Subject: - reflection and practice in nurses' computer-mediated communications

Murray, Peter John (2001). Subject: - reflection and practice in nurses' computer-mediated communications. PhD thesis The Open University.



This study is situated within the everyday practice of nurses around the world, engaged in discourse with colleagues through listserv discussion forums, and immersed in Schon's swampy lowlands of important problems. Taking computer-mediated communications (CMC) to be an integral part of nursing informatics, the study begins by examining the literatures on CMC and nurses' reflection on and in practice.

The study is congruent with emerging mixed method research approaches within both nursing and the study of CMC, and comprises an electronic ethnography, coupled with the development of a model of reflection within nursing listerv discussions. Using a corpus of discussion threads from the NURSENET list, together with questionnaires,interviews and Virtual Focus Group discussions, all conducted by CMC over a six-year period, a tapestry ofa virtual community, united through discussion of shared practice issues, emerges. The narratives of everyday discussions dispel some of the urban myths of CMC and show the possibility of real social engagement.

A model of reflection derived from Kim's phases of critical reflective inquiry and Johns'framework for reflection on action is used to examine a pilot sample of NURSE NET discussion threads. This pilot version of the model is shown to be insufficient to describe the reality of reflective discussion in this forum, and a revised model is developed, essentially inductively, from the data. This new model, tested against a larger sample of discussion threads, demonstrates a qualitatively different form of reflection from that encountered offline. The online reflection is a group, as opposed to an individual, process, is action-oriented, and shows a form of 'online reflection around action' as nurses engage in ongoing practice situations, as well as post hoc reflection on-action. It also provides evidence of nurses using the reflective discussions to change practice, and so illustrates reflection akin to that envisaged by Kemmis.

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