shift in locus of control.Some of the informants regained control by coming to therealization that they were not at the mercy of the program. Theinformants stopped focusing on how the program had failed them or on hownegative or painful their experiences had been.I: I guess my philosophy--there are certain things you have to gothrough in life to attain what you want to attain. Some of themare pleasant, and some of them aren't. But you get through it ifyou want them. . . . And if you want to fight the bloody system,you're going to waste an enormous amount of energy, and you're notgoing to get anywhere with it. Now I'm not saying that if peopleare very unhappy and they have a legitimate concern, that theyshouldn't follow the proper channels. I think they should. Butwe went into the program to learn. . . . There are some thingswe're not going to like. So either decide you're going to buckledown or decide that you're going to waste a lot of energy.I: I decided that you may not like it, but you gain from it. Youcan choose not to gain from it and bitch your way through and comeout the other end thinking you didn't learn diddly-squat. That'syour choice. Mine was, "I may not like it, but I'm going to getthrough it, and I will learn something."I: I think, initially, I started out with certain expectations ofthe instructors or whatever they would teach. And those, in someinstances, were not met. But out of that came a renewed135confidence that, irrespective ofor weren't met, there were othermyself. Dwelling on what shouldalways work out that way.whether my expectations were metavenues that I could meet thembe or could have been--it doesn'tThere was a shift from blaming and feeling like a victim to takingresponsibility and being accountable for their own learning.I: I realized that I had some responsibility for this--thatpeople are not doing unto me. I'm part of the interaction. Andrealizing that if I'm very unhappy, I can say to the person,"What's going on?"I: I never expected that I was going to fail because I can alwaysmuster up whatever it is--when it comes down to the crunch, I'llgo and say, "I did not put my career on hold and sacrificeeverything to come out here and fail." And I will be blunt aboutit. . . . I'm verbal about what I need, and they have toacknowledge me. I make sure that they're aware of my learningneeds and that they take that responsibility as an educatorseriously to help me meet my needs.I: I never felt that I didn't have options. Sometimes you can'tsee the options because you can't see the forest for the treesbut, when push comes to shove, there's always something more youcan do.I: I found myself victimizing myself at various times through theprogram like, "Oh, if that were different, I'd do this and dobetter at this, and if only that person was different." But youhave to take responsibility for yourself, and I've always believedthat. As a person, we're responsible for ourselves.Finding meaning.On an informal, social level, students tried to understand themotives of the faculty and the purpose of the experiences that they wereundergoing. "We try and do that. . . . Back in the grad lounge, we talkabout how they must be doing those things for a reason. You have tocome up with that. Otherwise, why would we even stick around?"136However, in making a perceptual shift that leads to a sense of control,some of the informants began to understand how their currentexperiences, painful though some of them might have been, would be partof the process of acquiring the knowledge and skills that would helpthem to realize their goals within the program and as well as after theyhad completed the program. Most of the individuals were able to achievethis kind of perspective by looking back on their experiences.I: At times, you say, "It doesn't make any bloody sense. Youpeople don't know what you're doing." And then I'd have to stepback and say, "These people are educators. They're competentpeople. They've gone through the process. Wake up and smell theroses. There is a purpose here. . . . It's a process and rememberthat, and you're going to have to trust these people to bring youthrough the program." . . . It's something that I think you do.You look at things in retrospect, and they look different. At thetime, you might say, "Damn it, I don't want to do that." Inretrospect, you realize that it was not a bad thing to do.I: I think this whole semester was built around writing scholarlyand getting our thinking process down and articulating ourselves,and isn't that what the thesis is? We're going to have to be ableto conduct research. So all this is probably an exercise so wecan get into that level.I: I had to find a reason for all this work. I had to think,"What's the purpose here that there's so much?" I realized thatpart of it is . . . to put this amount of work on you to stretchthe mind, to get you to take apart all of the things that you onceknew because it's no longer good enough to say, "It's just becauseI know." I think the whole process was--you have to go beyond,"Because that's the way I've always done it, that's the way Iknow, and that's the way I've been taught." You have to get moreinto an independent thought.I: There is a point when you take all this new information, andyou decide for yourself what you're going to take from it backinto your practice. . . . So there's a sense of restructuring inbringing practice to the forefront again and then streaming itthrough to the end of the program. You have a sense of directionor vision or whatever word you want to use for it. And theprocess doesn't seem so onerous anymore or so complicated.There's a sense of fulfillment.137The informants' experiences with the reality of being a master'snursing student led to a situation in which they experienced a loss ofcontrol. Using a variety of methods, they were able to regain control.However, regaining control was sometimes only a temporary or partiallyexperienced state. Often, informants who were able to make a perceptualshift by redefining priorities, shifting their locus of control, orfinding meaning were more successful in regaining control. In the nextfacet, the informants' perceptions of their experiences as master'snursing students will be discussed in terms of the concept of personalempowerment.Personal Empowerment The informants have described their experiences in terms of thethree components of experiencing the reality of being a master's nursingstudent and in terms of the process of responding to the impact of theirexperiences with this reality. In this final facet of responding to theimpact of their experiences, the consequences of the totality of theinformants' experiences are discussed in relation to the notion ofpersonal empowerment. The informants discuss personal empowerment bothas an outcome and as a process.Personal Empowerment as an OutcomeThe informants described what they had been able to accomplish orachieve as a result of their experiences as master's nursing students.These outcomes are discussed in terms of professional growth andpersonal growth.138Professional growth.As discussed earlier, some of the informants perceived that all oftheir individual learning needs had not been or were not being met.Nevertheless, all of the informants stated that they were growingprofessionally as a result of their experiences as master's nursingstudents. This professional growth consisted of gains that had beenmade in knowledge and skills that the informants identified as beingsignificant in terms of realizing professional goals.I: You were certainly challenged on your ideas which is the ideaof graduate school because certainly when you get out, you arechallenged. Now I can defend them better. . . 	 I learned how tobe more effective within the health care system . . . and Icertainly know now why some of the forces act the way that theydo. . . . And I have the ability to look at the overall situationwhich I'm not sure I had before--to look at all the alternativesbefore drawing a conclusion or making a decision.I: I'm grounded in something. . . . What I believe in now hasbacking, and I can articulate why we need something or why weshould do something some way. . . . I have more of a theoreticalbasis for what I'm doing.I: I feel more confident about my delivery, and I'm much moreconscious of the way that I think and how I present my ideas. Ifeel more confident about expressing an opinion in a scholasticrather than a guttural sense. I think before I speak most of thetime . . . and listening to other people's opinions andformulating mine based, not just on intuitive but, I think,rational thought. . . . sway a group of individuals to think oraccept or even to challenge, to give credence to my statementseven though they may not agree with them.Moreover, many of the informants also stated that their learningexperiences had given them a greater appreciation for the profession ofnursing and had strengthened their commitment to it.139I: It opened my mind for just seeing what else is out there innursing. . . . gave me such an incredible appreciation for whathas gone on in nursing in the past and where nursing can go in thefuture or what the capacity of its potential is for the future.I: I mean, I feel as one with the profession. I've never felt soclose to it. . . . recognize the depth of the profession--theknowledge base, the dedication, the impact that the profession hason the future of health care, and the camaraderie.Personal growth.Many of the informants spoke about personal growth in relation tothe notion of adversity. As one informant said, "All this pain we'vegone through? We'll grow."Some informants perceived that they grew in terms of self-awareness because the adversity of their experiences forced them into aposition in which they had to confront themselves--their strengths andweaknesses, their beliefs and values.I: Running into myself. . . . Even though it's been very apainful and negative thing--well, probably more positive--runninginto myself. . . . I mean that I had to confront things aboutmyself personally that I haven't had to before. . . . Like puttingthings out of proportion and getting overwhelmed and paralyzingmyself. . . . The program gave me the critical periods wherethings weren't working--like my old coping strategies. And thevarious crises that happened in the program, I thought, "I justcan't live like this anymore."I: Getting through what we've got through, I had to try and usewhatever abilities I had. . . . Maybe it was so challenging, itput me into a critical state to have to respond. . . . learn aboutwhat's important to me . . . challenging parts of my personalityor how I did things or thought about things or who I am . . . howI manage my time, how I manage stress.140Most of the informants gained a higher level of self-confidence inrealizing that they were able to achieve what they had set out toachieve despite the adversity that they had undergone.I: The fact that I will have worked very hard to achieve thiswill have an impact on my self-esteem because I'll be able to say,"I've done it. I had a goal and I achieved it. And it's going toenable me to now do what I want to do."I: I probably have a very high level for tolerating frustrationnow. . . . I do feel a sense of accomplishment, partly because itwas such an onerous process, but I think just recognizing that--valuing myself, reaching a personal goal. Just being able to giveup so many things. Sort of put your life on hold. . . . When youdo finish, you have an incredible sense of accomplishment andachievement. I carry that with me. I know that I can do it. AndI think that it's like learning survival skills. If you can getthrough graduate school, you can get through anything.I: Some experiences made me feel really bad, but I took control,and because I have been in a bad situation, and I have learned totake control of it, I feel really good. It was hard, but I cantake control of a bad situation.Personal Empowerment as a ProcessThe informants described their perceptions of the process ofpersonal empowerment within the context of their experiences as master'snursing students. In doing so, they accounted for the level to whichthey perceived that they had been personally empowerment as a result oftheir experiences as master's nursing students.At the very least, all of the informants perceived the experienceof being a master's nursing student as being challenging. In some ways,they recognized that if the process had been easy, then they would notvalue what they had learned and achieved as much. They would not feel141as empowered. As one informant said, "Empowerment comes from struggle."Therefore the informants acknowledged that the process had to bechallenging.I: I didn't think that they were going to settle for somethingless than my best--which made me feel good. It's too big a thing.I went through the master's program to ,work for my master's. Ididn't want to get through thinking that somebody had allowed methrough. There's no accomplishment to that.I: You need to be able to handle some stress. Even though Idon't know whether it's put out that way or written anywhere thatyou need to be able to handle stress, you need to be able to copewell or cope period. You need to be able to cope with this, andyou need to be challenged. You came into this program forintellectual challenge, and that's what you're going to get. AndI think that's what they very much succeed in doing.I: As horrible as it is and the deadlines have been and some ofthe marks have been, I still think that I'm learning things and Iknow a lot more than when I came in. . . . The assignments areextremely difficult and a hell of a lot of work but I'm learning alot.However, most of the informants perceived the process of achievingprofessional and personal growth as exacting too high a cost. Althoughthey were growing, the adversity that they experienced was personallydestructive and interfered with learning.I: It was too hard. The cost is tremendous. . . . I don't, everagain, want to cry silent tears of exhaustion at the back of thebus.I: I know that I've gotten a lot, but I lost so much. . . . Partof me grew tremendously, but other parts were shattered, and Ihaven't got them back. . . . You can look at it in a very concreteway in terms of having all your foundations shattered, and youjust sort of have these bricks tossed on top of this crumbledfoundation. They're just sort of pieces that have been tossed infor good measure.142I: I think it would have been less painful, and probably, thegrowth would have been accelerated if the resources were there tohelp us with the process of learning. If you're busy dealing withyour self-esteem or struggling to cope, you can only learn somuch. You have to be creative to learn, and if you're spending somuch of your energy--you need some anxiety to get you going, butif it's over and above the normal anxiety--the energy from thatanxiety could be put toward learning. . . . They don't build onyour self-esteem, they tear it out.Some of the informants questioned how much they had to sacrificein order to get through the program.I: Like how much am I giving up as an individual to do thismaster's in nursing program? I know I want to do it, but is it atthe detriment to the rest of my life? . . . I have a couple offriends who just recently completed their master's, and when Italked to them, they were so excited, "You'll love it. You'lllove getting in there. Everybody helps you out." You don't getthat sense here. I haven't had that sense. I haven't got thehelp yet. I don't love it yet.Many of the informants spoke specifically of the loss of self-esteem that they were experiencing or had experienced.I: Maybe you felt great when you got there, but then you'reallowed to go down that ladder to far. It's okay when you'redoing something new to feel uncertain and lack some confidence.That's understandable. But that dive--that deep