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SPATIALITY AND THE LIVES OF NURSING STUDENTS

 
Peter Gray

 

 

 

 

Thesis
Submitted in fulfilment
of the requirements for the degree of Ph.D
 
University of Stirling June 2004                                          


University of Stirling

Peter Gray

Institute of Education

Abstract of thesis entitled

Spatiality and the Lives of Nursing Students

Submitted for the degree of Doctor of Philosophy

June 18th, 2004

This study is an exploration of spatiality and its meaning.   It focuses primarily on the experience of nursing students at two Scottish sites, but draws wider conclusions about spatiality from this data.   Although the experience of nursing students has been researched in other studies, this is the first study which addresses this experience through the concept of spatiality, which integrates the student experience across different aspects of the life-world.

Its theoretical framework is based in phenomenology and in particular the work of Heidegger, but also uses more recent insights from social geography and elsewhere.   The philosophy of embodied realism developed by Lakoff & Johnson (1999)  is used to argue that embodiment is central to any consideration of spatiality.  It is suggested that a framework based on the interlocking concepts of proximity, mobility and possession provides a comprehensive analytical tool for investigating spatiality within discourse.

The study involved semi-structured interviews with nursing students across the two sites.   These revealed a diverse range of spatial issues relevant to their academic education and practical training as nurses.   The topics addressed include the experience of placements, self-directed learning, essay writing and the spatiality of libraries and lecture theatres. 

The results of the study suggest that consideration of spatiality should be a more prominent feature of educational discourse generally and the discourse of nurse education in particular.   It has been neglected in the past because of its transparency and closeness to everyday life, but as with other forms of difference, it has hidden effects.   Given the prominence of nurse recruitment and nurse education as issues in healthcare policy, the study provides evidence that the student experience in this area could be improved by a greater awareness of spatial issues. 



Table of Contents

List of figures ..............................................................................................................................................

Abbreviations used ....................................................................................................................................

Chapter 1 - Introduction

A study about the meaning and experience of space? ......................................................................

The theoretical framework .....................................................................................................................

Proximity .....................................................................................................................................................

Mobility ........................................................................................................................................................

Possession ....................................................................................................................................................

The research frame ...................................................................................................................................

The research question(s) – asking the impossible? ...........................................................................

Background to the present study ..........................................................................................................

Summary: the story so far ......................................................................................................................

Outline of the thesis ..................................................................................................................................

Chapter 2-Proximity, Mobility, Possession .........................................................................................

Introduction ................................................................................................................................................

Embodiment ...............................................................................................................................................

The body-in-the-world .............................................................................................................................

Proximity – a sense of (dis)stance? .......................................................................................................

Mobility ........................................................................................................................................................

Possession ....................................................................................................................................................

Summary .....................................................................................................................................................

Chapter 3-Methodology .............................................................................................................................

Introduction ................................................................................................................................................

The research and the researcher: In search of the lost world? .....................................................

The Theoretical perspective ....................................................................................................................

Methodology ...............................................................................................................................................

Summary .....................................................................................................................................................

Chapter 4-Method ........................................................................................................................................

Introduction ................................................................................................................................................

Interviews and other stories ...................................................................................................................

A tale of two sites .......................................................................................................................................

Data analysis – the method .....................................................................................................................

Principles of the analysis .........................................................................................................................

Summary .....................................................................................................................................................

Chapter 5-Nurse education ......................................................................................................................

Introduction ................................................................................................................................................

The historical background of nurse education ..................................................................................

Nursing – back to the future? ................................................................................................................

The nursing literature and Project 2000 .............................................................................................

Project 2000: the critical literature .......................................................................................................

The nature(s) of nursing ..........................................................................................................................

Space for nursing: conspicuous by its absence? ................................................................................

Summary .....................................................................................................................................................

Chapter 6-Into the data ..............................................................................................................................

Introduction ................................................................................................................................................

Is there a world outside nursing? ..........................................................................................................

Knowledge and the world of nursing ...................................................................................................

The Journey as space in its own right ..................................................................................................

Summary .....................................................................................................................................................

Chapter 7-Contested spaces

Introduction ................................................................................................................................................

Home is where the photocopies are? ....................................................................................................

The heterotopic  library ...........................................................................................................................

Computer labs: programmed to self-instruct? ..................................................................................

Lectures and seminars: sitting in the same seat? ..............................................................................

Chapter 8-Placements ................................................................................................................................

Introduction ................................................................................................................................................

The Placement and proximity ................................................................................................................

Disappointments and rearrangements .................................................................................................

Summary .....................................................................................................................................................

Chapter 9-Spatial metaphors in nurse education .............................................................................

Self-directed–learning: journey without a pause? ............................................................................

The essay – bringing it all back home? ................................................................................................

Summary .....................................................................................................................................................

Chapter 10-Conclusions ............................................................................................................................

Proximity, Mobility and Possession ......................................................................................................

Does the study answer its research questions? ..................................................................................

Spatiality in the context of nurse education: How does spatiality affect the lives of nursing students?              

Concluding the conclusions: as closure beckons, another spatial metaphor appears. ............

References ......................................................................................................................................................

Appendix One: List of nursing student identities .............................................................................

Appendix Two: Map of Campus locations ..........................................................................................

Appendix Three: Interview schedule ....................................................................................................

 

List of figures

 

Figure 1: the research questions ......................................................................................................... 14

Figure 2: the research questions again .............................................................................................. 72

Figure 3: themes and occurrences ...................................................................................................... 91

Figure 4: Thematic headings and issues arising in data ............................................................... 92

Figure 5: The Essay-writing process as a journey ................................................................. 201

Figure 6: The PMP Framework and types of space .............................................................. 212

Figure 7: The Research Questions revisited .................................................................................. 219

Figure 8: The complex future of healthcare – the paradoxes ................................................... 226

 

Abbreviations used

B&B ................................................................................................................................. Bed and Breakfast

CFP ........................................................................................................ Common Foundation Programme

COSLA ...................................................................................... Convention of Scottish Local Authorities

DIY .......................................................................................................................................... Do It Yourself

DoH ............................................................................................................................ Department of Health

DRC .............................................................................................................. Disability Rights Commission

HC ............................................................................................ Highland Campus, (University of Stirling)

HE ..................................................................................................................................... Higher Education

PMP ........................................................................................................... Proximity, Mobility, Possession

ICT .................................................................................. Information and Communication Technologies

RCN ...................................................................................................................... Royal College of Nursing

SC ................................................................................................. Stirling Campus (University of Stirling)

UKCC ..................................................... United Kingdom Central Council for Nursing and Midwifery

 

 

 
Acknowledgements

This thesis would not have been possible without the help of many people at the University of Stirling and elsewhere.   I would first like to thank the research participants from the Department of Nursing and Midwifery who generously came forward to answer my questions and whose contributions enrich and enliven the academic discussion.   Secondly, the initial encouragement to undertake the project came from Kate Sankey and  Professor Mike Osborne at the University of Stirling, and Professor Renate Holub at the University of California, Berkeley.   They had more confidence that the study would succeed than I did.  The project was funded by the University of Stirling and the ESRC, and I am grateful to staff at both institutions for making it possible.

 

Several supervisors have been involved with the production of this thesis, but Brenda Morgan-Klein has been there from the beginning and has endured many diversions and excuses with great personal warmth and insight  Professors Jon Nixon and Peter Cope were involved at earlier stages, whilst Professor Richard Edwards undertook the difficult task of persuading me to finish the project with the right balance of disciplinary power and ironic wit.   Professor Nick Boreham provided valuable support and encouragement in the later stages.

Discussions with many other colleagues and postgraduates made the process less painful, but I would especially mention Greg Mannion, Elizabeth Ezra, Liz Davies and Kim Tole.

Finally, and most importantly, I wish to thank my partner Jane for putting up with my spatial disruptions and disappearances over many years.

 

 

Funded under ESRC Studentship no. ROO429934171

 

(Note: styled in accordance with Oxford Style Manual: Ritter 2003)


 


 


 

 

Chapter 1 - Introduction

 

 

 

 


‘Come here’

Baley squirmed a bit, but did as he was told.   There was something indecent about the exposure of the privacy of a room to the outside world.   Sometimes the Commissioner carried his affectation of Medievalism to a rather foolish extreme.

  ( Isaac Asimov , The Caves of Steel)

 

A study about the meaning and experience of space?

‘S pace ’ is a term which is often used but which defies precise definition.   Its very looseness is what makes it useful and ubiquitous, but that same looseness conceals a topic of great complexity and interest.  This study is about the relationship between people, space and spaces, and the expression of this relationship in the term ‘spatiality’.   Its overall purpose is to show that ‘spatiality’ is a useful concept to use within social research.   In this introduction, I outline my reasons for undertaking the study, explain briefly why nurse education was chosen as a field for the empirical investigation of spatiality, and  outline its theoretical basis.   At this stage I will not attempt to provide evidence or authority for all the claims presented, but will outline the basic argument and provide some background information.

 

Spatiality is a neglected topic for the paradoxical reason that space is too much a part of everyday life, and too transparent, for it to have been systematically problematised.    It becomes a problem when, for example, access to some specific space is restricted, or when we do not have enough ’personal space’, but these problems are solved through coping practices, rather than by the application of spatial theory.  The experience of disability or agoraphobia, or the various disorders of spatial perception, can, however, provide clues as to how our coping with space can break down and cause our spatiality to be brought into question.   The epigraph, from Isaac Asimov’s science-fiction novel Caves of Steel (Asimov 1956), draws attention to the ways in which spatiality is culturally mediated.   The novel depicts a not-too-distant future, in which city dwellers have become frightened of the very idea of open space, and are unable to conceive of exposure to sunlight and wind as natural and desirable.   Interestingly, whilst The Caves of Steel is acute in its decoding of spatiality, and prescient in its technology (e.g. video-on-demand, swipe cards), it completely fails to foresee any transformation whatsoever in gender relations.   Thus, the status of women in the year 2200 is depicted as very similar to their status in 1950’s New York,  illustrating the way in which such topics disappear by virtue of their transparency and degree of embeddedness in culture at particular historical moments.   This study attempts to go beyond the everyday transparency of space and spatiality, and to suggest that experiences of spatiality might be differentiated in the way that experiences of gender, identity or sexuality are differentiated.  Following Massey’s (1992: 80) assertion that ‘the social is inexorably also spatial’, the spatial approach is the one employed here, but I wish to avoid reifying ‘spatiality’ into something with causal properties and quantitatively-measurable effects (Harré 1998).  More simply, and on a personal level, I wanted to know why going for a walk often helps with the thinking process.  Even this, as a  masculine activity, is problematic, however, and I am aware that there is extensive feminist critique of the ‘phallocentrism’ of spatiality (Irigaray 1987; Deutsche 1991; Rose 1993; Best 1995; Rose 1995) [1] . I have not used this as a starting-point here, since to do so would require an entirely different approach to the data, based on psycho-analytic theory, which I am not qualified to address.  The conclusions from the data, however, suggest that assumptions about spatiality have gendered impacts, and it is the purpose of the study to reveal those assumptions.

 

The intention of this study is thus to draw attention to the importance of spatiality, and to suggest what it might mean to have a discourse of spatiality, in the same way as there are discourses of identity or sexuality. In this study, I use the term ‘spatiality’ to represent the collective effects of being-in-space, in relation to the everyday lives of nursing students.   Space itself is a contested concept, and the study does not claim to provide a comprehensive overview of the philosophy of space [2] .   The kind of space to which I refer here is not the mathematical or astrophysical space of relativity theory, but space(s) as lived and experienced by embodied beings.

 

As such, spaces are information sources for such beings, and, crucially, they provide contextual information.  Spaces can ‘communicate’ with us both digitally and analogically (Bateson 1973).   I can see a sign which informs me that I am in the ‘University of Midshire’ or I can deduce from the presence of students, classrooms, academics and computers that I am in a university.  The sign is a digital communication whilst the space sends out an analogue message.   The two often reinforce each other.   As has sometimes been said in the CD (Compact Disc) vs.  vinyl debate (e.g. Tiefenbrun 1984), the digital version is more precise but the analogue often communicates more detail and emotion.  Essentially, therefore, this thesis takes spatiality to be the way in which spaces and people ‘communicate’.  Far from being a separation of people from spaces, spatiality, as I will argue, implies that persons and spaces are inseparable. In the following chapters, I argue that embodiment is a necessary starting point for any study involving spatiality, which is explored here through analysis of the stories which embodied nursing students tell about space .  In focusing on this specific group, I make the assumption that there is a ‘world’ in which the activities of nursing students make sense, both for the students themselves and for the other inhabitants of the world.  

 

A number of independent investigations converge on this body-world relationship as the basis of all cognitive activity (Merleau-Ponty 1962; Bateson 1973; Gibson 1979; O’Keefe 1999; Berthoz 2000).   Without this relationship there would be no thought of space,  time, existence, or anything else.   Lakoff & Johnson (1999) argue that the body and its sensori-motor activities in the world are inextricably connected to cognition via spatial and other metaphors.  The term ‘space’ itself is often used metaphorically, and the starting point for any discussion of space is usually a question about what sort of space, from the many ‘species’ available (Perec 1999), is being discussed.  This in turn is partly defined by the disciplinary background of the researcher.  Geographers are supposedly concerned with ‘objective’ physical spaces, whilst psychologists depend on a model of space which separates inner, ‘mental’ spaces from the external world, although both these generalisations are problematic [3] .   In educational research, there has been little direct consideration of spatiality, which until recently [4] was regarded as being unproblematic except in specialised areas of research, such as ‘classroom environment studies’ (Fraser 1986; MacAulay 1990). 

 

An additional reason to choose spatiality as a topic is that it makes connections between disciplines which are regarded as separate for arbitrary reasons of ‘academic [or] social...  necessity’ (Bourdieu 1988: 64).  In the current study, I draw on ideas from Heidegger and other ‘continental philosophers’ (itself a divisive term), from the new ‘philosophy of embodiment’ exemplified by Lakoff & Johnson (1999) and from social geographers and sociologists.   This is in line with the heterodox traditions of adult education, which has itself turned to such areas as humanistic psychology, behaviourism and critical theory for inspiration (Jarvis et al. 1998).   In that tradition, the study seeks to explore the difference between ‘representations of space’ and ‘representational space’, to use Lefebvre’s rather confusing terms (Lefebvre 1991: 38-39).   By this I mean that it moves from ‘dominant [conceptions of] space’ (ibid), which involve a kind of false neutrality, to a more nuanced conception of space in which its affective qualities, and its underlying assumptions, are made explicit.   As Merrifield (2000: 173) puts it, in a discussion of Lefebvre:

Critical knowledge has to capture in thought the actual process of production of space.   This is the gist of Lefebvre’s message.   Theory must render intelligible qualities of space which are at once perceptible and imperceptible to the senses.

Alternatively, Shurmer-Smith (2000: 163) draws on the work of Hélène Cixous to suggest that

There is still much research to be done on the way in which people feel space(s), research which needs to go beyond mere socially constructed fears and apprehensions.  (emphasis added)

Whether it is possible to go beyond ‘socially constructed fears and apprehensions’ is debatable, but both the above quotations serve to summarise the intentions of the project.   Urry (2002) has stated that ‘little empirical research’ has been done on spatiality itself, as opposed to its symptoms, such as the ever-increasing demand for travel and ‘co-presence’, or the parallel increase in the use of Information & Communications Technologies (ICTs).  Wenger (1998: 130) draws attention to the ‘relations of proximity and distance [which] may facilitate learning’ and links these to the creation of communities of practice, and it is worth exploring these ‘proximity and distance relations’ in detail.   This project is thus an attempt to provide  theoretically derived and empirically supported answers to questions about how spatiality might be experienced in the processes of learning and acquiring a professional identity.  In order to answer these answers, some form of theoretical framework is required, and it is the purpose of the next section to explain what form that might take.

 

The theoretical framework

My purpose here is to describe a theoretical framework based on the concepts of ‘proximity’, ‘mobility’ and ‘possession’.   This is not the only possible way of making sense of the student ‘stories’ which form the data, nor is it the only way of approaching the concept of spatiality.  It is not, however, an arbitrary division, and I argue below that this framework is a powerful tool for relating spatiality to complex experience, in this case the experience of being a nursing student in the process of becoming a nurse.

 

The key meaning which is sought here is that of spatiality.   I suggested at the start of this chapter that spatiality might consist of the stories which bodies tell about space.   Relations of proximity and distance are likely to be parts of those stories.   But there are further questions to be considered.   How do we come to have these relations at all?  Why is it that we feel at home in one space and not in another?  Why, to return to questions about the spatiality of nursing students, can one student work happily in the library whilst another finds it ‘completely useless’ for studying?   At one level the answers to these questions can be given in terms of individual preferences, but it is important to establish how these preferences come into being.  If space were to mean a simple void, an absence of objects, it could not ground the complex range of feelings which, as the data will show, articulate themselves to it.   More accurately, feelings are articulated to spaces , which are qualitatively different from each other.   There are subtle distinctions to be made between ‘spaces’ and ‘places’, but for the purposes of this study the essential distinction is between the generic and the personal or specific.   Thus, ‘kitchens’ are spaces, whilst my kitchen is a place (Bordo et al. 1998: 75). I use ‘spaces’ in what follows because the discussion is at the generic level of ‘lecture theatres’, ‘libraries’ etc., but if I were to write about Stirling University library, it  would be appropriate to use ‘place’.   The concept of spatiality is, however, inherent in the concept of place.  Malpas (1999: 41-42; see also Casey 1997) suggests that the relationship is reciprocal, with our sense of place being the source for concepts of spatiality, whilst Massey (1994a: 117) cautions against allowing essentialism to creep into conceptions of place, which should be regarded as a dynamic and evolving concept.  The concept of spatiality which I wish to develop here is complementary to this non-essentialist concept, and involves spatiality being seen as the experience of place, whilst place is the intersection and interaction of a set of individual spatialities.

 

‘Space’ is, then, what Fogel Keck (1994: 20) calls a ‘summative concept’.   That is, it ‘represents a global and extremely complex entity’, and as such, has to be analysed in some way in order to provide useful insights or research outcomes.   Wenger’s ‘relations of proximity and distance’ provide a clue as to how this analysis should proceed, but are insufficient in themselves to unpack the complicated spatial stories which form the data for this study.  There is no direct parallel between geometrical dimensions and the three concepts outlined here, but there is a metaphorical parallel, and the use of three dimensions is intended to give spatiality a ‘solidity’ or ‘depth’ which it might not otherwise have.   The analytical framework is thus based on the concepts of proximity, mobility and possession. 

 

This framework draws on a disparate group of theoretical sources, but draws from Heidegger in asserting that the human way-of-being (Heidegger’s Dasein ) is a way of being-in-the-world (or, more accurately, being-in-a-world).   In other words, people do not consist of encapsulated thoughts and feelings which only coincidentally happen to be in spaces.   Rather, we are bound up with spaces at a fundamental level, and can be detached neither from our spatiality nor from our temporality (Heidegger 1962: 146). Although Malpas (1999: 42) sees Heidegger’s concept of space as unsatisfactory, because of his privileging of temporality, Heidegger’s later work (1971a; 1971b; 1972; 1993a) stresses the affective qualities of place upon which Malpas  insists, and is therefore useful as a basis for the construction of the theoretical framework for the study.

 

Space, as a conceptual topic for research, then, needs to be both unpacked and enriched.   My argument will be that the activity and experience of embodied individuals is spatial at a fundamental level, and the following section suggests a more precise way of describing different aspects of this activity and experience, using the concepts of proximity, mobility and possession. 

 

Proximity

Space implies differentiation – if we were able to perceive the continuity of the physical world in terms of energy fields, rather than the lumpy stuff which we call matter, or objects, we might have no concept of space at all.   Gibson (1979) points out that there can be no concept of an organism without differentiation from its environment.   Provisionally, any such differentiated organism will exist in differing degrees of nearness or farness from the objects which constitute that environment – a rock, a tree, a river, other organisms – and these relations of nearness or farness constitute proximity, or the possibility of distance.   As Heidegger ( 1998: 135) puts it:

…the human being, existing as a transcendence that exceeds in the direction of possibilities, is a creature of distance .  (emphasis in original)

The concept of proximity will thus be taken, for the moment, to mean the possibility of distance. Heidegger will reappear below due to his suggestive thinking-through of the phenomenon of spatiality and his desire to get to the ‘bottom’, or ‘ground’ of things, spatial metaphors which are themselves crucial to his work, but first I will further explore the meaning of proximity.

 

As the possibility of distance, proximity is a relationship of concern rather than a relationship of action.   I experience proximity to tables, buildings and other people because in some way they are within my range of concerns (Law & Hetherington 2001).   This relationship holds even at great (physical) distances (Silk 1998), and is not a question of simple presence, but rather the possibility of presence and absence.   It does not, however, encompass the possibility of action across distance.   This is a question of mobility, the second of the three interlocking concepts of spatiality.

 

Mobility

Mobility, as I use the term here, is the possibility of action over distance.   All organisms have a relationship of (im)mobility with their environment, even those organisms which cannot roam around it at will.   Plants, for example, are mobile to the extent that they can propagate over distance, and some species (such as bracken and rhododendrons) are sufficiently mobile to be a menace to other species (McCarthy 1994).  Mobility, for people, is differentiated across lines of ability, gender, class, socio-economic status, age, ethnicity and so on (Albertsen & Diken 2001).   Urry (2001b) also makes the useful distinction between mobility as a right and as a duty, and this distinction will be highly relevant to my discussion of mobility within the data analysis.   Again, however, mobility is conceptually limited.   Whilst time enters into discussions of mobility in relation to speed, there are times when we hang around, hang out, tarry or  dwell in specific spaces.  Even to be nomadic is to remain within a static conception of space, according to Deleuze & Guattari (1988).   There is thus a question of a time-space relationship which is not that of speed (time over distance) but of what I will call possession (time in space).  

 

Possession

In connection with spaces, ‘possession’ is what is being represented in ‘making oneself at home’, ‘occupation’, ‘haunting’ or ‘familiarisation’.   As a concept,  it does not in itself imply a linear scale from strangeness (minimum degree of possession) to cosiness or ‘being-at-home’ (maximum degree of possession).   Possession is essentially a conceptual tool to capture the affective relationships which are formed as people interact with spaces over time, and to relate these relationships to the other two dimensions, thus creating an integrated model of spatiality.   As I will discuss further in Chapter 2, which presents the framework in more detail, the relationship between space and time which is to be captured by the concept of possession is not contingent, but is fundamental to both of them – one cannot exist without the other, and possession is a recognition of this co-dependency.

 

To summarise, then, the study uses a three-dimensional analytical framework, based on the concepts of proximity, mobility and possession (the PMP framework).  Possession is the relationship of dwelling, of being in space over time, whilst mobility enables possession in that it affords the possibility of moving through spaces, and proximity enables mobility in that it provides the possibility of there being differentiated spaces at all.  Whereas ‘proximity’ commonly implies nearness, the term as used here makes it the possibility of nearness, farness or any other relationship of distance.   Similarly, mobility is the possibility of action over distance, rather than its realisation.

 

The three elements of the PMP framework thus overlap each other and are mutually interdependent.   As analytical tools for the empirical data they not fragment it, or disconnect elements of the participants’ experience from their lifeworld.   Rather, the intention is to make sense of seemingly random spatial practices and contingencies, and to provide a coherent account of the spatiality of the participants.   In order to provide such an account,  research questions are required , but before outlining the research questions I will briefly describe the ‘research frame’ of the project.

 

The research frame

Thorne et al.  (2002: 1) describe four distinct aspects of the research frame:

its historical location, the manner in which the disciplinary orientation influences its logic, the theoretical and philosophical positions in which it is grounded, and the methodological strategy by which it has generated its findings. 

I consider these in greater detail in Chapter 3, but briefly discuss them here before considering the research questions.   It is important to emphasise that whilst the study focuses on nurse education, it does not claim to be nursing research as such.   The study is situated within the research traditions of adult education, a field whose distinct existence has  been questioned since the emergence of ‘lifelong learning’ (Jarvis et al. 1998: 2).  The traditions of adult education tend to place value on the individual expression of meaning (Law & Rubenson 1988: 232; Haggis 2002: 131), rather than on large-scale statistical analysis, which as Winter (2003: 769) points out, ‘may be distorted, albeit unwittingly, by a wide range of complex factors’.   An equally important feature of adult education is that the field is highly diverse and thus ‘tradition’ is a contentious term.    Thus, a collection of research in the field of adult education (e.g. Edwards et al. 2002) might reveal such diverse approaches as Lacanian psycho-analysis, Foucauldian power/knowledge analysis, video/digital image  research, phenomenological spirituality and complexity theory.   There is, therefore, no single research tradition which dominates the field.   As Usher (2000: 51)  suggests:

the production of any kind of systematic theoretical or  ‘scientific’ knowledge...always takes place and indeed requires a knowledge-producing community of some sort, no matter how flexible and loosely structured it may be.

As researcher and otherwise,  I have been part of a diverse ‘knowledge-producing community’ and this is reflected in the choice of both topic and  methodology.   The way in which such communities are linked to research, according to Usher, is through intertextuality.   The traces of other texts, which inhabit and inform this text, serve both to tie it into the  ‘knowledge-producing community’ of adult education, and to make connections to other such communities, such as social geography. 

 

In terms of the theoretical and philosophical positions in which the study is grounded, I have drawn on Heidegger (1962) and his variety of phenomenology, the embodied philosophy of Lakoff & Johnson (1999) and the work of social geographers such as Massey (1992; 1994a; 1994b), Urry (2002) and Adams (1999).   The methodology of the study assumes that meanings are generated in discourse on the basis of embodied being-in-the-world.    Although there may be variations in the degree to which these meanings are shared, the study of discourses (or narratives) can contribute to the ‘story-telling’ which Usher (2000: 51) sees as the task of social research.   This does not mean that ‘there is nothing outside the text’, as Derrida has been (mis)interpreted as suggesting (1976: 158).   Indeed, as I will argue, there is a great deal outside the text, which reaches us as ‘analogue’ information (Bateson 1973), but the existence of texts as repositories of meaning presupposes that some of this analogue information can be digitised and shared.  The above points are amplified below, but meanwhile I will lay out research questions to which the study aims to find answers, or for which it might at least provide ‘new stories’.

The research question(s) – asking the impossible?

From what I have already described of the research,  it involves two fields of study.   One of these is nurse education, which, as vocational or professional education for adult learners, is situated in the post-compulsory sector.  Whether this makes it a sub-field of ‘adult education’ is open to debate, since adult education is an ill-defined term whose meaning and connotations are in a constant state of flux (Baquero 2002).  The other field is spatiality, which lies at the intersection of ( inter alia ) philosophy, social theory and human geography.   I am thus using nurse education as a context, and nursing students as a body-in-question, for a study of spatiality.  This gives rise to several converging research questions, and these are shown in figure 1 (below):

Figure 1: The research questions

Question

Reason for asking

Body of knowledge to which study might contribute

What is meant by ‘spatiality’?

Own interest

Theories of space

What is meant by spatiality in the context of nurse education?

Attempt to cross disciplinary boundaries, reinforcing and deepening analysis of previous research in field

Theories of space, nursing literature

How does spatiality affect  lives of nursing students?

Desire to enhance student experience, lack of attention to spatiality in nursing literature

Literature of student experience within nursing literature

 

The left hand column describes a progression from generality to specificity in the nature of the research question, whilst the centre describes a similar process of ‘homing-in’ on a justification for the research itself.   The third column suggests where the research might fit into the literature.  The boundaries between all these questions are not, of course, as clear-cut as the table suggests, but the overall focus of the study, as the arrow suggests, is on spatiality as a cross-disciplinary concern manifested in concrete settings, in this case the settings of nurse education. 

The word which I use for the activities of nursing students is ‘studying’, rather than learning, because it is beyond the scope of this project to assess whether the experiences of spatiality which I explore have any effect on learning or ‘learning outcomes’.   Indeed,  the question of just what constitutes ‘learning’ remains contentious within educational discourse generally.  Within nurse education the question is especially difficult to answer since the nature of nursing itself is both problematic and historically specific (Benner 2000; Chiarella 2002) and therefore, as the history of nurse education demonstrates, what counts as learning for nurse students is also the subject of constant debate (Rafferty 1996).   Arguably, a substantial part of the process of becoming a nurse is the process of professional socialisation (Kirpal 2003), and the concurrent development of the practical skills and intuitive judgement which constitute nursing expertise (Benner 2000; Eraut 2001). The opposite pole of the argument is represented by the trend towards ‘evidence-based’ nursing (RCN 2003), which requires nurses to develop skills in reading and utilising research papers as a basis for practice.  What counts as ‘studying’ is therefore as problematic as what counts as learning, since it is clearly possible to read papers or other documentary evidence at home, whilst it is not possible to vicariously observe good practice or to engage in the majority of nursing activities in a domestic setting.  Furthermore, as the study will show, the relationship of the domestic, professional and educational spheres which is represented by the concept of studying is itself problematic, and the strength of the type of spatial analysis which I am engaged in here is that it has the potential to integrate the student experience across the three spheres, albeit that the separation between them is somewhat artificial.  To some extent, the acknowledgement that nurses have separable domestic and educational/professional lives is in itself an advance on the dominance of the hospital setting in the lives of nursing recruits.

In the next section, then, I look more closely at the practical grounding of the study and the setting in which it was conducted.

 

 

Background to the present study

One reason for choosing to focus on spatiality as it affects nurse education [5] was the possibility of access to a Department of Nursing and Midwifery located at two very different sites in the same institution, thus reducing the influence of institutional variation.  There is an ethical issue here in that the geographical circumstances of the sites involved make it difficult to disguise their real location,  and I have therefore chosen not to do so,.   The individuals involved have, of course, all been given pseudonyms.

 

Under Project 2000 (UKCC 1986), the University of Stirling  had taken responsibility for a former nurse training college and had absorbed a department within a Further Education College in the central belt [6] . The former institution serves a large part of the Highlands of Scotland, an area roughly the size of Belgium.   Practice placements at distances of up to 300 km from the campus thus form a significant part of the learning process.   The other department had been relocated to the main university campus, and serves a smaller but more densely populated area of Central Scotland.   Its students are also sent on placements, but these rarely involve journeys of more than 50 km from the campus.   It was thought that the Highland site, and the spatial transitions undergone by its students, might thus amplify spatial effects less easy to detect elsewhere, and this seems to have been the case.

 

As with other phenomena, spatial relationships become more visible under conditions of change.  Learners are involved in change in various ways (Jarvis et al.  1998; Bateson 1973), even if only to resist it (Paechter 2001).   A further element of change, in the form of spatial discontinuity is, however,  present for nursing students, in that all diploma or degree-level students undertake multiple placements and are thus continually making spatial transitions from site to site.    Thus, they constantly cross (or redefine) the boundaries between home, work, placement and educational institution.  This inevitably involves periods of acclimatisation to new spaces, periods in which theories, practices or beliefs previously taken for granted may become problematic, and which therefore provide a rich context for the exploration of spatiality.  

 

A climate of organisational change also prevails in the world of public services and healthcare generally (Howard 2001; Loughlin 2002), and this is briefly examined in Chapter 4.  Although the technicalities of NHS re-organisation are not the direct concern of the current study, there are reasons to relate some of them to spatial issues, particularly around those of flexibility and mobility.  One aspect of nurse education which is helpful in defining the scope of the study is that the majority are mature students (i.e.  aged 23+), with varied work experience.  The empirical analysis developed here thus becomes relevant to the emerging field of ‘mature student experience’ within the wider context of adult education.

 

Spatiality is, then, a topical issue for nurse education.  As I will show, space enters tacitly into much previous research on the nursing student experience.  This study, by foregrounding spatiality rather than topics such as work identity (Kirpal 2003), demonstrates the significance of space(s) to the nursing student experience.    Some conclusions will be drawn which are specifically located in nurse education, whilst also having a wider relevance within the field of research into student experience, but the overall intention of the study is to explore the nature of spatiality itself.

 

 

 

Summary: the story so far

In this introductory chapter I have discussed the need firstly, for an enhanced understanding of spatiality as a concept, and, secondly for the need to gain a fuller understanding of the relationship between embodied nursing students and spaces, in the course of their learning within Higher Education.  

