Recovery as a troublesome concept: A phenomenographic study of mental health nursing students’ learning experiences

Abstract

The notion of recovery is central to mental health nursing practice, yet little is known about the ways in which nursing students understand it. This study explores the variation in how recovery is experienced by nursing students and the troublesome nature of their learning journeys as they engage with the concept. Contemporary understanding of recovery has moved beyond the idea of ‘cure’ and is concerned with the person building a meaningful and satisfying life. This challenges the traditional thinking and practices of mental health professionals. There is evidence to suggest that in some areas nurses still rely on out-dated authoritative models of care; however, there is little literature exploring how the concept is understood by nursing students. As today’s student nurses represent the future nursing workforce, it is important that their educational experiences support the knowledge development required to embrace this contemporary practice.
Phenomenography and the threshold concept framework provide the research design. Semi-structured interviews were carried out with 13 pre-registration students at one UK University. Following phenomenographic analysis four qualitatively distinct categories of description, or ways of understanding recovery, were identified; Recovery as Clinical Improvement, Recovery as Making Progress, Recovery as Managing to Live Well, and Recovery as Learning to Live Differently. The threshold concept framework was utilised in considering the variation in how students’ progress (or otherwise) in their understanding of recovery in considering the obstacles to learning that students encounter. Four categories were identified; Troublesome Knowledge, Troublesome Learning Environments, Troublesome Practice, and Troublesome Relationships.
Understanding the dimensions of variation in student understanding and the obstacles to learning they might face provides important insights for future teaching. Findings here identify recovery as posing particular challenges for students requiring educators to consider a range of strategies to support transformational learning.