dive--it seems togo to far. And when it happens, they say, "Well, you're goingback to school, and that's all part of the student role," andthat's not necessarily so. A lot of people have been in schoolfor quite a while, and they're used to it. There's got to be away for students to feel better about themselves. But it doesn'tseems to be a priority to build the student up.Still others perceived that the process was not empoweringspecifically because of the negative relationships between themselves143and the faculty--relationships that were not only lacking in nurturingbut also counterproductive to the process of empowerment. The themes ofconditional respect and unintentional indifference have already beenexplored in detail, and it was those aspects of the student-facultyrelationship that prompted most of the informants to perceive theprocess as not empowering.I: . . . reminds me of Outward Bound. Like, dump you out, runten miles, get in those canoes and, no matter what, you have toget to point "B". And I feel we have been put into thishorrendous situation, and they just said, "Okay, this is whatyou're going to do, so do it."I: I feel it's been a very cold, empty process. It seems to methat giving us information has been the whole thrust of theprogram. . . . there's no nurturing going on. And so you're outthere in the cold, and they're just feeding into it with lots ofnegative criticism, and not acknowledging the knowledge andexpertise that you bring with you.I: Everybody has that power to give to the other person, and Idon't see that happening here. . . . I think that you have to takeresponsibility for helping yourself and learning, but I think theprocess should be stimulated or encouraged or whatever. They'vecertainly got a lot to share, but I don't see that happening here.I: Any respect I had for them was just sort of thrown out thewindow when they treated me like, "just a student". They get intotheir tenure track positions and into positions of power, and dothey just forget why they're there?I: I have friends who have gone through other programs, and thatwas their biggest thing--that you're not treated with respect andyou're not acknowledged by the professor. That just seemed sohorrific to me. I just couldn't believe it. But now I've livedthrough it. And I know exactly what they mean. . . . They couldhave made it a lot easier. It could have been less painful. . . .I didn't feel that I was validated, acknowledged as a person, oraccepted for where I was at."Many of the informants perceived that they had learned a valuable144lesson about how not to treat others should they assume leadershippositions in the future.I: I look at what it's done to me and my fellow students, and Isay, "One cannot do this to one's subordinates." You look at theimpact, and this is so important. You have such an importantlesson on what not to do when you move into that leadershipposition that they keep telling us about.I: I think I'm much more decisive about what I am going totolerate. I think for me, that was a real growth. I certainlycame away with the idea that this isn't the way that a group ofpeople should be treated. . . . Right now, I know that I'velearned a lot, but there's lots of turmoil in doing that. I'm notsure I'd do it again.In summary, all of the informants perceived that they had grownprofessionally through the acquisition of knowledge, skills, and a newappreciation for the scope of the profession of nursing. They grewpersonally by meeting the challenges associated with the experience ofbeing a master's nursing student and strengthening their capacity toovercome adversity. However, most of the informants perceived that,although, although they had grown both professionally and personally,the process was not empowering in terms of either professional growth orpersonal growth. The experience of being a master's nursing studentexacted too high a cost in terms of personal pain, personal sacrifice,and loss of self-esteem, and thus, the process was thus perceived asinhibiting personal growth. Moreover, it was seen as interfering withlearning and the level of professional growth that the informants wereable to achieve. The informants were challenged by their experiences asmaster's nursing students but they were not necessarily supported in145meeting the challenge. Thus, the informants were able to describepositive outcomes in their experiences as master's nursing students.These outcomes resulted from positive experiences in learning andrelating with faculty and fellow students. As well, they arose from asense of being able to overcome adversity. However, it is apparent thatthe informants' negative experiences in relation to the experience ofbeing a master's nursing student had a profound impact on theirperception of the level to which they had been able to develop a senseof personal empowerment and on their perception of feelings ofsatisfaction and accomplishment as master's nursing students.Summary Experiencing the reality of being a master's nursing studentresulted in a state of disequilibrium for the informants--a state inwhich they experienced a loss of control. Many facets of theinformants' self-concept were challenged or threatened by change andloss. The most significant threat was to the informants' perception ofthemselves as competent individuals. At the same time, the pervasivepressure and stress, associated with school, forced the informants tomake sweeping changes in lifestyle to accommodate doing the work ofbeing an MSN student and often, resulted in a threat to the informants'physical and emotional well-being. In response to losing control, theinformants used a variety of strategies to regain control. Depending onthe strategies used, they were able to regain control for varyinglengths of time and to varying degrees. A perceptual shift that enabledthe informants to reconceptualize their experiences as master's nursingstudents was usually the most effective strategy in promoting the147The reality of being a master's nursing student had an impact onthe informants such that they experienced a loss control. Theirexperiences challenged and threatened the stability and security oftheir professional self-concept, their personal self-concept, theirlifestyle, and their physical and emotional well-being. Regainingcontrol was a difficult process but through the passage of time and theuse of a variety of strategies, almost all of the informants were ableto regain control, albeit to varying degrees and for varying lengths oftime.	 Ultimately, it was an experience that resulted in personalempowerment--an outcome of both professional and personal growth.Conversely, it was also an experience that interfered with the degree towhich the informants were empowered; it was a process that was notempowering.Thus, the experience of being a master's nursing student was oneof dreams and disillusionment; joy and pain; adversity, and ultimately,triumph. As can be seen from the informants' accounts, the negative andpainful experiences took precedence over their joyful and triumphantexperienes. One informants' narrative summarizes the experience ofbeing a master's nursing student . .I: I feel like that person . . . in mythology who rolls a hugerock up a slippery slope every day for eternity. He spends allday pushing that rock to the top of the hill, inch by inch, andonce he gets it to the top, it rolls back down at the end of theday. Well, I'm going to get my rock to the top of the hill andit's going to stay there. I'm going to make it.148This chapter has presented the findings of the study of thedevelopment of personal empowerment in the experience of master'snursing students. In the next chapter, these findings will be discussedand compared in relation to relevant literature.149CHAPTER FIVEDISCUSSION OF FINDINGSIntroductionThis chapter presents a discussion of the findings of the study ofthe experience of master's nursing students in relation to the conceptof personal empowerment. These findings will be considered in light ofrelevant literature, which was described in Chapter 2, as well asadditional theory and research that will elucidate the meaning of thefindings. The discussion will be organized in the same format in whichthe findings were presented in the preceding chapter. Therefore, thediscussion will begin with "the dream versus the reality," followed by adiscussion of each component of "the reality of being a master's nursingstudent," and conclude with a discussion of each facet of "responding tothe impact."The informants' accounts of their experiences as master's nursingstudents represented a broad spectrum of experiences that can bevisualized along a continuum of positive and negative experiences inrelation to the notion of personal empowerment. The intent of thisresearcher was to record and recount this range of experiences.However, during the process of data collection and data analysis, itbecame apparent that the informants' negative experiences had a profoundand enduring impact on their perception of the process of personalempowerment during their experiences as master's nursing students. Theaccounts of negative experiences took precedence over and overshadowedthe informants' positive experiences. Thus, although most of theinformants described distinctly positive experiences that were150consistent with the development of personal empowerment, their negativeexperiences tended to color and influence the informants' perceptions oftheir experiences as a whole. In view of the significant impact of theinformants' negative experiences, a predominant focus in the followingdiscussion will be on these negative experiences and the role that theyplayed in shaping the informants' perceptions of their experiences inthe master's nursing program in relation to personal empowerment.However, it is appropriate at this time, to consider some of thepossible reasons for the negativity of the informants' accounts. First,most of the interviews occurred during the school year when theinformants may have experienced a high level of stress. Second, theinformants may have focussed on their negative experiences much as theydid with each other in their interactions about the program and thefaculty. Third, because many of the informants perceived that they hadlittle opportunity to make their concerns known to the faculty, they mayhave perceived their participation in this study as a way ofcommunicating these concerns. And fourth, as adult learners fulfillingmultiple roles, the master's student role may have been perceived as amore stressful and difficult role to fulfill. Further discussion of theinformants' negativity about their expereriences will take placethroughout this chapter.The Dream Versus the RealityThe informants described a vision of what they hoped to accomplishin terms of professional goals upon completing a master's nursingprogram as well as expectations of their experience as master's nursingstudents. These elements--the informants' hopes and expectations,151constituted "the dream." Underlying this dream was a strong commitmentto professional nursing goals. Moreover, the informants hadexpectations that participation in studies at the master's level wouldhelp them to achieve these goals and that they would probably besuccessful in their studies. These findings are consistent withtheoretical formulations about the motivation of adult learners toparticipate in educational experiences (Cross, 1981; Knowles, 1978).Nurse researchers substantiate the finding that returning registerednurse students tend to be motivated by specific professional goals(Beeman, 1990; Fotos, 1987; King, 1986; Thompson, 1992). Further, likethe informants in this study, they are deeply committed to beingsuccessful in their studies and, often, feel pressured to succeed inview of the sacrifices and adjustments that accompany a return to school(Shane, 1983; Thompson).The informants described ambivalent feelings about pursuing amaster's degree in nursing. They felt eagerly excited with the prospectof the challenge of a higher level of academic scholarship and, at thesame time, somewhat anxious and vulnerable. Despite having certainexpectations of their experiences as master's nursing students, therewas a high degree of uncertainty about the reality of the experience.These feelings of uncertainty and vulnerability are thought to be normalemotional responses to novel situations in which there is ambiguity or alack of clarity about the significance or meaning of events (Lazarus &Folkman, 1984). A similar finding of conflicting feelings and a senseof uncertainty and vulnerability has been reported in studies ofreturning RN students (Beeman, 1990; Shane, 1983; Thompson, 1992) and in152a study of doctoral nursing students (Van Dongen, 1988).The informants' high level of motivation to pursue a master'sdegree and their commitment to professional goals speak to the highvalue that they placed on being successful in the master's nursingprogram. Lazarus & Folkman (1984, p. 58) suggest that in situationsthat are ambiguous or in which an individual is deeply committed to agoal, there is a heightened sensitivity to cues that might serve toconfirm or disconfirm the possibility of harm or loss. Thus, it is notsurprising that the informants were unusually vigilant and sensitive tocues that might give meaning to or clarify the reality of the experienceof being a master's nursing student. Even on the orientation day, theinformants were sensitive to cues that suggested that their hopes andexpectations of their experiences in the program would be met or notmet. Similarly, a heightened sensitivity to cues in order to preparefor potential danger was reported in the findings of a study ofreturning RN students (Lee, 1988).Therefore, the results of this study suggest that studentsentering a master's nursing program have a high level of motivation anda deep commitment to the goal of achieving at this level of educationprimarily for the purpose of professional growth. Moreover, they are ina state of psychological vulnerability that renders them unusuallysensitive to environmental cues that might confirm or disconfirmcognitive appraisals of threat or harm. This sensitivity tends togenerate high levels of uncertainty and anxiety.153Experiencing the RealityThe Work of Being an MSN Student Trying to Learn.It was not surprising that all of the informants described feelingfrustrated and overwhelmed in response the amount of school-related workand the pace at which the work had to be generated. This finding isconsistent with that of other researchers who have studied theexperiences of graduate-level students and reported work-related stressassociated with work overload and deadlines (Becker, Geer, Hughes, &Strauss, 1961; Clark & Rieker, 1986; Heins, 1984; Khanna & Khanna, 1990;Lloyd & Gartrell, 1983). Similar findings are reported in research onnursing students from the undergraduate level (Beck & Srivastava, 1991;Gunter, 1969), to the master's level (Mancini et al., 1983), to thedoctoral level (Van Dongen, 1988). Interestingly, in this study, thepressure that some of the informants felt in keeping up with the workwas self-induced. Based partly on information obtained through the" grapevine" about the rigors of conducting research and writing athesis, these informants deliberately arranged their course load so thatthey would have only one course and their thesis to complete in thesecond year of the program.From the perspective of empowerment theory, unmanageable workloadsin nursing education are not empowering. According to Allen (1990),although large amounts of work to be completed in a short period of timemay result in adaptability, it also restricts the ability of learners toengage in the time-consuming activities of reflective and criticalthought. Thus, in this study, the informants' perceptions of inadequate154time to engage in reflective and critical thought