 

The study argues that human beings necessarily have a relationship to space, which I describe as ‘spatiality’, and which follows from the fact of their embodiment.  Spatiality acquires meaning within a ‘world’, a concept whose theoretical underpinnings are derived from Heidegger (1962), and that ‘worlds’ embody certain sets of assumptions about shared meanings.  I have outlined a theoretical framework, based on the concepts of proximity, mobility and possession.   The empirical component of the research specifically explores the relationship between nursing students and the spaces in which they live and study.

 

This spatial relationship, I argue, is fundamental to the way that nursing students are - and by extension, to the way that all students, and indeed all human beings are also.   In a more pragmatic sense, it is important to explore the experiences of nursing students at this time because  nurse education in particular, and the healthcare system in general, are in transition from a hospital-based system relying on a medical model of disease and treatment, to a more diverse, flexible system with new models of funding, learning and relationships between health and society.   These new models will involve different spatial forms, for example the increasing role of nursing advice given through telephone call-centres.   There will be concurrent demands on nurses for flexibility and work-practices (Dargie et al. 2000; UKCC 2001) for which their current education may (or may not) be preparing them, and I will argue below that research which takes account of the lived spatiality of the nursing student experience can help to rectify some of the deficiencies and conflicts of that experience.

 

Outline of the thesis

In Chapter 2, I  set out the proximity-mobility-possession (PMP) framework in more detail.    As Chapter 1 suggests, the study as a whole explores the spatial aspect of experience, and the framework suggests that there are three fundamental aspects of this spatial aspect: proximity, mobility and possession  These draw not only on Heideggerian thinking about being and spatiality, but also on a range of other sources. The PMP framework is essentially driven by theory, and it maps successfully on to the empirical data which I begin to present in Chapter 6.

 

In Chapter 3, I outline the methodology of the study in some detail.   Because spatiality is so closely woven into the fabric of everyday life, it is important to be explicit about the assumptions which underlie the research, both at the theoretical level and at the level of personal  experience.   I argue that a realist approach is called for, but one which acknowledges the possibility of multiple interpretations of reality.   The study has phenomenological characteristics, but it is important to be clear about which sort of phenomenology is being applied, and what its limitations are.   In Chapter 4 the research methods are described, including the way in which the data analysis was performed, and I also discuss some of the ethical issues around the researcher-researched relationship.

 

I postpone discussion of the nursing context until Chapter 5, in order that the reader will acquire a picture of the nursing background immediately before the chapters which describe the empirical research. The chapter describes firstly the policy context of nurse education as set out in official publications, and secondly, the historical context as set out in a number of key texts.   Secondly, it reviews some of the academic literature which deals with the student experience in nurse education, chiefly in connection with Project 2000.   The purpose of the chapter is to show that much of the existing material which deals with the nursing student experience is implicitly concerned with spatially-related topics, but fails to discuss them explicitly.   This does not negate its usefulness, but it does mean that there are unanswered questions about the way in which spatiality is experienced by groups and individuals.

 

Chapter 6 describes the geographical context of the research and some of the issues which arise from this context as revealed by analysis of the material.    One of the central issues which arises is the conceptualisation of the educational process as a journey, and I explore this further in chapter 6 with reference to three specific aspects of the student experience, namely, self-direction, essay-writing and student positioning in lectures.   The journey is shown to be a spatial paradigm of considerable importance.   In chapter 7, I discuss further spatial aspects of the student  experience, such as studying at home and the ways in which students make use of the library. Chapter 8 discusses the experience of the placement, and  I argue that nursing students experience conflict between the two spatial paradigms of ‘the journey’ and ‘dwelling’.  Chapter 9 discusses spatial metaphors, the use of terms such as ‘self-directed learning’ and the essay writing process, where the physical and conceptual metaphors of the learning process are mutually entwined.

 

In chapter 10, I draw together my conclusions about what has been revealed by the data.   I also discuss some alternative ways in which the research might have proceeded, and whether its methodology was successful. I argue that the neglect of spatiality in the discourses surrounding nurse education is an important issue which should be addressed in order to maximise the learning and retention of nursing students. Finally, I will discuss the question of what we can know about spatiality more generally, and whether such knowledge is socially useful or interesting.

 

 


 

 

Chapter 2-Proximity, Mobility, Possession

 

 

 

 


Sometimes he heard the sound of passing cars, but they were always in the next corridor, and however fast he rushed (for he would gladly have given himself up by then) the corridors he reached were always empty.   Sometimes he saw an exit far ahead that would lead to the City’s life and breath, but it always glimmered further away as he approached until he would turn, and it would be gone.                                                                                                   (Isaac Asimov, The Caves of Steel)

Introduction

T his chapter discusses the theoretical framework used to make sense of the concept of spatiality.  The framework underpins subsequent discussion of the data gathered from the experiences of nursing students , but is also intended to be a general framework which contributes to an understanding of spatiality.   In the first section of this chapter I discuss the nature of theoretical frameworks in general and their implications for the study of social phenomena.   I argue that such frameworks are an a priori feature of all research, regardless of its specific underlying assumptions.   The primary assumption of the study is that humans are embodied and exist in a physical world.  The second section of the chapter is, therefore, a discussion of what embodiment might mean for an exploration of people and spaces.  In subsequent sections, I describe the three fundamental elements of the framework – proximity, mobility and possession – in more detail.   Although they can be described separately, they form an inter-related whole, and it is this feature of the framework which is unique to the current study. 

 

The framework and its role

In order to analyse the phenomenon of spatiality it is necessary to provide more than descriptions of its appearances within the data.   What is needed is a device to turn description into analysis, and this device is generally referred to as a theoretical framework, Thomas (1997: 8) offers this critique of the framework:

...theory and theorizing...are about the construction of ideas into a framework.   The problem with such frameworks, in looser or tighter forms – in either the mental model notion of theory or in grand theory – is that once they exist they constrain thought within their boundaries.

Thomas sees Foucault’s work as exemplifying a critical approach to theory, based on ‘its homelessness, its theoretical and methodological anarchy’ (ibid).   Philo (2000: 212), in discussing Foucault’s relevance to geography, describes the situation thus:

The route that Foucault takes…thus depends [not only] upon the acceptance that a layer of theoretical materials must be laid over the specific events and phenomena under study, but also in ensuring that the concepts deployed have not so much an a priori character – having decided in advance what is ‘going on’ in any particular situation in any given time and place – as the character of ‘hovering’ responsively above the empirical details revealed. 

This might lead us to the metaphor of a helicopter hovering over the data, ready to winch up crucial pieces of evidence at the appropriate moment.   The framework does not determine what the data is, but it does play a part (along with the voices of the participants) in determining which pieces of data are ‘rescued’ and which are left in the sea of conversation.   Thus, in one of the interviews, several statements were made by the interviewee concerning the difficulties of long drives in winter.   The theoretical concept ‘hovering’ in this case was the concept of mobility, which enabled the statement to be put into the context of critical studies in this area.

 

With the above critique in mind, then, theoretical frameworks have three main purposes.  

Firstly, they facilitate the methodical identification of the phenomenon in the data.   Statements from the interviews are regarded as being valid expressions of belief about the phenomenon, but in each case the language of the conversation as a  whole is too variable and concrete to be handled at a high level of abstraction.   The theoretical framework thus acts as a bridge between the ‘messiness’ of the data (which also constitutes its value, in its richness and complexity) and the ‘purity’ of the conceptual analysis. 

 

Secondly, theoretical frameworks are needed to account for the ways in which the meaning of the phenomenon is understood.   There are competing theoretical paradigms of the relationship between meaning and the world, and in the introduction, I argued that meaning is predicated on our embodied existence in, and interaction with, a material world.   The framework which I propose to use here is dependent on this assumption, but this does not mean that it is the only way in which the meaning of space as a phenomenon can be studied.   It would have been possible, for example, to adopt a psychoanalytic approach to the ‘truth’ of spatiality (Brennan 1993; Blum & Nast 1996; Briton 2002), in which case the relationship between the orders of the Real, the Imaginary and the Symbolic would have formed the  basis of the theoretical framework for the study (Blum & Nast 2000: 183-185).   Blum & Nast point out that Lacan, the foremost source, after Freud, for psychoanalytic theorising, must ‘disavow the body’ in order for his system of signification to function (ibid: 184), whilst Yegdich (2000b) argues that psycho-analysis and existentialism are incompatible approaches to research.    I do not propose to explore this approach any further here, but suggest it as a contrasting ontology to the one actually employed here.  

 

Thirdly, theoretical frameworks help to relate the data to existing bodies of knowledge, and therefore influence what counts as knowledge about the phenomenon.   The question of what counts as knowledge is related to both the philosophical assumptions of the project and its location within an academic discipline.   There is, for example, an extensive literature on the visual perception of space within psychology (Eilan et al. 1999; Hershenson 1999).    The conventions of psychology, however,  usually require knowledge to be derived from controlled experiments rather than free-ranging interviews, and statistical analysis rather than textual interpretations.  The more eclectic disciplinary conventions of adult education and nursing research authorise the use of different forms of knowledge, such as phenomenology.   Although the current study is far from being  ‘true phenomenological research’, according to Crotty (1996; cf. Yegdich 1999) I draw on phenomenology for some of the theoretical background, and thus need to connect my use of the term to the phenomenological literature. 

In devising the Proximity-Mobility-Possession framework, I draw on the work of Heidegger (1962) in the first instance, because Heidegger’s account of spatiality privileges its relational aspect, rather than providing a depersonalized account of some mathematical or physical construct, as in Anglo-American philosophy of space (e.g. Christensen 1994).  There is, therefore, nothing in what follows about the mathematical philosophy of space, which is addressed to a different audience and is of no direct relevance to the lived-experience of spatiality with which I am concerned here.  

 

To have experience of, or an attitude towards, a space, or merely to be ‘located’, all imply relations of power, because, as Lefebvre suggests, the knowledge that I have of space, in its fullness and intimacy, is either opposed to the reductive knowledge that distanced others have, or is itself reductive.  Massey (1994b) discusses the spatiality of Kilburn High Road in these terms, as a lived space which defies static categorisation, whilst Lefebvre ( 1991: 106) puts it thus:

In this sense reduction and reductionism appear as tools in the service of the state and of power: not as ideologies but as established knowledge; and not in the service of any specific state or government, but rather in the service of the state and power in general.

In Lefebvre’s view, this dialectical tension applies to all spaces under capitalism, with the possible exception of those which Foucault has described as ‘heterotopias’ (Foucault 1986).   Lefebvre, in order to develop an avenue for resistance to the dominant spatial mode of capitalism, further develops his model of spatiality into a ‘trialectical’ system, in which he opposes ‘representations of space’, ‘representational space’, and ‘spatial practices’ (Lefebvre 1991: 38-39; cf. Merrifield 2000: 174).   Briefly, ‘representations of space’ are the province of planners and other ‘technocratic subdividers’.   These are abstract spaces described by numbers or other signs.   ‘Representational spaces’ are spaces as ‘directly lived’ and ‘passively experienced’ by their users, prior to being overlaid by  ‘spatial practices’, which are the empirical practices of everyday life under a specific regime, such as ‘neo-capitalism’ (Lefebvre 1991: 38-39).  Following Lefebvre’s model, possession is thus the product of the negotiation of the spatial trialectic by agents or actors, and Soja (1996) has taken up this notion of the trialectic in his discussion of a ‘thirdspace’ for confrontation and resistance.  As I argue here, spaces are inseparable from spatial practices, but, as Lefebvre argues, they are not indistinguishable.  The trialectic thus anchors spatiality to a material world in which ideological struggles are continually playing out, and specifically links the emergence of spatiality to the rise of modernity (Lefebvre 1991:125)

 

Heidegger has a similar aversion to space as a quantifiable object of calculation.  According to Clark (1992: 39, citing Heidegger 1971: 106):

Heidegger writes, simply, ‘Of space it may be said; space spaces’...To concern ‘space’ is not to take an entity and represent it, for space cannot be rendered an object in that manner

The idea that ‘space spaces’, that space is an active constituent of worldly reality, is central to the current study.   Clark attributes to Heidegger the claim that it is incorrect to represent space (as object) in language, and indeed, what Heidegger stresses about space is that it is neither object(ive) or subjective, but constitutive of human being itself (Heidegger 1962: 148; cf.  Malpas 1999, ch.2).   He is concerned not so much to prevent space being represented as to prevent representations of space, in the form of  ‘parameters for the measurement of nearness and remoteness’, from become dominant (Heidegger, 1971a: 102).   There are thus two ways of thinking space, essentially a quantitative way and a qualitative way.   Heidegger (ibid: 103) uses the contrasting examples of ‘nearness’ and ‘neighbourliness’.  City-dwellers can live next door to each other, without any sense of neighbourliness, whereas two farms, remote from each other in mileage terms, may be close neighbours in terms of their relationship.  There is clearly a hint here of the Gemeinschaft/Gesellschaft debate, and in the opinion of Fritsche (1999, ch.5; see also 96), Heidegger, in Being & Time , alludes to, and argues for, a specific form of ‘community’ ( Gemeinschaft ), as opposed to ‘society’ ( Gesellschaft) .    This is a continuation of a debate originating with Tönnies (1963).   As Fritsche explains, Gemeinschaft is intended to convey a sense of the organic interconnectedness and interdependency of community, historically prior to the rise of Gesellschaft, in which relationships are largely determined contractually and are dictated by the economic requirements of the capitalist system.  According to Fritsche, therefore, Heidegger’s conservative tendencies are showing through in his philosophical writing (see also Ott 1993).   Tönnies, in his original work on the concept (1963), held that Gemeinschaft and Gesellschaft would tend to co-exist, and the creation of Gemeinschaft -like ‘communities of practice’ within a  Gesellschaft -type economic system is a sustainable order of things.   Heidegger, conversely, sees the two as incompatible, and the replacement of Gemeinschaft by Gesellschaft as a crisis of modernity.   Despite its pretensions to philosophical purity, Heidegger’s conception of space is thus arguably political in its origins (Bourdieu 1991).  Similarly, the use of measurement-based data in the social sciences can be seen as a political statement based on a philosophical position, as Harré (1998: 133) observes [7] .   In effect, the use of measurement is, in this view, a devaluation of discourse and emotions or feelings as sources of knowledge about the world, and about the body-in-the-world, as discussed by Merleau-Ponty (1962) in Phenomenology of Perception,  which anticipates Lakoff & Johnson’s (1999) Philosophy of the flesh , and has much to say about embodied spatiality (Priest 2003: 101). 

 

Malpas, in developing a philosophy of place, has built on Heidegger’s work, particularly in teasing out the relationship between subjective and objective space. He comes to a similar conclusion to Heidegger (Malpas 1999:196), in that

… it is to this world, and the place in which it unfolds, that our philosophical explorations must always be addressed and to which they must always return. (emphasis in original)

This affirms the importance of embodiment to the experience of spatiality.  Furthermore, the recent work of Lakoff & Nuñez (2001) relates the spatial experience of embodied beings to the way mathematics is constructed, thus supporting Heidegger’s assertion that mathematical conceptions of space depend for their meaning on embodied concepts of spatial activity in the world.   In the next section, therefore, I examine the question of embodiment, which is crucial to the particular understanding of spatiality suggested by this study.

 

 

Embodiment

Although it seems extraordinary that it could ever have gone away, the body has returned to respectability within academia.   As Weiss & Fern Haber ( 1999: xiii ) note in the introduction to a recent collection of essays on embodiment:

the body is increasingly being identified as central to our sense of agency as well as a distinctive cultural artefact in its own right.

Csordas, however, draws a cautionary methodological distinction between body and embodiment.   He distinguishes between

the body as biological, material entity  [from] embodiment as an indeterminate methodological field defined by perceptual experience and by mode of presence and engagement in the world (Csordas 1999: 145)

For Csordas, the relationship of body to embodiment is akin to that proposed by Barthes (1975) between text and textuality; the book on the shelf versus the endlessly circulating text in its webs of signification (cf.  Couzens Hoy 1999: 4).   This is a distinction which enables the body to be absent from, or at least ‘invariant’ within, many of the formative discourses of modernity, supplanted by the disembodied application of Cartesian reason (Michelson 1998: 218; Couzens Hoy 1999: 3).  One of the central reasons for the re-emergence of embodiment from intellectual hibernation is the contested position of the biological body within discourses of gender and feminism (Bordo 1993: 151; Gregory 1994: 164; Michelson 1998)  Foucault’s work on medical practice and sexuality has developed the theme of the body as discursive construct (Couzens Hoy 1999; Foucault 1973; 1984: 179).   The idea of the body as discursive construct is useful but ultimately comes up against the limits of language and the intractability of the biological body. Tallis (1999) suggests that the intellectual basis of this discursive view of the body is profoundly flawed when it comes to the possibility of progress and material improvements in the quality of life of human beings, since it denies the reality of suffering and the ability of scientific advances to alleviate it.

 

Irigaray, meanwhile, has used embodied sexual difference to pose major questions about, for example, the unspoken privileging of vision and visual metaphor in western thought.   Her questions are specifically directed at  male philosophers, including Heidegger and Levinas (Irigaray 1993; Jay 1993: 528 ff.).   In turn, this leads Irigaray to link embodiment to spatiality in new and challenging ways.   Space is no longer ‘seen’ or ‘penetrated’ but ‘enveloped’ in a reversal based on sexual difference itself (Irigaray 1987).    Irigaray’s work is important in reminding us of the conceptual malleability of spatiality and of the gendered implications of conceptualising it in certain ways.   What I wish to provide here is an interpretation of spatiality which is sensitive to difference and its effects, whilst acknowledging that as an embodied being I cannot escape the influence of bodily specificity.

 

This, of course, raises questions about how much of the experience of spatiality is actually shared, given the bodily differentiation resulting from gender, ethnicity, ability, age and other lines of difference.   In reply to similar questions, Susan Bordo  (1990: 151) comments:

...the inflections that structure experience are endless, and some item of difference can always be produced which will shatter any proposed generalizations.   If generalization is only permitted in the absence of  multiple inflections or interpretive possibilities, then cultural generalizations of any sort - about race, about class, about historical eras - are ruled out.   What remains is a universe of counterexamples, in which the way men and women see the world is purely as particular  individuals, shaped by the unique configurations that form that particularity.

Bordo’s statement points to the necessity, for the  researcher, of assuming some degree of shared experience, whilst remaining alert to the location of individual stories.   This is one of the assumptions which underlies the term ‘embodiment’ here.   A wide range of experiences can be gathered under the heading of ‘travelling by bus’.   Not all of these will be shared experiences, but the basic features of the category ‘bus’ (e.g.  rows of seats, windows, other passengers) are shared understandings.

 

The body-in-the-world

In this study, I use ‘embodiment’ to imply the presence of the biological body, a presence which is mediated by discourse but which refuses to be reduced to it.   The biological body both enables action and constrains it within a range of possibilities (Collins 2000: 181 ff.).   In Phenomenology of Perception , Merleau-Ponty (1962) develops a theory of action which, whilst it draws on Husserlian phenomenology and Heidegger’s subsequent work on being-in-the-world (Heidegger 1962; Moran 2000), goes much further than Heidegger in emphasising the importance of embodiment in the context of the body/world relationship:

Our own body is in the world as the heart is in the organism: it keeps the visible spectacle constantly alive, it breathes life into it and sustains it inwardly, and with it forms a system (Merleau-Ponty 1962: 203)

Merleau-Ponty (1962) expresses the re-integration of the intellectual and the physical in the concept of ‘the intentional arc’.   For Dreyfus & Dreyfus ( 1999: 103) :

The intentional arc names the tight connection between body and world, viz.  that, as the active body acquires skills, these skills are ‘stored’, not as representations in the mind, but as dispositions to respond to the solicitations of situations in the world.

They suggest that the specifics of human embodiment (two arms, two legs, binocular vision, upright stance, opposable thumb, etc.) act as a limiting factor on the possibilities-for-action established within neural networks, thus relating the size of these networks to the capacity of the human brain.   Further elaboration of this point is given by Kelly (2000: 175), who shows that there is a divergence between the actions of ‘grasping’ and ‘pointing’, such that grasping is ‘not merely a way of locating the object objectively in space’.  The motor-intentional act of grasping tends, according to Dreyfus & Dreyfus ( 1999: 103)   towards

bring[ing] the current situation closer to the optimum gestalt that the skilled agent has learned to expect.

In other words, when I go to grasp my coffee mug, I reach for and grip it in such a way that it does not spill, without consciously having to work out how to control my movements in order to achieve the desired result.  Pointing, conversely, does require just such an objective location of the object.    Kelly’s argument is that this dichotomy between grasping and pointing effectively puts paid to what Lakoff & Johnson refer to as the ‘absolute dichotomy between perception and conception’ (Lakoff & Johnson 1999: 37).   They argue, with Kelly,  that recent advances in neural modelling and motor concepts have rendered obsolete the idea that mental representations are necessary intermediaries in transactions between bodies and objects.   This is not to say that no mental processes are involved in this relationship, but that these processes are part of the ‘cognitive unconscious’ (Lakoff & Johnson 1999: 12-13), which comprises all the activities carried on by the brain without the need for conscious, intentional action.    Activities such as breathing and walking are open to conscious control, but are normally carried on without it.   Representations are, in this view, part of the conscious mind, and they have little or no role in the everyday functioning of bodies in the world.   This supports the Heideggerian notion that our understanding of the world, and our coping with it, precede any conscious interpretation of that understanding.   As I will argue below, the experience of spatiality is generally enabled by just such a pre-interpretative understanding.   It is important for the purposes of this study to distinguish between perceptions of space and experiences of space.   Perceptions of space are, for Husserl (Moran 2000: 177), Merleau-Ponty (1962: 98; 105; 141) and even perceptual psychologists such as Hershenson (1999: 3), perceptions of space from the body .   In becoming experiences, however, these perceptions are mediated by the physical characteristics of individual bodies and by the historical and cultural context in which those bodies find themselves.  As O’Keefe (1999) has argued, three-dimensional spatiality is fundamental to the way in which we function as living organisms, and the brain is structurally incapable of functioning in four-dimensional space, although mathematicians may be able to model it.

 

In assuming that embodiment is a precondition of cognitive activity, I am also assuming, then, that the representation of experience is a reduction of experience – the body is always experiencing more than  can be brought into language.   Two possible ways of theorising this are the neuroscientific view that at least 95% of mental activity is unconscious (Lakoff & Johnson 1999: 13; Carey 2000), and the Heideggerian concern over this reduction of everything to ‘lived-experience’ (Heidegger 1999: 91).    This reduction is described by Heidegger as ‘abandonment of being’, and his thinking of ‘enowning’ ( Ereignis ) is an attempt, not to capture what is lost in this reduction, but to suggest  what this loss might mean for human being (Heidegger 1999: 330).   The current study is less ambitious, but it  assumes that there is a deficit in any description or representation of spatiality.   This is a problem which is not confined to research on spatiality, and one way to partially overcome it is via the study of metaphors (Lakoff & Johnson 1999).   In this case, spatial metaphors will prove to be significant in connecting the embodied realm of action to the processes and experiences of being a nursing student. Kenny (1984, n.p.),  sees metaphors as ‘pulling the world into the body’, which neatly captures the connection.

 

In this section, I have been concerned with the question of embodiment and the connection between body and world..  The body which will be discussed in relation to spatiality is, in the first instance, the biological body.  Whilst acknowledging the role of discourse in shaping the body, positioning it within the world and representing its viewpoint, the body remains stubbornly located in space, and  in the following sections I will discuss proximity, mobility and possession, the three dimensions of embodied spatiality which are at the core of the present study.

 

Proximity – a sense of (dis)stance?

In this section, I will suggest that one’s sense of proximity (an interpretation of distance) is a combination of the ability to distance oneself from one’s world (or to be apart from it as well as a part of it), and the ability to dis-stance oneself from it, in the sense of bringing it into the range of one’s concern.   This combination forms one of the fundamental dimensions of human spatiality.    This view of proximity is a synthesis of Heideggerian and other philosophical approaches to spatiality, but it is consistent with evidence from the natural sciences about the nature of spatial perception.   The work of Berthoz (2000), O’Keefe (1999) and Regier (1996) suggests that neural structures determines our conception of space as three-dimensional and that whilst this structure has evolved as a result of external influences, it is ontologically and phylogenetically prior to any subsequent conception of objects (O’Keefe 1999: 59; cf.  Malpas 1999: ch.2; see also Bermúdez 1998; Campbell 1994).   The current study takes as an underlying assumption the view that there are neural structures which determine spatial perception and functioning (Regier 1996).   This assumption is consistent with my claim in the introduction that embodiment is fundamental to an understanding of human spatiality, and makes use of the work of Lakoff & Johnson (1999) on embodied thought.   The current study makes no claims to add to knowledge about neural structures, however, and the suggested theoretical framework is intended only to assist in analysing experiential data about spatiality. 

 

An aspect of proximity that needs to be unpacked here is distance, or spatial separation, which seems such an obvious concept that attempting to unpack it might seem unnecessary.   The capacity to conceive of ourselves as autonomous beings is, however, dependent on this basic concept, which, as Malpas (1999) has shown, lies behind our ability to gain objective knowledge of entities.  O’Keefe (1999), has demonstrated in animals that the brain possesses structures which build up a three-dimensional picture of the world beginning with a calculation of the distance to some recognisable object (such as a food source).   From a geographical perspective, Law & Hetherington (2001:3) argue that

distance demands communication and interaction.  Its very possibility depends on communication or interaction. (emphasis in original)

Bauman maintains, furthermore, that ‘’...distance’ is a social product; its length varies depending on the speed with which it may be overcome’ (Bauman 1999: xxii).    This does not fully capture the essence of distance, which is located by Heidegger (1962) in the concept of ‘de-severance’ ( Entfernung ) which determines the possibility of distance.   For Heidegger, one first engages with the world, ‘takes it on board’ or brings it within one’s ‘range of concerns’, and only then imposes distances or ‘distantiality’ ( Abständigkeit ) upon those entities which this engagement reveals.  (Heidegger 1962: 138-148) .  Entfernung can also translated as ‘dis-stancing’ (Dreyfus 1991)  or ‘remotion’ (Kisiel, in Heidegger 1992), and both these expressions help to  gain a sense of its intended meaning.

 

I use the expression ‘...engages with the world’ above, rather than with ‘entities’, or ‘things’, because, for Heidegger, ‘world’ is prior to ‘things’.   Things can be ‘ready-to-hand’ as equipment ( Zeug ), or present-at-hand as entities.   Things as equipment can only show themselves from their worldly location and relevance, which are not private cognitions, but shared concerns.   This functional approach has been criticised by Levinas (1969) on the grounds that it lacks an ethical dimension, although Carey (2000) claims that the possibility of an ethics is grounded in a world of embodied practices.

 

It is important to emphasise two things here.   Firstly, the possibility of distance, within the overarching concept of spatiality, is foundational in Heidegger’s schema, and to be human is to be within a world of spatial relationships (Arisaka 1996).   Furthermore, being-human is dependent on self-consciousness and the ability to question our own way of being.   Being conscious of self in turn requires the possibility of separation from the environment which distance and dis-stancing creates, although as Harré (1998: 105) notes, ‘the state of the body...is as much a material environment as the world outside’.   Secondly, as conceived by Heidegger, distance does not objectify the other as a thing, but establishes a basis for recognition of, or being-with, the other ( Mitsein ), as co-implicated in a referential network :

The others who are thus ‘encountered’ in a ready-to-hand, environmental context of equipment, are not somehow added on in thought to some Thing which is proximally just present-at-hand; such ‘Things’ are encountered from out of the world in which they are ready-to-hand for Others - a world which is always mine too in advance.   (Heidegger 1962: 154)

That is, just as items of equipment are implicated in shared networks of meaning and are only meaningful when ‘plugged into’ those networks, so too are others encountered  in action (ibid: 156), and their existence is locked into the same sort of networks of meaning by their functional relationships with the world.     Ultimately these networks have as their horizons the totality of embodied, worldly existence, although there is some debate as to where the horizons of these ‘regional’ networks might lie (Arisaka 1995; Villela-Petit 1996; Malpas 2000).

 

The argument that objects are meaningful only within networks of referential relationships applies to a wide range of ‘things’, from hammers to hospitals.  As actor-network theorists also insist (Law & Mol 1999), objects, or ‘actants’ such as hospitals are constituted as stable objects by virtue of their location within the networks of healthcare.   One of my early interviews took place in a Victorian building used as a psychiatric hospital.   By the time of my later interviews, it was closed and was about to be re-constituted as residential flats.  The building stood still, but its meaning had changed.   For the students, it had become more distant, but was still dis-stanced from them, or was within their range of concerns, because it persisted both in physical space (as a building), in the conversational space of discourse and in the mental space of memory  This was an example of a particular way of grasping an object (the hospital), and in turn an example of an ‘affordance’ (Merleau-Ponty 1962; Kelly 2000; Urry 2001b). 

 

Sanders (1999), drawing on Gibson (1979), suggests the concept of affordance as capturing the body-world connection. Affordances are ‘opportunities for action in the environment of an organism’ (Sanders 1999: 129).   Affordances are ‘specific to entities and actions’ (Gibson 1979: 127).   Whilst the soil affords moles the opportunity to make tunnels, it affords the gardener the opportunity to cultivate a lawn, an activity incompatible with that of  moles.   This specificity is not necessarily at a conscious level.  If I enter a computer laboratory  in the University, the floor affords me the opportunity of walking on it, and I do not need to think about the floor, or the chair on which I sit, whilst word-processing.   I do not need to think about these opportunities because they have evolved mutually between myself and the ‘equipment’ over a long period.   The concept of affordances is interesting because it helps explain why spaces are rarely discussed explicitly.   The spatial affordances which we use in everyday life, such as doors, rooms or roads, are too transparent and too close to the body to be noticed, unless there is a breakdown or a limiting condition, such as a frozen lock, a hole in the floor or traffic congestion. 

 

The psychiatric hospital in the example above ‘affords’ its users an opportunity to be grasped for various functional purposes, just as grasping a hammer affords the opportunity to knock in  some nails.   In either case, the object is grasped as part of an action, such as the referral of a patient or a hammer-blow.   Proximity is the relationship within which affordances manifest themselves, because affordances, as Urry points out, ‘stem from the reciprocity between the environment and the organism’ (Urry, 2001b: 243-244, emphasis added).   In a relation of proximity, both subject and object, or subject and other, remain recognisable and autonomous (Honneth 1995: 69).

 

Proximity, then, is the possibility of establishing any sort of distance at all, for a human being as organism in an environment.   By ‘any sort of distance’, I mean to suggest that even sensations of wholeness or closeness which we may experience in relation to other entities are predicated on this possibility of distance, rather than being a negation of distance, as  Hesushius (1994) suggests.   This is important in establishing the usefulness of proximity as an analytical tool, since it can then encompass situations or narratives in which feelings of distance are conflictual or multiple.    There is, for example, a body of feminist critique which sees various devices of science and art (e.g.  the microscope, the telescope, perspective in the Renaissance) as indicative of a specifically male desire for distance from the maternal body (Brennan 1993; Irigaray 1993).   Haraway, conversely, argues against the idea that distance itself is alienating, but maintains that ‘[v]ision is always a question of the power to see – and perhaps of the violence implicit in our visualising practices’ (Haraway 1995: 181-182; see also Jay 1993).   Hagen, however, in her detailed study of the geometry of representative art, argues that the discovery of the key visualising practice of  perspective during the Renaissance was not so much an effect of patriarchal or masculine ideologies, as an advance in the technology of representation.  As  Hagen (1986: 8, emphasis in original) puts it:

...representational pictures, all representational pictures from any culture or period in history, exploit the fact of natural perspective , the geometry of the light that strikes the eye.   They succeed as representations because they provide structured visual information equivalent to the real scene represented.

Hagen’s work confirms, from an entirely different direction, one of the underlying assumptions of the concept of embodied spatiality, which is that human bodily structures are prior to culturally embedded interpretations, and are thus crucial to the ways in which spatiality is experienced. Similarly, Malpas (1999: 36) has argued convincingly that the capacity to conceive of objective space must be based on the a priori experience of subjective space.  Proximity, therefore, conceived as the possibility of distance and involvement, is bound up with the possibility of embodied action.