and to demonstrate thedevelopment of these skills led to the expected result of frustrationand low self-esteem.The informants perceived that their learning experiences in theprogram did not always address their needs and interests as individuallearners. There were two issues associated with lack ofindividualization of learning experiences. First, the informantsperceived that there was little recognition of individual abilities andneeds in relation to academic scholarship and in relation to the abilityto be self-directing or independent learners. The emphasis appeared tobe on meeting the requirements of academic scholarship and littleattention was paid to the process of helping the informants to meetthose requirements. Second, the informants perceived that theirindividual learning goals and interests in relation to specific contentand skills were not considered. Learning experiences, especially in thefirst semester of the program, did not always appear to be significantor relevant in view of past learning and work experiences and in view offuture professional goals. Thus, the informants perceived a controlover learning experiences and a lack of flexibility with the courses andwithin the program such that their individual learning needs, interests,and goals were not necessarily met.The notion of diversity among adult learners is recognized in theliterature in terms of cognitive development, learning style, contentand skill needs and interests, and ability to be self-directing(Brookfield, 1985; Cross, 1981; Grow, 1991). Numerous studies ofnursing students have been completed in this vein and, although the155findings are mixed, they reflect this diversity (Beeman, 1990; Brooks &Shepherd, 1990; Frisch, 1987; Gross, Takazawa, & Rose, 1997; Hodson,1985; Jones & Brown, 1991; Laschinger & Boss, 1989; Merritt, 1983;Pardue, 1987; Russell, 1990; Sullivan, 1987; Tiessen, 1987; Valigna,1983; Wells, & Higgs, 1990; Williams, 1988). Specifically, there areother studies of returning RN students that substantiate that studentsdesire, and/or need, and/or do not get individualized learningexperiences (Beeman, 1990; Linares, 1989; Mattson, 1990).There is considerable support in the literature for the notion ofmore personalized or student-centered learning or self-directedlearning. Participation in defining and planning learning experiencesthat are personally relevant is thought to increase and maintainmotivation for learning in adult learners (Ennis et al, 1989; Knowles,1973; Rogers, 1969). However, the realities of fundamental requiredcourse content and of academic standards of scholarship cannot beignored (Brookfield, 1985; Garrison, 1992). Thus, the stance that isadvocated by many adult educators (Garrison) and nurse educators (Bevis,1990; Hedin, 1989; Tanner, 1990a) is one of negotiation of learningexperiences to satisfy both the institution's requirements and theneeds, interests, and goals of the individual student. Indeed,educational experiences in which learners are able to make choices andto participate in decision-making and goal-setting are thought to beempowering (Hawks, 1992; Sellers & Haag, 1992; Zerwekh, 1990).An educational process that is empowering respects the capacity ofindividuals to be self-determining (Haney, 1988); understands diversityamong learners (Fahlberg, Poulin, Girdano, & Dusek, 1991; Sellers &156Haag, 1992); provides learners with the knowledge and skills to achieveprofessional goals (Mason et al., 1991); and permits freedom to explore,experiment, and be creative (Chally, 1992; Chavasse, 1992). Moreover,the focus is on process rather than on content (Diekelmann, 1988; Myers,Stolte, Baker, Nishikawa, & Sohier, 1991). In a process-drivencurriculum, the orientation is toward developing the students' abilitiesto obtain, select, construct, and use knowledge. The development ofskills of inquiry and knowledge-making such as analysis, synthesis,logical argumentation, and perspective-taking are thought to be thecritical elements in learning experiences. Content is used tofacilitate the process, and, thus, can vary with students' interests andgoals. In short, educational experiences that are empowering enablestudents to become both motivated and able to be self-directed, lifelonglearners. Movement toward the goal of increased independence inlearning must be based on consideration of the learners' beginning pointand acknowledged as a process in which both the student and teacher areinvolved and committed (Cross, 1981; Garrison, 1992). In fact, it hasbeen suggested that independent learning requires more time and energyon the part of faculty than more traditional approaches to teaching andlearning (Garrison). These notions of collaboration, process, andnegotiation of learning experiences are very different from the findingsin this study.The informants described constructive feedback as an important andcritical aid in the process of learning. However, they reported thatthey often found the feedback on papers to be deficient in terms ofproviding an awareness of current strengths and weaknesses and in terms157of providing direction for growth. Had the feedback been constructive,timely, and regular, it would have decreased their level of uncertaintyabout their progress toward academic goals and boosted their self-esteem. Similarly, other studies of student populations indicate thatinadequate feedback contributed to feelings of intense stress or had anegative impact on self-esteem (Beck & Srivastava, 1991; Katz &Hartnett, 1976; Flagler et al., 1988; Mechanic, 1962). In contrast,empowerment theory speaks to the need to build on the individuals'strengths (Pinderhughes, 1983; Rappaport, 1984) and to provide affirmingfeedback (Zerwekh, 1990).The findings related to the theme, "trying to learn," imply thatmasters' level nursing students, by virtue of their previous educationaland work experiences, have diverse learning needs, interests, abilities,and goals that may not always be acknowledged or addressed in themaster's nursing program. The workload may have been perceived by theinformants as particularly onerous in view of this apparent failure onthe part of the nursing program. Deficiencies in constructive feedbackappear to have contributed to feelings of frustration and low self-esteem. Undoubtedly, more individualized attention to students' needs,interests, abilities, and goals would be empowering. The same is trueof critical selection of learning experiences that prevents theimposition of "busy work," and of affirming and constructive feedback topromote learning. Moreover, the findings suggest that informationalsupport might also be effective in decreasing the frustration of "tryingto learn." Faculty advisement in relation to course selection andworkload might be instrumental in mediating the informants' perceptions158of being overwhelmed by the workload particularly in the first andsecond semester of the master's nursing program. Many of the informantsdeveloped an appreciation for the value of their learning experiencesfrom a retrospective position. Thus, ongoing dialogue between studentsand faculty directed toward an understanding of the purpose or rationalebehind learning experiences might promote increased feelings ofsatisfaction and motivation in the students during the learning process.TrYinq to measure W.The evaluative component of the work of being a master's nursingstudent was conceptualized in terms of "trying to measure up." Theinformants reported trying to meet the standards set by faculty, theirpersonal standards, and the standards of their peer group. Thestandards set by faculty appeared to be the most difficult standards toachieve for most of the informants. The theme, "hitting a movingtarget," reflected the notion expressed by the informants that achievingthe standards set by the faculty was an elusive goal whose attainmentwas not always within their control. The informants identified severalreasons for this notion, including reluctance on the part of faculty toassign first-class grades, lack of clarity in the requirements of theassignments, inequitable grading, work overload, and lack of consistencyin the faculty's expectations. These elements in the educationalprocess were perceived as being barriers to achieving expected standardsof performance. Similar findings have been reported in other studies ofgraduate level students (Butler,1972; Khanna & Khanna, 1990) and instudies of baccalaureate nursing students (Beck & Srivastava, 1991;Olesen & Whittaker, 1968).159Several of the informants described measuring their achievement inrelation to personal expectations. However, the informants quicklydiscovered that personal expectations, based on past academicachievement or current levels of exertion, were not significantpredictors of grades. Consequently, the faculty's standards and thoseof their peer group became more meaningful standards. Further, many ofthe informants expressed that, regardless of whether they received highor low grades, they had little personal conception of the quality oftheir work. Self-evaluation was a relatively meaningless exercise--there was always some uncertainty about the quality of their work untilthe faculty stated their opinions.In comparing their performance with the standards set by theirfellow students, the informants can be said to be making use of areference group for the purpose of comparison (Lum, 1988). According toLum, "comparison groups . . . set standards . . . against which a personcan evaluate self and others" (p. 259). In this study, the informantswere comparing, not only performance achievement, but also the fairnessor equitableness of their situation. Some of the informants found thisprocess reassuring while others found it disconcerting. Similarfindings were reported in studies of the experience of being a medicalstudent (Becker et al., 1961) and the experience of being a graduatestudent (Mechanic, 1962).Lum (1988) theorized that making use of reference groups tocompare one's behavior can be done in either a competitive sense ornormative sense. Although all of the informants compared theirachievements with peers in a normative sense, it appears that informants160in one of the three classes used their peer group in a competitivesense. Interestingly, Becker et al. (1961) suggest that littlecompetition occurred among the medical students in their study becausethey were so individually intent on being able to survive theeducational process. However, in other studies of graduate students,competition was found to exist and acted as a source of stress (Butler,1972; Clark & Rieker, 1986; Khanna & Khanna, 1990). In a study ofbaccalaureate nursing students, Olesen and Whittaker (1968) reportedthat the students took pains to conceal an innate sense of competition.In empowerment theory, evaluation is considered a sharedresponsibility between students and teachers and, thus, a processdissimilar to the findings in this study. Through mutual agreement ofevaluation criteria, expectations are clear for both parties and thereare no hidden agendas or secret criteria for success (Brookfield, 1985;Zerwekh, 1990). Grading is a collaborative process so that the learnerengages in self-evaluation and reflection on current strengths andlimitations (Diekelmann, 1988). Limitations are perceived as temporaryproblems to be solved rather than personal-deficits; evaluation is ameasurement of the process of growth rather than a judgment (Funnel etal., 1991). Furthermore, competition between students would not existbecause the focus would be on collaboration and the notion that powercomes from the collective (Kieffer, 1984). Empowerment is not aboutoneupsmanship but rather a process by which everyone grows (Wheeler &Chinn, 1989). Farly (1990) describes evaluation practices that aredisempowering as rooted in "power garbage." "We come out of the woodsafter the students have done the best they could do under the161circumstances. We come out of the woods after their war is over andshoot them down with our 'power garbage'" (p. 89).Measurement of achievement in relation to standards is anessential element in education. None of the informants advocated thatthe standards of scholarship that were expected in the master's nursingprogram should be lowered. Instead, they suggested that barriers toachieving these standards should be examined and addressed by thefaculty. Action in this vein as well as in promoting and acknowledgingthe credibility of students' self-evaluation might significantlydecrease competition among students and convey that learning is aprocess. These measures might reinforce the notion that evaluation canbe an empowering experience.The thesis process was perceived as the most challenging elementof the master's nursing program. There was a certain mystique about theprocess and the challenge was perceived as one that would confirm theinformants' scholarly abilities and as one that would require a largecommitment in terms of time, and physical and mental energy. In orderto cope with the thesis process, the informants ususily soughtinformation about the experience through the "grapevine." As well, theysought out faculty members to serve on their thesis committees whom theyperceived as likely to meet both their academic and personal needs.This finding is supported by theoretical literature that addresses theneeds of nursing students, engaging in a thesis process, forinformational support and support from significant others in theenvironment (Baj, 1987; Cronenwett, 1987). Ultimately, although thethesis process was perceived as the most challenging element in the162master's nursing program, it was also the most personally andprofessionally satisfying. For many of the informants, therelationships that they developed with their thesis committee memberswere the most caring, collegial, and growth-producing. Significant pre-requisites for these relationships included mutual trust and respect andthe informants' perception that their thesis committee members believedin their ability. Thus, the process of creating and producing ascholarly piece of work was usually an affirming, positive experience.Feelings of insecurity and uncertainty about achievement continuedinto the second year of the program though to a lesser degree. Becausethe thesis process was a new experience for the informants, it ispossible that it contributed to these feelings. As suggested by thefindings, a positive self-concept arising from the students' perceptionof competence and achievement in the first year of the program mightcontribute significantly to feelings of confidence and control in thesecond year of the program.The Interdependence of Being an MSN StudentRelating with the faculty.The themes that arose from the informants' descriptions of theirrelationships with faculty were "conditional respect" and "unintentionalindifference." They reflected the personal pain and negative emotionexperienced by most of the informants in many of their interactions withfaculty members. It is possible that the informants' predominantlynegative stance regarding relationships with the faculty was a functionof telling the researcher what they thought the researcher wanted tohear or that it was easier to externalize blame for disappointments in163academic achievement than to consider personal reasons. More often thannot, it appeared that a relatively small number of negative experiencesin interactions with faculty colored the informants' overall perceptionsof their relationships with faculty. Nevertheless, the informants'perspectives of the pain of their experiences can not be denied.The first theme, "conditional respect," reflects the informants'accounts of the scarcity of interdependent relationships with facultybased on acceptance, respect, trust, and sharing. Many classroominteractions appeared to be controlled and inhibited by the facultyeither through the choice of a lecture teaching method or through verbaland nonverbal messages that the informants' contributions were notcorrect, valued, or significant. This appeared to be particularly truewhen the informants offered perspectives based on previous educationalor professional life experiences. In this study, many informantsdescribed speaking only after careful deliberation and in a way thatreflected critical thought. Moreover, in several classes, what oneuttered in class was data used for evaluation purposes by the faculty.Thus, instead of having their thoughts valued and being helped todevelop these thoughts, the informants perceived that they were beingtold that their thoughts were wrong or inadequate. In this way, thelegitimacy of being a learner was negated.The effectiveness and meaningfulness of learning experiences thatacknowledge and make use of the students' diverse backgrounds has beenreported by nurse researchers (Rather, 1992; Rendon, 1988). This themeis also a predominant focus in the nursing literature on returning RNstudents (Beeman, 1990; Bramble & Siegel, 1990; Rice, 1992). These164findings are also strikingly similar to those reported by Belenky,Clinchy, Goldberger, and Tarule (1986, p. 107) in their description ofwomen learners as "separate procedural knowers." These women werelearning the rules of reasoned argumentation and were vulnerable tocriticism by authorities when they introduced any subjectivity intocontributions. A collaborative process in which there is sharing ofperspectives is widely recognized as being the most effective student-teacher interactive mode for adult learners (eg. Conti, 1985; Knowles,1978). This is thought to be especially true in the development ofhigher levels of thinking (Garrison, 1992). When this philosophicalperspective to teaching and learning was actualized in the master'snursing program, the informants in this study perceived the process asbeing empowering and advocated more universal application of teachingand learning strategies based on this perspective.The second theme that characterized student-faculty relationshipswas "unintentional indifference." While the informants acknowledged thelack of deliberate intent on the part of the faculty, they were clearlydemoralized by some of the faculty's apparent lack of sensitivity to andcaring about them as unique individuals and as learners. Similarfindings have been reported in a study of caring and uncaringinteractions and relationships between undergraduate nursing studentsand faculty (Hughes, 1992). Two studies of graduate level students wereconsistent with the findings in this study that the faculty weregenerally not interested in them and were not responsive to their needs(Khanna & Khanna, 1990; Lloyd & Gartrell, 1983). In a study ofbaccalaureate nursing students, Nelms (1992) reported that the students165were surprised at the faculty's lack of awareness and sensitivity to theexperience of being a student, especially since the faculty had oncebeen students themselves.The themes of "conditional respect" and "unintentionalindifference" both speak to the absence of a sense of connection thatthe informants perceived in many of their relationships with thefaculty. A sense of collegiality was the exception; a sense ofseparateness was the norm. In a study of students from theundergraduate to the graduate level, Magolda (1987) reported that thedesired relationship with faculty was one that was characterized byrespect, camaraderie, and caring. In studies of baccalaureate nursingstudents in the clinical area, interpersonal aspects of the student-faculty relationship such as respect, conveying confidence,availability, freedom to ask questions, and honesty were more importantthan teacher competence (Bergman & Gaitskill, 1990; Brown, 1981).Moreover, the recent studies of the intellectual (Belenky et al., 1986)and the moral-ethical (Gilligan, 1982) development of women substantiatethe primacy of caring, connection, and relatedness with others. Indeed,nurse educators and feminist scholars assert that empowerment is afeminist process with themes of consensus, valuation, the power of thecollective, a safe caring environment, and "power to" rather than "powerover" (Deutchman, 1991; Ruffling-Rahal, 1992; Sohier, 1992; Symonds,1990).Contemporary perspectives on empowerment in nursing educationadvocate teaching/learning experiences that are "congruent with the goalof education for professional practice" (Carlson-Catalano, 1992, p.166140). Experiences that promote scholarliness and the development of apositive self-concept are based on equality (Bevis, 1990; Sellers &Haag, 1992), mutual affirmation and validation (Allen, 1990; Kosowski etal., 1990), reciprocal and open dialogue rather than a monologue on thepart of the teacher (Chally, 1991; Fahlberg et al., 1991), consensusbuilding (Kosowski et al.), and mutual respect and trust (Chally, 1992;Gibson, 1991; Hawks, 1992; Sellers & Haag, 1992). The descriptions ofempowering student-faculty interactions in this body of theoreticalliterature are in stark contrast to the perceived experiences of theinformants in the study.One of the conditions in the teaching/learning situation that isthought to be fundamental to empowerment is a sense of collegiality(Carlson-Catalano, 1992; Hughes, 1992). Collegiality means that nurses"value the support of colleagues and the extensive experience of othernurses" and faculty demonstrate collegiality by the "conscious andconsistent outward valuing and rewarding of students' efforts" (Carlson-Catalano, p. 142). Chally (1992) asserts that the teacher structures alearning environment that is empowering by conveying that eachparticipant is integral to the group, and that the diverse knowledge andperspective that learners and the teacher bring into the group learningsituation can be used to achieve a shared vision of knowledge. Theenergy generated in such a process propels each individual in the groupto a higher level of empowerment (Chally; Mason et al., 1991; Montisano-Marchi, 1990). The teacher is a co-learner and does not demonstrate anattitude of being the individual in the group who has power or who isthe expert. In such a case, the result would be destruction of group167cohesion, and the focus of the group would shift from the process oflearning to concerns about papers and evaluation (Chally; Sellers &Haag, 1992). The self-concept of each learner is deliberately enhancedwhen the teacher values the contributions of each learner and conveysthat the learner is a knowledgeable person (Chally; Chavasse, 1992).Furthermore, faculty behaviors that are empowering includeenabling students to acquire the most relevant information in the formof written resources (Lord & Farlow, 1990); promoting creativity andspontaneity (Bevis, 1990); recognizing and responding to the stress andfrustration of being a student (Chally, 1992); and "being sensitive toboth the negative and positive effects of one's presence and one's wordson others" (Copp, 1989, p. 169).Thus, the findings of this study lend credence to the notion thatthe nature of student-faculty interactions is critical to thedevelopment of empowerment in nursing students. Collaboration,collegiality, and caring are key elements in an empowering educationalprocess. The informants emphasized in their accounts that theyperceived that their negative experiences with faculty were the resultof thoughtlessness rather than deliberate intent on the part of thefaculty. The informants' acute sensitivity to potentially threateningenvironmental stimuli may have contributed to inaccurate perceptions ofthe faculty's verbal and nonverbal behavior. There was usually anaccumulation of small negatively-perceived events rather than a singleexperience of crisis proportions. Thus, seemingly inconsequentialexperiences or events in student-faculty interactions may assumeexaggerated negative proportions from the perspective of the master's168nursing student role. The informants' recommendation that measures betaken to increase dialogue among students and faculty would appear to bea potentially fruitful beginning to resolving many of the issues andconcerns in student-faculty relationships.Relating with other students.According to the informants in this study, the nature of theirrelationships with the faculty was decidedly different from that withtheir fellow students. It appears that the students' sense of a commonvulnerability and shared goals provided the foundation for relationshipsthat were characterized by mutual respect and trust, caring, andsharing. Lum (1988) suggests that peer groups within a subculture arean important supportive resource because "past suffering and successesserve as a powerful bond" (p. 266). Comparing experiences with thosewho shared the same experiences was as supportive and validating aprocess (Lee, 1988; Rather, 1992) for returning registered nursestudents as it was for the master's nursing students in this study. Itwas a way in which "to feel that someone . . . understands and that youare not alone in your misery. You also know that you aren't crazy ormisperceiving the entire experience; others have gone through the sameemotions and situations" (Shane, 1983, p. 140). Becker et al. (1961)characterized the medical student cohort that they were studying as a"community of fate and suffering, bound together by feelings of mutualcooperation, support, and solidarity" (p. 267). Additionally, similarfindings were reported in a study of baccalaureate nursing students; thestudents had a "do or die--them against us" attitude that drew thestudents together (Nelms, 1990, p. 293). There was a camaraderie or a169feeling that "we're all toughing it out together. . . . knowing that I'mnot the only one that feels this way" (p. 293).The finding that the informants' relationships with fellowstudents was an "exclusive fellowship" has been similarly reported inother studies. In Nelms' (1990) study, the baccalaureate studentsreported that "no one on the 'outside', so to speak, can ever reallyunderstand the intensity of pursuing nursing education" (p. 293).Urbano and Jahns (1988) add that it is common to find that doctoralnursing students' relationships with each other take precedence overprevious relationships because the latter are less relevant to thecurrent daily concerns of the students. Further, supportive peerrelationships among graduate students have been reported to have a botha mediating and moderating effect on stress (Butler, 1972; Goplerud,1980; O'Connor, 1988). Bradby (1990), in a qualitative study ofbaccalaureate nursing students, reported a low level of group affinityexcept in terms of adversity. That finding is consistent with thefindings in this study, but there was a high degree of affinity withinthe smaller cliques that developed over time in the program.From the perspective of personal empowerment, student support foreach other is important in the process of empowerment (Chally, 1992)particularly because of the notions of a shared understanding and ashared adversity (Kieffer, 1984; Lord & Farlow, 1990). By extension,the notion of empowerment as a collective process suggests thatinteractions among the informants would be based, not just sharedunderstanding and shared adversity, but also on mutual valuing, mutualtrust and respect, and collaborative efforts. These qualities of170empowering relationships are consistent with the findings in this study.The findings also reveal that there were some negative relationships andinteractions among the students and that these were similar to thosethat the informants experienced with many of the faculty. However, assuggested by the informants, their need for each other tended to promotemore sustained efforts to create and maintain effective relationships.Opportunities for the informants to interact with other students werealso more common than with the faculty. Thus, in contrast to therelationships that the informants had with the faculty, therelationships that the informants enjoyed with their fellow students canbe said to have been empowering.The Art of Being an MSN Student The notion that there is an art to being a master's nursingstudent arose from the informants' accounts of a body of knowledge andskills that were associated with successful and comfortable negotiationthrough the academic system. The initial confusion and loss of securityand predictability that the informants experienced on entering themaster's nursing program was consistent with findings in other studiesof other nursing students (Bradby, 1990; Shane, 1983; Van Dongen, 1988)and graduate students (Butler, 1972; Lange, 1980).Vigilance and information-seeking are strategies used byindividuals in situations that are ambiguous and arouse feelings ofuncertainty and vulnerability (Lazarus & Folkman, 1984; Mishel, 1988;Pearlin, 1985). This theoretical perspective on cognitive appraisalsubstantiates the findings in this study. The informants wereparticularly attentive to environmental cues that might guide their171behavioral responses and to information that might have implications fortheir success in the program. In a study of registered nurse students,Lee (1988) similarly reported that the students gathered information inorder to prepare against possible harm. The informants in this studyperceived that the faculty did not consistently provide informationalsupport that would help them to adapt to the master's nursing studentrole. Deliberate attempts by the faculty to discover and convey usefulinformation were minimal; at times, information was deliberatelywithheld. Sometimes, information was provided that was predictive andenabled the students to plan and make choices about their behavior(Janis, 1985). However, it was often provided in such a negative waythat the informants felt helpless to control the implied threat in themessage. Informational support that allows for choice, anticipatoryplanning, and control would be more consistent with the notion ofempowerment.In so much as the information from the faculty was deficient ormisleading and channels of clear and honest communication betweenstudents and faculty were often closed, the informants in this studyreported obtaining information that was based on inferences made byfellow students or on information from the "rumor mill." Warnings aboutfaculty members and "horror stories" seemed to predominate ininteractions in the graduate student lounge and often had the effect ofundermining the informants' sense of security or competence. Similarly,Shane (1983) reported that rumors were common and often focused onevents in the past or involved individuals who were not present in theconversation. The informants in this study stated that stories about172successes and achievements and enjoyable learning experiences were lesscommon. Olesen and Whittaker (1968) also noted that telling positivestories, especially about achievement, was unacceptable to thebaccalaureate nursing students in their study because one would bebragging. The authors stated that those students who achieved mostsuccessfully avoided censure from fellow students "by relating storiesof befuddlement, of failure, of embarrassing errors undoubtedlyoccasioned by faculty shortcomings in teaching" (p. 191). Exceptionalachievement was not the group norm and, for students who did excel, itwas a problem to "excel without offending their classmates" (p. 192)."It was bad manners to boast of making an A . . . unless it was donewith a tinge of astonishment" (p. 193). Thus, the intense negativityexpressed by some of the informants in this study may be due in part tothis tendency of students in the master's nursing program to focus onpainful experiences in their interactions with each other and,consequently, with this researcher.Theories about roles contribute several perspectives that haverelevance to the notion of an art to being a master's nursing student.A subculture is a collection of individuals within a larger societalgroup that often has a language that is distinct (Lum, 1988). Learningand using this language is an identifiable sign of membership in thatgroup. This subculture concept may be useful in interpreting thefinding that the informants had to learn the language of being an MSNstudent. The same phenomenon of learning and using a distinct languagewas reported in a study of the baccalaureate nursing student subcultureby Olesen and Whittaker (1968).173Additionally, a subculture "develops perspectives . . . specifyingthe kinds of activities that are expedient and proper" (Lum, 1988, p.267), as well as norms and values to which the individual must conformin order to belong to the group. Lange (1980) theorized that anessential part of being a graduate student was to "learn the norms ofthe already existing student subculture" and get "information on 'how toget things done'" (p. 147). These ideas are consistent with thesubtheme of "deliberate accommodation" that was described in this study.By using two reference groups--the student group and the faculty group--the informants compared and modified their behavior to fulfill the roleof master's nursing student.The notion that there are rules for acceptable ways of thinkingand behaving in a university setting is not new. There have beenresearch studies in which the purpose was to elucidate the acceptabilityor unacceptability of certain behaviors from the perspective of studentsand of faculty (eg. Amsel & Fichten, 1990). In their seminal study ofthe socialization of medical students, Becker et al. (1961) reportedthat the students had a "collective understanding .	 . about mattersrelated to their roles as students" (p. 46) and perspectives on handling"problematic situations. . . . those things that everybody knows andeverybody does" (p. 36) in order to "get through school" (p. 163). Inkeeping with the findings in this study, Becker et al. described medicalstudent' collective perspectives on how to deal with the faculty, make agood impression, or handle the workload. Perhaps not coincidentally,the practice of "brown-nosing" was as poorly tolerated in the medicalstudent group as it was in the master's nursing student group. In a174study of baccalaureate nursing students, Olesen and Whittaker (1968)reported the phenomenon of "studentmanship" in which the studentslearned "how to get through school with the greatest comfort and leasteffort" (p. 150) by "psyching out the faculty, knowing when to ask foradvice from a faculty member, using the appropriate language, and otheruseful behaviors. One form of studentmanship was "fronting" (p. 173) inwhich the students demonstrated the behaviors that they believed wouldcreate the most favorable impression with the faculty. This consistedof blending "the correct mixture of assertiveness, humility, andawkwardness" (p. 177), and, of course, demonstrating interest inwhatever the faculty member had to say. Going too far in fronting wassimilar to "brown-nosing" and was considered "in bad taste" (p. 184).Finally, "countervailing strategies," another form of "deliberateaccommodation," in order to fulfill role demands, was reported in astudy of graduate occupational therapy students (Butler, 1972)."Deliberate accommodation," "developing perspectives,""studentmanship," and "countervailing strategies" are all similar inthat the students perceive them as ways of getting through theireducational program efficiently and successfully. They are means ofgaining and maintaining membership within the student peer group. Moreimportantly, they are a reaction to a perceived need to protectthemselves from the from the faculty and from what Olesen and Whittaker(1968) called, "the perils of an incomprehensible and unfriendlyinstitution" (p. 292). In view of the fact that the informants in thisstudy felt that they were in a dependent and less powerful position thanthe faculty, they were more likely to be outwardly accommodating and175less likely to be challenging, assertive, and to take risks. Theperspective of the students in this study and in other similar studieswas to "find out what they want and give it to them."This same phrase was used by Belenky et al. (1986) to describewomen as separate procedural learners. These authors stated that suchstudents learn and apply the rules of thinking but are unaware of ordenied the expression of their own subjectivity and respond in learningsituations by "[finding] out what the guy wants and [giving] it to him"even though intuitively they know that this knowledge is "meaninglessand unreal" to them. They do so in order to "placate the authorities"(p. 98). Further, similar to one of the informant's narratives in thisstudy, Belenky and colleagues describe separate procedural learners as"chameleons [who] cannot help but take on the color of any structurethey inhabit" (p. 129). They accommodate to rather than assimilateknowledge (p. 123) and "many students become adept at playing theacademic game of separate knowing" (p. 107).Thus, in this and other studies, carefully calculated conformingand compliant behavior was a way of surviving the educational process.Conformity is thought to lead to feelings of security because everyoneis doing it, but it fails to allow for individual difference andpersonal fulfillment (Starr and Goldstein, 1975). Compliance is thoughtto be functional for the student role. However, it contributes tofeelings of powerlessness and low self-esteem and, consequently, hasnegative implications for fulfilling future professional roles becauseit inhibits independent thought and promotes excessive respect forauthority (Rendon, 1988). In empowerment theory, significant indicators176of the absence of empowerment in nursing education are conformity,compliance, and decreased risk-taking (Allen, 1990; Chavasse, 1992;Clay, 1992; Zerwekh, 1990). The authors writing in this area speak tothe basic mistrust that students have for the faculty in educationalexperiences that are not empowering, and to the students' acuteawareness that the faculty are in a position to punish them,particularly through the use of grades.Thus, while the art of being a master's nursing student serves abeneficial function in providing informational support to the students,it is also a potentially harmful phenomenon. Information gleanedthrough the "grapevine" was not always conducive to the generation ofaccurate appraisals of events and experiences and thus did notnecessarily provide predictive information that would allow foranticipatory planning. Moreover, the art of being a master's nursingstudent was perpetuated by the informants' ongoing perception of threatand loss in their experiences in the nursing program. The resultingconformity, compliance, and decreased risk-taking ultimately createdfeelings of powerlessness and resentment.SummaryThus, the reality of being a master's nursing student can be saidto be a less than ideal and empowering experience. The informants'accounts of positive experiences are diminished by their accounts ofnegative experiences. Many of these perceived negative experiencescould be avoided or eliminated through increased opportunities fordialogue among the students and the faculty. A number of possiblefactors have been identified that might account for the intense177negativity of the informants' reports of their experiences and,consequently, the negativity must be interpreted with caution.Nonetheless, there is no doubt but that the informants did suffer someexcessively negative and painful experiences as master's nursingstudents.Responding to the ImpactThe Impact: Losing Control Shaking the foundations.From the perspective on the informants in this study, becoming amaster's nursing student entailed loss, change, challenge, and threat.The predictable and secure foundations on which the informants definedthemselves as professionals and as people were shaken. Although theinformants anticipated a change in self-concept, they appeared to havebeen unprepared for the extent to which they experienced this change.Their perceived loss of control over experiences impacted on their self-concept as well as their responses to these experiences.Loss and change in relation to transition from a professionalnursing role to a student role appeared to be the most predictableaspects of becoming a master's nursing student. Challenges toprofessional beliefs, values, and assumptions meant developing a newprofessional identity. Threats to self-esteem arose from experiencesthat disrupted the informants' perceptions of themselves as competentindividuals, as individuals who were able to fulfill theirresponsibilities independently, as individuals with personal integrity,and as individuals who had some control over the outcomes of theiractions. Lazarus and Folkman's (1984) distinction between challenge and178threat in the process of cognitive appraisal is a useful way to reflectthe informants' experiences in this study. Both threat and challengenecessitate coping strategies. However, threat has negativeconnotations of anticipated harm or loss and associated emotions offear, anxiety, and anger; challenge infers a potential for gain orgrowth and associated emotions of excitement and eagerness (p. 33).Thus, while the informants were excited with the challenge of learning,their self-esteem was threatened by circumstances and experiences duringthe process of learning.Losses and changes are thought to be associated with roletransition (Hardy & Hardy, 1988; Schlossberg, 1981). In this study, theinformants described the transition into the master's nursing studentrole as resulting in the loss of status and credibility, changes infinancial and living circumstances, and disruptions in interpersonalrelationships. These losses and changes are consistent with findings inother studies of graduate-level students (Butler, 1972; Clark & Rieker,1986; Khanna & Khanna, 1990) and in studies of returning registerednurse students (Diekelmann, 1989; Klaich, 1990; Shane, 1983; Van Dongen,1988).Challenges to professional identity among returning registerednurse students are also well documented in the theoretical nursingliterature (Bramble & Siegel, 1990; Throwe & Fought, 1987; Woolley,1978). Basing her discussion on Mezirow's theory of perspectivetransformation, Duff (1989) contends that returning RN students mustundergo a perspective transformation in which current beliefs,assumptions, and practices are challenged by new knowledge, skills, and179experiences. A changed professional self-concept arises out of thestruggle to resolve this cognitive dissonance. In this study, theinformants perceived these challenges to professional identity asexciting and yet disconcerting.Likewise, this process of change or transformation was perceivedas disturbing in studies of other students (Butler, 1972; Rather, 1992).In her study of transitions in the professional identity of master'snursing students, Klaich (1990) reported findings that reflected thatthe participants in her study were "undergoing multiple changes in selfand in their surrounding environment" (p. 21) as were the students inthis study. Moreover, similar to the findings in this study, Klaichreported that the process of transition in professional identityoccurred concurrently with a disturbing disruption to the students'self-esteem. Low self-esteem has also been reported in other relatedstudies (Bradby, 1990; Butler, 1972; Khanna & Khanna, 1990; Van Dongen,1988). These authors' explanations for the students' low self-esteemare similar to those identified in this study.A positive self-concept and a sense of control are thought to behallmarks of personal empowerment (Gibson, 1991; Hawks, 1992). On theother hand, an attitude of self-blame, feelings of helplessness orhopelessness, victimization, dependence on others, and a sense of lossof control over one's life are indicators of the absence of personalempowerment (Chavasse, 1992; Gibson). Moreover, according to Stevenson(1990), the development of personal empowerment is contingent on self-esteem. Thus, educational experiences that are empowering willdeliberately provide experiences that promote the development of self-180esteem (Zerwekh, 1990). More than any other single factor, the student-faculty relationship is the most critical in the development of self-esteem (Zerwekh). Even simple actions, such as being available to thestudents and expressing a belief in their abilities, act to enhanceself-esteem and are therefore empowering (Hughes, 1992). Again, thedifference between the informants' experiences and theories of personalempowerment is significantly different.The pervasive pressure of school.The informants in this study described the ways in which theunrelenting pressure of school impacted on their day-to-day lives. Theinformants perceived that they had little control over their lives:they had lost the stability of routines and predictability, and they hadto give up or reduce usual activities that often were used as copingmechanisms. The notion of "role overload" refers to a state in whicheither "the demands of a role are excessive" (Hardy & Hardy, 1988, p.225) or a state in which there is an overwhelming multiplicity of roles.In this study, the informants had to contend with both kinds of roleoverload. Within the student role, the informants reported having tomodify their lifestyles in an attempt to cope with an unmanageableworkload. At the same time, fulfilling student role responsibilitieshad to be balanced with responsibilities associated with other rolessuch as wife, mother, sister, nursing employee, and friend. Similarfindings have been reported in Van Dongen's (1988) study of the livedexperience of being a first year doctoral student. She reported that,"students typically worked a nonstop 17-hour day that included diversefamily and student responsibilities. Subjects described the need to181`make every minute count' and routinely strived to accomplish severalactivities simultaneously" (p. 22). Non school-related activities werecurtailed when possible. Van Dongen concluded that such lifestylechanges are "survival strategies that enable the student to meet thedemands of doctoral studies within the context of concurrent lifeevents" (p. 23). Changes in interpersonal relationships, includingmarital relationships, were substantiated in Klaich's (1990) study. Ina study by Campaniello (1988), it was found that occupying multipleroles did not significantly influence perceived role conflict but ratherthe nature of the role. Campaniello stated that, in particular, therole of parent was the most significant in relation to role conflict.In a qualitative study of the experience of baccalaureate nursingstudents, Nelms (1990) reports that the lived experience was, in part, a"life-pervasive intensive commitment" in which a seeminglyinsurmountable amount of work created "constant pressure" andnecessitated dramatic lifestyle changes. Unlike the findings in thisstudy, however, Nelms reported that a strong theme was "putting life onhold." This is contrasted with the informants in this study whoseperception was more that of, "life must go on." This discrepancy ispossibly explained by a probable difference in developmental stage oftypical baccalaureate students and the more mature master's students inthis study.In empowerment theory, the individual is viewed from a holisticperspective. There is knowledge about individuals within the context oftheir lives and, thus, there is an awareness and acknowledgement ofpersonal and situational constraints on goal achievement (Katz, 1984;182Kieffer, 1984; Lord & Farlow, 1990). Thus, in a master's nursingprogram, personal empowerment would require awareness of constraintsassociated with role overload and appropriate adjustments inteaching/learning experiences to account for such constraints.The threat to physical and emotional well-being.The finding that the stress and pressure of being a