 

Following Heidegger, then, the central idea within proximity is that of concern or involvement, more specifically, from entfernung, or dis-stancing, the idea of mutual involvement in a world of significant relationships. Because this is a study of participants who engage in a particular constellation of actions (in this case, nursing students engaging in nurse education), I need to add another concept to deal with the possibility of action across the spaces opened up by proximity.   I have chosen to call this ‘mobility’, although as with ‘proximity’ I intend a meaning which encompasses the negative aspect of the concept.   Mobility thus includes the concept of immobility, and the spectrum of possibilities in-between, and the importance of mobility lies in the possibility of action over distance, rather than in any specific form of action.

 

Mobility

Proximity, as discussed above, establishes a range of concern radiating from the individuated body.   Proximity establishes what counts as ‘here’ and ‘there’ for some-body.   To quote Heidegger  (1993a: 359)

When I go toward the door of the lecture hall, I am already there, and I could not go to it at all if I were not such that I am there.   I am never here only, as this encapsulated body; rather, I am there, that is, I already pervade the space of the room, and only thus can I go through it. 

This passage expresses the co-involvement of body and world in a system of practices.

I know that there is a door over there and, because of my socialisation into a world of practices, which includes the use of doors, I know that I can use it to leave the room.   I am in a relationship of proximity to the door.   But in order to get to it I have to act over a distance, to cover a few metres.  The dual meaning of ‘cover’, as both ‘travelling across…’ and ‘spread out over…’ is an important key to understanding the concept. The point of Heidegger’s discussion of the door is that it is not an unknown destination but, as a cultural artefact, is part of the set of practices involved in being in a region and making that region intelligible (Dreyfus 1995: 105).   The door is another example of an affordance, but the concept of mobility, however, generalises the specific affordances of doors or hillsides into the affordance of space itself.   Space affords the opportunity to move around, to be mobile, whilst retaining an egocentric (i.e. body-centred) sense of self.    This is not to say that mobility is always freely afforded, nor is it to say that the self necessarily remains the same as a result of the exercise of mobility.   What is important is the inescapable continuity provided  by bodily activity.  Malpas (1999: 107) puts it thus:

That which does the unifying that makes for the possibility of a self, of mental content or of a unitary subjective space is...nothing over and above activity itself, and is not grounded in the prior existence of an agent.

In other words, the self cannot be conceptually separated from its spatial activity.  Mobility provides a way of designating a specifically-spatial form of agency experienced in the necessary interactions of people and spaces.  Dorn (1998) describes the different perspectives on mobility experienced by the disabled, and  frustration at one’s lack of mobility and the exhilaration of movement are both consequences of the general affordances for action offered by spaces.   

 

Although human societies have performed extraordinary feats of mobility since prehistoric times  (Cavalli-Sforza et al. 1995), the recent history of mobility is distinguished by its industrialisation in the era of ‘hyper-mobility’ (Adams 1999).   As Urry (2001a) puts it,  ‘[t]he scale of contemporary travelling...is awesome’.  In a later (2002) paper, he attempts to explain, however, why people feel compelled to travel.   The need to be with relatives at Christmas, or the compulsive forays of sales representatives are, for Urry, due to the desire for co-presence or ‘the compulsion to proximity’ as Boden & Molotch (1994) call it.   Urry refers to this co-presence as ‘proximity’, as does Latour (1997), but its importance stems from its fundamental existential significance, as Heidegger (1962) and Levinas (1969) have argued, from rather different standpoints.   Proximity is not something added-on to human existence, but is a fundamental dimension of en-worlded, embodied spatiality, and is the necessary precursor of mobility.

 

Mobility, as the individualised possibility to act over distance, is highly differentiated at both the individual and collective levels.   For example, stairs are unproblematic for able-bodied walkers but represent a breakdown in ‘affordance’ for the differently-mobile bodies of wheelchair users (Dorn 1998; Moser & Law 1999).   Even  the other side of the room may be inaccessible (for different reasons) to wheelchair users or the newly-born.  The mobility of wheelchair users may be differentiated from that of the able-bodied by prevailing spatial assumptions, for example the assumption that public buildings  should be accessed via stairs rather than by ramps or flat surfaces. 

 

Mobility is thus an attribute of embodied  action in the world, which is fundamental to human being (Merleau-Ponty 1962; Lakoff & Johnson 1999; Malpas 1999), and it is both differentiated and relative. It describes actors’ sense of their power or ability to act over distance, as distinct from proximity, the sense of distance itself.  Albertsen & Diken (2001: 3-4), drawing on Boltanski and Thévenot (1991)  put it thus:

Mobility is what makes action at a distance possible.  As Boltanski suggests, ‘action at a distance’ is the ‘very attribute which describes in the most concise and striking fashion the intuitive content of the idea of power’. 

Boltanski and Thévenot (1991: 200-210.)develop the concept of ‘regimes of justification’ to explain the deployment of power across networks, even in the absence of overt rules or sanctions.  Regimes maintain themselves through the creation of ‘grandeur’ (1991:135) which imparts a sense of awe to the ‘subjects’ of the regime. Urry (2002: 262) thus sees mobility as performed under a ‘legal, economic [or] familial obligation’.  Thus, under the domestic regime of justification, for example, one feels compulsion to visit one’s parents (or parents-in-law) regardless of whether this is an enjoyable experience or not.

The reason for adopting this theory here (apart from its own grandeur as the work of French intellectuals) is that it provides a social model relating to spatial phenomena and the power relations which they exemplify. I will return to this theme in the discussion of the data, but

although some aspects of the power-relationships embedded in spaces are captured by the concept of mobility, a third term is necessary to capture the spatial significance of the other.   That term is what I will call possession.

 

Possession

The following passage from Philip Pullman’s The Broken Bridge (Pullman 2001: 13) eloquently describes the spatial sense of possession:

Everything from the airfield to the caravan site, from the main road to the edge of the sea, was Ginny’s.  She owned it, first, because she knew it; during the years they’d lived here, she’d wandered over this gently sloping margin, this halfway place between the hills and the sea.  She owned it because she’d drawn it, from the insects on the dry-stone walls to the decaying church half-buried in the dunes…And she owned it, finally, because she loved it.

Possession is not propositional (‘I own this house and forty acres around’) but emotional, as the above extract from The Broken Bridge suggests.  It is easy to find examples of affective relationships with spaces.   Hillwalkers might summon up the atmosphere of their favourite ridge, whilst many people dislike being in banks or social security offices.   In terms of this study, universities are diverse collections of spaces, some of which are more popular than others.  Sometimes spaces are transformed – sports halls become exam rooms, and venues for graduations, each producing a different emotional response.  Neither proximity nor mobility alone can capture the affective relationships to space which I wish to examine here.   Moreover, proximity and mobility do not fully address the questions of power and power-relations which, as Paechter (2001: 3) points out, ‘inher[e] in the multiple and complex relationships between all individuals, groups, institutions and even spaces in a given society’.   Nor do they capture the social aspects of spatiality (and temporality), as Doreen  Massey has stressed (Massey 1992).    In order to include both time and affectivity in the theoretical framework, therefore, it is suggested that a third term, ‘possession’, should be included with proximity and mobility. 

 

As Robert Musil suggests, in The Man Without Qualities (Musil 1995: 610), the Latin roots of the word ‘possession’ ( potis and sedere ) indicate that it means to ‘sit upon’ or to ‘beset’ something, and suggest its etymological connection to ideas of land and property.  The extract above conveys the temporal element of this relationship: it is not possible to gain possession of a space, in this sense, without taking the time to acquaint oneself with it, to be there.  This would apply even in a virtual sense, such as in the case of one who takes possession of a discussion group on a website.

 

 

‘Spatiality’, as a summative concept, thus attempts to represent the human dimensions of space.  Proximity, mobility and possession are three qualitative dimensions of spatiality, whereas length, breadth and height  are merely three quantitative dimensions of distance in so-called ‘Euclidean space’ (Hershenson 1999: 3). I have established that proximity is a relationship of distance, and that, in concerning myself with a space such as a room I distance myself from it.   My relation of mobility to the room, based on this proximity, is my ability to act over distance, to walk around it or to enter and leave it.    But the room is not simply given, it has been built by somebody, for somebody, to use for something.   Even if it is useless in a functional sense it may be a work of art or a religious symbol.   My relationship with the room results from my relations to the social processes which determine its meaning. Even the absence of others from a space is a form of social interaction, since presence and absence are only meaningful given the existence of others.  This suggests that privacy and possession might be related concepts, although spatiality is not primarily about privacy, nor is privacy primarily about spatiality.   Yet the overlap between the two concepts is important.  

 

As Inness (1992: 3) suggests, ‘[e]xploring the concept of privacy resembles exploring an unknown swamp’.   The debates around privacy are both legal and philosophical, but in neither case is there clarity as to the basic definition of the concept.   According to Inness, however, an initial distinction can be made between privacy as isolation from ...  [an external world, sphere or space] and privacy as autonomy or the right to control access to ...  [an intimate space, information or the content of decisions] (ibid: 6).    Reiman (1976: 39) argues that ‘[p]rivacy is a social ritual by means of which an individual’s moral title to his [ sic ] existence is confirmed’, and he goes on to suggest that:

The social ritual of privacy seems to be an essential ingredient in the process by which “persons” are created out of prepersonal infants

This fits with Heidegger’s assertion that ‘... Dasein is in each case one’s own...   a world which is always mine too in advance.’ (1962: 154).   It also fits well with Lakoff & Johnson’s work on the embodied mind, and their assertion (1999: 267)  that:

we have a system of different metaphorical conceptions of our internal structure...[a]nd there are a small number of source domains that the system draws upon: space, possession, force, and social relationships. 

The cultural norms of Western society promote self-possession as a positively desirable state, as Lakoff & Johnson (1999: 273) point out, and this entails a high degree of control over one’s bodily and mental functions.   Loss of this control equates to a loss of privacy, and a corresponding loss of self.

 

A university library is a good example of a space, or a collection of spaces, where different forms of privacy co-exist.   Carrels (small cubicles for study) provide a degree of isolation from other students, but are subject to the surveillance of porters enforcing regulations.   Staff offices within the library are accessible to other staff members but not students.   Reading desks are less isolating than carrels but can still be kept as a space free of major intrusions, except perhaps by one’s friends.   The issue in the library, however, is not privacy as such, but the ability to do what one needs or wants to do, subject to whether that action is within the conventions of library use, or, if not, whether it can remain undetected.   The conventions of privacy are only part of one’s ability to make sense of the library and to get things done there.   Knowledge of its workings and layout, which is gained mainly by repeated use, is a factor, as is  social interaction – asking questions or telling others to be quiet.   None of these factors are unique to libraries, but what is common to all of them is that they contribute to our being able to cope with, or possess, spaces.   Possession thus encompasses  privacy and related concepts such as isolation and autonomy, and in doing so implies that space must be shared with others. In order to make this description of possession more theoretically coherent, I will once again refer to the work of Heidegger.

 

In Being and Time (Heidegger 1962), the concept of Dasein refers to the locatedness of human being, literally its ‘being t/here’ (Inwood 1999: 42).   From a Heideggerian perspective, spaces are demarcated by Dasein ’s ‘concernful coping’ and ‘foresight’.   Spaces are in relation to Dasein , and because ‘ Dasein is an entity which is in each case I myself; its Being is in each case mine’  (Heidegger 1962: 150), it ( Dasein) is self-possessed, i.e.  it has ownership of its self.  Crowell (2001) points out that this passage from Being and Time is insufficient in itself to establish more than a ‘formal reflective awareness of the ‘I’  as Heidegger himself puts it (Heidegger 1962: 151).  Against Husserl, Heidegger is not apparently interested in establishing the authority of the ‘I’ with regard either to its contents or its self awareness (Crowell 2001: 435).   Crowell, however, goes on to show that Heidegger, in Division II of Being and Time, develops another sense of the ‘I’ as the being of a being which can give reasons, or can take responsibility, for its actions (ibid: 449), including  taking responsibility for itself.

 

In Heidegger’s terms, then, the responsible  ‘I-self’ is inseparable from, and gives meaning to, the ‘world’ into which human beings are always already thrown, in common with all others.  By definition, Dasein , the human way of being t/here, ‘opens up’ or ‘clears’ spaces-in-the-world for itself and is therefore always spatial.   But as Heidegger goes to great lengths to show, Dasein is  also temporal.   The detailed logic of Dasein ’s temporality is complex (Blattner 1992; 1999) and need not be fully explored here.   The essential point is that human being is unavoidably shaped by temporality, both by the past as either ‘tradition’ or ‘heritage’ (Heidegger 1962: 437; Fritsche 1999: ch. 2) and by the future as possibility, one’s ‘for-the-sake-of-which…’ (Heidegger 1962: 365 ff; Blattner 1999, ch. 2).    Possession, as I use the expression here, locates this temporal process in space, as, following Heidegger’s own reasoning, it must be so located (Arisaka 1996: 36-38).   Heidegger, in fact, eventually re-prioritises space over time (in the form of the ‘site’), in the context of thinking ‘appropriation’ ( Ereignis ) (Heidegger 1972: 23; see also 1999: 259-264).  There are thus grounds for thinking that there must be a human capacity or process for integrating experiences of space with consciousness of time, and possession is the name which I give to this process-dimension of spatiality.

 

Thus, in studying for a degree, I inherit the role of student from others who may have played out their roles earlier, and I am simultaneously drawn through the process by the future possibility of obtaining a degree.   In going through the process, I occupy spaces as ‘somebody’, and my relationship with spaces is mediated by the kind of ‘somebody’ that I am.   This is not to suggest that the occupation of spaces is always goal-driven or purposeful.   Even as a bored youth hanging about on a street-corner, I am, as it were, ‘stretched-out’ in time across the space of the street-corner in my role as a bored youth.   This relationship between time and space, however, stems from the pervasiveness of spatial metaphors in the language which we use to talk about time (Lakoff & Johnson 1999: ch.10).   Heidegger’s temporal schema is itself an attempt to re-describe time, not as a series of ‘nows’, but as a ‘unity of that horizon from which each being can present itself in the world’ (Dastur 1996: 165).   He argues that because human beings are capable of death, and are therefore subject to finitude, time can be experienced as a unity in which future and past ‘co-temporalise’ the present.   Thrown into a present in which I am a student, because of what ‘has been’ in the past, I project myself upon a future which, as a possibility for being, is also with me in the present.   This is not to suggest that the experience of this unity needs to be on an epic scale.   It is enough that I be there in the seminar room because I was there last week and will be there next week.   Past and future are stretched out  across the space of the room, which is ‘haunted’ by memories and possibilities.  

 

De Certeau (1984: 108) suggests that ‘[h]aunted places are the only ones people can live in’, precisely because the places in which we live are suffused with the memories and possibilities which create a sense of self. My relationship with spaces is also influenced by my mobility in being able to get to them, but the possibility of getting there and the fact of being-there are two entirely different things, as Michael Arlen has eloquently described in the case of the Armenian diaspora (Arlen 1975).  In Passage to Ararat, Arlen suggests that these displaced Armenians have a sense of possession (as I use the term here) of   Mount Ararat, the dominant mountain in Armenia, even though individuals within the diaspora may never have spent time in the physical region of Ararat.   The temporal aspect of possession is, in this case, cultural as well as individual.   This does not mean that possession generally means ‘possession of land’, nor does it restricts the use of possession as an analytical concept to a specific kind of timeline or geographical scale.   Possession applies to any kind or scale of space, even literary spaces.   My own use of certain writers here is partly a question of possession of their textual spaces rather than others, and this possession is itself a matter of contingency: I feel more ‘at home’ with one work than another.

 

We have, then, our own ways of possessing (or haunting) spaces.   If, for example, I study in my own room, in a house in which I enjoy friendly relations with the other occupants, then my sense of possession of the space will probably be strong.   If I study in a corner of a bus station then my sense of possession of that space will be weak.   This is not to say, however, that possession is distributed solely along an axis representing power (strong/weak, low/high).   The important point about possession is that as humans we occupy space, and as embodied creatures, we cannot avoid occupying space temporally.  Possession is to have a temporal relationship with that space, to make it a haunt, to dwell there, or, conversely, to be prevented from having had a temporal relation with it, to be dispossessed.

 

Possession, however, is not just a temporal relationship.  Because we spend time in spaces, we cannot avoid having an affective relationship to them.   As Heidegger perceptively argues, even indifference is a mood (Heidegger 1962: 172-179).   Indifference to a space is an attitude, a way of standing-towards it.   I will use the example of a bus station to further illustrate what I mean by possession, in the light of the above discussion.   If I just walk past (or even think about) the bus station on the way to somewhere else, it functions as a representational space, a space which announces itself as being ‘a bus station’ but no more.   I do not think of it in the abstract, but as a concrete space, to which I have a proximity relation.   As a passenger awaiting a connection, however, I engage in spatial practices in relation to it (which may include avoiding it for as long as possible).   My spatial practice in relation to it  relates to my lack of power over it.   I experience it as bleak, usually cold, lacking somewhere to sit, a space which for me is transient and in which I do not wish to linger unavoidably.  

 

Conversely, as station manager, my relationship towards it, my sense of possession, would be very different.   I have an office, I know some of the regular visitors, I spend a great deal of time there.   I may still think of it as bleak,  cold and dirty, but I have some control over it, based on my knowledge and my position as legitimated by the local council.   From the point of view of the council, as an institutional body, bus stations are representations of space, abstract spaces.   The bus station is discursively constructed as part of an ‘integrated transport policy’, and is described quantitatively, as an area of x m 2 through which y buses and z passengers pass every day.

 

The three forms of spatial knowledge of the site are thus in tension.   There is tension between the architecture and its function, tension between its representation, its intended use and the uses made of it, such as a shelter for the homeless.   Someone forced to sleep rough in the bus station also engages in a spatial practice, but one which incorporates resistance.    Even more disempowered by the reductive functionality of the bus station than the normal user, it can be argued that even the rough sleeper has the  power to trigger action, even if this turns out to be the action which prevents her from sleeping there.   One who lacks power remains in a reciprocal power relation, as Foucault has pointed out  (Foucault 1984: 247).  

 

The point of the above discussion is to show that possession is the dimension through which power-relations are manifested in spatiality.   As the discussion here revolves around embodied spatiality, I now need to bring out the relationship between embodiment and possession.  As an embodied being, I ‘own’ my body, but it is never entirely mine to dispose of as I wish, given my involvement in a world of practical entailments and normative actions.   My body, as a student, is placed in certain ways by the requirements of the institution.   This placement is a negotiated settlement, as it were, between different proximities and mobilities.   My attendance (or otherwise) at lectures reflects a ‘compulsion to proximity’ (Boden & Molotch 1994) and a degree of mobility.   The ownership of my body and of the lecture theatre are intertwined – I own the space, I am at home there, but I am  also ‘owned’ by the institution, as the legitimating, civil regime under whose auspices the lecture is held.   Thus, possession is contested and even my non-presence in a space involves issues of possession, provided I have a proximity relationship with that space.  As a student who, in choosing a negative form of mobility, fails to arrive for a lecture, I maintain a degree of possession in relation to the space of the lecture theatre.  My presence and absence are merely two sides of the same possession.   This possession is not a static ‘slice in time’ (Massey 1992: 68), but requires an element of time to realise it.   Our relationships with spaces constantly evolve, in the way in which a house becomes a home over time, or a particular journey becomes habitual.   Again, this evolution need not be experienced in a positive way.   The feeling of wanting to be dispossessed of a space is familiar to airline passengers, or to students in an overcrowded lecture room.

 

Possession thus completes the spatial triangle which is based on proximity and set in action by mobility.  Possession, therefore, can be regarded as a negotiation between self, space and other.   As Heidegger (1962: 154) puts it:

The others who are thus ‘encountered’ in a ready-to-hand, environmental context of equipment, are not somehow added on in thought to some Thing which is proximally just present-at-hand; such ‘Things’ are encountered from out of the world in which they are ready-to-hand for Others - a world which is always mine too in advance.  

That is, just as items of equipment are implicated in shared networks of meaning and are only meaningful when ‘plugged into’ those networks, so too are others encountered  in action (ibid: 156), and their existence is locked into the same sort of networks of meaning by their functional relationships with the world.   To talk with a professor in her office is not the same as talking to her in the pub.   To be a nurse in an acute hospital is different to being a nurse in a community health centre.  

 

Possession is shared possession of space, and space, in a Heideggerian interpretation, is neither exclusively private nor public (Arisaka 1995; Young 2000).  For Heidegger, being-with others ( Mitsein ), the sharing of space, is a component of  human being    ‘Knowing oneself [ Sichkennen ] is grounded in Being-with, which understands primordially’ (Heidegger 1962: 160-161).   Shared, socially-constituted understanding thus precedes any interpretation, and ‘just as Dasein ’s own spatiality is essential to its basic state of Being-in-the-world’ (p.148), so must the shared spatiality which arises from being-with others also be essential to being-in-the-world.  According to Heidegger, shared understandings are ‘primordial’, and therefore inescapable, an insight which accords with Lakoff & Johnson’s (1999) work on the relationship between shared understandings based on embodiment, and shared spatial concepts.

 

Without shared understandings of what one does with equipment - rooms, desks, books - life would be very difficult.   But sharing understanding is not the same as sharing the same interpretation.   I might share the bus station with someone sleeping rough there,  but although we have a shared understanding of the bus station as functional entity - as equipment - we interpret it, and therefore possess it, in different (or differentiated) ways.   It is worth noting that Levinas (1969) relates proximity specifically to the recognition of the existence of the Other, and it is the failure of Heidegger to address questions of the ethical relationship with the other across distance which Levinas criticises.   Possession, as I use it here, takes account of this aspect of proximity, and should not be seen as an inherently conflictual way of experiencing spatiality.   Rather, it involves a mutual recognition that space is shared and that this joint possession can be beneficial to the parties which are involved in that sharing.  

 

 


Summary

In this chapter I have enlarged on the theoretical framework which I briefly described in the introduction.   As with all frameworks, there is much to be added before the structure is complete.   This conceptual framework is predicated on the existence of an intimate self (one which can have knowledge of itself)  which locates itself within a world of shared practices and meanings.

As it stands, however, it consists of three elements, proximity, mobility and possession, the combined experience of which constitutes spatiality.   Proximity establishes the possibility of distance between self and environment, whilst acknowledging their mutual co-dependence.

Mobility is the possibility of action over distance, and possession is an interpretation of the way in which a given space discloses itself to the individual over time, in  terms of mood and power-relations and in relation to relevant proximity and mobility factors.  The three dimensions are dependent on each other but they can be differentiated, in the same way that structure and agency are ‘not separate but separable’ (Shilling 1992; cf. Wilmott 1999).  The discussion of possession has necessarily been more complex than the discussion of proximity and mobility, because it is the most innovative of the three dimensions, and because it is intended to encompass both the temporal and affective aspects of spatiality, as well as the aspect of power. The reason for adopting a theoretical framework such as proximity-mobility-possession is to facilitate the data analysis, introducing new concepts which help to illuminate the themes which emerge from the interview material.  Next, in chapter 3, I set out the methodological basis of the study, which will entail further justification for the theoretical framework, whilst in subsequent chapters I  begin to explore the empirical data with its help.

 


 

 

Chapter 3-Methodology

 

 

 


“What I’m getting at is that the more important and fundamental the property being tested, the simpler the needed equipment...”                                                                       (Isaac Asimov, The Caves of Steel)

 

Introduction

I n the previous chapter I set out a theoretical framework for interpreting spatiality, and the purpose of this chapter is to situate the use of  particular research methods in relation to this framework,  their philosophical background and  the type of knowledge sought.   Researchers do not always reveal their reasons for researching a specific topic, or the methodological history of the research design.    Despite its importance in determining the outcome of the research, this ‘research frame’ is rarely made explicit, which, according to Thorne et al. (2002: 8):

makes an important difference in the way the research results can be interpreted and applied to ongoing inquiry or to practice.

In this chapter I describe the research frame as it relates to the theoretical framework which I outlined in Chapter 2.    The research frame is the general set of disciplinary practices, philosophical principles, personal interests and pragmatic considerations which form the background to the research, whereas the theoretical framework is the specific set of concepts which are to be tested against empirical data.

 

The first section in this chapter briefly describes the background to the research and its effects on the way in which the study was pursued.  Situating research in this way is becoming more common amongst social researchers, although its value is disputed.   The second section addresses the structure of the research frame in more detail, under the headings of ontology, epistemology, theoretical perspective, and methodology.   Within the sub-section on theoretical perspective, I discuss the question of phenomenology and its relevance to the current study. Research methods and the practical aspects of the research are discussed in Chapter 4.


The research and the researcher: In search of the lost world?

Before I move to a discussion of the methodology of the study, there is some unpacking to do in respect of the spatial metaphors most often deployed in this type of research.   ‘Exploring’, in this context, implies movement through and around the data, perhaps stopping at interesting vantage-points from time to time in order to note salient features of the landscape.   In exploration, there is sometimes a symbolic objective (the summit, the pole  or the lost world) which justifies the journey, but it is the learning experience during the journey which is the significant outcome.   Bateson (1973: 22) points out that ‘an explorer can never know what he [sic]  is exploring until it is explored’.  The creation of hypotheses and the use of experimental methods (“what will happen if we try this?”) is different from the process of entering a discourse to extract shared meanings (‘what will we find if we go there?’).

 

The initial data analysis, in the form of the coding process, might be likened to an aerial mapping exercise, plotting the co-ordinates of landmarks or places but unable to gain any sense of their atmosphere or inner workings.   The data exploration phase attempts to remedy this lack by moving-in on the ground and getting close to the participants’ discourse.   In a sense, this is the real exploratory phase, despite Stronach & Maclure’s (1997: 102) characterisation of ‘fieldwork’ in current educational research:

The practice begins as an expansive, prolonged and colonially sponsored immersion in exotic cultures....[f]inally, it is condensed in the 1980s to a notion of fieldwork that involves handfuls of semi-structured interviews clinging precariously to the fading memory of a theoretical sampling rationale. 

The process of engaging in conversation with the participants is thus in one sense the symbolic objective of the expedition.  The outward journey, which involves such expedition-like activities as gathering sponsorship and buying supplies (tapes and books) and the return journey, which involves reflection on the symbolic objective and, in its later stages, dissemination of its findings, are complementary, although there are precedents for expeditions whose perilous return journeys were perhaps more interesting than their objectives, attained or otherwise (e.g.  the Shackleton expedition, or the  Apollo-13 lunar mission).

 

Outram (1999: 284), in a discussion of the relationship between exploration and knowledge in the Enlightenment, suggests that:

...exploration knowledge was profoundly at odds with attempts...to find epistemological legitimacy for experiment-based science in a denigration of knowledge based on the senses

Exploration knowledge, as Outram (ibid, p,283) points out, is largely based on trust in the explorer’s veracity in reporting the sense data collected along the way.   In this respect,  extracts from interviews function like photographs, snapshots from a conversational journey which convey only a partial, filtered sense of their spatial location.  The journey is recreated in a different form by the narrative of the research text, rather like the explorer’s slide show.   Veracity is thus a function of rhetorical ability rather than  reproducible experimental conditions (Law & Mol 2001).

 

This (over-)extension of the expedition metaphor confirms the importance of foregrounding the research process.   In this chapter, the extended ‘return journey’ from the data collection begins, even though the data itself lies ahead.   As Lakoff & Johnson (1999: 194) point out, ‘[t]he very flexibility of the concept of a journey makes it extremely useful in metaphorical thought’.   Describing the research process as a journey avoids the necessity of imposing closure on processes, such as learning or understanding, which otherwise resist closure (Strathern 2000), since the destination of the journey need not coincide with the attainment of such learning or understanding.   The use of ‘journey’ and related metaphors of movement thus restores a sense of stability to processes which, as Haggis suggests, might otherwise be unmanageable, or chaotic (Haggis  2002).   In the course of exploring the data, I reflect on the importance of the journey metaphor to the educational process, and on possible alternative metaphors.

Describing the research frame will involve detailed consideration of the philosophical ideas which inform it and its relationship to the research methods.  The researcher however, exists prior to the research and prior to consideration of any of the philosophical questions discussed below.   As the researcher, in conjunction with supervisors and others, pursues research questions, s/he encounter other projects, other texts and other researchers, and these influence the way in which the project develops.   Personal and material spatiality surfaces here, in such ways as commuting by train, which provided contact with postgraduates in other departments (English, Modern Languages, Film & Media Studies), and sharing an office in the university.   Consequently, the project started with a sense of differentiated distance from colleagues, continual travel and of opening up my own space within the university, All these affected my thinking at an early stage, and the proximity-mobility-possession framework can be seen in outline in these three senses of spatiality.   Distance from colleagues is a proximity issue, travel revolves around mobility and having access to one’s own space is about possession, although all three dimensions are inter-related.

 

There is also a connection between the practicalities of being a situated postgraduate and the nature of the research frame.   The physical act of walking from station to university, and the solidity of the terrain and the buildings which I passed on the way, convinced me that a realist approach – one which acknowledged the existence of a mind-independent world – was correct (for me). The phenomenological slant came from an interest in Heidegger, which in turn had been stimulated by an exchange visit to the University of California, Berkeley.   Because I was an inexperienced researcher, I was attracted to what seemed like the most obvious and straightforward data collection method – the face-to-face interview – which was also something at which my principal supervisor had much experience.    It was suggested that  researching nursing students offered a way of accessing a larger pool of participants than would have been available in other areas of adult education.   The fact that a second, nursing-only campus existed, geographically separate from the main university, was seen as a source of spatial interest, and it was also considered advantageous to develop a cross-departmental project. 

 

Finally, although there were good reasons for researching nurse education, I was too much in awe of what I perceived as both the professionalism and high workload of nursing students (Howard 2001: 35) to want to intrude excessively on their lives by using some form of  ethnographic or participative method.  They were also mainly ‘mature students’.   Although these constitute a high  proportion of the student population overall (Osborne & Davies 2001), mature students are constructed in opposition to ‘traditional’ students, typically regarded as those aged 17-21 (Agbo 2001: 4).  As mature students, nursing students coped with conflicting demands and took their chosen discipline seriously but required different kinds of support from so-called traditional students (Cuthbertson & Smith 2001; Howard 2001).   Thus, I approached them in a way which sought to minimise my intrusion as a researcher and my disturbance of their ‘balancing act’ (Schuller et al. 1999)

 

The circumstances of the research as outlined above are probably similar to those of most doctoral projects.  Failure to take these circumstances into account would, however, lead to a false picture of the research process, as Cooper & Woolgar (1996: 148) suggest:

... It is extraordinary that almost all sociological research texts assume that researchers work on their own, make their own decisions and otherwise proceed in isolation of the demands of their colleagues, their institutions and discipline. 

Cooper & Woolgar argue that research is a complex interaction between its producer(s), its sponsors and its audience, and that it is problematic for the researcher to make this interaction relevant and visible without alienating the very audience which she is attempting to inform.  In the current study, it is suggested that the experience of spatiality is pervasive, and must therefore affect the researcher in some way.   More generally, Bhaskar (1979: 69) argues that all scientific research is value-laden, and that the selection of a problem to be addressed is itself an expression of a value judgment.   He also argues (ibid: 72-73) that attempts to lay out those values in relation to their effects on the research process (as I attempted above) are futile, since either consciousness of the underlying values leads to the possibility of objectivity, in which case the attempt is unnecessary, or unconsciousness of the same values (despite professions to the contrary) renders the statement misleading.   Whilst Bhaskar’s argument is logical, a certain amount of background information is desirable in this case, again because the topic itself calls attention to the spatial background out of which activity arises.

 

Although the circumstances related above are not sufficient reasons for pursuing a particular methodological path, the role of chance and contingency in research has been severely undervalued (Dutch 2001).    For example, the work of Lakoff & Johnson (1999) has been influential on the assumptions driving this project, and Sowa (2003) points out that their thinking in turn is heavily influenced by their personal reactions to the teaching of Chomsky in the early 1960’s.   Whilst this is partly acknowledged in their published work, the full extent of Chomsky’s influence is made clear by Sowa’s ‘insider’ knowledge.   Were it not for this contingent fact of specific inter-personal contact, the direction and emphasis of Lakoff & Johnson’s own research might have been somewhat different.   Similarly, my own research direction was contingent upon specific spatial and temporal circumstances..   In the next section I discuss in more detail the components of the research frame which result from these circumstances.
Four levels, and a leap into the unknown

In this section I discuss some theoretical questions concerning the research frame.   Crotty (1998)  suggests that the formal structure of the research frame should describe its ontology, epistemology,  theoretical perspective, methodology and method, and I will use these headings to build a picture of the overall research frame of this project, although the discussion of method will take place in Chapter 4.   The discursive separation of the headings does not imply that these are isolated considerations, since the opposite is the case.  Each is dependent on the other, in ways which should become clear below.