master'snursing student resulted in threats to physical and emotional well-beingwas anticipated in view of similar findings reported in numerous otherstudies of students including baccalaureate nursing students (Beck &Srivastava, 1991), returning registered nurse students (Shane, 1983),graduate-level students (Firth, 1986; Johnson & Remus, 1985; Khanna &Khanna, 1990), and graduate nursing students (Van Dongen, 1988).Clearly, personal empowerment is less likely to occur when students areconcerned with more fundamental needs for physical and psychologicalsafety.Before leaving the discussion of the impact on the informants oftheir experiences as master's nursing students, it is important toconsider their preoccupation with grades and how the reality of being amaster's nursing student contributed to that preoccupation. Throughoutthe interviews, the informants focused on grades. The significance ofthese grades was evident in the strong relationship between grades andself-esteem. In many instances, it appeared that learning was far lessimportant than grades. Three circumstances appeared to have influencedthe informants' stance on grades. First, the possibility of failure toachieve was clearly a threat to the informants' short term goal ofsuccessfully completing the master's nursing program and to their long183term goals of fulfilling professional dreams in terms of career orfurther education. As was discussed earlier, the informants had a greatdeal invested in being successful in the program and were highlymotivated to achieve their professional dreams. Second, becoming amaster's nursing student removed the informants from the usual basis oftheir self-esteem--their identities as professional nurses. The work ofbeing an MSN student limited their ability to engage in secure andpredictable ways of being and coping, and social relationships werepredominately with other students in the program. Thus, developing anew identity and a renewed sense of self-esteem had to develop from theexperiences of being a master's nursing student. Shane (1983) theorizedthat, for the registered nurse student, total immersion in theexperience of being a student leads to the student role becoming theonly source of "validation, identity, and self-esteem" (p. 142). Inview of the fact that the informants received little feedback except inthe form of grades, they thus became much more meaningful to theinformants. Third, the faculty did not convey a belief in thelegitimacy of being a learner to the students. There were few effortsto convey, through acknowledging growth or measures to promote growth,that learning is a process. Feedback in the classroom or on papers wasmerely a continuing judgment of the informants' inadequacy as scholars(Belenky et al., 1986). Therefore, forces in the teaching/learningenvironment and within the student inevitably made grades pre-eminent inthe eyes of the informants. The reality of being a master's nursingstudent perpetuated an unhealthy preoccupation with grades and made theprocess of learning a secondary goal.184Interestingly, studies of students in other nursing programs or ofgraduate level students did not report the same intense focus on gradesas was found in this study. Most of these studies mentioned grades as astress-producing factor in the students' experience but not to the samedegree. Although only one of the informants mentioned the possibilityof failing; all of the other informants were concerned about how hightheir grades were. The only students, reported in the literature, whoappeared to match the intensity of concern about grades were medicalstudents and, for the most part, their concern was in achieving passinggrades rather academic standing.Thus, the informants' experiences as master's nursing studentsresulted in multiple changes in professional and personal identity.This disruption led to the informants' perception that they, not onlyhad minimal control of events in the nursing program that werethreatening or harmful, but also that they were not in control of theirresponses to these events. Moreover, they perceived that they adiminished ability to adapt positively to the reality of being amaster's nursing student. Preoccupation with grades appears to havesignificantly contributed to the perception of threat and harm in theinformants' experiences and may have acted as a stimulus for feelings oflow self-esteem and powerlessness. However, the informants reportedthat the most damaging experiences to their personal identity resultedfrom negative interactions and relationships with faculty members.Regaining Control Regaining control was a process that did not progress in a linear,forward manner. In particular, situations in which the informants185doubted their abilities most often contributed to renewed feelings ofloss of control. In a description of the experiences of returning RNstudents, Shane (1983) refers to a similar phenomenon which she calls"oscillations" between one stage of a "return-to-school syndrome" andanother (p. 107). The two categories of strategies that the informantsused to regain control have been conceptualized thematically as"manoeuvering for survival" and "the perceptual shift." The differencesbetween the two are in their passive or active orientation and in theirtemporary or more enduring effectiveness.The strategies in "manoeuvering for survival" included defensivemeasures such as displacement, rationalization, using humor, and beingpositive. The other strategy was persevering, which required denial ofpainful experiences to some extent and a repeated refocusing on thecommitment to goal achievement. Other researchers report the use ofsimilar strategies by baccalaureate RN students (Mattson, 1990;Thompson, 1992) and by doctoral nursing students (Van Dongen, 1988).The "perceptual shift" encompassed three strategies for regainingcontrol: redefining priorities, a shift in locus of control, andfinding meaning. These strategies required introspective thought on thepart of the informants and, thus, the informants described them asdeliberate responses rather than mere reactions to their sense of lossof control. In making a perceptual shift, many of the informants wereable to transcend the pain and negativity of their experiences.Priority setting was used by the participants in Van Dongen's(1988) study of doctoral nursing students' coping with the demands offulfilling multiple roles on a day-to-day basis. That finding is186similar to the one in this study. However, in this study, many of theinformants also redefined priorities based on a new perspective on themeaning of grades.Shifting locus of control meant that the informants moved frombelieving that they had little or no control to believing that they hadsignificant control over their experiences as master's nursing students.At the same time, they gained awareness of aspects of their experiencesover which they did or did not have control. Thus, instead of feelingvictimized and powerless to influence the outcomes of their experiences,the informants took personal responsibility for meeting their ownlearning needs, interests, and goals.Finding meaning in their experiences as master's nursing studentswas usually done retrospectively by these informants. The focus of manyinteractions among the students was speculation about the purpose oflearning experiences or the motives underlying the behavior of thefaculty. Often, such discussions reinforced negative perceptions of thefaculty and of the program. Only a few of the informants, eitherindividually or as a result of discussions with selected fellowstudents, were able to reflect on and gain a more personally significantperspective on the meaning of their experiences as master's nursingstudents. This process is similar to the resolution of the "returning-to-school syndrome" described by Shane (1983). She described studentswho are "bicultural" and who seemed to be getting the most out of theireducation experience because they were "not fighting any more (p. 117),but rather were accepting of experiences because they now perceived themas significant personal learning experiences. A parallel phenomenon187occurred in the registered nurse student group studied by Rather (1992).With time to reflect upon their experiences, the students in that studywere able to make sense of them and to understand the positive outcomesof a painful process of change in their ways of perceiving and thinking.Not all of the informants made a perceptual shift. The perceptualshift has been conceptualized as a movement away from "deliberateaccommodation." Well into the second year of the program, some of theinformants were still feeling victimized, angry, or "playing the game."However, for those informants in whom the shift did occur, the accountsdescribed feeling more personally satisfied with their learningexperiences and more committed to the process of learning. It has beensuggested that individuals have a greater commitment to a goal andperform at a higher level following a dissonance-produced attitudinalchange (Markus & Zajonc, 1985). As a subgroup of the sample, theinformants who had graduated from the program were more successful thanthose still in the program in finding meaning from their experiences asmaster's nursing students. They found that their experiences enabledthem to attain professional goals and to function effectively inadvanced nursing positions. Thus, as one informant said, "The proof isin the pudding."The informants who made a perceptual shift were like the learnersdescribed by Belenky and colleagues (1986) who began to "integrateknowledge that they felt intuitively was personally important withknowledge they had learned from others" (p. 134). Similar to theexperience of the informants in this study, they were able to achievethis kind of "constructed knowing" after going through "a period of188intense self-reflection and self analysis" (p. 135). Ultimately, theyhad the same feelings of satisfaction with their learning experiences;their learning had personal meaning and relevance.Thus, although all of the informants utilized strategies to regaincontrol over their experience as master's nursing students, most of theinformants utilized ones which were only temporarily or partiallyeffective and, consequently, merely survived their educationalexperience. Those few, who were able to make a "perceptual shift,"expressed significantly stronger feelings of strength, competence, andconfidence than those informants who had not made the shift. However,this shift required personal work on the part of the informants toregain control over their master's nursing student experiences. Suchwork required time and energy--variables which were identified as beingin short supply in the master's nursing student experience. Specificinterventions by the faculty to promote this process of making a" perceptual shift," and recognition of the benefits of this process bymaster's nursing students may significantly impact on the development ofempowerment in master's level nursing education.Personal Empowerment Personal empowerment as an outcome.All of the informants related that they were growing or had grownprofessionally as a result of their experiences as master's nursingstudents. They identified new knowledge and skills, and an enhancedperspective of the profession of nursing. A study of changes in theprofessional identity of master's nursing students by Klaich (1990)reflected similar kinds of professional growth.189The personal growth that the informants experienced occurred as aresult of responding to adversity in their experiences as master'snursing students. They had endured painful and negative experiences andwere achieving or had achieved the goal of successfully completing theprogram. The result was a new awareness of self in relation tostrengths, limitations, beliefs, and values. Further, there was a senseof feeling stronger as a result of being able to deal with adversity andaccomplish the goals of the program successfully. These findings aresimilar to those in other studies of nursing students (Nelms, 1990;Shane, 1983; Van Dongen, 1988). It has been suggested that, insituations in which individuals are tested and able to meet the inherentchallenges, the result can be a sense of resourcefulness, resilience,self-esteem, and capability (Younger, 1991). Similarly, Lazarus andFolkman (1984) describe the "growth of competence and the joy of triumphagainst adversity" (p. 3) in overcoming challenging situations. Thetheoretical literature suggests that nursing students need to developskills to cope with ambiguity, disequilibrium, and multiple rolesbecause those are the kinds of stresses that will be experienced in theworkplace (Fahy, 1986; Kennedy, Oakley, & Denyes, 1988; Van Dongen,1988). These coping skills were identified by some of the informants asthe type of personal growth that they had experienced.Therefore, the findings substantiate that the informants in thisstudy perceived that they had developed a sense of personal empowermentin their experience as master's nursing students. The challenge of thework of being a master's nursing student was perceived as resulting inprofessional growth; achieving successfully in the master's nursing190program despite painful or negative experiences was perceived asresulting in personal growth. These findings introduce the notion thatadversity in the pursuit of master's level nursing education may notnecessarily be counterproductive to the development of personalempowerment.The process of personal empowerment.The informants perceived that they had grown professionally andpersonally from the experience of being a master's nursing student.However, they were much less satisfied with the process of achievingthat growth. First, the idea that the process would be a challenge wasacceptable to and anticipated by the informants. However, they did notexpect to pay the price that they did in order to achieve the goals ofthe program. For them, the pain and the adversity had been excessive.Specifically, the informants described a devastating loss of self-esteemduring their experiences as master's nursing students which theyprimarily attributed to the actions of the faculty. One of theinformants in this study described feeling like she had growntremendously, but in the process, "parts were shattered, and I haven'tgotten them back." Belenky and others (1986) described a student at theend of graduate studies, who, using almost exactly the same words,stated that she "feared that she had lost parts of herself" (p. 132) inthe course of her educational experience. Another of the informantsspoke of obstacles to personal empowerment in terms of the energyexpended in maintaining a sense of self rather than expanding a sense ofself. Second, the informants perceived that they had not been empoweredto the extent that they might have been had their relationships with the191faculty been different. They suggested that the faculty were inadequateas facilitators of the process of mastering challenge and overcomingadversity. Williams, Block, and Blair (1978) reported that graduatenursing students perceived that the faculty had not contributedsignificantly to their learning and that they had learned more fromwriting papers and from their peers.The notion mastery has been identified as an outcome of theprocess of empowerment (Gibson, 1991; Hawks, 1992). Mastery has beendefined as "a human response to difficult or stressful circumstances inwhich competency, control, and dominion are gained from the experienceof stress. It means having developed new capabilities, having changedthe environment, and/or reorganized the self so that there is a meaningand purpose . . . " (Younger, 1991, p. 81). Mastery goes beyond merelyenduring a stressful situation to "transcending the difficulty of theexperience" (p. 86) and experiencing a transformation that leads to asense of harmony. Those