 

The ontology of this project needs to be made explicit because the nature of space is itself a fundamental component of any ontology.  The Christian Church imposed its own ontology prior to the ‘Copernican revolution’ (Russell 1961: 521), whilst current Western ontology is based on a Physical-mathematical conception of space (or space-time) as bounded by the curvature of the universe at one extreme and by the existence of some form of fundamental particle at the other.   In this ontology, the physical nature of the universe is discoverable by science and can be described in languages of various kinds.

 

Ontology is described by Heidegger (1962: 32) as ‘that theoretical enquiry which is explicitly devoted to the meaning of entities’, and  Heidegger’s project is explicitly to radicalise ontology via the phenomenological study of existence (Moran 2000: 197). This radicalisation situates spatiality at the intersection of human being and world, both of which are conditional on there being an  ‘earth’ which makes the existence of worldly humans possible.   The meaning of ‘spatiality’ within Heideggerian ontology therefore derives from this human-world relationship.   The ontological pre-suppositions of the research are that human beings are meaning-makers, rather than meaning being  given by the transcendental reality which is ‘out there’ prior to and regardless of the existence of beings.   This is not to say that there is no such mind-independent materiality, but that such materiality is meaningfully structured by the embodied existence of human beings and their specific features.   Our knowledge of this materiality is thus subject to constraints as a result of embodiment, and this gives rise to epistemological considerations, as I will now discuss.  

 

Epistemology is concerned with the possibility of (gaining) knowledge under various conditions of reality, or ontologies.   The three main strands are objectivism, constructionism, and subjectivism.   According to Crotty (1998), objectivism is concerned with the possibility of certain, value-free knowledge, usually of the natural (as opposed to human) world, and therefore tends to be associated with science and positivism.   Subjectivism is at the opposite end of this continuum, and suggests that knowledge is discursively created by subjects and is therefore entirely relative.

Constructionism is in the middle of the continuum, and assumes (broadly) that there are objects, but that our knowledge of them is always socially constructed or mediated, and therefore always partial and provisional.   This is an epistemological  view which studies in the sociology and philosophy of science have endorsed (e.g. Kuhn 1962; Latour & Woolgar 1986; Latour 1987).    The current study situates itself in this middle position, which. as Paley (1998) suggests, is compatible with the Heideggerian position outlined above.

 

This is, then, a constructionist (Crotty 1998: 42) project based on transcendental realism (Bhaskar 1975: 56-62; 1979).  It is based on the idea that there is a reality which precedes (and exceeds) the existence of humans, but which is given meaning only by human cognitive and social activity.    This is opposed to empirical realism, in which ‘[t]he world is what men [ sic ] can experience’ (Bhaskar 1975: 58).   In Bhaskar’s terms, there is an ‘intransitive’ reality of which we can have ‘transitive’ knowledge, but which precedes, and is independent of, our existence.  If this were not the case, science, and all other forms of knowledge would be impossible.  As Bhaskar (1975: 39) argues:

To be is not to be the value of a variable; though it is plausible (if, I would argue, incorrect) to suppose that things can only be known as such.   For if to be were just to be the value of a variable we could never make sense of the complex processes of identification and measurement by means of which we can sometimes represent some things as such.   Knowledge follows existence, in logic and in time; and any philosophical position which explicitly or implicitly denies this has got things upside down.  (emphasis in original)

This position fits with Heidegger’s assertion that we are always already ‘thrown’ into a world (Heidegger 1962: 174).   It is important to establish the existence of such a world not only to make the epistemological basis of the study consistent with its theoretical sources, but also to make it possible to talk of ‘spaces' as entities, as opposed to space as a relational concept, the subjective/objective distinction discussed by Malpas (1999: 35-38). 

 

There are those who appear to argue for a view of reality, as distinct from knowledge of reality, as entirely socially constructed.  According to Searle  (1995: 157), these include Dummett, Goodman, Kuhn, Feyarabend, Putnam, Rorty, Maturana, Varela and Winograd, together with Derrida, against whom Searle’s critique is principally directed.   Their views can be summed up under the heading of ‘anti-realism’, and Searle asserts that anti-realism makes it impossible to conceive of ‘a reality independent of our representations of it’ (ibid).   Searle (p.154) argues that:

Realism is the view that there is a way that things are that is logically independent of all human representation.  Realism does not say how things are but only that there is a way that they are.

Searle is clear that this argument does not, of itself, make any claims about the way things are, even non-material things like space and time.   What is at stake in the world in which we live is the possibility of different descriptions of external reality, rather than different realities (Searle 1995: 165).   Similarly, Heelan (1983: 279) concludes, in his survey of the hermeneutics of perception, that ‘the essence of being a human perceiver is to-be-in-a-world’.   The existence of a (spatial) world does not depend on the existence of observers, or ‘client-perceivers’ as Heelan calls them, but the observers depend on the world.   According to Cerbone (2000: 269) Searle’s arguments do not function as proof of external realism, but the point which both Searle and Heidegger make, in different ways, is that asking for such proof is itself proof of a misconception about existence.   For Heidegger, human being is being-in-a-world, and the notion of a worldless subject is literally non-sensical. 

 

A cave is an example of a space which is independent of human beings in terms of its geological origins, but which fulfils various human purposes and hence acquires multiple meanings, as (e.g.) shelter, temple or art gallery.  Its spatial meanings are thus human constructions, whilst the ‘facts’ about the cave – its length, geological nature or bat population – might be held out as ‘objective’ by scientists, despite arguments for a socially-constructed dimension of ‘objective knowledge’ (Latour & Woolgar 1986; Latour 1987; Law & Mol 2001).  Law & Mol (2001) suggest that there are in fact specific spatialities which attach themselves to supposedly universal scientific ‘truths’ or technological objects.   Although, for example, a metre is apparently a metre everywhere, it takes effort, expressed across space, to maintain the standard as a standard.   Where this effort fails, other standards apply, as on a remote island, where a piece of driftwood might be pressed into service as a standard (but arbitrary) measure.

 

The same argument applies to a built space such as a classroom – its physical parameters are measurable by science against ‘standard’ quantities, and on one level can be objectively compared to other classrooms.   The idea of a classroom, however, is only mobile, or what Latour (1999) calls an ‘immutable mobile’ within a network which sustains its meanings.   These meanings, are ‘located’, for its users or, in other words, they are spatially constructed, and so, to use Bhaskar’s term, are ‘transitive’, for example, a 'classroom' may have different meanings in, for example, Scotland, Botswana and Hong Kong.  

 

Given that there is a world to be perceived and experienced, then, what would be the appropriate way to gain knowledge of the world in general or about space in particular?  It would be possible to measure many of the parameters of student usage of space in ways which would conform to the requirements of a scientific, objective study.    The frequency of library visits and the mileage driven to placements could be recorded, or different configurations of seating in lecture rooms could be tested experimentally for their effect on student behaviour.  This form of research would not be able to answer the research questions as set out above, however, because these are questions about meaning, rather than questions in which a meaning is assumed.    Equally importantly, it would lack the inexactness which, as Heidegger  astutely points out, is required for rigorous inquiry in the human sciences (Heidegger 1999: 104).   As Cioran (1976: 222, cited in Crotty 1998: 81) eloquently puts it:

Our inmost aridity results from our allegiance to the rule of the definite , from our plea in bar of imprecision, that innate chaos which by renewing our deliriums keeps us from sterility. (emphasis in original)

It is this inexactness which enables the  discovery of new forms of meaning-making activity, whereas the precision of scientific methods enables predictions to be made once these activities have been described.   Heidegger (1999: 104) states the same view even more clearly:

The ‘human sciences’ by contrast [with the ‘exact’, i.e.  natural, sciences] must remain inexact in order to be rigorous.  That is not a lack, but an advantage of these sciences.   Moreover, execution of rigour in the human sciences in terms of performance always remains more difficult than carrying out the exactness of ‘exact’ sciences.  (emphasis in original)

Here, Heidegger is concerned to preserve being as that which lies beyond beings and is always in excess of what can be discovered about beings.  In doing so, Heidegger, seen in his historical context,  is perhaps challenging Weber’s  ‘passion for empirical verification or his concern to explain in causal terms’ (Crotty 1998: 71), a passion antithetical to Heidegger’s own project (cf.  Heidegger 1999: 101).   

 

A constructionist-realist epistemology has therefore been adopted, in which the independent existence of a material world (populated by embodied beings) is acknowledged, but in which also, knowledge is negotiated and provisional rather than discovered and fixed.   Clearly, there is a difficult balance to be attained between shared meaning and personal account, and the next section begins to explore how this might be attained through a phenomenological approach.

 

The Theoretical perspective

Given the constructionist-realist stance outlined above, the most likely theoretical perspectives to stem from it might be those aligned with interpretivism, such as symbolic interactionism, phenomenology or hermeneutics (Crotty, 1998: 5).   According to Harris (1996: 1):

Symbolic Interactionism rests on three primary premises.  First, that human beings act towards things on the basis of the meanings those things have for them, second that such meanings arise out of the interaction of the individual with others, and third, that an interpretive process is used by the person in each instance in which he must deal with things in his environment. 

Although all three of the above premises apply to the current study, the focus of symbolic interactionism on interpersonal relationships and role-taking makes it less useful for the study of phenomena such as spatiality.   Crotty (1998: 79) distinguishes between ‘constructivist’ and ‘constructionist’ approaches, and symbolic interactionism is a constructivist approach in that it ‘describes the individual human subject engaging with objects in the world and making sense of them’ (ibid) whereas in constructionist approaches, we are delivered over to a pre-existing complex of culturally-determined meanings.     Phenomenology, far from being about those culturally-determined or ‘negotiated’ meanings themselves, is, in its Husserlian form, about certainty, although it bears a  different relationship to certainty from that of traditional scientific objectivism.   Phenomenology seeks to reach grounds, essences, foundations and ‘the things themselves’, even if it acknowledges that it can never quite reach them  It is the ‘way’ (as in Heidegger’s (1971) On the Way to Language ) which is important to phenomenology, the way which leads through the unmediated experience of existence.  For the researcher results cannot be in the form of  ‘unmediated’ experiences, which have to be reduced to language in order that they can be shared.  Although the perspective which will emerge in this study is, therefore, not ‘pure’ phenomenology, it is worth exploring the development of phenomenological thought in order to assess its usefulness to the study of spatiality.

 

As Moran (2000: 6) relates, the roots of phenomenology extend much further back into history than Husserl, but his work is generally credited as being the source for its adoption by researchers.   Husserl was initially concerned to found  philosophy on the certainty of ‘[t]racing acts of cognition to their ground in acts of clarifying and fulfilling intuition’ (Moran 2000: 107; see also 124).   This tracing process involved what he called the ‘phenomenological reduction’, the exclusion of all but  pure intuition from consideration by the ‘ego’.    It is important to note that this reduction excludes the application of theory or logical inference to the data as the experiencing subject) (re)cognises it.    Meaning should not be imposed on the data in phenomenological research, rather, the data, as pure unmediated experience, is the meaning.   As Crotty suggests, ‘[p]henomenology is about saying ‘No!’  to the meaning systems bequeathed to us’   (Crotty 1998: 82).    This lack of presupposition itself forms a theory, and the same problem occurs with derivations of phenomenology such as ‘grounded theory’, as Thomas (1997: 5) and Schuttermaier & Schmitt (2001: 1) both suggest.  In defence of Husserl, Spiegelberg (1971: 83), points out that

In Husserl’s case, the phrase ‘freedom from presuppositions’ stands for the attempt to eliminate merely presuppositions that have not been thoroughly examined...It is thus not freedom from all presuppositions, but merely freedom from unclarified, unverified and unverifiable presuppositions that is involved.

Despite this proviso, and as Husserl and his critics realised, the attempt to ‘bracket out’ what Heidegger (1962: 34) calls the ‘ontic’ manifestations of the ‘life-world’ was highly problematic (Bell 1991).   These ontic manifestations - physical objects in space and time, and assumptions and prejudices rooted in everyday life - are not easily eliminated.   As Moran (2000: 191) puts it;  ‘[t]rue phenomenology, for Husserl, cannot be founded on any science of human being’ (cf. Bhaskar 1975: 56).   Husserl intends the opposite, which is to found all science on phenomenology   This is the basis for Husserl’s dispute with  Heidegger over the latter’s appropriation of phenomenology in Being and Time .   Husserl viewed Heidegger as doing  a form of anthropology rather than true phenomenology, as did Heidegger himself in his later work (Brandom 1992).   Nevertheless, Heidegger’s project, in Being and Time, is ontological, whilst Husserl’s grounding of science is epistemological.  Whilst Heidegger sought to show how human being manifests itself in the everydayness of (for example) ‘coping’, ‘mood’ or ‘guilt’, Husserl searched for a ‘transcendental idealism’ (Moran 2000: 190), radically separate from everydayness.   For Husserl, the everyday life of things and individuals acted to obscure the phenomena, the ‘things themselves’.   Heidegger criticised Husserl in turn, rejecting transcendental idealism, the idea of pure description (that is, without interpretation) and the lack of concrete historical thinking in Husserl’s work (Moran 2000: 20), although Levinas (1998: 131, cited in Moran 2000: 327 ) attributes to Husserl:

...the principal intellectual means for substituting a human world for the world as physico-mathematical science represents it.

Heidegger, against Husserl, sees everyday life on two levels.   Firstly, it amounts to a  lostness, a forgetfulness or a covering-up of being (Heidegger 1962: 264), in which human beings are absorbed in, and carried along by, a complex of cultural practices and norms.   Heidegger refers to this state as ‘ Das Man ’, the ‘they’ or the ‘one’ as in ‘this is what one does...’.    At the same time, the modes of  human relations to things within a world, as equipment or otherwise, are the means to ‘unveil a primordial kind of being of Dasein ’ (Heidegger 1962: 210).   Heidegger is ostensibly no more interested than Husserl in exploring the cultural practices and norms which shape everyday life, although as Fritsche (1999: 59; see also 188) points out, Heidegger himself  partakes of these cultural practices in a highly politicised manner, and they permeate Being and Time just as much as they do the popular newspapers of the time (Holub 1999).  

 

This is not just an arcane point of philosophical debate, however, since it fundamentally affects the conduct of the research process.   Husserl is not an empirical researcher, but is concerned with the nature of  representation and cognition, with how it is possible to have knowledge of anything rather than with acquiring knowledge as such  and although Heidegger continually reiterates that he is interested in Being rather than (human) beings, he seems more attuned than Husserl to the complexity of how humans cope with the world [8]

 

Both Heidegger and Husserl thus pose difficulties as ‘guarantors’ of a phenomenological theoretical perspective.  The point of research, for Heidegger, is not the validation of a hypothesis but a questioning leap into the unknown.   The reduction of the world to ‘lived-experience’ and thus to representation is, in Heidegger’s view, a disaster (Heidegger 1999: 92-93).   This, of course, opens up the paradox of  how to represent a phenomenon, such as spatiality, which lies somewhere between representations of lived experience and ‘the things themselves’.   The experience of spatiality is always more than can be adequately represented   The only way in which I can know this to be the case is through my own experiences, but I can only describe these through language, and thus through the cultural categories which are embedded in it.   On the other hand, acknowledgement of the existence of an external world  means that there has to be an excess of ‘world’ over ‘experience’ – how can I describe what is happening in a distant part of the world, or even behind me?  This is not a problem unique to the study of spatiality, and it means that a study such as this can only provide a partial description of that aspect of experience which it chooses to describe. 

The reason for the extended discussion of phenomenology here is to emphasise that this point has been problematic even for those, such as Husserl and Heidegger, who have spent most time in thinking about it.   The lesson which must be drawn from study of the primary sources of phenomenological thought, by would-be phenomenological researchers, is that neither Husserl’s ‘bracketing-out’, in the ‘phenomenological reduction’ nor Heidegger’s ‘thinking the question of Being’ can themselves form the sole basis of viable research methodologies, and conversely, that many of the research methodologies which claim to be phenomenological are misinterpretations resulting from the absorption of phenomenology into various Anglo-American research traditions (Paley 1998; Searle 2000: 71-88).  Searle makes the point that there is no reason why phenomenological and causal explanations cannot co-exist, provided the question permits these forms of explanation, but the debate continues within nursing studies and elsewhere as to whether it is possible to conduct  phenomenological research in the true Husserlian sense (Crotty 1996; Yegdich 1999).  The current study uses a derivative version of phenomenology, a version which Benner (2000: 299) calls ‘interpretive phenomenology’, in which descriptions of phenomena are sought via their symptomatic representation in speech, writing or other representations.  This would seem to preclude any direct access to the phenomenon of spatiality, but there is a way round this problem, through the study of spatial metaphor.  Pratt (1992), however, cautions that

Although some of the spatial metaphors circulating through contemporary academic discourse are useful aids for problematising positionality, others dress up and potentially reproduce some very conventional intellectual subject positions (for example that of the distanced observer), underwrite new sets of dividing practices, and promote a remarkable arrogance or naivety towards the construction and destruction of and caring for places.

 

Speech and writing are forms of language, and Hardin (2001: 13) suggests that post-structuralist understandings of the self as constructed through language negate the ‘unspoken assumption that individuals are free acting agents’, and suggest that discursive positioning, or the emergence of the subject from language, constrains action.   Recent thinking on the relation between cognition and embodiment, however, suggests that linguistic constraints on thought are consequences of embodied action (Lakoff & Johnson 1999; cf. Regier 1996; Lakoff & Nunez 2001).    Lakoff & Johnson argue that it is bodily action in the world which produces language, via metaphor, and that attempts to  disembody language, as with analytical philosophy, are doomed to fail as explanatory frameworks for reality.

 

The zone of slippage in which language moves from being a metaphorical space to being about space is thus an important methodological area, and It is important to separate representations of space from the lived experience of space, a point made explicit by Lefebvre (1991: 44-6) and further developed by Soja (1996).   Heidegger goes further, regarding even ‘lived experience’ as a reductive concept, and implying that the reduction of being-in-the-world to ‘lived-experience’ which ‘knows no limits’ is ultimately a refusal to acknowledge the finitude of human, spatial existence (Heidegger 1999: 91).   For Heidegger, live[d] experience is the domination of being by human self-representation.   How might this affect what can be researched, or indeed the desirability and meaning of research itself?  How can we reconcile the insight that embodiment brings the world into thought with the notion of beyond-ness and the critique of ‘lived experience’ as reductive?  To some extent these questions have to be set aside in the current context, but there remains the question of the extent to which the experience of spatiality can be shared and represented.

 

Heidegger’s explanation of interpretation (1962: 188-195) supports the idea that all interpretation is predicated on prior understanding, or ‘fore-sight’ ( Vorsicht ).   Our interpretation of a door is predicated on an understanding of the way in which it relates to rooms, corridors, hinges and doorknobs.   We know what doors do, and interpretation builds on that understanding.   If someone slams a door and locks it from the inside, we might interpret that as a demand for ‘personal space’.   Alternatively, an open door to a professor’s office might signify her availability for consultation.   The key element is the sharing of this understanding,  Even ‘self-professedly subjectivist’ accounts, which Crotty (1998: 83) sees as typical of the kind of phenomenology  mainly practised by American nurse researchers, depend on shared understandings to make interpretation possible.   In Heidegger’s account, these shared understandings are not the object of his questioning, but a means to another end entirely: the clarification of the question of Being ( Seinsfrage ) itself.  Although the current research addresses  spatiality via the study of human relationships with space, or, more precisely,  nursing students’ relationships with space, these relationships are not its object. Rather, its object is the phenomenon of spatiality itself.

 

This is a phenomenological study in that I am attempting to access a phenomenon which I have labelled ‘spatiality’ via the lived-experience of a group of participants.  Lawler (1998:105) points out that researchers in this tradition are ‘asking different questions and seeking to know the world differently’.  As Crotty relates, phenomenology and research have had a complex relationship, especially in nursing,  and there have been misunderstandings of both principle and method (Crotty 1996; cf.  Lawler 1998).   Even given the understandable focus of nursing research as being on the patient, as opposed to phenomena such as pain or stigma (Thorne et al. 2002), Crotty ( 1998: 48) sees:

a rampant subjectivism...in the turning of phenomenology from a study of phenomena as the immediate objects of appearance into a study of experiencing individuals. 

The current project is about the phenomena of ‘space and spatiality’ and is not about individuals as such, but even phenomenological researchers need to work with research participants to provide data: introspection is not enough.   Green & Holloway ( 1997: 1015) argue that

the phenomenological approach has a humanistic ideology that nursing, with its own discrete professional values, can both identify and feel comfortable with.  These professional values include...participative aspects that emphasise the actor’s own meanings and interpretations

It is arguable whether, in fact, phenomenological approaches do have a ‘humanistic ideology’.   Heidegger in particular has been accused of ‘anti-humanism’ (Holub, 1999) and indeed has denied being a humanist in his own writing (Heidegger 1993c).  Nevertheless, the empirical component of this study is about how nursing students experience spatiality as they cope with their world.  Thus, the study is not truly phenomenological, but involves a series of prior assumptions about, for example, who nursing students are and what spatiality might mean, with further assumptions about embodiment and its inseparability from spatiality.    Spatiality is thus a phenomenon which can be further explored and conceptually enriched through the study of everyday practices and their related affective states.  

 

In the introduction, the evolution of the research questions was traced in the following table:

Figure 2: the research questions again

Question

Reason for asking

Body of knowledge to which study might contribute

What is meant by ‘spatiality’?

Own interest

Theories of space

What is meant by spatiality in the context of nurse education?

Attempt to cross disciplinary boundaries, reinforcing and deepening analysis of previous research in field

Theories of space, nursing literature

How does spatiality affect  lives of nursing students?

Desire to enhance student experience, lack of attention to spatiality in nursing literature

Literature of student experience within nursing literature

 

In the current study, it is suggested that answers to questions about student experience might be used to provide knowledge about the way in which spatiality is experienced , rather than simply providing knowledge about specific aspects of the student experience itself. To do phenomenological research, as I use the term here, is to derive descriptions of phenomena from descriptions of  everyday life.   This in itself constitutes critical activity (Crotty 1998: 112) since for both Husserl (Moran 2000) and Heidegger (1962), the existing state of our understanding of the relationship between phenomena and natural science (for Husserl) or Being (for Heidegger) is unsatisfactory.   To engage in further analysis of everyday life is, however, to engage in cultural , as opposed to philosophical, critique, and to move beyond phenomenology (Paley 1998).   Heidegger provides no clear statement of how the disclosures of phenomenology are to be applied in everyday life and indeed, claims that ‘[p]hilosophy is useless but at the same time masterful knowing’ (Heidegger 1999: 26, emphasis added).   By ‘useless’, here, Heidegger specifically means that true philosophy does not partake in ‘machination’ (ibid), the quantification and reduction of everything to efficient use. Providing specific recommendations for practice is thus not, in Heidegger’s view, the point.

 

It is therefore, difficult and indeed pointless to attempt ‘pure’ phenomenological research, which would have to ‘bracket out’ all the external factors mentioned above. On the other hand, thinking about phenomenology can help to identify whether there is a phenomenon to research at all.  Additionally, the humanistic tradition imposes an ethical obligation on researchers in which outcomes related to the needs of the participants are considered to be important (Moch & Gates 2000).   The current study attempts to address these considerations, and is intended to have outcomes at three levels.    At the level of the ‘useless’, the study should provide an argument for the existence of something called spatiality.   At the level of lived-experience, the study should provide a medium for the discursive contributions, or ‘voices’ of the participants to be heard.   Finally, at the level of ‘machination’, the institutional level, the study should provide some  guidance for the improvement of whatever might be found to contribute to a ‘positive’ spatiality. In the next section, I will discuss methodologies which might contribute to achieving these aims.

 

 

 

Methodology

It is not my intention here to engage in a debate between qualitative and quantitative methods which Flyvbjerg (2001) has shown to be partly the result of social science attempting to predict the unpredictable.  Educational research is currently under pressure to produce predictive results based on numerical evidence as in random controlled trials (Moore et al. 2003).  Chiarella (2002: 202-204) draws attention to the predominance of qualitative research in nursing studies, and suggests that this ‘has been accorded lower status [compared to methods such as random controlled trials] as a means of providing evidence about practice’ (see also Smith 1994).  The qualitative/quantitative debate is ultimately fruitless, according to Schuttermaier & Schmitt (2001), as it is confusing ‘method’ with ‘methodology’, but  in Chiarella’s view, the use of qualitative methodologies forms part of a long struggle to differentiate nursing from medicine.   Because of the ‘outsider status’ (Chiarella 2002: 31) of the current  study, which is based neither in nursing studies nor in a ‘positivist’ field such as medicine or experimental psychology, there is no clear disciplinary tradition to influence the choice of a particular methodology.   Educational research itself has been subject to heated debates about appropriate methodologies, and whilst the methodology of the study must ultimately be determined by the research questions, there is also an element of partiality, stemming from the personal context of the research. in the decision to side with those nurse-researchers who have opted for a qualitative approach.   This is not to say that all those involved in nursing research are open to such methods and methodologies.    Moch (2000: 127) gives the example of a journal article (on the topic of the researcher experience in qualitative research) which was rejected because it had, in the reviewer’s (only) words ‘No Objectivity!’.  As Usher (2000: 54) points out, we should ‘take nothing for granted in doing research’, but as he also emphasises, research takes place in a worldly context and is not some form of ‘transcendental activity’.  

 

The use of a qualitative methodology is, however, primarily justified and required by the affective and experiential nature of the phenomenon in question, rather than by any disciplinary tradition   There are, of course, many variations on the qualitative theme, such as:

grounded theory studies, phenomenologies, ethnographies [and] a wide range of less prominent methods, such as narrative analysis, qualitative case analysis, discourse analysis, participatory action research, naturalistic inquiry, feminist methodology, and biographical analysis (Thorne et al. 2002: 9)

The predominant focus of nursing research is the nurse-patient relationship in its many forms (Chiarella 2002: 203) or ‘...human responses to actual or potential health problems’ (Reynolds & Cormack 1994: 159), and it is therefore rooted in a dialogical, person-centred view of research.  

 

In  the previous chapter, I  argued that the best approach to the study of spatiality would be to use a three-dimensional model (the Proximity-Mobility-Possession framework) which started from assumptions about embodiment and the existence of  physical reality, albeit  a reality which might be described in various ways.   Each of the three ‘dimensions’ represents an aspect of the experience of space, related to distance, action and time.   The conceptual framework is predicated on ‘mine-ness’ and the existence of an intimate self which constructs or locates itself within a world of shared practices and meanings.  This suggests that, in order to access knowledge about spatiality, there has to be a contribution from the intimate self of the other, and phenomenological research raises questions about the possibility of acquiring knowledge of, or from, the other.  Husserl (1960: 114-115) puts it thus:

The character of the existent ‘other’ has its basis in [a] kind of verifiable accessibility of what is not originally accessible.   Whatever can become presented, and evidently verified, originally - is something I am; or else it belongs to me as something peculiarly my own.

In other words, I cannot directly access the experiences of the other, but can relate to it only insofar as I have access to shared experiences, or at least a similar reality to that of the other.  

Summary

In this chapter I have discussed at some length the philosophical basis for the current research. This has involved a certain amount of untangling of the relevant epistemological, theoretical-perspectival, methodological and methodical considerations.  The study embraces realism, constructionism, and interpretive phenomenology. Its use of realism enables the existence in principle of physical spaces and objects, whilst the adoption of a constructionist epistemology acknowledges the role of cultural factors or pre-dispositions in gaining knowledge of those spaces or objects.   The phenomenon of spatiality is argued to be anchored in material existence but essentially consists of interpretations of that existence.  The methodology of the study is thus, of necessity, based on a realist ontology and a constructionist epistemology, an acknowledgement that that there is something shared and concrete which precedes our descriptions, interpretations and knowledge-gathering activities. I have discussed the different ways in which the term ‘phenomenology’ has been used in the research context and whether the phenomenon of spatiality can be adequately represented in language.  In the next chapter, I will discuss the specific methods used in the research and some of the practical and theoretical issues around these.


Chapter 4-Method

 


“A human brain...cannot be completely analyzed by any mathematical discipline now known.  No response can therefore be counted upon as a certainty”. 

(Isaac Asimov, The Caves of Steel )

 

Introduction

G iven the epistemological, theoretical and methodological considerations outlined above, a number of data-gathering methods might have been used in this study .  What I will present in the data-analysis chapters is drawn from a series of stories about aspects of experience, events or emotional states related to space and spatiality. The ‘method’ consists in creating interpretations of stories which are themselves interpretations of experience (Freeman 2000; see also Usher 2000: 53).  I will go on  to interpret these stories in terms of the theoretical framework presented here, rather than simply describe their phenomenal content, because I believe that the richness and complexity of these everyday interactions has explanatory power, both in relation to the concept of spatiality and to the activities of the participants.

 

At this stage, however, I should clarify that, although I referred to ‘stories’ above, I will not be focusing exclusively on narrative or story-telling as ways of analysing the data (Coffey & Atkinson, 1996, ch.3; Harré 1998), but will be analysing the material thematically rather than, for instance, from a life-history perspective (West 1996).  Although the primary analysis is thematic, however, parts of the interview material clearly constitute ‘stories’, which may provide a means of access to the assumptions which underlie participants’ statements, although there are questions of ‘voice’ and ‘audience’ to be addressed here (Ochberg 2000: 109; see also Collins 1998).   Specifically, the researcher needs to ask whether the voice of the participant is directed at, and attuned to, the researcher in ways which influence the sort of information presented.  Here, Bakhtin’s concept of ‘polyvocality’ is useful, in highlighting the capacity of language to speak from a cultural position, as well as from a culturally-embedded agent (Morson & Emerson 1990).  

As Ochberg (2000: 111) points out, there is more to answering questions than factual responses:

The self-images that narrators see reflected in the eyes of an audience matter because of the life-historical resonances they evoke

These resonances need not be positive affirmations, but, according to Ochberg, can also

be a form of self-denial, or a reciprocal interrogation of the interviewer.   The role of researcher as audience is thus one which needs to be borne in mind when analysing narrative, or other participant statements.   The statement itself can, however, be problematised.   Foucault ( 1972: 107) says of the statement that it has:

…a modality that allows it to be something more than a series of traces, something more than a succession of marks on a substance, something more than a mere object made by a human being; a modality that allows it to be in relation with a domain of objects, to prescribe a definite position to any possible subject, to be situated among other verbal performances, and to be endowed with a repeatable materiality. (emphasis added)

Foucault’s main point here is that the statement is part of a discourse (or discursive formation), part of an ongoing conversation between people, culture, language and objects, and is thus more than an individual utterance.  That it is also endowed with a ‘repeatable materiality’  connects it not just to other statements but to a world, a theme which is also found in the work of Bakhtin (1994) and his concept of heteroglossia and polyvocality (Morson & Emerson 1990), or positionality (Holloway & Kneale 2000).  For Bakhtin, discourse or speech utterances embed the speaking subject in a web of material and social relationships, which speak through the subject.

 

There are thus links between the idea of ‘being-with’ which was discussed above in relation to possession, and the emergence of materiality (and with it, spatiality) from language.  It is unlikely, however, that any practical methodology whose final expression is a written text could hope to capture the full richness of an embodied existence, as Philo (2000) discusses in relation to Foucault and Roussel.   This point was made above in relation to the phenomenological method, but there is a counter-point in that narrative or story-telling are themselves enriching processes (Coffey & Atkinson 1996: 55) which restore the ‘colour’ to the faded outlines of materiality.   De Certeau, meanwhile, makes an explicit connection between spatiality and narrative – ‘[e]very story is a travel story - a spatial practice’ (de Certeau 1984: 115), whilst Lakoff & Johnson (1999) show that this connection between bodily action, space and language is supported by a variety of evidence from cognitive science and linguistics.   It is thus reasonable to pursue the topic of spatiality via language and in particular the language of research participants in the interview situation. As I argue below, the interview was the most practical and least intrusive way of obtaining data, given the constraints of the nursing situation.

 

The interview material which I draw upon in the following chapter(s) is produced by human beings using language in social and historical contexts (Allen & Hardin 2001), or worlds, in a  Heideggerian sense (Heidegger 1962: 114)   The relationship between language and world is reciprocal, that is, these worlds or contexts are themselves ‘open spaces’ in which forms of language can evolve, diversify, flourish or become extinct.  As Strohmayer (1998: 111) suggests,

Only the spaciousness of language, or the impossibility of a one-to-one match between word and object, is what allows for meaning in the first place, not in the form of a Husserlian appearance, but in the form of an ‘understanding’ of what meaning is attributed to a word, a concept, a sentence.  (emphasis in original)

There is thus no such thing as an isolated piece of text, independent of a world or context (or inter-text) (Usher, 2000: 51) although there can be texts, or objects, which have been ‘de-worlded’ and which are therefore difficult or impossible to interpret, e.g.  the obelisk in Kubrick’s 2001 – a Space Odyssey (1968).    Because languages and texts need to be understood in their worldly contexts, it is important to share at least some experience of the world of the participants.  Being part of the world of the university to which the students belonged was therefore helpful to the research. 

 

In the current study, what is of interest is the diverse ways in which students made sense of their spatiality, irrespective of whether this sense-making could be generalised to predict the best forms of practice for future students.     The problem is to find an appropriate way of accessing the spatial aspects of student experience.  Students are by definition part of an organisation, and as Morgan (1993: 169) suggests, organisations and their members are driven by a multitude of ‘hidden forces’ which it is the function of research to reveal and analyse.   This ‘iceberg’ effect can be overcome using terms such as ‘spatiality’, into which the isolated fragments of experience can be gathered.   Anderson (1983: 77-78) describes the process more eloquently:

Like a vast shapeless rock worn to a rounded boulder by countless drops of water, the experience was shaped by millions of printed words into a ‘concept’ on the printed page, and, in due course, into a model.

The essence of the phenomenological method, as I discussed above, is that the data operate not only on the ‘surface’ level of lived-experience but at two levels – the level of lived experience and the level of the phenomenon.     What is given in language is  ‘symptomatic’ (Massey 2001: 35) of something happening ‘in the depths below’.   Lakoff & Johnson argue that there are three significant levels which, when taken together, structure human reality.   Briefly, the level of neural embodiment is the level of cells, nervous systems, neurons and other ‘wetware’ of the body.   The  level of the cognitive unconscious is the level at which the neural ‘body’ is organised in specific ways, e.g.  to enable breathing or other bodily functions, talking and cognitive activity generally, and the phenomenological level is the level of consciousness (Lakoff & Johnson 1999: 102-103).  None of these levels, taken alone, provides a comprehensive account of the world.   The pervasiveness of metaphor in language, however, provides a bridge between the three levels (ibid: 128).   

 

Lakoff & Johnson’s work draws on positivist scientific evidence, but in many ways, including its critique of Cartesianism and analytic philosophy, it confirms some of the insights of phenomenological thinkers, whilst at the same time establishing that the scope of difference is ultimately limited by embodiment.    It also provides an analytical tool, the study of metaphors within language, which directly links spatiality, bodily action and language. Given the importance of language and metaphor, and the existence of shared conceptions of phenomena relating to spatiality, it would seem that some form of dialogue with participants would be required.  The next section discusses how this dialogue was to be achieved.

 

Interviews and other stories

Although I have suggested that dialogue is important, there are several ways of engaging in it, and there were two sets of constraints on the data collection process.   The first was imposed by the choice of nursing students as research participants and the necessity of submitting research proposals to an ethics committee in the relevant academic department, which was rightly concerned to protect its students from intrusive methods and to maintain their privacy and anonymity.  Posing covertly as a nursing student would have been ethically unacceptable, especially since contact with patients might have been involved. The ethical aspect, and my own status as a ‘non-nurse’ also ruled out any form of ‘insider’ ethnography. Equally, there was no suitable way of operating as an ‘outsider’ (Chiarella 2002: 25), or even an ‘outlaw’ (Pierce 2000: 148),  in an ethnographic approach.  

 

The second set of constraints resulted from the desire to gain a perspective on the full range of participants’ spatial activities.   Being openly present as a researcher within classroom situations might have been possible, but would only have allowed access to one of the many kinds of spaces used by nursing students.   Gaining access to homes, accompanying students on journeys to placements or being around them in placements for extended periods would have been intrusive.   It is possible that this reflects my perceptions of what Chiarella (2002: 39) calls ‘the nurse as ministering angel’ image, which creates a ‘halo effect’ (ibid: 51).   This made me reluctant to occupy the space and time of the students more than was absolutely necessary.

 

This suggests that the face-to-face interview would be the most appropriate method (Smith 1996: 59; see also Witz et al. 2001).   As Urry (2002: 259; see also Giddens 1993: 178; Boden & Molotch 1994) points out, human beings attach a special significance to the ‘face-to-face’ encounter, in which the expressions of participants can be mutually monitored and other forms of non-verbal communication can take place.   Smith (1996: 60; cf.  Harré 1998) argues that the interview overcomes the gendered  limitations of questionnaires and other survey instruments, which often ‘as[k] only those questions about social life which men want answered’.   Interviews themselves, however, are problematic, and Baker & Johnson (1998:230) argue that:

Language comes to be seen as a resource for describing states and assembling social realities in particular, setting- and listener-relevant ways.  Interview talk cannot be viewed naively as more or less truthful or complete or valid in some a priori way.

Given the underlying assumption of the study that spatiality is embedded in the world, and that my situated embodiment is part of that world, this raises the question of my own gender (and other) biases and their possible effects on the type of questions asked and the direction taken by the interviews.  This is a difficult, if not impossible, question to answer, and I have chosen not to pursue it systematically here, given both the impossibility of achieving gender neutrality from a situated gender perspective, and because only two of the nursing students interviewed were male.  In a larger study with multiple researchers of different genders, this could perhaps have been explored more fully. Whilst there were differences between male and female responses, these were not consistent  differences, and there were equally significant differences between individual respondents.  There is thus an argument for regarding gender, in this context, as a set of practices rather than as an essential difference.  Some of the interactions reported in the interviews might thus be seen as revealing gendered practices, but the overall focus of the study was on spatiality as providing the possibility of differentiated practices, rather than on a particular aspect of differentiation.

 

In the research interview situation, there is a need to balance the researcher’s desire to steer the interview towards relevant topics with allowing the interviewee to suggest what might constitute ‘relevance’ or the emerging phenomena (Witz et al. 2001: 216) but here it is worth recalling Strohmayer’s (1998: 111) reference to ‘the spaciousness of language’, in which interviewer and interviewee can ‘stretch out’ and interrogate each other’s claims about meaning.   This spaciousness is not available in research instruments which confine participant responses to agreeing or disagreeing  with given statements.   The interview also has limits as a  research tool, being a ‘snapshot’ rather than a moving picture, although it has the potential to elicit narratives which depict the historical and futural [9] . Before I describe the interview process itself, however, the next section outlines the geographical background. 

 

A tale of two sites

In this section, I will fill in some of the background to the sites in which the research took place.   Given that the study relates to space and spatiality, it is important to establish the specific geographical features of these two sites, and because of this specific geographical description of the region involved, it would be difficult to convincingly disguise the institutions involved. Thus, they retain their real names, and the main University of Stirling campus is designated SC, and its satellite Highland Campus is designated  HC.    Participants have all been given pseudonyms, and extracts from interviews have a unique ref.  no.(e.g.<Terry 20>).   Appendix 1 lists the participants under these pseudonyms and provides brief biographical details of each.

The move in nurse education towards an academic qualifications structure under Project 2000 has had effects on both the sites involved in the study.  The two sites, however, had rather different histories.   Stirling is a small city in the Forth Valley of Central Scotland, and Stirling District is an area which:

...lies at the very heart of Scotland.  It covers 220,000 hectares from Tyndrum and Crianlarich in the southern highlands to the villages of Killearn and Strathblane in the south west and the former mining villages of Plean, Fallin and Cowie in the east.  The 83,000 population splits 50:50 urban to rural, with the urban population centring around Stirling, Dunblane and Bridge of Allan.  (COSLA 2002)

Stirling University received its charter in 1967 and was built on a greenfield site two miles outside the city.   Its department of Nursing and Midwifery was opened in 1997  after the University had taken over the nursing role of Falkirk College, which had formerly undertaken nurse education for the former Central Region.  The city of Inverness has a marginally larger population than Stirling itself (c.42,000) but its surrounding region is much larger, and is, as an official website declares:

one of the most beautiful and sparsely populated areas of Europe, extending to 10,000 square miles   [2,560,000ha.] The Council provides a wide range of essential services to 208,000 people living in the Highlands.  (COSLA, 2002)

Highland Campus was formerly  a nursing college adjacent to Raigmore Hospital, on the outskirts of Inverness, which has been an NHS Trust hospital since 1993 and is the largest acute hospital in Highland Region.   Taken over by the University of Stirling in 1995, it remained primarily a nursing centre, with occasional use by other departments in connection with part-time degrees and distance learning.

The adjoining Raigmore Hospital provided some, but not all, the acute placements for HC, and many of the students went on placements either in other parts of Inverness, or in more distant parts of the Highlands.   It was unusual, however, for HC students to do placements at, say, Stirling Royal Infirmary, or another institution outside Highland Region, unless a particular specialism was unavailable, and HC offered a diverse range of possible placements in all four branch specialisms (adult, paediatric, learning disabilities and mental health).

 

There are around 22 academic staff at HC, together with administrative and library staff.   The head of department is based on the Stirling campus, and an Associate Head of Department is based in Highland campus.   The two sites are approximately 256 km apart by road (see map in Appendix 2).  

Over half of the participants (n=9 for HC and n=7 for SC) in the study were from Highland campus (HC), and there were, therefore, questions in the schedule about the institutional status of HC  in relation to  SC (Stirling University, the main campus), which gave rise to some  interesting responses.   The unique geography of the Highland region made the lives of the HC participants more spatially diverse than those of their SC counterparts, and there was a clear sense in all the discussions with HC students that they saw themselves as peripheral to the activities of SC, whereas SC students had no such concerns in relation to HC.  Articulating the HC students’ concerns is therefore a way of acknowledging their generous co-operation with this project.

 

The selection process comprised two rounds of invitation letters which were sent to course tutors (at both campuses) via the Nursing & Midwifery departmental office.  The invitations covered the full spectrum of Diploma and Degree-level undergraduate courses running at the time, but not postgraduate courses, although one PhD student was recruited via her role as a course tutor. These were issued to students in classes by tutors, and students responded using reply-paid envelopes.  The response rate was relatively low (21 replies out of 240 invitations, or about 9%), suggesting that the target group were both busy and, as the course tutors had informed me, ‘over-researched’.  Most of this research was generated by nursing students themselves in the form of project work.  The split between students from the two campuses involved suggested that the Highland campus students were more enthusiastic about being researched, since their response rate was approximately double that of the Stirling students.

 

The interviews were carried out in two rounds, the first of which was nominally a pilot study.   In practice, both the participant response and the functioning of the schedule were sufficiently satisfactory in the first round for these interviews to be regarded as the main study, with the second round (probably for reasons of timing and class organisation) providing fewer volunteers.  The schedule was modified only slightly between rounds, with a ‘tick box’ section on types of computer usage deleted as being irrelevant.  The interviews were conducted in a variety of settings, ranging from  the student common room at HC, through the postgraduate room in my ‘own’ part of SC to a placement (day care centre) and a student’s home.    All of these spaces had implications for the power-relations of the research process.    In my introductory letter, I indicated that the participants were free to choose the interview venue, and I indicated my willingness to come to them, as recommended by Smith (1996: 63).   Most of them, however, chose to be interviewed on the campus at times when they were there for other reasons.   The physical setting differed, however, between the two campuses.   At HC, I used the student common room, whilst at SC, where I was on ‘home ground’, I used empty seminar rooms or the postgraduate ‘office’.  A home visit was necessary to rendezvous with a student who was in-between remote placements.

 

In most cases the students were not under specific time constraints on the occasion of the interview.   One was on a lunch break during a placement, and therefore had less time to spend than might otherwise have been the case.   Marrow (1996: 44) notes the problem of interruptions when using public spaces, but these were not a problem in any of the interviews.   She also notes that the nurses in her (unrelated) research tended to bring up grievances about Project 2000 which she had to postpone to the end of the interview and which frequently went unresolved.   In my case these grievances tended to arise in the course of discussing spatial issues and thus formed part of the interview.  Otherwise, interviews ended when I had been through the schedule and had followed up any particular questions which arose, although the best material often came out in the closing exchanges (I soon learned not to stop recording until the participants had left the room).

 

Although I left each interview with a tape or mini-disc full of useful material, the participants left with no material benefits from the research.   Smith, however, suggests four ways in which participants may benefit directly from the research interview (Smith 2000: 19).  They may gain new insights into personal experience, or the interview may validate their own perceptions of reality.   The interview may help them to integrate past events into their present sense of self.   Finally, the interview may help them to formulate accessible depictions of life history.   Clearly there will be huge variations in the value of any or all of these benefits to participants.   Participants spoke at the time of finding the conversations ‘interesting’ or ‘enjoyable’, which went some way towards allaying my fear of being intrusive. 

 

The interview schedule is reproduced in Appendix 3.   It was produced by considering the patterns of activity which, as a student, I felt would be typical of a mature student at the specific sites chosen for the study.   The questions were designed to be as open-ended as possible, with a view to maintaining the validity of the responses.

The section on metaphor, in which a list of possible metaphors representing the University was shown to the participants as a stimulus for their own views, was prompted by Gordon & Lahelma’s (1996) paper, School is like an Ants’ Nest , and by an exercise which I had carried out with a class of part-time mature students.   This involved them in brainstorming and discussing various metaphors for the university or for their situation relative to it.   In the interview situation the method was less successful, and tended to break up the flow of the conversation.

 

The schedule itself does not mention space or spatiality as such, but my introductory preamble, or ‘opening statement’ (Knight 1998: 1288) explained that the study was concerned with the spaces in which the participants studied, which could be ‘on the kitchen table’, ‘in the library’, ‘on a placement’ and so on.  This led into the first question which was ‘where do you do your studying?’.   The purpose of the preamble was to stimulate diversity in thinking about spaces without suggesting that there might be a ‘right’ or ‘wrong’ answer to any of the questions.   Cohen & Manion (1989) refer to this technique as ‘the funnel’ (quoted in Marrow 1996: 44).  Even this innocent-sounding preamble, however, imposes a hierarchical form on the text, a form which is inescapably set up by the research situation.   This is the case even if the flow of information is not all one-way.

 

The schedule focused almost exclusively on the participants as nursing students.   Whilst this was in line with the focus of the project as it had developed at that stage, there could have been  specific questions which addressed their identities outside the world of nursing.   Nevertheless, all the participants revealed much about their personal circumstances, and the pictures which emerged from the transcripts were of complex individuals and life-histories.

 

Data analysis – the method

The interviews were all recorded and were transcribed using IBM ViaVoice, a proprietary speech recognition system.   This proved very successful, and the system managed to interpret all but the most difficult proper names (‘Wick’, but not ‘Drumnadrochit’), leading to improvements in the quality of the data handling process (Cane 1998).  Because of the speed of the process, as opposed to my slow typing, there was less temptation to skip sections, thus invisibly editing the transcript.  Speech recognition also created an opportunity to ‘relive’ the conversation in a more immediate  way than would have been possible with a typed transcription, with the prospect of developing ‘theoretical sensitivity’ (Knight 1998: 1288) to the data.   As Strauss & Corbin put it, ‘insight and understanding about a phenomenon increase as you interact with your data’ (1990, cited in Knight 1998: 1288).    Witz et al.   warn that merely by working with transcripts ‘one does not reach the feeling of complete understanding that is possible by absorbing and immersing oneself in audible aspects and nuances’ (Witz et al. 2001: 213), and with this in mind I re-played the tapes from time to time in order to reinforce my perception of the participants’ moods, vocal expressions and the ways in which they emphasised certain points. 

 

This resulted in a rich ‘harvest’ of data, with around 750 individual paragraph-length segments.   These were initially coded within the transcripts, to preserve context.   This proved valuable at all stages of the process, since statements were kept in their original context until their final appearance in the text of the study.   Coffey & Atkinson (1996: 26) suggest that coding is a process of ‘ generating concepts from and with [the] data’.   As Richards & Richards (1995: 81) suggest, the application of categories to the data ‘offer[s] not just a code-book but a conceptual structure’, which should be ‘a flexible container for complex contents’.  Richards & Richards also suggest that categorisation can be ‘data-driven’ or ‘theory-driven’, ‘bottom-up’ or ‘top-down’ respectively.   These spatial metaphors are interesting in themselves,  but more importantly, the methodological separation between the two is difficult to sustain.   The difficulty increases as categories shift from being objective (e.g.  use of ICT, length of journey to campus) to subjective (e.g. anxiety in computer laboratories, boredom on journeys).   There are also questions about what counts as theory.   Even the spatial metaphor of  enclosing the ‘complex contents’ of the data in a ‘container’ (however flexible) suggests that the data, once collected, can be closed off from something.   The data are assumed to be complex, but what renders them complex is their ‘material existence’ (Foucault 1972: 100), which is lost as they are ‘organised’ into the researcher’s own text.   This material existence is only partly restored by the researcher’s shared knowledge of the participants’ world, which is unavoidably incomplete.  The process is rather like a carpenter trying to recreate a tree from the pile of planks into which it has been sawn.  This is a problem which is recognised in the philosophy of transcendental realism underlying the study, as the possibility of different descriptions of an inexhaustible reality.

 

Although the three themes of proximity , mobility and possession were the basis for the coding, a number of sub-themes were developed directly from the data as it was repeatedly reviewed.   Most of the material fell easily into segments, which were either whole responses to questions or parts of longer responses.   Sometimes shorter responses were edited together by omitting interjections from the interviewer.   Each segment was then allocated a unique index number consisting of a letter which identified the pseudonym of the participant and a number which ran consecutively from the beginning of each interview.  In the coding process, the theme and sub-theme were recorded as editing changes to the transcript document using the <track changes> facility in the Microsoft Word <Tools> menu.   This enables highlighting of additions to the original text.   By reading through the transcripts and listing index numbers against themes and sub-themes, a coding table was produced enabling rapid location of statements by opening the relevant transcript file and using the <Find> facility to locate the index number.  An example is given below (figure 3):

Figure 3: themes and occurrences

Theme /sub-theme

Occurrences

Proximity-concept of University

G41,G42,G43,G44,G45,G53,J20,J21,J46,L28,B27,M40,M41,M43,M44,M45,M46,

M52.M53,M54,D9,D69,D70,E59,E60

 

In the table, themes emerging from the data are coded as sub-themes relative to the main theme of Proximity, producing a hierarchical table.  The main themes were used as a form of typological classification of the sub-themes, a classification which underwent several stages of revision as I became more familiar with the data.    The second part of the table lists the kind of statements which fell into each sub-theme (figure 4, overleaf):

 

 

 

Figure 4: Thematic headings and issues arising in data

Thematic headings

Issues arising in data

Proximity-concept of University

sense of isolation at HC, ivory-tower mentality of staff, SU as resource vs. neglectful partner, relative size of HC-SU, informal knowledge of SU prior to entry, scope of possible placements,

 

It was originally intended to use one of the commercially-available qualitative data-analysis (QDA) packages, such as QSR NUD*IST or Atlas/Ti , for this purpose.  There has been some critique of the usefulness of these packages in the literature (Coffey & Atkinson 1996: 166; Pateman 1998; Morison & Moir 1998).   Pateman points out that most of the functions of dedicated QDA packages can be performed, albeit less efficiently, by word processing software.  The assumption that using an analysis package was a necessary part of the study was also challenged by post-graduate colleagues who had explored the issue and who had resorted (in one case) to traditional paper-based methods.   Thus, there were factors external to the study which influenced its methods. 

 

It was felt, in any case, that the most significant issue in pursuing the analysis was the coding and categorisation of the data, which could not be automated (Pateman 1998: 81) and was therefore the area most likely to be subject to the idiosyncracies and inconsistencies of the individual researcher.   In larger projects various forms of cross-checking between coders would have eliminated some of these inconsistencies, but the individual nature of the Ph.D project precluded this.   Because the chosen method involved repeated readings of the interview transcripts over an extended period, however, many of the inconsistencies were removed and sub-themes rationalised or eliminated as reading progressed.

 

 

 

 

Principles of the analysis

 

The data were analysed thematically in the first instance, but there was also some linguistic analysis, which was specifically concerned with the use of spatial metaphors, as suggested by the work of Lakoff & Johnson (1999; see also Paechter 2001).   Allen & Hardin (2001: 164) claim that any ‘thematic’ analysis of interview material ‘reproduce[s] a common-sense perspective which is difficult to shake’.   They argue that an approach based on critical discourse analysis is necessary in order to overcome the deficiencies of the phenomenological approach.   As ‘we enact our roles and relationships in language’ (ibid: 165), it is the differences expressed through our inherited language which must form the  basis for analysis.   The problem is to show that the material is open to interpretation in a meaningful way - that is, it means more than it says it does.   As Hardin (2001: 11)   puts it:

...innovative research studies require moving beyond individual levels of analysis into broader historical, social and cultural understandings of human behaviour. 

As I have argued in earlier sections, there are good reasons to believe that language does not tell the whole story about spatiality, and that spatiality and embodiment are co-implicated in constructing knowledge about reality.   Allen & Hardin are, however, right to point out that ‘the reproduction of [linguistic] relationships point[s] to the power relations embedded in social structure’ (Allen & Hardin, 2001: 167).   Thus, what is sought in the analysis of texts is not so much individuals’ descriptions of reality as it exists ‘in’ their experience, but maps of the lines of difference which run through the texts.   In other words, it should be the differences and contrasts, the asymmetries, between various accounts of reality, rather than the content of particular accounts in themselves, which are revealing, and this proved to be the case with the data here. 

 

There has also been much controversy over the methodological issues surrounding the validity of qualitative research and data analysis.  Whittemore et al. (2001: 523) suggest that it is not possible to use the criteria traditionally associated with quantitative research in a natural science mode, criteria such as  internal and external validity, reliability and objectivity.  They suggest (ibid: 524) that:

Qualitative research seeks depth over breadth, and attempts to learn subtle nuances of life experiences as opposed to aggregate evidence...Qualitative research is contextual and subjective versus generalizable and objective. 

The distinction between qualitative and quantitative research is, however, a false dichotomy, and beside the point, as Schuttermaier & Schmitt (2001) point out.   They contend that, because all research involves ‘a dialectical process of deduction-induction’ (p.2) and: 

...the debate about which method is the most ‘correct’ approach...only disguises the fact that all researchers set out to find what it is they want to find, regardless of the methods adopted.   Therefore, any claims to universal validity are simply an illusion. (p. 5)

The point I am making here is not that method is unimportant, but that, given the constructionist-realist epistemology which I outlined earlier in the chapter,  claims for the objective validity of one method over another cannot be sustained.   Equally, I cannot claim that there is no other valid epistemology, although I can argue for the one which I have in fact used here.   Against Whittemore et al. , I would, however, argue that the epistemology and theoretical perspective used here are neither objective nor subjective, and with Bhaskar (1975) that this does not prevent the use of reasoned argument to convince an audience that one method or result is preferable to another.

One of the validating methods which can be used here is that of inter-study comparison, and in this case I have been able to refer to several studies of the nursing student experience (May & Domokos 1992; May et al. 1997; Lauder & Cuthbertson 1998; Howard 2001).   Given that the experiences of nursing students often provided contradictory evidence, even within a small sample such as this one, the statements as a whole are in line with those in earlier studies.

Summary

This chapter has discussed the underlying rationale for the research processes used in this study. Reference to the work of Lakoff & Johnson (1999) suggested that embodied metaphor would form an important bridge between the world and the texts which form the empirical data for the study.  In turn, this suggested that the data should take the form of interviews or conversations with the participants, although this was not the only form it could have taken under different circumstances.  The data-gathering, coding and analysis methods were described,  and their limitations were acknowledged.

 

The combination of method and theoretical framework used here is a tool, and ‘tools help but have no life or capacity to construct by themselves’ (Schuttermaier & Schmitt 2001:1).   The research is thus a test of the usefulness of this tool (or tool-kit) in a specific context.   The tool is designed to select, differentiate and contribute to the analysis of statements arising in the course of qualitative research generally, and not just the interviews carried out in this study.

Before I begin to look at the data itself in Chapter 6, however, Chapter 5 explores the nursing background and the literature which informs the study in this area.


 

Chapter 5-Nurse education

 

 


Oh, improve health, raise the standard of living.  The usual talk, it didn’t impress me...It’s just a matter of humoring them and hoping they’ll keep within reason in their notions.  Maybe some day...                                                                                                                               (Isaac Asimov , The Caves of Steel)

 

Introduction

T he purpose of this chapter is to provide background information about nurse education as the specific field in which the empirical research was conducted and from which the research participants were drawn.   Nursing is a major source of employment and a vital component of the National Health Service, and is therefore the subject of much debate, particularly in terms of the recruitment and retention of staff (Kirpal 2003).   It should thus represent an important area of interest to  researchers.   Despite the high profile of nursing within policy discourses, however, the spatial aspects of the nursing student experience have been under-researched.   This is probably because, as was suggested in Chapter 1, space is too close to us, too much taken for granted and too transparent, to be regarded as an important research topic in its own right.   The circumstances of nursing and of nurse education, however, give rise to a number of interesting spatial issues, to which this chapter will draw attention.  It is important to emphasise, though, that the focus of the study is on the use of the proximity-mobility-possession framework as a way of engaging with spatiality generally, rather than an attempt to provide substantive conclusions about nurse education.

 

In common with other healthcare interest groups, nursing is affected by the ongoing transformation of NHS working practices as a result of the introduction of Primary Care Trusts and other organisational changes within the healthcare system generally (May et al. 1997; Knight 1998: 1287; Woods 1999; DoH 2001; Jarvis 2001).   Within the context of these changes, not only is the identity of nursing itself once again brought into question,  but the structure of nurse  education is also challenged.   A further round of re-organisation is on the way with the integration of trust services into unitary NHS Health Boards, due to take place in  2004.  These organisational changes are already well documented, but their effect on the spatiality of nurses and, more specifically, on nursing students have not been directly researched.  The current study merely provides an analytical framework for carrying out further targeted studies in this area, but even then, it is first necessary to explore the historical background of nursing in order to put the current situation of nursing students into perspective. 

 

The historical background of nurse education

The relationship with space is a fundamental relationship for nursing students, as indeed it is for practicing nurses.   In the mid 19 th century, there were struggles over whether nursing should be located in the home (domiciliary nursing) or within medical institutions and over the ‘registration issue’, which referred to the right of nursing to be represented as a body in public space (Rafferty 1996).   Representatives of government, the universities, medical schools, hospitals and specialised colleges have since argued intermittently over where nurse education ought to be located.   These histories (or, more appropriately, herstories) of nurse education and of nursing are, as Rafferty points out, stories about the contestation of knowledge and the nature of work. Rafferty (1996: 188) argues that:

Nursing has invested much of its intellectual identity in science, although social rather than natural science.   Nursing’s intellectual alignment with social science has partly been defined in opposition to the alleged positivistic and technocratic values of medicine...part of a desire to cleave a cognitive course which distances nursing from medicine

Since its inception, nurse education has been a controversial and multi-dimensional issue, within which the natural-science vs.  social-science debate, to which Rafferty alludes above, continues.   The two main themes of the continuing arguments around nurse education have, therefore, been firstly, the professional identity of nursing (Davies 1995) and secondly, the appropriateness of the various institutional arrangements charged with the delivery of sufficient qualified nurses to meet the growing demands of the health care system (May et al.  1997).   This ongoing debate was translated into policy via the Project 2000 proposals, put forward in 1986 following a debate begun in 1972 (Boreham et al. 2000; UKCC 1986).

 

Nurse education has undergone  major structural changes over the thirteen years since  the initial implementation of Project 2000 in 1989 (May et al. 1997).  Project 2000 began the process of moving nurse education away from being a largely practice-based training process, in which student nurses were in-service trainees  who worked for, and were paid by, healthcare institutions during the training period (Jacka & Lewin 1987, quoted in Holland 1999: 230).   Instead, under Project 2000, they became nursing students, with supernumerary status in relation to some (but not all) of their practice placements (UKCC 1986; May et al.  1997).   This meant that they were not rostered, or counted towards staffing complements, in these situations.   Apart from the economic implications for health care providers (Lloyd-Jones & Akehurst 1997), this was an important distinction, according to Infante (1985, quoted in Holland 1999: 230) in that it implied that the transitional moment of ‘becoming a nurse’ would be deferred until after training had been completed.   As May et al. (1997) show, and as the current study confirms, this deferment of the transition from student to nurse did not reflect the experience of the participants, most of whom, as mature students, either brought a nurse-identity with them into college or rapidly acquired one.   The student identity was secondary, although it did have some significance, as I will discuss below in connection with the data.

 

The transition of nurse education from specialised colleges and nursing schools into the Higher Education system was the outcome of a complex political process both within and outside nursing itself (Rafferty 1996; Davies 1995).   Nevertheless, nursing  became an academic topic with its own degree structure, comprising an 18 month Common Foundation Programme (CFP) and an 18 month Branch Programme in one of four specialisms (Holland 1999: 231; May et al. 1997).   Departments of Nursing (and Midwifery) were established in a number of universities, often as a result of the assimilation of former colleges or nursing schools.    This is the context in which the participants in the current study worked and studied.

 

Nursing – back to the future?

Whilst the dynamics of this shift into HE are yet to be fully resolved (May et al.  1997),  the spatial movement of nursing into HE parallels the beginning of a move towards a ‘new professionalism’ in nursing (Davies 1995).   As Spitzer (1998) observes, there has been a movement towards the differentiation of nursing from medicine, in which ‘the diagnosis and treatment of human responses’ is contrasted with ‘[the] pathology, diagnosis and treatment of disease’ (ibid: 788).   At the same time there has been a trend towards clinical specialisation and the training of nurse-practitioners in the medical model.   Davies (1995) argues that this trend, whilst it promises to allow nurses the opportunity to practice in their own right instead of being support staff for doctors, could also lead to nurses becoming absorbed in the management of auxiliary staff.   Thus, a distanced, masculinist model of practice  which, she argues, characterises the medical profession, would be reproduced in the sphere of nursing.   Although Davies is specifically concerned to bring out the gendered aspects of professionalism, the policy discourse also treats the new model of professionalism as an issue, as recent government documents on the future of healthcare (DoH 2003) confirm.    The role of the nurse is increasingly seen as that of a skilled practitioner, with unskilled or lesser-skilled tasks delegated to non-nursing staff.   This strategy is, however, dependent on the ability of nurse education to deliver enough suitably-qualified candidates.    As Jarvis (2001: 11) points out,  plans to delegate more of the work of doctors to nurses depend on the ‘supply [of nurses]...an increasingly scarce commodity’.   The role of the nurse is potentially ‘hollowed-out’ by this trend, which Davies (1995: 135) calls the ‘polo-mint problem’.   The essence of nursing, according to Davies (see also Benner 2000) lies in  sustained, interactive contact with the patient, and this is threatened both by movement towards a consultancy role, and by workload and staffing problems which result in a task-oriented, reactive approach to patients.   Thus nursing disappears into ‘the hole in the middle’ of the polo-mint.   This problematisation of the nursing role might be expected to play out differently across the varied spatial settings in which nursing is currently practised, and thus forms part of the research interest in this study.

 

In connection with questions of professional identity, there is also the (equally contentious) issue of the place of research in constructing the self-image of nursing.    The medical profession, historically, has appropriated, and legitimated itself by, the power of ‘positivist science’ (Yegdich 2000a: 29-30).  As Rafferty (1996: ch. 1) notes, there have been sporadic attempts to put nursing on a ‘scientific’ or ‘evidence-based’ foundation, but nursing has only recently begun to build an extensive research base of its own, and to make research an intrinsic part of nurse education.   It is this openness to research which is said to characterise the ‘new professionalism’ (Davies 1995) of nursing.   Loughlin (2002) points out, however, that there are dangers in relying on ‘scholarly’ references to support health-care practice, without ensuring that these references are themselves based on practice rather than on endless circles of referentiality.  This is, of course, a danger in relation to the current study, one which its use of in-depth material from practitioners is designed to counter.