students who had been able to make a perceptualshift--particularly those who found meaning in their experiences--mostclosely approached the notion of a sense of mastery. However, themajority of the informants perceived that their experience as master'snursing students was predominantly one of survival.Thus, master's nursing students can be empowered to a higher levelthrough deliberate actions on the part of the faculty to promote thestudents' acquisition of knowledge, skills, and self-esteem. Althoughsome students are able to empower themselves through making a"perceptual shift," this process can be facilitated by the faculty forall students. Suffering, in the form of excessively painful or negative192experiences clearly inhibits the development of personal empowerment;challenge and adversity, combined with the resources to achieve mastery,promote the development of personal empowerment.In conclusion, although the informants had achieved many of theoutcomes of personal empowerment, the process of achieving thisprofessional and personal growth was not necessarily conducive to thedevelopment of personal empowerment. Brookfield (1985), a respectedauthority in adult education, suggests that "significant personallearning may involve anxiety, pain, self-doubt, and ambiguity" (p. 45).However, he goes on to say that only if a sense of "individualempowerment and self-esteem is realized will adults possess theemotional strength to engage in that form of personally significantlearning which is seen as the outcome of adult education" (p. 47). AsFarley (1990) states about nursing education, "Pain is inevitable, butsuffering is an option" (p. 93). Empowerment in nursing education isabout stopping the suffering.Chapter SummaryThis chapter has discussed the findings of the study in relationto relevant literature and, specifically, in the context of the conceptof personal empowerment. The three major sections of the findings--"thedream versus the reality," "experiencing the reality," and "respondingto the impact" have been considered in this light.The literature supports this study's findings that master'snursing students experience increased levels of stress and decreasedlevels of self-esteem in response to their academic experiences. Theseexperiences are predominantly associated with the work of being a193master's nursing student and with the perceived negative relationshipswith faculty. The informants' relationships with fellow students tendedto moderate stress levels by providing significant emotional support.The art of being a master's nursing student was practiced in order tocope with perceived threats in the master's nursing student experience.The findings clearly suggest that the impact of the reality of theexperience of being a master's nursing student is a sense of loss ofcontrol. Disruptions occur in professional and personal identity,lifestyle, and emotional and physical health. Regaining control is aprocess that is more effectively achieved through making a "perceptualshift." The informants reported that, ultimately, they had developed asense of personal empowerment through professional and personal growth.However, the process, by which they growth was achieved, was unusuallytaxing and, thus, the level to which they had been empowered waslimited.Several possible explanations have been proffered for theinformants' decidedly negative perspective of the master's nursingprogram. Nevertheless, there are undoubtedly circumstances and eventsin the master's nursing program which probably inhibited the informants'development of personal empowerment. Many of these have been previouslyidentified in the literature. However, an equally significant factor inthe development of personal empowerment were the informants' actions andresponses to the experience of being a master's nursing student.Actions to front-load the program requirements created self-imposedpressure. Competition and an unreliable "rumor mill" served to increasestress and undermine confidence. A tendency, on the part of many of the194informants, to respond passively to feelings of loss of control may haveperpetuated a sense of powerlessness and interfered with achieving asense of mastery over the experience of being a master's nursingstudent. Thus, the implications of these findings is that thedevelopment of personal empowerment in master's nursing students is mostlikely to be facilitated by the deliberate intent to achieve this goalon the part of both the students themselves and the faculty who areshaping the educational experience.In the following chapter, the study's summary, conclusions, andimplications for nursing education and research will be presented.195CHAPTER SIXSUMMARY, CONCLUSIONS, AND IMPLICATIONS FOR NURSINGSummaryThis study was conducted to explore and describe the developmentof personal empowerment in the experience of master's nursing students.Personal empowerment in nursing education has been recognized as apotentially critical element in the development of professional nurseswho will be able to respond to and shape a changing health carelandscape. The empowerment of master's level nursing students hasparticular significance in view of the expected leadership roles thatthese graduates will assume.	 No other studies could be found thataddressed the phenomenon of personal empowerment in nursing education.For this reason and because of the dearth of studies of the experienceof master's nursing students, the initial literature view was conductedto acquire a theoretical perspective that would guide the datacollection process.The researcher selected the ethnographic method of qualitativeresearch. This method was consistent with the researcher's intent todescribe the phenomenon of the development of personal empowerment inmaster's nursing students. Moreover, ethnographic data collectionmethods enabled the researcher, who was a member of the subculture understudy, to maintain a sense of objectivity in data collection andanalysis.A total of 13 female informants participated in the study. Ofthis total, five were enrolled in the first year of the program, fivewere enrolled in the second year of the program, and three had graduated196from the program in the past year. Semi-structured interviews wereconducted to obtain rich and detailed accounts of the informants'experiences as master's nursing students. A total of 27 interviews wereconducted. Audiotapes of these interviews were transcribed verbatimimmediately following the interviews. Observations, made by theresearcher, of events and situations in graduate nursing studentsettings that required clarification or validation led to theformulation of questions that were posed to the informants. Further,the researcher maintained an ongoing log to record personal experiencesin the master's nursing program and reactions to these experiences inorder to consistently be aware of personal feelings and reactions thatmight influence the process of data collection or data analysis.Data collection and data analysis were conducted concurrently.During data analysis, the transcripts were examined repeatedly forsimilar and dissimilar themes. These emerging themes were clarified,elaborated upon, and validated in the data collection process. Thefinal analysis provided a conceptual schema for reporting theinformants' accounts, and the themes contained in this schema werevalidated by the informants in order to remain faithful to theirexperiences.The three major sections of the experience of being a master'snursing student were conceptualized as "the dream versus the reality,""experiencing the reality of being a master's nursing student," and"responding to the impact of the reality." A decidedly negative tonepervaded the informants' accounts and this negativity has beenconsidered in the light of possible explanatory interpretations within197the context of the totality of the informants' experiences.In "the dream versus the reality," the informants describedconflicting feelings of excitement and anxiety in their initialexperiences in the master's nursing program. They were highly motivatedto achieve specific professional goals and, on entering the program,were excited by the challenge of academic studies at the master's levelin nursing. The anxiety that the informants experienced was based on asense of uncertainty about the reality of being a master's nursingstudent. Because they had much at stake and because of their sense ofuncertainty, the informants were acutely sensitivity to cues that mightbe interpreted as threats to their sense of self or to their goals.The reality of being a master's nursing student was characterizedby experiences that resulted in feelings of frustration and a sense oflow self-esteem. This reality had three components: the work of beinga master's nursing student, the interdependence of being a master'snursing student, and the art of being a master's nursing student. Thework of being a master's nursing student and relating with the facultywere perceived by the informants in a particularly negative light.Although relating with fellow students was generally perceived aspositive experiences, phenomena such as competition among students andthe "rumor mill" contributed to frustration and low self-esteem. Theart of being a master's nursing student was seen as a necessary butsometimes distasteful way of negotiating the academic system comfortablyand effectively.Responding to the impact of the reality of being a master'snursing student was a process of experiencing a sense of loss of198control, regaining that control, and moving toward empowerment. Theinformants' perception of a loss of control centered around disruptionsto their professional and self-esteem, adjusting to the pervasivepressure of school, and managing threats to physical and emotionalhealth. Grades were the single factor most closely associated withfluctuations in self-esteem. Regaining control was an uneven processand dependent on events in the experience of being a master's nursingstudent. While most of the informants utilized sufficiently effectivestrategies to survive their experience as master's nursing students,those few informants who were able to make a "perceptual shift" achievedthe highest levels of a sense of personal empowerment. All of theinformants perceived that they had been empowered through professionaland personal growth. However, the process of the development of a senseof personal empowerment was perceived as being unacceptably painful.Negative experiences in interactions with the faculty were perceived bythe informants as the most significant cause of this pain. Moreover,the informants identified the deficit of deliberate efforts on the partof faculty to facilitate their professional and personal growth asinhibiting the level to which they had developed a sense of personalempowerment.The development of personal empowerment is contingent, to somedegree, on overcoming adversity. Thus, while an educational programmust present a challenge to the students, there must also be the peopleand material resources available to assist the students in meeting thechallenge. Although the faculty's behavior in interactions andrelationships with the students and their selection and shaping of199learning experiences have undoubtedly contributed to the development ofpersonal empowerment in the students, the informants' intense negativitysuggests that the faculty have been deficient in providing adequateresources to facilitate this process. In fact, they may haveinadvertently inhibited the process of the development of personalempowerment in the students. However, the findings suggest that thedevelopment of personal empowerment is a shared responsibility amongstudents and faculty. Master's nursing students themselves have thecapacity to respond activity to the experience of being a master'snursing student to personally promote the development of a sense ofpersonal empowerment. Deliberate efforts by both the students and thefaculty in a master's nursing program are required to promote thedevelopment of personal empowerment. Moreover, relationships betweenand among students and faculty that are characterized by collaboration,collegiality, and caring facilitate and promote the development ofpersonal empowerment.ConclusionsBased on the findings of this study, the following conclusionshave been drawn:1. Master's nursing students are unusually sensitive to cues thatmight indicate a threat to their successful achievement in master'slevel studies. This sensitivity is heightened in novel or ambiguoussituations and may lead to misinterpretation of environment cues asthreatening rather than challenging.2. Insufficient participation by master's nursing students inshaping learning experiences results in decreased motivation to engage200in apparently irrelevant learning experiences. It contributes to thestudents' perception of a sense of powerlessness and generates angry andresentful feelings about course work. Moreover, students' unique needsand abilities in relation to meeting the demands of academic scholarshipand in relation to individual professional goals may be inadequatelyaddressed.3. Timely and constructive feedback is critical in promoting asense of control over the learning process and feelings of competence inmaster's nursing students.4. Lack of reliable and useful information from the facultycontributes to students' feelings of powerlessness and frustration.This situation tends to result in the students' reliance on rumor andgossip within the student group. Such a reliance generates andperpetuates negative perceptions of the master's nursing studentexperience, and exacerbates feelings of anger, powerlessness, and lowself-esteem.5. Master's nursing students depend more on external standards ofachievement to evaluate the progress of their learning than on personalstandards when self-evaluation is not given credence or when criteriafor achievement are ambiguous or unknown. This phenomenon contributesto an unhealthy focus on grades and to a sense of competition among somestudents. There is a strong relationship between academic grades andself-esteem.6. Master's nursing students expect acknowledgement andaffirmation from the faculty of their knowledge and skill based onprevious learning and work experiences. Moreover, they desire the201opportunity to share their expertise and to use it as a foundation forfurther learning.7. Insufficient dialogue among students and faculty creates andperpetuates a sense of separateness in the student-faculty relationship.This separateness inhibits the development of caring, collaborative, andcollegial relationships. A hierarchial power structure is maintainedwhich contributes to students' feelings of powerlessness andinsignificance. Misunderstanding and misinterpretation of motives andactions tend to occur.8. The student group can be a significant positive resource forinformation, emotional support, and academic assistance. However, thestudent group can also be a significant destructive force in promotingnegative perceptions of the master's nursing student experience. Ininteractions with each other, students tend to focus on negative orpainful experiences and to minimize or ignore positive or satisfyingexperiences.9. Unwritten information about "rules" and acceptable andadvantageous behavior is passed from student to student within the sameyear and between years. This information facilitates transition intothe master's nursing student role, but may have long-term negativeeffects. Students vary in their continued reliance on such informationas they gain more experience in the master's nursing student role.10. A sense of loss of control is a typical response to thereality of the experience of being a master's nursing student. Thisloss results from losses and changes associated with transition into themaster's nursing student role. It also arises from experiences