 

Whilst the professional identities of nurses were brought into question even in traditional hospital settings,  the trend towards diversified spatial settings for nursing practice extends and deepens the debate.   An increased emphasis on Primary Care (DoH 2001; Jarvis 2001) places nursing in a collaborative role, with doctors and support staff, as the first point of contact for clients in the community.   The development of NHS Direct ( NHS24 in Scotland) has, for example, resulted in nurses responding to patients from telephone call centres, ‘[whose] role is not one of diagnosis but rather one of assessment and reassurance’  (NHS Direct 2002).    As Jarvis (2001: 6) points out, this is both a consequence of ‘increasing consumer expectations’, in line with the provision of  telephone banking or 24-hour filling stations, and:

the increasing feminisation of  the GP workforce, with an attendant trend towards part-time working and increasing focus on the conflicts between home and work issues.

This is in line with Davies’ (1995) call for a ‘new professionalism’ in healthcare as a response to feminist critique of gendered social structures over the past forty years.   These ‘struggles for recognition’ (Honneth 1995; Taylor 1994), in the context of nursing as a profession or otherwise, are still going on.  (Davies 1995: 19-65).  The issue for this study is not so much the construction of ‘nursing’ as a profession, or the gendered construction of nursing skills over time,  but rather the ways in which spaces and nursing students interact in the context of nurse education.  The relevance of this evolving ‘new professionalism’ to the current study is that these trends in healthcare policy, although initially manifested at a macro-level of socio-political policy, or ‘organisational governance’ as Woods (1999: 121) calls it, also manifest themselves spatially in the lives of nurse students.  Although, in this study, I seek to explore the micro-level of everyday life, the level at which learning is transacted, the macro-level generates  conditions and constraints.   These  may  be the result of deliberate policy decisions, or, as Woods suggests, they may be contingent in the sense that they are produced by conflicts between ‘dominant’ and ‘marginal’ stakeholders, each pursuing interests or ‘idealisations’ of their own.   Nursing students are marginal stakeholders in the sense that they have little input to policy-making, although nurses might well be considered as major, if not dominant, stakeholders in the healthcare system as a whole.

 

So far, then, I have briefly discussed the evolving context of nurse education, the parallel, if contested, rise of a new professionalism in nursing, the increasing importance of nursing research and the diversification of settings resulting from policy trends in healthcare.   There is, of course, an existing literature concerning the experiences of nursing students under the Project 2000 regime, and the next section reviews this literature.  Although it does not set out to be exhaustive, it covers a sufficiently wide range to establish the point that the debates around nurse education in general and Project 2000 in particular have, in my view, focused too narrowly on nursing students in the context of their institutional ‘bodies’, and have thus failed to make important points regarding nurses as embodied and located beings.   This does not necessarily mean that the current study will come to radical conclusions about the nature or problems of nurse education.   In fact, there is a strong correlation between my own findings (in terms of the specific problems facing nursing students) and those of earlier studies (e.g.  May et al. 1997).   This study is intended to demonstrate not so much what the nurse-educational issues are, although they are worth reiterating, but to show how they relate to the spatiality, the lived-experience of space, of the students concerned..

 

 

The nursing literature and Project 2000

Before reviewing the critical nursing research literature, it is necessary to describe the context in which nurse education is currently provided,  The key document here is Project 2000: A new preparation for practice (UKCC 1986) in which the UKCC  laid out its vision of the future of nurse education provision in the UK, at a time when ‘[a] bewildering amount of change [within health care] was already under way’ (ibid: 3).   This vision started from the premise that the existing system of ward-based nurse training, in which trainees provided a substantial contribution (around 20%) of the overall nursing and midwifery staffs in hospitals, was deeply flawed.   The key to the future of health care provision was increased flexibility and this was to be promoted by the spatial dispersion of care, in a reversal of the centralising tendencies of 18 th and 19 th century medicine (Rafferty 1996; cf.  Foucault 1973).  This in turn made the provision of training via acute hospitals ‘less appropriate’ (UKCC 1986: 19). The future thus lay in a strong initial education programme (the Common Foundation Programme or CFP) followed by  modular provision of specialist courses.   Of particular importance here is the linguistic shift from ‘training’, in which student nurses were employees from the outset, to ‘education’ in which nursing students participated in a (roughly) similar way to non-nursing students.   There continue to be considerable differences between the experiences of nursing and non-nursing students, however, and this will be an issue in the discussion of the empirical data.  

 

The shift from training to education discussed above resulted in more institutional involvement from outside the healthcare sector than had previously been the case.   The Project 2000 report notes that, in Scotland  c.1985, a college of education, five colleges of higher education and even two universities were involved in various aspects of nurse education.   The report makes the point that this provision was poorly co-ordinated and was supplementary to that of the colleges of nursing (and midwifery) attached to hospitals.   Furthermore, the fragmented nature of the existing training and qualification structures created a ‘vacuum’ between the identity of nurses as ‘assistants’ and as ‘managers’.   Nursing, as an activity in its own right, fell into this vacuum and disappeared (UKCC 1986: 38; see also Chiarella 2002: 47; Davies 1995).  Part of the process of change initiated by the report consisted in the replacement of a two-tier system of registration involving Enrolled Nurses (EN) and Registered Nurses (RN) with a single level of ‘registered practitioner’, thus filling the vacuum and giving nursing a more coherent purpose and identity.  The report (UKCC 1986: 33, see also p.35) promotes:

...a new model of professional regulation...a more mature approach to what a professional is and should do; taking personal responsibility for one’s own development, discussing principles, and participating in policy decisions are all part of this.

This reflects discourses of flexibility and individualisation which have arisen over the last thirty years, including discourses of lifelong learning and enterprise.  (Edwards 1997; Morgan-Klein & Gray 2000).  Given the higher level of professional autonomy expected of future practitioners, the report proposes a radical alteration in the status of entrants to the profession.   A further concurrent shift occurs in the curriculum, which moves (at least in the proposed Common Foundation Programme)  from a focus on ‘disease’ to a focus on ‘health’ (p.46).  Nursing, under Project 2000, is to be refocused on holistic consideration of the needs of the client, rather than on a task-based approach under institutional direction. 

The report (UKCC 1986: 55 ) sets out three general principles of being a student (although the second and third are closely related).   These are

that the student can clearly become part of an educational establishment, can become increasingly self-directive as the educational programme progresses and can be permitted to explore areas of knowledge and skill on an individual basis.

These principles will form an important aspect of the discussion of the data, and are all, to differing extents, contested issues for the participants.  The underlying change is that students are to be ‘supernumerary’ in terms of the health care workforce, rather than being a substantial part of it, in a shift from ‘training’ to ‘education’.   This might  be expected to alter the experience of students on placements, who are required to negotiate their formal and informal relationships with existing staff on the basis of a new asymmetry in their status.   This was also a topic which emerged from the data. 

 

To summarise, then, Project 2000 aimed to re-establish nurse education in line with a fundamental restructuring of the profession.   Entrants would become students rather than trainees, and partnerships would be formed between health care providers and higher and further education institutions in order to deliver the new CFP and subsequent branch programmes.   Since 1986, however, there has been a continuing debate over the proposals and their subsequent execution.   The next section will discuss some of the literature  which contributes to this debate.

 

Project 2000: the critical literature

The previous section discussed a UK-wide report, which nevertheless contained specific proposals relating to nurse education in Scotland.   The first substantial review of the progress of Project 2000 in Scotland was conducted by May & Domokos (1993) on behalf of the National Board for Nursing, Midwifery and Health Visiting for Scotland (NBS).   By the time this report was published, the first Project 2000 students were still in the nurse education system and had not reached the registration stage, thereby making it difficult to draw substantive conclusions about the success or otherwise of the project.

 

May & Domokos, however, were clear that ‘different images of the professional role exist throughout the education and service sides of the health care system’ (ibid: 3).   This was to be expected given the scale of the transformative task initiated by the project.   In the transitional period, there were those who were bound to the previous system by their own training and experience, together with those who espoused the new professional identity of the single-practitioner model.   Resistance to this new identity  had a ‘strong clinical emphasis’ and centred on

...the increased emphasis on community [nursing], the shortness of clinical placements and the non-rostered [i.e. supernumerary] status of students. (ibid: 4)

Again, these issues will surface in the data analysis sections of the present study, but  the section of May & Domokos’s report which is of most relevance here is that on ‘teaching and learning processes’.   In this section, a number of issues are raised which are, in terms of the present study, spatial issues.   These include the audibility of lectures (ibid: 16), the shortage of study space (ibid: 18) and the variable usefulness of, and practical difficulties with, placements (ibid: 20-21).  A final point made by May and Domokos is that the shift to Project 2000 and student status has created confusion around the question of whether attendance at lectures and other classes should be compulsory (ibid: 26).    This in turn adds to the difficulties surrounding the concepts of learner autonomy and professional autonomy to which I referred above and to which I will return in connection with the data.   

May & Domokos’s report thus confirms that the problems discussed here under the general heading of spatiality were problems common to nursing students at different times and in different parts of the country.   There are also  questions as to why, as perceived problems or barriers to learning, they still arise, some years after they were first raised as issues.   The results of this study suggest that this is because the importance of the spatial aspects of the student experience has been severely undervalued.

 

A more recent report on the effectiveness of Project 2000 is that of Runciman et al.  (1998).  To some extent, this report, also produced for the NBS,  followed logically on from that of  May & Domokos, in that it was prepared five years later, at a time when the first cohorts of nurses to have been educated under the auspices of  Project 2000 had been in employment for up to 27 months.   Its research questions were designed to discover whether these nurses were, or were not, perceived by employers to be adequately skilled for their roles.   Usefully, it also wished to find out whether employers distinguished between skills, performance and competence in the context of nursing.   What it did not do directly was to look into the student experiences of these nurses, or the experiences of those involved in delivering nurse education to them.

 

The main issue raised by the Runciman study is again the issue of professional autonomy vs.  student autonomy.   In the opinions of the managers and supervisors interviewed, the newly-qualified nurses who had been trained under Project 2000 had frequently spent too short a time on specific placements to fully develop their practical skills in certain areas.   The short placement meant that tasks were not repeated often enough for the students to progress from ‘novice’ to ‘expert’ in that task (Dreyfus & Dreyfus 1986; Benner et al. 1996; Eraut 2001).   This is not, however, solely a question of skills acquisition. It is, rather a question of professional socialisation, and lack of sufficient time for this raises doubts as to the adequacy of the overall placement process, as Runciman et al. (1998) argue.

 

The most significant report in this section is that of May et al.  (1997), Preparation for Practice: Evaluation of nurse and midwife education in Scotland.  This report evaluates delivery of the interim phase of Project 2000, preceding full transfer of responsibility to the HE and FE institutions in 1996.   It incorporates a substantial qualitative element, and many of the participant statements foreshadow statements made by participants in this study.

I will refer to specific examples in connection with the data analysis, but the May et al. report again serves to confirm that the student statements recorded for the current study were consistent with those made by other students in other places, some three to seven years earlier.

As with Runciman et al. , findings of interest here include the following:

placement length was influential in determining the development of a range of skills and adequate assessment of practice. (May et al. , 1997: ii)

 

Placement-based learning was compromised by [students] being required to fill gaps in service. (ibid: iv)

A number of other findings from this report will be discussed in later chapters, but the problems encountered by students here are in line with those reported by May et al. .    I should stress, however, that these problems are not themselves the focus of the current study but provide evidence for the ways in which spatiality is experienced by the participants.   These participants draw upon many sources for their identities, but for the purposes of the study the most important of these sources is the discourse and nature of nursing itself, which is discussed in the following section.

 

The nature(s) of nursing

A  basic question which underlies this study concerns the nature of nursing itself.   There is a rich literature concerning this topic, and for reasons of brevity and relevance I will review only the material which has influenced this study.   

A useful departure point for this section is Rafferty’s The Politics of Nursing Knowledge (Rafferty 1996).    The author argues (p.186) that, historically:

nurse education policy was more the product of conflict than consensus, and its implementation was predicated predominantly upon political and economic contingencies.

Whilst nursing is now mainly associated with institutionalised healthcare, whether publicly or privately funded, there was a historical period, prior to the mid-19 th century, in which ‘nursing’ was mostly ‘domiciliary nursing’.   This was an activity carried out in the homes of the sick or injured, rather than in centralised hospitals or other spaces devoted to the purpose, and it is important to recognise that much nursing or caring activity still takes place outwith institutional settings.   Rafferty (1996: 187) , however, traces the complex historical linkages between personalities, institutions, the state and nurse education, and concludes that:

...notwithstanding the insights derived from two decades of scholarship, our understanding of the role that knowledge and education play in mediating the power relations between different status groups within health care remains incomplete, if not inchoate.   What is needed is a historical sociology of nursing knowledge to take the analytic...forward.

I would argue that not only a historical sociology, but also a spatial sociology, is required to reach such an understanding of the power relations within nursing and specifically within nurse education.   This is because the range of spaces involved is much wider than specific health care sites alone.   Learning and nursing both happen in other places and spaces, and all of these interact.   These spatial interactions have historical effects.   As Rafferty notes, conditions in the homes of many working people were transformed as the factory and the hospital centralised (though not in all cases) production and ‘sickness’ (Rafferty 1996: 39).  Conversely, the reputation of hospitals as fearsome places changed to reverence, as they developed into centres for recovery and care (ibid: 25, cf.  Foucault 1973: 18).  These tendencies are part of a process identified by Foucault as being crucial to the development of medicine in the 18 th and 19 th centuries, a process in which the singular and heterogeneous spatiality of the (sick) person was replace by a homogeneous space of classifications (Foucault 1973, ch. 1).The subsequent emergence of the educational role of hospitals involved a series of spatial interactions between these hospitals, laboratories and medical schools (see also Schwirian 1998: 62).   These spaces of interaction  mediated the competing influences of administrative bureaucratisation, scientific discovery and the medical establishment on the development of nursing and nurse education or training.   Rafferty’s study is useful in its well-documented presentation of the historical development of nurse education, but does not directly address the spatial issues generated alongside issues of power and knowledge.  

 

Another author who addresses general issues of nursing identity, with particular reference to gender, is Davies (1995).   Davies suggests that nurses have had an on-going problem with their identity because of the male-dominated power-structures associated with medicine.   The notion of ‘professionalism’ itself is, she argues, a patriarchal concept, the adoption of which, as an aspirational goal for nurses, is deeply problematic (Davies 1995: 62).  Davies also points out that the entire ‘manpower’ model of the NHS is predicated on massive assumptions about gender roles and career trajectories, and she outlines the kind of support structures which might be possible were nursing to adopt a ‘womanpower’ model (p.70).   The importance of Davies’ work to the current study is that it demonstrates that everyday life, in this case the everyday life of nurses, can be structured by pre-reflective understandings, such as understandings of ‘professionalism’, which can be re-interpreted and questioned by appropriate forms of enquiry.   Whilst Davies takes gender as her central theme, I have taken spatiality, but without attempting to emulate the ‘gendered spaces’ approach of, for example, Best (1995), Munt (1998) or Gordon et al. (2000). 

 

Chiarella (2002) comes to similar conclusions to Davies about the fragility of concepts such as ‘professionalism’, but takes a rather different approach, focusing on the problematic legal status of nurses as symptomatic of  deeper ‘difficulties which [they] experience in their political, professional and clinical lives’ (p.13).   Using an extensive range of legal case studies, she argues that there are five images of the nurse which have influenced public and institutional perceptions of the nursing role (p.32).   These are:

  1. the nurse as domestic worker
  2. the nurse as the doctor’s handmaiden
  3. the nurse as a subordinate professional
  4. the nurse as administering angel
  5. the nurse as autonomous professional.

Chiarella argues that the first three are ‘stock stories’, often imposed by doctors or administrators,  in which nurses are ‘under [their] control’.   The last two are ‘outsider stories’, actively promoted by nurses themselves at various historical junctures in order to alter perceptions of their role.   In the context of the present study, this is important, because nursing students are involved in an additional story, that of the shift into the academic world of Higher Education, or, ‘the nurse as academic student’.   Their identities are thus doubly problematised, since, as Chiarella suggests, ‘[t]he five images...are not separate or distinct in the daily lives of nurses’ (ibid: 232).   There is therefore an inherent difficulty for nurses and nursing students in conceptualising their relationships with other health workers, patients and even with each other.   This difficulty extends to their relationships with spaces, an important consideration for two reasons,  Firstly, changing conceptions of the functions of healthcare and the roles of those who work in it are putting nurses into a wider range of spatial settings than before (UKCC 1999).   Nurses are to be found in primary care centres, call centres and health promotion settings, as well as the acute clinical settings popularly associated with nursing.   Secondly, the problems of identity highlighted by Chiarella  feed into what Davies (1995: 135) calls the ‘polo mint problem’, where nurses are either overloaded with unskilled routine administrative and ‘domestic’ duties, and therefore have insufficient time to practice nursing as such, or are given managerial and professional responsibilities which have a similar effect but from the opposite direction.   Either way, their nursing role is ‘hollowed out’ and devalued.

 

The questions which Chiarella addresses have recently been the subject of a publication (RCN 2003) by the RCN (Royal College of Nursing), entitled Defining Nursing.  This currently represents state-of-the-art thinking around the topic, and it is significant that there was a perception at the highest level of nursing that the profession suffered from the lack of  a clear identity and vision of its purpose.  The current study should, therefore, have a function in helping to unpick the complex strands which make up nurses’ professional identity.  The RCN report suggests (2003: 15) that nurses have a role as an ‘amalgam’, or connecting substance for a variety of other functions and activities.  This is a useful spatial metaphor, to which I will return.

The maintenance of a coherent self-image and sense of purpose for nursing students is thus both important and difficult, in a period of  transitions within the healthcare system.   Carberry (2001) suggests, however,  that there are tensions between the certainties demanded by evidence-based practice, and  a world where nursing ‘positions’ are multiple, and knowledge is ‘fluid and plural’ (p.83).    Her work suggests that acknowledgement of this multiplicity and fluidity can be emancipatory, but only if it leads to a continual reflection on,  and re-telling of, the stories which establish positionality and power (see also Francis 2000).

 

In another discussion of issues of power and positionality in nursing, Hicks (1999: 130) points to the need for ‘reconsideration of both the theoretical and practical foundations of clinical care’ in order to deal with the ‘advent of audit, accountability and litigation’.  There is thus a requirement for nursing to be founded on the rational application of principles and the evidence of empirical research, rather than the traditions and ‘ritualistic practices’ of the past.    The insertion of a research role into nursing models, as Hicks suggests, has gender(ed) implications, moving the perceived stereotype of the empathic feminine nurse towards a more ruthless, positivist and masculine image (1999:136; Yegdich 1999: 85; see also Owens & Glennerster 1990: 40; Davies 1995).  

 

There is a certain historical irony in this, given Florence Nightingale’s passionate advocacy of statistical research techniques (Schwirian 1998: 60-61), which themselves reflect a ‘masculinist’ model of the scientific method.   According to Rafferty (1996: 44), however, Nightingale opposed suggestions that nurse education should become an academic, university-based discipline because nursing ability, for Nightingale, was a question of character rather than of the possession of  medical knowledge (Chiarella 2002: 44).  More recently, Robinson ( 1994: 10) has argued that:

Although we may apply natural science knowledge in some aspects of nursing practice (and therefore need to understand the different frames of reference to which natural science relates), we have also to distinguish between this knowledge and knowledge for the activities which we call ‘nursing’ and which in themselves represent a social process.  (emphasis in original)

This epistemological split becomes an issue for nursing students in the space of the placement, where they confront different perceptions of the extent to which either form of knowledge should validate practice.  Loughlin (2002) argues that the separation of theory and practice is based on a false premise, and that nursing in particular cannot be divorced from its practical context. 

 

Fealy (1999) goes further into the question of the theory/practice relationship which

is at the core of nursing education and its transition into higher education.   Drawing on Carr’s typology of theory/practice relationships (Carr 1986), he points out that  the regulation of practice by science and scientific theory is not the only form which the relationship can take.    The information flow from theory to practice is not necessarily unidirectional, an important consideration when students are making continual spatial transitions from classroom to placement.  The experience of nursing students on placement is, as I will show, mediated in part by their use  of evidence and theory in the process of becoming socialised into the profession.   Hicks (1999) points out that there is a danger that the move towards a more masculine (i.e.’managerial’ and ‘scientific’) model may reinforce existing gender inequalities and imbalances, confirming males in their domination of the higher echelons of the profession.   If that were to be the case, then it is possible that spatial consequences would follow, perhaps in the form of a harsher regime (e.g.  greater expectations of personal mobility) for students.

In the present study, then, I do not set out to problematise existing  models of nursing,  but I highlight areas of the data where conflict occurs.    The traditional image of nursing is of acute care work in hospital settings, and previous research has found that this self-image is prevalent amongst nurses themselves (Heslop et al. 2001), although Tierney (1998) notes that ‘community [nursing] has been emphasised increasingly over time’.    Tierney goes on to discuss the influence of post-modernist views on the debate around nursing models, and concludes that professional diversification needs to be supported by a coherent vision of what nursing is about.   At the same time, some of the insights of post-modern thought are useful in keeping nursing models ‘open and alterable’ (Reed 1995, cited in Tierney 1998: 84).   Benner (2000: 306) also uses the metaphor of openness to describe a Heideggerian approach to nursing, an approach which is based on ‘care’ as both a fundamental element of human being and that which is increasingly absent from the calculations of the scientific-technological-industrial complex which has commodified health and disease.   Whilst Benner’s work is not specifically concerned with the spatiality of nursing, it attempts to apply Heideggerian phenomenology to nursing in general, although there has been much critique of her work, both of its interpretations of Heidegger and phenomenology (Crotty 1996; see also Barkway 2001) and of its relevance to nursing practice, especially in British  nursing  circles (Lawler 1998).   It nevertheless establishes a link between Heidegger’s work and nursing which will be further explored below. 

 

The above discussion has shown that there are major issues of identity attached to the business of nursing.   This has established a basis for exploring the spatiality of nursing, which as embodied activity must negotiate these identity issues in spatial settings.   In any event, it is important to explore the landscape of nursing in order to reveal problems hidden by the very transparency and familiarity of spatial, embodied life.   In the next section I give some examples from the literature where spatial issues are implicitly raised, but are not discussed or analysed as such.

 

Space for nursing: conspicuous by its absence?

Heslop et al.  (2001) provide a good example of a paper which highlights spatial issues without labelling them as such.   They describe some of the problems experienced by Australian graduate nurses in transition from undergraduate programmes.   This process is seen as an ‘obstacle course’, an example of the ‘journey’ metaphor, in which students are socialised into the profession within hospital settings which are the site of ‘ritualistic’ and even ‘destructive’ practices.   Yet it is these hospital settings which, according to the authors, prove most attractive to aspiring professional nurses.   ‘Locality’ was specifically identified as the single most important factor influencing students’ choices of graduate programme

(p.629).   ‘Familiarity’ was another significant factor with spatial implications, and  I return to ideas of ‘familiarity’ or ‘at-homeness’, both of which relate to possession, in my discussion of the data.   Heslop et al.  thus draw attention to some potentially interesting spatial issues without themselves addressing their importance, which is not, of course, the purpose of their paper.

 

Cope et al.   (2000) report on the placement experiences of Scottish nurses who had recently completed their training.   They  note that students ‘have to succeed in joining and being accepted by the community of practice’ (ibid: 852) and make a useful distinction between ‘social acceptance’ and ‘professional incorporation’ as they occur in this context.   The placement experience, for Cope et al., was seen as an experience of social interaction rather than spatial activity, as I characterise it below.   Both standpoints are legitimate ways of researching the same topic, and Cope et al.   reach similar conclusions to the present study about the ways in which joining a community of practice is both important to nursing students and neglected ‘in course planning or curriculum development’ (ibid: 854).   What is missing is a sense of how the space of the placement interacts with other spaces in the lives of students.   Indeed, the notion of ‘placement’ itself is not differentiated or problematised.    As the participants in this study point out, placements are highly variable both in terms of their function within the healthcare system and in the quality of the learning experience derived from them.

 

More generally, Thomas et al. (2002) offer some insight into the changes which have begun to be implemented in nurse education following the recommendations of UKCC (2001) and the DoH report Making a difference (DoH 1999).   These include the use of problem-based and enquiry-based learning, the fostering of ‘learning communities’ and team-working.   One of the aims of these changes is to more fully integrate the university into its local community and to enable students to make better use of local resources.   These are clearly spatially-significant aims, and their implementation in any given location would require more attention to the particularities of place and space than Thomas et al. acknowledge.

 

Similarly, Brown & Edelmann (2000) address the problems of stress for Project 2000 students and qualified nurses.   Although they identify  ‘environmental demand’ as one form of stress, their paper treats stress as an individualised, psychological condition rather than as a conjunction of social, psychological, physiological and spatio-temporal factors.   For Brown & Edelmann, stress can be alleviated by ‘support’ and by ‘coping techniques’ and does not appear to have material causes or be amenable to structural solutions.    Again, an approach focused on spatial location can be revealing about  stress, and may also reveal potential solutions.   In the current study, discussion of accommodation problems on placements revealed that booking accommodation on placements was stressful due to inadequate information coupled with supply & demand problems.   The autonomy expected of nursing students caused this stress to be downplayed by students who ‘didn’t want to be seen to make a fuss’.   The students’ spatiality was characterised in this case by unease caused by the obstacles, both physical and metaphorical, which they encountered in arranging placements.

 

Lloyd-Jones et al. (2001)  approach the placement via the question of mentoring, and again, although passing reference is made to students and mentors ‘[being] together in the placement area’ (ibid: 159), theirs is a study which focuses on time to the exclusion of space.   The linkage of time and space is illustrated in the current study, where, for example, students on community placements in remote areas felt that they benefited from ‘quality’ time spent on car journeys with their mentors, journeys which were not in themselves ‘work’ or ‘learning’ as defined by Lloyd-Jones et al..   It would thus have been interesting to know how spatial details of   particular placements contributed to the quantity and quality of student-mentor contact in the Lloyd-Jones study.

 

One study which does address the spatial issues generated alongside issues of power and knowledge is that of Burden (1998).   Burden discusses ‘space’ in the context of ‘curtain-positioning strategies within the maternity  ward’, and hers is one of a small number of extant nursing studies which are overtly spatial (see also Edwards S.C.  1998, Båck & Wikblad 1998).   Burden makes the important point that ‘survey and experimental studies do not facilitate the observation and analysis of the meaning of everyday activities’ (Burden, 1998: 17).    The meaning(s) of an activity  cannot be inferred without referring to social contexts.  

These contexts are accessible, however imperfectly, through interviews with social actors.   Burden also discusses the problems of researcher participation and influence on these contexts, a problem to which I return in the methodology chapter (below).   In her study, consideration of spatiality  connected it to issues of privacy, isolation and communication, each of which were mediated by a particular spatial strategy (curtain-positioning), but were not brought into discourse directly .   Thus, spaces were qualitatively altered in the course of  social interactions, and research into spatiality produced answers across topic boundaries. 

 

Båck & Wikblad  (1998) discuss the specific issue of privacy in hospital.   This is relevant to the current study because privacy is partly a question of the possession of space and the control of boundaries.  Their study indicates that being able to monitor and provide appropriate degrees of privacy to patients is a skill which requires practical experience in order to apply it in line with patient needs (see also Smith 1994: 85).   This is part of a range of spatial experiences which, as I will argue, are crucial to the learning experience as a whole.  


Summary

This chapter has reviewed some of the relevant literature in the field of nursing and nurse education, in order to situate the present study within that field.  Discussion of this literature has established that there are tensions between different notions of nursing identity.  There is a lack of nursing literature which directly addresses the questions about spatiality which are asked here, but the existing literature suggests that nursing is in a transitional state which is leading it away from traditional ideas centred around the hospital, to a more dispersed spatial model of nursing activity. Several questions arise from this discussion.  Firstly, if nurses are involved in spatial transitions, both contingently in their education and structurally in the course of changes in the profession, what tools can be used to to make sense of these transitions?  Secondly, is there anything in the spatiality of nursing students, or nurses themselves, which needs to be addressed in the interest of better retention and recruitment.  Finally, is the lack of spatial discussion in the literature a reflection of the lack of inter-disciplinary discussion of spatiality generally?  The current study attempts to provide answers to these questions.  Meanwhile, the next chapter begins to  examine the empirical data obtained from the nursing student interviews.

 


Chapter 6-Into the data

 

 


You, Mr Baley, won’t even believe that a City dweller is capable of crossing country to get to Spacetown.  Crossing space to get to a new world must represent impossibility squared to you.”                                                                                                                                                                        

 

“That won’t last” said Baley confidently.  He looked at the strips stretching to either side , with their human cargo whipping to his left more and more rapidly as their distance from him increased.  He had felt the strips beneath his feet many times a day almost all the days of his life, but he had not bent his knees in anticipation of running them in seven thousand days or more.  He felt the old familiar thrill and his breath grew more rapid...

(Isaac Asimov, The Caves of Steel )

 

 

Introduction

In chapter 4, I looked at some of the issues surrounding the data collection process, in terms of the participant/researcher relationship.   Here, I start from the knowledge imparted by the participants. As in the rest of the study, what I wish to show is that the ways in which participants experience space in the course of everyday activity can be related to the proximity-mobility-possession (PMP) framework which I outlined in Chapter 2.   In order to demonstrate this, I need to begin from the experiences of individuals and deduce their ways of experiencing from those concrete experiences.

 

To give an example which occurs in the data, a participant may have a particular experience of using the library, perhaps disliking of the noise made by other students.  The participant’s sense of possession of the library is reduced because of this noise.   Another participant may prefer to engage in continual social interaction in the library, thus creating a noisy library, and in doing so increases her own sense of possession, at the expense of the other, who dislikes noise.  It is thus not possible to generalise about whether students prefer quiet or noisy libraries, although it might be possible to state that ‘ x% of students surveyed said that they preferred the library to be quiet”, based on a different research method. This figure is in itself insufficient to reconcile the ‘quiet’ and ‘noisy’ students, not to mention the librarians.

 

It is possible, however, to suggest that there is an underlying concept (possession) around which these preferences for different noise levels  revolve.  The issue is more complex than simple preferences, and the dynamic and temporal aspects of ‘possession’ enable it to account for the varying nature of the experience of the library, for example in and out of term-time, or at different phases of the essay-writing process.   Possession leads away from a concept of the library as a homogenous space to a  ‘heterotopic’ conceptualisation which accounts for its many contradictory functions, to which I will return.   With this in mind, I will  now begin to explore the data, looking first at the geographical relationship of the two campuses and its consequences for relationships of proximity.

(In the extracts presented below, participants have been allocated pseudonyms, and the numbers which accompany these refer to the indexing system as described in Chapter 4.)

 

The research participants were situated in two major overlapping institutional spaces.  

The areas served by the respective health boards, Forth Valley for SC and Highland for HC were clearly defined and different in geographical size by a factor of about twelve in favour of Highland.   The University as a whole, conversely, had an undefined catchment area, although drawing many of its students (c. 85%), from the Forth Valley and Central Scotland.   The pattern of recruitment to HC  followed a similar pattern, with approximately 80%  of its students recruited within its extended locality (University of Stirling 2001). 

 

In the case of the HC students, the boundary between their campus, formerly the nursing  college.  and the adjacent hospital was somewhat fluid.   Although the two sets of buildings were physically separate, they were less than a minute's walk away from each other.   Buses came to 'Raigmore Hospital', rather than 'the University', and all the coming-and-going of a busy acute hospital, with ambulances and especially helicopters, maintained the medical atmosphere, or ‘gave [the campus] a buzz’ as one participant put it.    Many of the students chose to eat in the hospital canteen.   This was constantly busy and one could immerse oneself in an atmosphere of activity, professional gossip and banter.   The identity of the ‘University of Stirling, Highland Campus’ was announced by signs, but these buildings were otherwise dominated by the more obvious physical presence of the hospital.  The institutional merger with SC appeared to have little influence on the spatial relationships between hospital and college, and few practical implications  for the day-to-day activities of the students, except perhaps in relation to the library, which will be discussed in chapter 7.

 

As Nespor (1994) recounts in his study of physics and management students in the US, the negotiation of the boundary between ‘student’ and ‘professional’ spaces is part of a larger process of spatio-temporal ‘funnelling’.   Student’s understanding of their identity at HC  was conditioned by this funnelling effect, in this case towards the professional identity of healthcare: 

…everybody around here is in the health professions, everywhere’s just people in uniform, doctors, nurses and so on, and you are constantly reminded of the fact that you're a nursing student, and that you are not doing physics or something. (Doreen,  15)

It is interesting that ‘physics’ should be seen by Doreen as a discipline highly differentiated from nursing.   Nespor’s characterisation of the spaces occupied by physics students depicts them as closed-off from other disciplines and from the public, in a hidden world of esoteric apparatus and knowledge.   Although the medical world has been similarly characterised (Davies 1995: 59), the hospital’s functional role, and the role of nursing within that space, requires boundaries which are permeable.   For the nursing students at HC, Lave & Wenger’s (1991) ‘legitimate peripheral participation’ is enabled by the permeable boundaries of the hospital and its spatial proximity to the hospital, even for those students who are not officially on placement there. 

 

At SC the spatial situation was (and remains) quite different.  The Department of Nursing and Midwifery was housed in  new, purpose-built premises (connected by corridor to other departments), but there was no significant health-care institution within walking-distance.   The nearest large hospital (Stirling Royal Infirmary) was approximately three miles away.   Consequently, the funnelling effect noticeable at HC was not maintained by local, spatial arrangements, and the locality was dominated not by a hospital, but by the University, so that, outside the boundaries of their own building, nursing students were dissolved into a much larger student body.  

 

The funnelling process, however, was maintained in other ways.  Nursing students were set a more intensive temporal schedule than other students, working a 48-week academic year outside the two-semester system (which effectively provided for 24 weeks of teaching time).   This led to nursing students spending time on campus out of semester when

...you could probably find a [study] room anywhere, if you wanted to spread stuff out, a little bit in the library, around the computers, wherever.  There's a big variation in how easy it is to find space between when the regular students are here and when they're not here.  (Karen, 72)

This seasonal variation is also experienced by academic staff, but is more marked for nursing students because they rely on a set of spaces which they share with other undergraduates.   These possessions are public (in the sense of being shared) spaces, whereas staff have access to spaces which remain more-or-less the same over time.   In the quotation above, the sense of possessing these public spaces is modulated by the presence or absence of non-nursing students as ‘others’.  For nursing students, the experience of spatiality is thus partially constituted by their sense of possession of the space of the university.   Nespor’s ‘funnelling process’, the process of professional socialisation, is partly maintained by the different temporal flows of students through the spaces of the campus, which creates differentiated senses of possession for nursing and non-nursing students. 

 

Two participants with previous experience of Higher Education had mixed feelings about the high degree of focus experienced on nursing courses, enjoying the ‘supportive’ environment but missing the cultural opportunities provided by University life. Otherwise there was little evidence that  contact with non-nursing students was either specifically sought or had any effect on the learning process and the experience of the spatiality of the campus at SC.   This is a consideration almost entirely absent from the literature on Project 2000, which, because it largely originates in nursing studies, focuses on nursing students as nurses and not as students.   Whilst recent changes to Project 2000 priorities (Howard 2001: 37-38) have made this less of an issue, with shorter Common Foundation Programmes and more clinical involvement in the educational process, there are still reasons to pursue the question, as I will discuss in the following section.  

 

Is there a world outside nursing?

One HC participant had been a student at SC some years earlier, and was thus able to compare her experiences of nursing and non-nursing programmes.   In this case, the funnelling effect was related to the level of support provided by fellow HC students:

Yes, I don't know whether it's the course, or it’s people on the course as well, I would say that they are much more supportive here of each other, than everywhere...  I felt, it's because it's a smaller campus as well, everybody tends to know quite a lot of people, I'm not saying that...you know, there's always somebody there you can talk to here if you're stressed or whatever, there are a few of my friends on the course who have got young families, younger or older families and have certain social situations that make it difficult sometimes for them to come into the library or whatever, and you always say, well, if you’re needing a hand, just let me know, I find that so much more supportive here.  I was on a completely different course, so I don't know if it's because we are supposed to be going into... a caring profession or the people that are coming in are a different personality and I think it's...  part of it is that we’re on a smaller campus as well because Stirling's huge, there's so many different people from so many different backgrounds doing completely different courses and there's a tendency to get swamped , whereas here, it’s smaller, so I suppose it's easier to get to know people… (Wanda, 30, emphasis added)

Several interesting points arise from this passage.   There is repeated emphasis on the ‘supportive’ qualities of HC students, but doubt about the reasons behind this – is it because of the supposed nature of the ‘caring profession’, or because of the type of people who become nursing students, or because of the smaller campus?  The first point reflects the problem of multiple identities highlighted by Chiarella (2002) and Davies (1995), in which nurses are torn between several possible ways of being, including models of ‘professionalism’ constructed, according to Davies in the gendered world of medicine.   The second point is the related one of seeing nursing as being a ‘calling’ (Chiarella 2002: 136) requiring different qualities of its entrants from those of a non-nursing student.   The issue here is not whether nursing is a ‘calling’ but whether it causes nursing students to position non-nursing students as Other.  When this is combined with the metaphor of being ‘swamped’, as experienced during her previous course at SC, it creates a picture of a strongly-constructed group identity.  The third point is thus that the smaller campus, with its history of nursing studies and its ‘remoteness’, is seen to constitute itself as an ‘organic community’ ( Gemeinschaft) , in which ‘everybody tends to know quite a lot of people’ against the ‘faceless’ Gesellschaft represented by SC.   

 

The use of ‘we’ to refer to the nursing student community (a common occurrence in the interviews) is similar to its use as reported by Wichroski, which indicates ‘a reluctance...to speak in terms of the self without reference to the community’ (Wichroski 1997: 269).   The same student had reported earlier that, in conversations out on placements, ‘...you get everybody comparing what was in the past with what is now’ (Wanda, 29)  The use of ‘everybody’ maintains the collective voice, whilst the ‘past’ to which the student refers is the pre-Project 2000 past of nurse education, prior to the introduction of academic pedagogical methods and supernumerary status (Howard 2001: 33; Rafferty 1996).   Had this extract been taken in isolation, I could have claimed it in support of a nostalgic interpretation of Gemeinschaft versus Gesellschaft (Giddens 1991).   In the context of the conversation, however, it reflects a slightly different view:

you can't compare what they've done with what we've done because you've not been through their side of things and they've not been through your side of things… (Wanda, 29)

This reflects not so much a nostalgia for the past as the fragmentation of the nursing body along the lines of (crudely) academic/non-academic training or post/pre-Project 2000

Another extract, however, seems to contradict the idea that nursing students are purely focused on their own discipline:

If I  were eighteen, this would be an horrendous disappointment, because for an all-round education the university experience isn't happening...  (Doreen,  20)

The participant in this case had also gained previous experience of higher education outside nursing, and elsewhere in the interview speaks about the excitement of the cosmopolitan life she had experienced as a music student in a large Scottish city:

For me, as a very mature student, I've been at college before...being able to join the University Orchestra, or the College Choir, would be brilliant.   Here, we have absolutely nothing, other than the fact that we are nursing students, I think the focus is far too limited , for an all-round education, this is not where you would get it  (Doreen, 16, emphasis added)

The two metaphors here suggest that, for this participant, the spatiality of HC is experienced visually, in terms of a ‘view’, and spatially, as a restriction.   Her sense of proximity, as with some of the other examples below, is generated by the physical proximity of one spatiality being opposed to the remembered proximity of a different and more satisfying proximity elsewhere.

In feeling this dissonant sense of proximity, she presents an alternative view of the Gemeinschaft version of ‘community’ with its ‘conflict, oppressions and limitations’ (Usher & Edwards 2000: 34).   This example illustrate the dangers of being selective in using participant quotations, however, because the extract continues ‘...but at 40 with the kids and a house, that doesn't matter… (Doreen, 20)’ The point here is that the participant sees maturity as narrowing the focus of her efforts, a view discussed by Webb (2001: 410), who suggests that  there is a more complex relationship between age, previous educational experience and family ties than is sometimes acknowledged in the literature on mature student experience.  

 

Along with the cultural advantages of a larger institution, there are potential problems of academic compartmentalism, which this participant’s previous experience enabled her to appreciate:

I feel that certainly in the CFP [Common Foundation Programme],  some of the physiology...because of my previous knowledge,  I found that some of their information wasn't accurate, or wasn't entirely accurate, I know physiology is a complicated subject, sometimes it takes a while to get to grips with it, but maybe having more specialised teaching, you know, somebody who has done physiology outwith nursing would be a help......but in some ways it's an advantage having the nursing perspective, because that's a perspective you have to have anyway, but I do find that...there was some confusion over some of the more complicated parts of physiology, and I'm sitting there thinking, ‘no that's not right, it should be the other way around’, and eventually they have turned round and said ‘yes, that is right’, but for those who haven't got a background in physiology, physiology is hard enough to take on as it is, without having confusion given by teachers, so maybe it would help having somebody who's got...more in-depth qualifications in the subject and an understanding in that area.   ( Wanda, 33)

The point here is that only by experiencing other worlds can a perspective be developed on any given world, a world which otherwise seems self-evident, a world which is ‘understood’ (in Heidegger’s (1962) sense of the word) prior to any conscious interpretation.  Because nurse education, conceived as vocational training, has traditionally been based in specialised institutions attached, for the most part, to hospitals, it has not been in close proximity to the range of academic disciplines available within the university setting.   In other words, this has limited the opportunities for practitioners to work with (and therefore to bring into their range of concerns) academics in other fields, which is not to say that the field of nursing studies lacks reference to other academic fields, as the literature shows (Tierney 1998; Crotty 1996; Fogel Keck 1994). This is a spatial issue because it is as much the spatial contingencies of local geography, departmental siting and building design, rather than institutional policies   which mediate the interactions of teaching staff, students and researchers.  Policies, of course, lie behind decisions on siting and building design, but the complexities of spatial interaction are such that they can only partially influence the  outcomes of interactions, as Hillier acknowledges (Hillier 1996; 1999; Hillier et al. 1998). 

 

Knowledge and the world of nursing

There is a different proximity problem which applies to students from non-nursing backgrounds (such as the participant above).   As May et al.  note, quoting a midwifery mentor,

[recruiting students other than qualified nurses]...made us realise how much of our nursing knowledge we take for granted. (May et al.  1997: 219)

Nursing is a region, in the Heideggerian sense, within the world of healthcare, and as such, involves a wide range of pre-conscious assumptions and tacit knowledge.   As a ‘supplier’ to the largest occupational group (for women) in the country (RCN 2002),  nurse education involves substantial numbers of students, and the background of the staff involved in teaching them is predominantly in nursing itself.   There is a large and rapidly growing body of nursing research which provides an evidence-base for practice, but there is also a vast amount of tacit knowledge which resides with practitioners.   Tacit knowledge is ‘...rooted in individuals’ experience and spread through direct communication’ (Tsui-Auch 2001: 718).   Both institutionally and individually, nurses overwhelmingly learn from other nurses, and are in proximity to other nurses.   Again and again, participants referred to ‘we’ or ‘the girls’ when talking about nursing students.   It could be argued that this is a question of group identity rather than an experience of spatiality, but the two concepts are not in conflict, since ‘being-with’ is a fundamental condition of human being which, manifested as possession, is also a fundamental element of spatiality.

 

The above discussion suggests that a sense of proximity is an important way of experiencing spatiality for the participants.   Having a preconception ( Vorsicht , in Heidegger’s terminology) of the university, or other purposeful space, having a sense of proximity to it, having it within the range of one’s concerns, all these affect the way one experiences being a nursing student in spatial situations. The ways in which identity is experienced by nursing students suggest that there are interactions between different forms of community, or ‘worldhood’ (Heidegger 1962: 114) which form important components of this identity.   Although ‘identity’ and ‘spatiality’ are not synonymous, they are connected via the notion of worldhood, and I will now discuss one aspect of this connection - ‘nighness’ - as it relates to the PMP framework and to the experiences of the participants. 

 

Although, in the first extract in the section above, the ‘smaller’ size of HC relative to SC is a spatial factor affecting the experience of being a student there, it is important to consider what ‘smaller’ means in this context.   The implication of the passage is that it is smaller in terms of its ‘population’, that is, it is only occupied – possessed -  by nursing students.   This is not a discussion of floor area or student numbers.  It  is an example of Heidegger’s distinction between ‘nearness’ and ‘nighness’ (1971a: 104; cf. 1971b: 175).   Parametric distance cannot measure the closeness or distance of neighbours or colleagues, which Heidegger characterises as ‘nighness’.   Nighness is more than ‘being within one’s range of concerns’, or  proximity, and more than mobility, being able to act over the intervening distance.   It involves an affective relationship, but is not synonymous with possession, the object of which, as I use it here, is always a space.   Nighness to supportive colleagues is what establishes a particular relationship of possession here.   The spatial metaphor in ‘supportive’ also gains significance from the work of Lakoff & Johnson, which suggests that the physical action of supporting, of keeping something up, is related via its metaphorical usage to the conceptual structure of feelings-as-objects (Lakoff & Johnson 1999:88; 230-231).

 

Nighness and possession, however, both have negative sides.   For Anita (a post-graduate student who was also a tutor) the relationship with SC resulted in a form of dispossession.  In discussing her feelings about the SC/HC merger, this was expressed as the kind of indefinable strangeness captured by the German word Unheimlich :

[I] feel the proximity of the hospital in an ambiguous way - in one sense it makes the Highland campus seem closer to the hospital than the University...it's an odd relationship, because we used to be part of the same organisation as the hospital, but on the other hand it also means that there's a huge resource over there, it's an odd relationship now, it's not negative in any way, it's not that people feel we're different from the way that we were four years ago...when we came in...it's just different...I suppose that change started a long way back when the hospital trusts were set up and we weren't part of the health board altogether, so part of it traces back to their changes...it's very strange...(Anita, 20, 21)

That the proximity relationship does not depend on parametric distance is demonstrated by the second line above, in which it is implied that HC ought to feel closer to the University than the hospital, but does not, in fact, feel close.   The sense of possession felt by this participant is constructed partly on the basis of her sense of proximity, which maintains HC as a ‘world of its own’ essentially independent of its dominant institutional parent.  The indefinability and 'strangeness' of the difference seem to arise from the ambiguous nature of the ‘odd relationship’ of HC to the remote SC and to the world of nursing and healthcare, which appears close physically but is now more distant institutionally.   There is thus a split sense of proximity which generates dissonance between the institutional world of the university and that of the healthcare system.   Possession thus emerges from this split sense of proximity, in this case as a ‘strange’ sense of dispossession.   The feeling that things are not as they might be, or ought to be, alters the sense of possession, but cannot abolish it, since it encompasses both positive and negative ‘possessions’, with a range of ‘in-betweens’.  

One of the SC participants, Terry, neatly illustrates this connection between proximity, distance and possession:

I know it's [HC] there, but I haven't actually thought about it as part of the University, I know it's part of our campus, but it’s faraway, I never really thought about it…  (Terry, 27)

HC is on the horizon of Terry’s range of concerns, just within view but not close enough to grasp as an affordance (Gibson 1979; Kelly 2000).   It is therefore in the proximity of the participant but not in his possession, nor is he called upon to exercise mobility in relation to it.   This is not, however, to suggest that this is a static relationship :

...it's [visit to HC] being talked about, Highland campus and Stirling, us meeting up and spending some time, and know what’s happening, meet the students from up there to discuss things and see what's going on, to exchange ideas, a different viewpoints, I think that would be really good, it's been talked about but nobody's really acted on it yet. (Terry, 25)

The sense of ‘farawayness’ might be replaced, after the visit, by a sense of nighness, of graspability and therefore of possession.  Whilst there is a slight contradiction between the two quotations (‘I never really thought about it’ and  ‘it’s being talked about’), it does not affect the shift from proximity to possession which will inevitably occur when the two groups come together.  This relationship between the two campuses was mediated by various features of the institutional politics of the university, as the next section will show.

 

In the course of discussion about  perceptions of the University, a course tutor [10] at HC came up with the following metaphor for SC:

Eldorado-cum-Mothership, ...it feels like checking back in with the control centre...and the power source as well I think.  (Anita, 22)

The locus of control - the committee meetings and the offices of those in charge - was thus firmly situated at SC:

[I think] there is an issue of power relations  between [SC and HC]...a sense of being out on the periphery, a sense of not being in the centre of decision making and ...not being aware of what's going on all the time...we don't meet many people, we're not in those informal networks, most of our contacts are with the other end of the department, and not even very much with other departments within the faculty...so our links are really quite limited...we miss out on all those informal things. (Anita, 23)

This passage reveals that the dissemination of certain types of knowledge within and across the institution is not just a matter of e-mail lists and departmental newsletters, but involves ‘the compulsion of proximity’ (Boden & Molotch 1994; Urry 2002: 159) in other words, informal, face-to-face contact on a daily basis.   Face-to-face contact is, of course, no more neutral in power terms than any other form of communication (Nespor 1994; Scott 2001: 40).    Although some meetings between staff members were held at a venue half-way between the two sites, there were still many occasions when staff from either site were compelled to make the full journey.   The level of mobility expected of staff was thus quite high, but what is significant here is that distance had not been abolished by , but was maintained both by physical spatial arrangements and by  particular alignments of networks.   The experience of spatiality, for this participant, was thus one in which her proximity relationship with the University (as institutional hierarchy) interfered with her sense of possession of the locality.   Her mobility, required under a ‘civil regime of justification’ (Boltanski & Thévenot 1991: 202; Albertsen & Diken 2001: 3-4),  far from increasing her sense of possession across the space of the University, actually reduces it, because the remoteness of SC in terms of mobility was reinforced by an apparent lack of interest or involvement in HC activities ( a proximity relationship) amongst SC staff:

I don't know, I've been here [SC] many  times, and I feel comfortable here, but I also get the feeling that hardly anyone here knows who we are or knows of our existence - I was at a meeting this morning and the chair asked if there were any issues from HC and a few eyebrows shot up, I don't think they'd thought, I don't think they knew who I was and I don't think they'd consider that  was relevant…Before we joined I rather naively thought there would be more traffic, south to north, we'd be seen as quite a good resource that other departments would make use of...

( So there's a perception that you're quite isolated?) Yes there is.  (Anita 22)

The purpose of this discussion is to highlight the way in which spatiality is constitutive of the historical experience of the institution as a whole, whilst it is rarely foregrounded in institutional discourse.   It would require more research using a different set of informants to produce a balanced account of this aspect of spatiality, but the example suggests that analysis of the relationship between proximity, mobility and possession would be a useful way of pursuing this research.

 

Perceptions of distance between HC and SC were, therefore, important, although this applied more to staff than to students:

I suppose from a student's point of view I'm not really aware of the relationship [between HC/SC], it's more for the administrators and managers here, I don't really consider myself part of Stirling University, I'm more of a Raigmore student...(M23)

The proximity of the University was reduced by the lack of any perceived connection or involvement between the two sites.   None of the participants at either site had visited the other campus in the course of their nursing studies, although one had done a (non-nursing) degree course there and another had visited briefly ‘as a tourist’.   There was a high level of curiosity as to what the other campus was like, and there were intermittent suggestions for some sort of coach trip in one direction or the other. 

 

There was thus a perception amongst HC students that HC was peripheral to the interests of the University as a whole, although in relation to the overall size of the Dept.  of Nursing & Midwifery,  the HC staff and students made up about 40% of the total.   This feeling was apparent in an exchange about spatial metaphor:

(Q: Do you think of SC as being up or down from HC?)

I think I say I'm going down the road, not using up or down in any evaluative way (laughs) ...we do joke about how the road south to north is much longer than north to south, but that was always the case.  (Anita, 25)

The second sentence above, although apparently flippant, is only partially so, reflecting a feeling of asymmetry in the power relations between the two sites.   The north-south divide  was an issue in other ways. 

I had really expected that other departments would want to make use of the north, that [SC] departments like Education and Social Work would be sending students, and that other people would be interested in research...the nature of our area is so different and unique...and natural sciences too, I had expected that there would be something there to engage them ...it's all a little disappointing (Anita, 50)

Anita seems to suggest here that HC should be regarded as a resource, a kind of field centre to which SC nursing students could come to take advantage of opportunities not available in Central Scotland, such as the possibility of placements in remote rural communities.   This lack of interest or ‘engagement’ on the part of SC again suggests that the proximity relationship between them is weak.   A strong sense of possession at HC is suggested by talk of ‘ [t]he different and unique nature of [our area]’, and a lack of mobility between the two sites contributes to a diminished sense of possession of the University space as a whole.

 

In the above quotation,  what contributes to  the north being a potential  ‘resource’ is its difference and distance from other regions, but this difference was not always apparent from ‘outside’, andthe reality of rural life in Highland Region was not always what the students expected:

…they get surprised when they come across rural problems, and I think they have a picture of the west Highlands as being really twee and cuddly, a bit like the Monarch of the Glen , but they come across alcohol problems and child abuse and ...it’s very difficult for them. (Anita, 28)

This extract illustrates the increasing range of problems with which nurses are expected to engage as their role expands (Magennis et al. 1999).   The problems of alcohol and child abuse are not confined to Highland Region, and as the extract suggests, the public image of ‘the Highlands’ is that of a scenic area, a picturesque wilderness, rather than that of a region with multiple areas of social and economic deprivation (Scottish Executive 2002). This difference in perceptions is emphasised during the course of journeys to HC, even relatively short ones:

It's [journey to HC] not too bad, only about 20 minutes, the only complaint would be...  the single track roads up here.  (Andy, 23)

The phrase 'single-track roads' has connotations of remoteness, sheep, hills and slow journeys, and all of these characteristics of the region, are, as  Urry (2001b) puts it, ‘consumed’ by tourists  whilst problematic for ‘locals’.    Differences in terrain and scale between HC and SC alter the effect of placements on the student experience, and the role of the tutor is also subtly altered, leading in some cases to a more concentrated experience and to a better relationship between student and tutor :

In a way going to visit the more remote [student on placement], it's a more intense visit...I'd be there for longer and I'd have a very clear idea of what we were going to do...It's to make going that distance worthwhile.  and also to address issues about isolation and working alone and unsupervised that sometimes students have when they're working in areas like that, and also some of the issues that they will have come across…

(Q: Would you say isolation was a big problem for them [the students]?)

It can be...if you're a two hour drive from the next person in your group, and we do try to put them as near together as possible, occasionally if you put them into an area like Lochaber or the far North, there will be one or two who will be a long way from the rest of the group, and particularly if it's winter they do feel very cut off.  (Anita, 28/29)

Here again, the issue of proximity is extremely important, and there is an alteration in the sense of proximity due to perceptions of the increased difficulty of the journey.   The sense of ‘feeling cut off’ is not dependent on whether the journey actually needs to be made, although that will sometimes be the case, but on the possibility of making the journey.   In terms of the PMP  framework, the students’ mobility is restricted, leading to a reduction in proximity.

 

The tutor’s efforts ‘to make going that distance worthwhile’ bring in another set of metaphorical concepts: the ‘Time is a resource’ metaphor (Lakoff & Johnson 1999: 162).   ‘Going that distance’ is an expression of time as space, whilst the implication is that time is expensive, making it necessary to get better value out of the visit.   In this case.  the tutor’s sense of possession (with regard to the supervisory visit) is enhanced both temporally and spatially.   Overcoming the obstacle(s) presented by the difficult journey is rewarded by a better visit.   In the PMP  framework, one of the key features of possession was that it describes the relationship between self and space over time.  This extract describes how possession is gained in placements:

I like to give myself three days to fit in to, and to know where things are, not the routine as such, but to get familiar with the particular times, breakfast lunch and dinner, that kind of thing so I say to myself, ‘three days to be able to gain the confidence of my supervisor’, and if I'd gain the confidence of my supervisor, her confidence would allow me to do more...(Naomi, 22)

The reason for describing this process as ‘[gaining] possession’, and not as ‘familiarisation’ is to acknowledge the wide range of positive and negative feelings  which spaces afford the students or other actors involved with those spaces.   It also acknowledges the power relations which apply to them.   One final extract on this topic illustrates how possession does not automatically increase over time:

there was the one particular placement, I walked in, and automatically thought, I'll suss this out, I got the feel for, well, at this isn't exactly...student friendly, I know where I stand, so I'm really going to...  Very hesitant to mention that I was an enrolled nurse, and then as you get to know people, as you do, it came out that...  I was an enrolled nurse, and my supervisor overheard it, and it wasn't taken very well, so apart from it being a less than marginal OK placement, it decreased dramatically after that, very snide, very unpleasant, but I stuck with it and did what I could, and when you're working by yourself with particular patients, you do tend to say, well this is the time when I'm actually going to make the most of it, and do what I think was right (Naomi, 21)

In this extract, it is clear that issues of identity pervade the space in which the placement is operationalised, and that these prevented the experience of the placement being a useful and enjoyable one for the student.  Recognising that possession of the placement setting is an important component of professional socialisation would be a first step towards improving the process. Taking an overtly spatial approach might mean concessions and negotiations, and acknowledging that all spaces are shared spaces by definition.

 

Mobility and the journey

 

This section extends the exploration of the data by focusing on issues of mobility, the power to act over distance.  Action over distance implies that both the departure point and the destination or target of the action are within the range of concerns of the actor.    Mobility across this range of concerns may, of course, be impeded both by contingencies and by structural constraints. Examining the use of the metaphors and discursive constructions, especially those around the concept of ‘journey’ helps to identify these contingencies and constraints as they affect the student experience of spatiality.   Essentially, the journey connects two or more domains (e.g.  home-college), but also acts as a space in its own right, and as a spatial metaphor for the learning process.   In the following sections, I begin to address each of these meanings.

One of the questions which originally inspired the study was ‘why does walking help thinking?’.   The following extract explores the relationship between the physical and the cerebral:

I really like my time walking, I'd just come out of the [name] building and walk, I enjoy the peace it gives me, the time to unwind, and just reflect on things, or if you've just come out of something and your head is buzzing...so I enjoy my walk and the benefits of  physical activity as well (Karen, 10/11)

Walking is a good example of the intertwining of the spatial, the metaphorical and the temporal - moving through physical space in a way which enables concentration on things other than the activity itself.   In this case Karen’s home was near enough to the campus for her to walk to classes.  The extract continues:

It started off, I felt very apprehensive because it was such a big step and it was new and you felt like this new kid on the block, even though you knew there were other people, there were feelings of apprehension, now you just concentrate, I really enjoy the walk, all that wildlife, there's a pleasurable sense as you walk along, of the smells and the flowers and seeing it turn all green and lovely which is nice, and then you walk across the bridge and that's you in and I'm concentrating on what's ahead of me .  (Karen, 12/13, emphasis added)

The interesting points here are the shift from the physical mobility of walking to the metaphorical mobility of the ‘big step’, the shift from a weak to a strong sense of proximity (from ‘outside’ to being ‘in’) and the concurrent increase in Karen’s sense of possession (‘now you just concentrate...’) as she exercises her mobility in moving to what is ahead, both in the physical and temporal sense.   Karen had, by her own admission, little in the way of domestic responsibilities, and was thus able to experience walking as pleasurable rather than as a slow  means of travel (or resistance to mobility).

 

In other interviews, however, the relationship between personal space and activity was expressed in connection with driving.  HC students rarely mentioned walking as the distances involved were (usually) too great or (occasionally) too short to count as ‘a walk’.   Driving was an important part of living in Highland Region, as was highlighted by one student:

If you've got company it is [useful time] but if you're on your own...the scenery's nice but...the weather's horrible...I got up to Wick and the day after we were snowed in [at] Helmdale [which] is wicked...I do at least 12,000 miles [per year] down to Birmingham and back...so I'm used to long journeys (Helen, 30)

Attitudes towards driving are important in establishing the significance of distance and thus the ways in which spatiality is experienced via the journey.    Helen’s car, and the road system, and the fuel supply, and a multitude of other contributory elements, ‘knot together’ to position her as a mobile actor.   It is the relative stability of this knot which is important.   When the stability of the knot breaks down, on a snowy day in Wick, her mobility is brought into question.   The ‘handiness’ of the road transport system (its Zuhandenheit , in Heideggerian terms) begins to break down and the interdependence of its elements becomes apparent - the car becomes a useless lump of cold metal.   Her phrase‘...but I’m used to long journeys’ serves to confirm that her mobility is justified by both the ‘industrial’ and the ‘domestic regimes of justification’ (Boltanski & Thévenot 1991: 200 ff.).   The industrial regime provides and profits from the technologies which enable Helen to fulfil her domestic obligations (Urry 1999: 262).

 

Given the complex systems which create and sustain it, it is not surprising that mobility is highly differentiated, and the work of Doreen  Massey (1992; 1994a; 1994b; see also Bridge 1997) is exemplary in exploring the spatio-political implications of this.   This differentiation was apparent in the statements of those who did not drive.   Most journeys to placements, if they were undertaken by public transport, took several hours, and although it was possible to use the time for study, the effect was that the students concerned were deprived of quality study time, or time with their families.   Trains were not always available, and the bus - on winding and hilly roads - was not a good environment for reading, much less writing.   The under-valuation of the students’ time reflects a particular conception of their professional identity (Chiarella 2002), but more importantly for this study, it also reflects an underlying assumption that mobility is a duty as well as a right, an assumption which remained valid whether or not the students had access to cars.

 

Despite the cost of car ownership relative to income, the deficiencies of public transport provided an incentive to take up driving:

I don't have a licence, but I am going to be getting a car, so I am working towards getting my licence. (Naomi, 9 )

It was clear from discussion of remote placements in the Western Highlands  that driving was one of the skills necessary to function as a community nurse, and probably in other branch specialisms as well.   Although not on the curriculum, the expectation was incorporated in job descriptions and other discourses.   One postgraduate student and tutor raised the related issue of car ownership:

...sometimes [travel problems] can disadvantage [students] in the experience they can get, I visited a student last month who was a third year doing community nursing in Skye, and she can drive but she doesn’t have a car, if she could have had a hire car...we’re negotiating to get this, it seems to me very slowly...if she could have had a car she could have had a much better experience, she could have taken on a caseload and functioned really quite well, and it would have taken a lot of pressure off her supervisor who had to ferry her around an awful lot. (Anita, 34, emphasis added)

Unusually, this extract challenges the assumption that mobility is a duty as well as a right, and.   the expression ‘ferry her around’ positions the student as passive and helpless in her failure to participate in ‘driving culture’.   This was the only statement in which the possibility was raised that mobility should be the responsibility, at least in part, of the institution rather than the individual student.   As Urry (1999: 12) puts it:

Not to drive and not to have a car is to fail to participate fully in western societies...The car is never simply a means of transport.  To possess a car and to be able to drive it are crucially significant rights... 

This hints at a general assumption which underlies discourses of professional ‘flexibility’ and mobility.   The assumption is that individuals will manifest certain types of mobility as a matter of course, and that these can be co-opted for the purposes of optimising their usefulness to the labour market.

 

The SC students had relatively short journeys to the campus and the majority of their placements, and from the students’ perspective these journeys were generally unproblematic.  This raises the interesting question of how journeys are conceptualised, and suggests that those taking less than about 20 minutes are almost disregarded, whilst journeys taking more than 20 minutes become spaces in their own right:

I come in from [X], it's about half-an-hour in the mornings, and about 20 minutes when it's not busy, [that's driving], I have to drive in every day and drive back. (Doreen   11)

I travel to.[X]..every day...  it's not too bad, about an hour-and-a-half drive. (Joanne, 14)

…I do at least 12,000 miles a year, to [X] and back, for relatives, so I'm used to long journeys. (Helen, 30)

These three extracts illustrate how long car journeys have become the norm, not calling for protest or further comment.   The three journeys here are respectively 16, 54 and 439 miles (on-road distance), and demonstrate varying degrees of what Adams (1999) calls ‘hypermobility’.   Although the third extract refers to journeys performed for reasons not directly connected with nurse education, it establishes that this level of mobility can be seen as both a right and a duty (Urry 2001b: 238), and is self-reproducing, as the extract demonstrates.  Once one becomes ‘used to’ the long drive, or rail journey, it is easy to extend it further.   The car is especially seductive in this respect as it extends the capabilities, or the ‘grasp’,  of the body (Merleau-Ponty 1962; Urry 1998; Kelly 2000).