that202challenge the students' professional identity, disrupt normal lifestylepatterns, and threaten their physical and/or emotional health. Mostsignificantly, there is a grave threat to the students' self-esteem.11. Students respond in a variety of ways to the experience ofloss of control. Those who are more successful in regaining controltend to have a more active orientation to creating and using adaptivestrategies.12. The passage of time tends to promote the regaining of controlin all students. Moreover, over time, the students tend to develop moreobjective and/or positive perceptions of their experiences as master'snursing students. Students who have graduated are able to express theirperceptions in light of the implications of their learning experienceson the fulfillment of professional nursing roles.13. Personal empowerment of master's nursing students entailsprofessional growth in terms of the acquisition of knowledge and skillsassociated with the individual's professional nursing goals. In thissense, master's nursing students are empowered as a result of theireducational experiences.14. Personal empowerment of master's nursing students alsoentails personal growth in terms of self-knowledge and a higher level ofself-esteem. Students achieve this personal growth from overcomingadversity in the master's nursing student experience.15. Master's nursing students achieve varying levels of a senseof personal empowerment. While students, themselves, are able topromote the development of personal empowerment, the faculty are asignificant influencing force in the process.203Implications for Nursing EducationThe findings of this study suggest many implications for nursingeducation.1. Nursing faculty members should create more opportunities forinformal dialogue between students and faculty. A variety of forumsshould be provided to enhance learning about one another as uniqueindividuals, and to acknowledge and address the students' concerns,problems, and suggestions for change.2. Faculty must provide timely and accurate information tomaster's nursing students that will permit anticipatory planning andjudicious decision-making by the students. Predictive information mustnot negate the students' sense of control.3. Faculty members should acknowledge the multiple roles thatmust be fulfilled by master's nursing students. This acknowledgementcan be actualized through the provision of information that allowsanticipatory planning, through flexibility in assignment due dates, andthrough the prudent selection and organization of learning experiences.4. Efforts should be directed toward increasing studentparticipation in identifying, shaping, and evaluating learningexperiences. These efforts will require increased dialogue withstudents to ascertain their unique needs, interests, abilities, andprofessional nursing goals. Criteria for evaluating learningexperiences could be mutually negotiated between students and faculty.Students' self-evaluation can be given more credibility and self-evaluation skills can be developed through dialogue about strengths andlimitations, identification of progress in the process of learning, and204negotiation of grades. This dialogue would supplement, rather thanreplace, written guidelines for assignments and written feedback onpapers.5. The faculty should identify events and experiences thatconstitute novel situations and, thus, might generate inaccurateperceptions of threat and plan specific strategies to mediate thoseappraisals. Two such situations are orientation day and the thesisprocess. In particular, because the thesis process is perceived as themost challenging element in the master's nursing program, accurate anduseful information is critical. Students who have experienced thethesis process could be interviewed to determine the informationalsupport required by master's nursing students.6. The use of teaching strategies that promote participation andinvolvement of the students should be fostered. Strategies such asdiscussion, debate, and small group presentation would be appropriate.The lecture style of teaching or regurgitation of written informationshould be avoided and replaced by a focus on critique, inquiry, andapplication of information. Acknowledgement and validation of eachstudents' contribution in the classroom is essential. Students'suggestions about classroom learning experiences should be solicited.7. Written resources should be available and useful to students.Deliberate efforts to provide up-to-date reading lists should be apriority. Teachers who possess articles on the reading list should makethese available to the students. Library resources should be monitoredby the faculty.8. Faculty should support students' efforts to create and205maintain semi-formal forums for sharing information and experiences.Support may take the form of information sharing, or material orfinancial assistance.9. Faculty should provide information about available resourcesthat would facilitate transition into the master's nursing student role.These resources could include those that address issues related tostress management and those that promote the development of the skillsassociated with academic scholarship.Implications for Nursing ResearchThis study's findings suggest that the development of personalempowerment in the experience of master's nursing students is a complexprocess. Further research would enhance understanding of the process ofpersonal empowerment in nursing education.1. This study was conducted with master's nursing students whowere enrolled in full-time studies. Replication of this study withother nursing student populations would contribute to a richerunderstanding of the process of personal empowerment. Further, suchstudies, conducted with students enrolled in other levels of nursingeducation, including the diploma, baccalaureate and doctoral levels, orwith master's nursing students enrolled in part-time studies, wouldelucidate similarities and differences in the experiences of eachpopulation.2. The findings suggest that master's nursing students are ableto achieve a sense of personal empowerment to varying degrees.Research that sheds light on the characteristics of master's nursingstudents relative to their level of perceived personal empowerment may206contribute to knowledge about strategies that faculty might implement topromote the development of personal empowerment. These studies mightfocus on master's nursing students' personality qualities, educationaland professional background, level of academic achievement, or copingstyle.3. The quality of student-faculty relationships were identifiedby the informants as being the most influential factor in thedevelopment of personal empowerment. A study of the phenomenon ofpersonal empowerment among nursing faculty would enhance anunderstanding of the transactional nature of this concept.4. The data suggest that students' perceptions of theireducational experiences change over time and that an appreciation oftheir experiences in relation to the notion of personal empowerment maynot be fully realized until after the students graduate from themaster's nursing program. Therefore, a study of the perceivedexperience of being a master's nursing student in relation to personalempowerment could be conducted on nurses who have graduated from theprogram. These nurses could offer their perspectives based on adeparture from the program of at least 12 months and based on thecongruence or lack of congruence between their educational preparationand the demands of their current professional nursing roles.5. There is an apparently significant relationship between gradesand self-esteem. Measuring up to the standards set by faculty and byfellow students is, thus, associated with the notion of personalempowerment. More specific studies of these relationships arewarranted. One such study might entail a quantitative measure of the207relationship between grades and self-esteem. Another might involveresearch into the factors that promote or inhibit competition amongnursing students for the highest academic standing.In conclusion, this study has explored the development of personalempowerment in the experience of master's nursing students. Forcesinfluencing this process have been identified and described. 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What kind of effect did these experiences have on you as a person?(to promote elaboration if necessary):- How did they affect your perception of yourself?- How have they changed your behavior?- What have you learned about yourself?4.	 What kind of effect do you think these experiences will have onyou as a nurse?(to promote elaboration if necessary):- What have you learned that will affect your performance as anurse?- What experiences have influenced your perception of yourself asa nurse? In what way has your perception been influenced?5.	 What does personal empowerment mean to you? Tell me about howyour experiences in the master's nursing program have contributedto your development of personal empowerment.224Appendix BProposed ObservationsObservations will be made of the day-to-day activities of theparticipants in their role as master's nursing students and of thesettings in which these activities take place. In this study, thesettings will be locations within the school of nursing such asclassrooms, the student lounge, and the cafeteria. Observations of thesettings, such as physical characteristics, available resources, andartifacts within the settings will provide a context for understandingthe students' behavior. The students' conversations and behavior willbe observed and recorded to validate and add to the data provided by keyinformants. Relevant observations of the students' conversations andbehavior include those related to interactions with each other,interactions with faculty, and the use of resources and artifacts withinthe settings.225Appendix CLetter of Information to Prospective ParticipantsDear [	 ]:My name is Linda Chow and I am a second year student in theMaster's in Nursing program at the University of British Columbia. Theexperiences that I and my fellow students have had since enrolling inthe program have stimulated my interest in learning more about theexperience of being a master's nursing student. I believe that nursingeducation should promote the personal and professional growth of itsstudents and that by exploring and describing the experiences thatmaster's nursing students have had, this growth can be fostered.Consequently, I have chosen to study the experience of master's nursingstudents to fulfill my thesis requirement. The proposed title of mystudy is, "The development of personal empowerment: A qualitative studyof the experience of the master's nursing student".If you would like to participate in this study, I will arrange tointerview you at a time that is mutually convenient and in a setting ofyour choice. The interview will be audiotaped and then transcribed. Ifyou wish, you may refuse to answer any of the questions during theinterview and following completion of the study, the tapes will beerased. Following this initial interview, there may be up to twoadditional interviews within a two or three month time period for thepurposes of clarification, elaboration, and validation. Each interviewwill require between one and two hours of your time. I anticipate thatour presence in the same settings at the school of nursing may lead tosome unscheduled, informal interviews. At those times, I will verballyrequest your permission to record the information that you have sharedin the form of field notes and to use the information in my study if itis pertinent.I will be the only person to have access to the audiotapes. Mythesis committee members, Professor Sally Thorne and Professor ElaineCarty, will have access to the transcripts and field notes. Transcriptsand field notes will be modified when necessary to protect your identityand to prevent the identification of other students, faculty members,and courses. Excerpts from the transcripts may be included in writtenreports of my study but no names or identifying factors will appear.You have the right to refuse to participate and to withdraw fromthe study at any time. Your refusal or withdrawal will have noinfluence on your academic progress in the master's nursing program. Ifyou decide to participate, I will ask you to sign a consent form.Although the findings may have implications for educationalpractices in master's nursing education, participants in the study willnot experience these benefits directly. However, as a participant, youmay benefit from having the opportunity to express your thoughts and226feelings about the experience of master's nursing education to anattentive listener. There are no financial benefits or expected risksassociated with this study.If you have any questions about the study, please contact mythesis supervisor, Professor Sally Thorne at 822-7482 or me at 738-1550,or you can fill out the following letter of response, place it in theattached envelope, and leave it in my mailbox in the graduate students'lounge in the school of nursingThank you for considering participation in my study.Sincerely,Linda ChowTo: Linda ChowI am interested in your study of the development of personalempowerment in the experience of master's nursing students. I wouldlike to discuss the study with you with a view to possibly becoming aparticipant.Signed 	Phone number	227Appendix DParticipant Consent FormStudy Title:Investigator:The development of personal empowerment: Aqualitative study of the experience of the master'snursing student.Linda ChowMaster's student in nursing, School of Nursing,University of British ColumbiaPhone number: 738-1550Thesis supervisor: Professor Sally ThorneSchool of Nursing, University of British ColumbiaPhone number: 822-7482	 , hereby agree toparticipate in the above-named study which seeks to describe thedevelopment of personal empowerment in the experience of master'snursing students. I understand that the findings may have implicationsfor educational practices in master's nursing programs and thus benefitfuture students enrolled in master's nursing programs. I give myconsent to being interviewed and to having the interview sessionsaudiotaped. I understand that each interview will require between oneand two hours of my time and that there may be up to three interviews.I understand that the interviews will be transcribed and that theinvestigator's thesis committee members, Professor Sally Thorne andProfessor Elaine Carty, will have access to the transcripts. Iunderstand that in situations in which I might share information withthe investigator during informal interviews, the investigator willverbally request to record this information in the form of field notesand to use this information in the study if it is pertinent. Iunderstand that transcripts and field notes will be modified whennecessary to conceal my identity and to prevent the identification ofother students, faculty, or courses. I understand that audiotapes willbe erased upon completion of the study. I further understand that myname or other identifying information will not be associated with anypublished or unpublished reports arising from this study.I understand that I am under no obligation to participate inthe study and that I am free to withdraw from the study at any timewithout jeopardizing my academic progress in the master's nursingprogram. I understand that I have the right to refuse to answer anyinterview questions. I also understand that there are no financialbenefits or expected risks associated with my participation.228I have had the opportunity to discuss the study with theinvestigator, and my questions have been answered to my satisfaction. Iacknowledge receiving a copy of this consent.Participant's signatureInvestigator's signatureDate

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