 

The issue here is that nurse education institutions are able to demand this embodied and enhanced mobility by virtue of their proximity relationship with a certain space (e.g. Highland Region). Their proximity relationship  with the region is not simply one of  ‘location’, but their incorporation within networks of hospitals, community health centres and so on.   These are known to the institution and vice-versa. Mapped on to this relationship, however, is an official discourse which requires a certain aggregate time on placement for each student.   This discourse is not spatially-specific, and thus travel times and snowbound roads do not often figure within it.   Significantly, however, Peach (UKCC 1999: 33), notes that ‘difficulties with travelling to and from practice placements’ continue to be a significant cause of attrition for nursing students.   The evidence from this study is that these difficulties are not a result of individual circumstances but are symptomatic of an underlying spatial paradigm in which mobility is taken for granted and is experienced as desirable in its own right.   This paradigm has been brought into question by environmentalists (Wackernagel & Rees 1996), and Adams (1999) specifically addresses the question of the long-term sustainability of this trend.  In the case of the HC students and their institutional context, there are, at least in the short-term, few alternatives, given the shortage of placement opportunities in the immediate area of their campus, but future recruitment and retention policies may have to take more account of the difficulties highlighted here.

 

The Journey as space in its own right

Apart from extending the ‘grasp’ or reach of the body, one of the other reasons that car travel is so seductive is that it provides a high-quality personal space, free from interruptions (mobile phones excepted), with comfortable seats, controlled temperature and usually some form of audio entertainment (Urry 1999).    Responsibility for controlling the car is delegated largely to the cognitive unconscious (Lakoff & Johnson 1999), and the actions of driving rarely intrude on consciousness except in circumstances such as a driving test or a ‘breakdown’ situation (Dreyfus & Dreyfus 1986; 1999: Eraut 2001).  Time spent travelling in cars is perceived  as unavoidable and can only be colonised by work in certain ways, such as having a conversation but not by typing or reading.   For drivers, and to some extent passengers, possession of the space of the car, and of the space opened up by the car, is therefore at a high level.

 

Because of the distances, and therefore the time, involved in road journeys in the Highlands, this was an important time-space in its own right for those participants required to travel.   In this case, time and space were connected – one was not so useful without the other, as in the case of bus journeys:

…even near [placements] can be an hour or two's trip away, so sometimes you take your articles and read them on the bus, at the beginning stages of formulating your essay

( Q: So the journey is that sometimes useful study time?)

Sometimes, taking the train would be of more benefit, because when you're in the early stages of writing your article or essay you could use the train as a table and it would be stable enough to do that, whereas on the bus there is just no space to do anything like that...  (Naomi, 6/7)

Naomi  had previously described a certain way of spreading out her materials for essays at home, and would clearly like to be able to do things similarly on the train.   As with colonisation of the home, colonisation of the journey by academic work appears to be an efficient use of  ‘wasted’ time.   The spatial problems which prevent this efficient use are related to the terrain and to transport policy in the first instance (winding roads, few train services), and to lack of study time overall, a problem made worse by the need for long journeys.  The tutor from HC described the competing pressures for this time/space:

[My enjoyment of the journey]...depends how I'm doing it, if I'm driving alone, not always, it can be alright, some good thinking time, the students get very wise to this and say ‘If you're coming this week it must be Thursday and it turns out when I get there...  they want a lift back, that's fine, it gives me an extra couple of hours with them sometimes, which is very worthwhile...long journeys alone, I do sometimes take tapes and use that time, it's not always possible, I'm not sure that it's a good idea to have your attention divided, particularly if it's dark...  (Anita 31/32)

The students also found that journeys, even relatively short ones (c.20-30 min.) were useful opportunities for discussion:

If possible I do give people lifts, for the company, it saves them messing around with buses...(Helen 29)

I take someone else in, and it's quite useful to talk to another student in the car, because we can reflect on what happened the day before, and what's going to happen today...(N25)

The difference between the social setting of the shared journey and the social spaces of the campus lies in the one-to-one interaction which becomes possible in the confines of the car.    There are negative associations to consider as well, as one of the participants (a nurse-mentor) in May et al.’s research pointed out:

I find I’m talking as I’m driving all day which is physically and mentally shattering as well as dangerous.   I also find that there is no time, when you have a student, to change into another gear and wind down for a few moments... 

(May et al.  1997: 320)

The use of the ‘change...gear’ metaphor is significant in linking the physical activity of driving to the social activity of dealing with students.  The giving of undivided attention is potentially vital both in driving and to the maintenance of a student-centred approach to mentoring – albeit that these require different ‘gears’ from the person performing these actions.

 


Summary

In this chapter I argue that nursing students form a unique group within the communities of higher education in which they find themselves under Project 2000.  One of the most prevalent metaphorical conceptualisation of these activities was that of the journey, and that the physical-spatial activity which students undertook in the course of performing the activities reinforced this metaphorical conception.   Analysis of  metaphors used by the students  related them to proximity, mobility and possession, the three elements of the PMP  framework.  The proximity of nurse students to the institution and to each other is significant in terms of mutual support and identification as a group.  Conversely, the distance between the two locations in the study had interesting effects on both sets of students, who each tended to see the other site as more desirable or interesting than their own.  There was a perceived asymmetrical relationship of power between the two sites which caused some resentment at times.  Finally, physical journeys were seen to have effects on the process of becoming a nurse, which were not always recognised by the institution.  In the next chapter, I continue to focus on the interview material in the context of some specific ‘contested spaces’ within the world of the nursing students.

 


 

 

Chapter 7-Contested spaces

 

 


Of course it’s rather gruesome eating in a strange kitchen.  There’s no-one about whom you know.  In your own kitchen it’s quite different.  You have your own seat which you occupy all the time...

What was the capacity of an average kitchen?  He had once seen the figure.  Two thousand two hundred, he thought.  This one was larger than average...

(Isaac Asimov, The Caves of Steel )

 

Introduction

I n this chapter, I refer to ‘contested spaces’, because it is the contestation or ‘friction’ around spaces which renders them visible and brings them into discourse.   The spaces are the home, the library (including computer laboratories) and the lecture theatre.   I will discuss these both generically and with reference to specific examples, since my argument will be that spatial interactions around these concepts are both contingent and subject to institutional constraints and strategies, More fundamentally, the roles played by specific types of spaces are less important to the studying and learning activities of the students than the spatial whole formed by their conjunction, and the PMP framework will again prove useful in demonstrating this.

 

Home is where the photocopies are?

In the discussion of the PMP  framework, I used the concept of ‘home’  in a representation of the basic proximity-mobility-possession structure, which, in its simplest form, is analogous to  home - going home – at home.  ‘Home’ is a good example of a contested spatial concept (Edwards & Usher 2000: 34-35; Bordo et al. 1998) and  I use it cautiously here.   Within earlier writing on spatiality, the notion of ‘home’ is a central theme in Bachelard’s The Poetics of Space , (Bachelard 1969; Best 1995:182).   Bachelard explores the poetic linkage between space(s) and thought, which are also Heidegger’s fundamental concerns in Building Dwelling Thinking (Heidegger 1993a).   With both writers there are strong links between the housed body and the self (Malpas 1999: 176).    For Irigaray, it is the unspoken desire, within this male-dominated discourse, to return to a  ‘maternal’ origin which she problematises (Irigaray 1993; Brennan 1993, ch.1 & p.88 ff.; Rose 1993:108), and concepts of ‘mothering’ were certainly present in the interview data.  Nevertheless, the ideas of ‘home’ or ‘dwelling’ carry multiple connotations, some of which are conflictual (Stone 1996), and their meanings cannot be reduced to singular or binary essences.

 

Feminist critics such as Rose (1993) have problematised ‘home’ as, for example, the site of domestic violence, or in the context of technology, as constructed around a gendered notion of ‘family’ (Wajcman 1991: 110).   Recent trends in tele-working, and the continued exploitation of ‘home-workers’ in the garment and other trades, have brought the boundaries between ‘home’ and ‘work’ into question (Wajcman 1991; Castells 1996; Edwards & Usher 2000), and for students, the boundary between home as home, and home as study-space, continues to be problematic, especially in on-line & distance learning (Twining 2001).   In this chapter, I examine some of the empirical material relating to concepts of ‘home’ and its boundaries, and discuss what these data might  tell us about the spatiality of ‘home’ for nursing students.

 

The basic requirement for studying at home is ‘personal space’, which involves both control over spaces within the home and of the times when it might be available.   The initial questions in the interview schedule were in fact about this control of domestic space.   Private, undisturbed personal space was seen as a highly desirable commodity:

I live in a flat with one other person, and we have a Landlady who comes and goes, so it's very quiet which I like, the other person, she's just finishing a one-year course ...or something like that, but she's only in for about three months and then she's off so I have really long periods of time on my own which is great.  I have been lucky in that way, in that it has been so quiet.  (Karen, 7)

The student in the above extract was single and therefore had to make minimal  compromises to create a suitable space for studying.   What the extract emphasises is the importance of patterns in the spatio-temporal activity of (other) actors for the maintenance of personal space and quality  study time.    As with much of the material here, this hints at an underlying spatial paradigm which constructs studying as a solitary activity.  Other students had to use other means to achieve the same ends:

I usually study quite early in the morning before anybody gets up, so  that I can spend some time with my family, my husband’s at home quite a lot during the day, and then I have a room that I study in quite a lot.  I don't tend to study much at University, because it's too far away for a start and I travel with other people, for me it's not really conducive to studying, there's too many people coming and going, you get too easily distracted by chatting to people (Susan, 1/2)

The spatial paradigm which begins to emerge here is constructed around a number of problematic points.   Firstly, the space(s) of the University were not seen as conducive to studying.   This was particularly marked in the smaller buildings of HC, where the library had little in the way of quiet space.   At SC there were carrels in the library, and various other rooms which could be used for study, but the participants did not use them regularly.  None of the participants stated that they did all their studying at the University (HC or SC), and all the participants claimed to do most of it at home.   The advantages of studying at home are often balanced by the need to create spaces and times for that purpose, and these are often in short supply.  

 

This leads into the second point.   Studying and family (or other group) activities are seen to be  incompatible, because of the perceived need for spatio-temporal isolation, but there is an unspoken institutional assumption that this colonisation of the domestic by the academic is acceptable, and forms part of being a student.   Howard (2001: 35) reports that domestic tensions and relationship difficulties are exacerbated by the high academic workload imposed on students under Project 2000, and Lauder & Cuthbertson (1998)  comment on the financial problems which contribute to these tensions and difficulties.  As the above extract demonstrates, there was considerable pressure on students with families to ‘make room’ (spatially and temporally) for study at home.   Possession of domestic space was thus contested between student, family (if any) and institution.  This does not necessarily mean that students disliked studying at home, but it does reflect an assumption that the colonisation of domestic time and space for this purpose is acceptable.

 

The third point relates to the emergence of ad hoc arrangements for addressing these problems.  In the above extract, the participant’s home was about 80 km from the university, too distant for frequent visits.   Travelling with others, however, (in a car-sharing arrangement), provided a useful discussion opportunity which compensated for the lack of social time and space on-campus and at home:

Q: How about the journey itself? Is that useful in terms of talking to people about the work?

Definitely.  There's things been discussed in that car...  when we've been going into our exam, we came out and said ‘if you hadn't said that I wouldn't have known that in the exam’.  That means every time we've had an exam we have been talking for an hour before we got there...  (Susan, 12)

The colonisation of domestic space and the lack of on-campus study space are both symptomatic of a spatial paradigm based on the metaphor of the journey, where these and other study-related problems are seen as  ‘obstacles to be overcome’.   In the example above, the physical journey is itself a way of overcoming an obstacle, which in itself reinforces the dominance of the paradigm.  This use of the journey as a study-space is predicated, obviously, on the privacy and co-presence provided by the ‘private car’ a phrase which sums up the special role of the car as a moving space.   The key factor in its usefulness is the parallel movement of the metaphorical and physical journey, and the structural commonalities of both.   As Strathern (2000) observes, understanding, like travelling, does not proceed at an even and predictable pace, but moves forward in fits and starts.   The understanding process of learners does not map easily on to the modular timetable, just as flows of traffic are chaotic and can be halted by relatively minor incidents.  In this case, understanding is facilitated, albeit indirectly, by a specific type of journey.

 

From several of the extracts, there is a sense that that the availability of personal space is in a constant state of flux, over longer or shorter cycles.   Sometimes these cycles are seasonal:

What I do is, it's quite interesting, in the winter it's too cold to study upstairs, so in the winter I study in the kitchen, and carry everything I need in a blue carrier box, and in the summer I study upstairs where I have my own space …It's better, but I couldn't work up there in the winter because I would freeze to death (laughs) so it's quite nice when spring comes, to change venue, to move study space (Doreen,   4/5)

The materiality of buildings and the negotiations around the division of domestic space are a familiar theme in studies of adult learners (Morgan-Klein 2003)    There are clearly questions about gender here, but for this study, the important issue was about individuals having power over space, as an aspect of possession.  The power to have undisturbed spatial arrangements was highly valued, and  several students referred to the importance of their papers, books etc.  not being moved around in their absence: 

I stay by myself, so I've got no interruptions at home, I'm single with no children so things can be left!  (Lynne, 8/9)

This is both a power/control issue and a spatial issue.    In terms of students’ information sources for assignments, information was often spatially arranged on the bed or the floor and it was this (analogue) spatial arrangement which was remembered, rather than the information being (digitally) ‘listed’ as text, e.g. in a plan or outline (Bateson 1973: 252). The essay is not just about information, but about acquiring a particular academic ‘voice’ (Read et al. 2001).  In the nurse student situation, there is however an emphasis on factual content which predominates over finding one’s voice, and the students reported that the scientific idiom demanded of them was particularly impersonal.

 

Another example of the importance of spatial arrangements in marshalling information is given in this extract, in which a student discusses the library:

What really annoys me, when you are looking for journal articles, students put them anywhere at all, they don't put them back in the correct order in the correct box and you can go searching through stuff that is in the library but you've got to go raking for it, so it's in the wrong year somewhere, and I think that's inconsiderate, I really do. (Terry, 6)

There was an emerging relationship between the physical distribution of documents and the conceptual distribution of ideas within an essay, as one participant described:

…I've got a table, it can be a small diameter table or a long table, it doesn't matter, as long as I can see my papers, I put my papers in particular piles, and just looking at them will trigger off what I want to say, so as I go from each section, I tend to use that as a triggering response and then I take that article as I’m going to refer to it, jot it down as the reference.  It's a continuous cycle kind of thing…

(Q: ... so that the layout of the stuff on the table is important for you?)

Yes, very important for me, it's like a triggering response. (Naomi, 1)

Possession, as the absence of spatial interference from others, and proximity are linked here by the embodied concepts of the mind as container for ideas (Lakoff & Johnson 1999: 240), and the study space as container for documents, both of which need to be ordered in a certain way for effective functioning.   For the student, the home is thus part of the spatial whole which enables learning activity.  It is not merely a shelter or store-room, but is a part of the thought process itself.

 

In the next extract, the function of the home as part of such a ‘spatial whole’ was problematic because the student was concerned about the spatial autonomy  of other family members:

That's why I prefer to work at the University instead of studying at home, that's why [the library] closing at 7 o'clock hinders me, because I try to work at home but my son is playing his CD,  I'm trying to get on, the phone’s going, I need peace and quiet to concentrate, it has to be quiet…

( Q: Would you use the labs for studying if they were more comfortable and there was room to spread out...?)

I think I would, sort of like a plush area, where you could spread out books and things ...  that would be a good idea, because with the with the library shutting at 7, I find it hard to go home and study, I can't tell my son to stop playing, he needs his time.  (Terry, 20/22)

This extract illustrates the conflictual demands of ‘home’, as a space for family interaction and as a space for studying.   It also emphasises how the relationship of one (domestic) space to another (institutional) space is a product of activities and interactions which are beyond the immediate concern of both.   Thus, the student’s son (above) was present at home in the evenings because of his conventional working hours, whilst the opening hours of the library were determined in part by the demands and work/play patterns of the ‘traditional students’ (and its staff) who could more easily socialise in the evenings and thus tended to vacate the library by 7 p.m.

 

The above participant’s mobility, in being able to drive to the library, was also a contributory factor in the possession relationship.   Urry (2001b; 2002) suggests that the concept of home, or at least the distinction between ‘home and away’ is problematised by increased mobility.   In Urry’s words, the distinction ‘loses its organisational and ideological power’ (2001b:4) .    The PMP framework, however, suggests that increased mobility brings with it  changes in proximity and possession.  i.e.   increased mobility brings more things within one’s range of concerns and causes greater importance to be attached to the possession of particular spaces.    Being frequently away from home, or even frequently moving home, are symptomatic of hypermobility (Adams 1999) and actually serve to reinforce the importance of home as part of the home/away binary.   As Cairncross (2001: 5) observes, the advent of new forms of ICT may enable people (at least, those with sufficient financial and social capital) to have homes where they want to, not where their employment compels them to live.   Urry is right to observe that ‘cultures imply and necessitate diverse and extensive forms of mobility’ (Urry 2001B: 238) but the aspects of mobility which arise from the data in previous chapters indicate that mobility is, in this context at least, as much to do with maintaining a stable home (life) as with problematising it.   The culture of extensive commuting is the reverse of the nomadic lifestyle.   In the examples given in the discussion of the journey, the three students involved were covering considerable distances because they wished to keep their homes in place, not because they wanted to enter the world of the ‘digital nomad’ (Urry 2000: n.p.)

 

The idea of ‘returning home’ thus appears to be a significant aspect of mobility for the participants, and the following extract gives a sense of the continual displacements to which HC students were subjected:

Yes, I'm up at Wick at the moment, I was supposed to be in Inverness the last time, but I ended up in Tain instead, it's about an hour on the same road north, I've been to Drumnadrochit, Tain, Wick twice and Inverness the other times, I have been away quite a lot and I find that quite hard, I find it quite hard to study away from home. (Joanne, 7)

‘Home’ thus acquired importance as a study-space because it could be separated from other, less controllable spaces, as in these extracts:

If I tried to deal with [administrative work] at home I would never get any writing done.  I have to demarcate different spaces for writing and for dealing with other things.  (Peter, 7)

...I probably do more at home than anywhere else...I’m in the fairly fortunate position at (HC) of not sharing an office with anyone, so I have a room there with a lock on the door, that’s helpful, but I tend to use that a bit less than you might  expect because it’s not free from interruptions - people coming to the door, telephone...so I’d use that rather less...home is preferable, but there are problems with that too. (Anita, 1/2)

‘Home’ thus  fulfils a vital role in the spatial processes of learning for the students.  Boltanski & Thévenot (1999) point to the importance of stable objects in helping actors to deal with uncertainty, and it is this relationship which emerges from the interviews.   The learning process is a balance between order and chaos (Weick & Westley 1996), and conflicts played out at home  disturb this balance.   The institutional role should be to restore the right balance, and the next section looks at a space which contributes to this role, that of the library.

The heterotopic  library

The library continues to be a significant space for nursing students, as it is for students in general.   Although the impact of ICT shows up in the data as involving the colonisation of domestic space and a feeling of being drawn into a ‘wired world’, the library remains the main information source.    The gradual re-allocation of resources from traditional paper-based knowledge-stores to electronic databases, however, puts the students into a transitional mode, in which they are neither fully home-based and independent of the institution, nor fully dependent on being present in the institution to  gather material.    Previous work on adult learners in higher education (Schuller et al.  1999) suggests that this is not purely an ICT issue, but relates to more general spatial and temporal constraints, e.g.  library opening hours and availability of photocopiers.   One student was particularly concerned with these matters:

I do most of [my studying] in the [SC] library, in the carrels upstairs…

( Q: And does that give you any particular problems?)

Opening times, because when the main body of the students are away home, times are cut back in the library, 9-7 and 5 o'clock on a Friday and only in the mornings on weekends, so we’re disadvantaged that way especially if we’re on placements. (Terry, 1)

Not all students found the hours problematic, which itself creates a dilemma, since the library has to balance its own budgetary and staffing requirements with these diverse needs. 

 

As a space with diverse functions and clientele, the library is thus in some senses ‘heterotopic’ (Foucault 1986, see also Gregory 1994; Soja 1996).   In Relph’s words:

Heterotopia is...pluralistic, chaotic, designed in detail yet lacking universal foundations or principles, continually changing, linked by centerless flows of information; it is artificial, and marked by deep social inequalities. (Relph 1991, cited in Gregory 1994: 151)

The main purpose of describing a space as ‘heterotopic’ is to reveal some of the complexities which pervade any such space.   The library conforms to all of the above criteria.  It has a wide range of purposes and functions which, at this institution, are subsumed under the general heading of ‘Information Services’.   Its purposes are defined both by policymakers and by its users, who are diverse and ‘generally chaotic’ in that their actions are not temporally co-ordinated, either with each other or with the institution (i.e. they do not always work 9-5, Monday-Friday, or exclusively on-line).   The following extract offers an alternative interpretation of the library’s availability:

( Q: What do you think about the library as a place to work? )

Generally it's OK, I tend to come through at the weekend, especially in term time, a Sunday is really quite good because it's quiet, and so you can get on with things, you can get access to computers, and the photocopiers, articles, during the week especially, in term-time everybody is in looking for the same information, so I tend to come through at weekends when it’s quieter. (Lynne, 2)

This extract highlights the inequalities of access which have long been the subject of complaints from part-time and other non-traditional students (Schuller et al.1999; Gray 2000).   At one level this is a resource issue, but at the level of spatiality, the library is not yet fully understood as a space with its own complex interactions within the larger space of the university.

 

The chaotic patterns of activity in the library are well summed up in this extract:

…there’s a tendency not to use the library [for studying] because there's lots of to-ing and fro-ing, and there's a tendency if they're all doing an essay, for them all to be in there, it's more like a social event, so you will say ‘how’re you getting on’ and anything interesting rather than sit down and study…I do tend to come across here to print out stuff, but not a huge amount of study, usually it's in my own flat in the halls or on placement…

(Q: The fact that you tend to bump into people in  the library, and socialise with them, is that useful in itself apart from the fact that it distracts from your studying?)

Sometimes, sometimes not, if you’re at the same stage when everybody is trying to find information, it's useful, you can ask ‘what have you found?’ But when you're at the stage where you just want to read, you just want to study, and somebody comes up to you, it can be quite distracting and not always very useful.  Depends what stage you're at, if you're at the information gathering stage it's quite handy because everybody else is at the same stage. (Wanda, 1/2/3)

The issue of noise and distraction in the library was thus raised in contradictory ways:

...I can't think in the library, there's too many distractions...noise, telephones, people, other students coming in, people talk, it's very distracting...(Doreen, 2/3) 

 

- if there's anybody I know in there [the library] we tend to talk instead of studying, what's happening on the ward or about the essay or whatever...(Wanda, 1)

One conclusion might be that there is a need for separate social spaces in which students can simply chat and engage in informal learning, or alternatively that the conception of the library as a quiet space for study is wrong and that it should function as a social space.   The library in question (HC) might be considered as too small, and an ideal library might combine quiet spaces with social areas. 

 

Whatever the function of the library as social space, it has an organising function in relation to information, and another example of the importance of spatial stability in marshalling information is given in the next extract in which a student discusses problems encountered in the library:

What really annoys me, when you are looking for journal articles, students put them anywhere at all, they don't put them back in the correct order in the correct box and you can go searching through stuff that is in the library but you've got to go raking for it, so it's in the wrong year somewhere, and I think that's inconsiderate, I really do… (Terry, 6)

This participant also had a part-time job, so that his time on-campus was severely limited, and the extract points to the extent to which possession, whether of home-spaces or institutional spaces,  is related to stability, or being able to find things in the same place on repeated visits.   Regular users of the library learn its geography through embodied movement and this pre-conscious embodied learning supports their conscious deployment of information.   This requires time, and as the following passage reminds us, there are alternatives to the University library which open up other times and spaces to studying:

The public library here is fantastic, they are open until eight any evening, and four on a Saturday…it's really great now, they are open till about eight at night, they've got this scheme whereby if you're any sort of a student you can get on to the Internet free, so that they all sort of know me because I've been going there for two years…I do use the university sometimes, possibly if I was travelling myself I would use it more but I travel  as a group,, it doesn't work, it's just not suitable.  We do sometimes stay for an afternoon...But I can't really relax even then, you're trying to deal with three other people at the same time, so I can't really take time to deal with the things that I'm trying to think about, whereas at the public library, I can take time to think about what I'm doing.  (Susan, 6)

 

Again, this indicates that proximity (knowing that there is a public library), mobility (being able to reach it) and possession (being able to use it without distraction) are fundamental to the analysis of competing spatial requirements. 

 

Comparing the two campuses, the library facilities at HC were often perceived as inferior to those at SC:

From what we can gather, their library down there [SC] is a lot better than our library, because every book we look for is ‘[SC] only’...our library is quite bad, a lot of the stuff is old, they tell us not to use books more than five years old, and most of our books are 1989, 1991, when there's ninety of you all looking for the same books and someone keeps them... (Christine, 45)

This was also an issue in relation to essay-writing, but the issue here is the comparison between HC and SC in which the marginal status of HC, in the perceptions of its students, is reinforced by the proximity of a remote ‘parent’ institution.   This gave rise to discontent that their sense of possession of the university as a whole was being diluted, and that only some of the potential benefits of sharing facilities were being realised.   A similar frustration with books being held at HC was, however, expressed by SC students, reinforcing the idea that it was the proximity relation, as much as the actual availability of books, which was the source of the problem.

 

Similarly, the flow of information into HC, both electronically or in the form of requested books, journals and other paper sources, was seen as being rather slow.   Book requests, for example, generally took about a fortnight.   This contrasts with the relatively good accessibility of Inverness from Central Scotland, with average journey times by train or car being about 3-4 hrs.   There was, therefore, a discrepancy between possible and actual speeds of document delivery, again reinforcing notions of peripherality

 

Computer labs: programmed to self-instruct?

The University computer laboratories are ‘heterotopic’ in similar ways to the library, and are related to it within the Department of ‘Information Services’.   Its population is also fluid, reflecting cycles of assessment, e-mail correspondences, job-hunts and a variety of other connections.   Within Relph’s definition (in Gregory 1994: 151), it is clearly artificial, and even its designation as a laboratory codes it in terms of positivist science.   It has elements of post-office, library, games arcade and sometimes even dormitory.   Furthermore, it embodies the dichotomy between individualism and collectivity within ICT identified by McKie (1996).   McKie argues that ICT, both in advertising and in a wider theoretical discourse, is paradoxically depicted as potentially enabling entrepreneurialism and creativity for the individual whilst at the same time promoting a collective, democratic spirit freed from the constraints of time /space.   These two potentialities are not necessarily incompatible, of course, and the computer lab is an example of where individuality and collectivity come together, perhaps accidentally, in the form of casual peer support.   But the need for such support reflects inequalities in computer literacy, computer access and spatial provision found throughout the university system.   These inequalities surface in the following extract, where the student complained that, although she used a computer at home, when she attempted to use University computers:

...I found it totally unsatisfactory, because there was again too much noise, distraction and less of a quiet space to think things out if you made errors - too many people trying to correct things, which just adds to the stress of it all - I'm not computer-literate...I feel more safe using one at home than in the computer labs across here...I'm still a bit frightened of computers (Doreen, 7)

‘Peer support’ thus shades into harassment, an example of the ways in which spaces are ‘striated’ (Deleuze & Guattari 1980) by the complex power-relations which over-write them.   This was not merely a question of personal security but more a feeling of unease at being seen to be uncomfortable with unfamiliar, quirky computers in an environment where others were perceived as highly competent, a sentiment which was echoed in the following extract.

this is the first time I've ever used a computer, for any length of time and I feel more safe using one at home as opposed to in the computer labs across here before I got it, so that's basically what I use it for, just writing my essays… (Lynne, 8/9)

There were also comments about the slowness of data transfers or searches from the HC computers.  Hyperbolic claims that space has been conquered or abolished,  and that we live  in an age of simultaneity (Plumb 1999),  perhaps cause these delays to be particularly irksome to the students, in the same way as the slow delivery of book requests discussed above gives rise to frustration: so near, yet so far.

 

The libraries and their related computer laboratories form a complex spatial assemblage which extends across both sites.   The frustrations and problems experienced by students at these sites are probably little different in principle to those experienced elsewhere, and if one was in search of ‘best practice’, it would be useful to undertake comparative studies across other sites.   My original intuition, however, had been that space involved an affective dimension which could not be captured by observation.  In a library, one could be irritated or elated, puzzled or confident, distracted or focused without any obvious, outward sign.   Knowing what a sample of students felt whilst in the library would not reveal all possible modes of being-in-the-library, but  two possible ways of improving the library and computer laboratory system were connected to the proximity and mobility of information and the achievement of possession.   The former represents the achievement of order, stability and transparency, whilst the latter represents the creation of opportunities for chance meetings, conversations and informal learning.

 

Lectures and seminars: sitting in the same seat?

The stereotypical spatial situation within the University is that of the lecture hall or lecture theatre, and the related situation of the seminar room.   Although the ‘didactic’ lecture might be seen as incompatible with adult-learning principles (Badger et al.  2001), the combination of large student cohorts, limited staff numbers and shortages of suitable rooms meant that lectures were a regular feature of the student experience for the students in the study (see May et al. 1997, appendix E4 for a related case study).   At HC, the specific rooms which were used gave rise to  a number of problems:

...  A lot of the evaluations have said that the rooms are not really designed for the size of group, we’re usually either in the Rec[reation] hall or in the lecture theatre, and the acoustics are very bad, the seating is very bad, voices don't carry it all in the lecture theatre, and if the teacher does not have a loud voice, you can't hear a thing, you have to sit in the front row so there have been complaints about that and the Rec.  hall is even worse because it's like a club room...  But it's purely the size of our class, because there’s 90 people in our class, we could do with one of those amphitheatre sort of lecture theatres (Christine, 40)

One way of approaching these problems is through  a phenomenon which can be observed in most educational settings, the tendency of people to sit in the same seats on successive occasions.   As a student, I have done this regularly.   Students appear to be (and, in my case, were) more comfortable, both physically and emotionally, in certain seats than in others.   This would appear to be a topic for observational methods and/or quantitative analysis [11] but, as with essay-writing, the topic emerged from the data rather than being part of the research design, and thus was not a specific focus of the study.   This illustrates the importance of spatiality as a way of re-examining common pedagogical issues.  The question here is whether there is an underlying phenomenon.  The extracts cited below provide some evidence that there is.

 

This student gives practical reasons for sitting in the same seat on successive occasions:

Yes, I'm one of those people who habitually sit in the same place... 

 

(Q: Do you feel more comfortable doing that?)

 

Yes, I wear glasses, and when there's a lot of background noise, I can't hear that well, my hearing is normal, but you don't always pick it up, and there is one lecturer who is very, very soft, and everyone is aware of the problem, although it's very frustrating, they are aware of it, but there is not much that you can do except being frustrated and understanding at the time.  (Naomi, 18/19)

There is a comparison to be made here between the problem of missing library books, and the problem of soft-voiced lecturers mentioned in the above extract.   In both cases desired information is within the range of concerns of the participant concerned (proximity relationship), but a mobility problem (an unreachable book, a voice which does not carry over distance) intervenes, with the result that the participant experiences loss of possession of the space in question.   There are technological solutions (e.g. sound reinforcement systems) to this particular problem, but spatial analysis of the situation leads to a more fundamental appreciation of the problem.  The next extract also highlights the relationship between spatial and pedagogical issues:

There are small rooms, but they can't always get the class booked up, if you think about it, there's 90 of us, if you go into to groups of 10 they haven't always got the teachers, we understand it's difficult for them but it's not really conducive to good lectures, great if you’ve got a teacher with a good voice and if you’re interested, but you notice if it's quiet and it's not a very interesting lecture, people in the back are going ‘chat chat’ and it’s even worse...   (Christine, 41)

Here, attention is drawn to the institutional compromises which necessitate the spatial

co-presence of large numbers of students, and the student stratification which is produced by something as subtle as a variation in the speaking ability of the lecturer.   This was confirmed by the next extract, which suggested that sitting in the same seat was:

A social thing, definitely a social thing, although for me, I prefer sitting at the front so that I can see what's going on, I find at the back that some speakers are quite quiet spoken, and you can't hear them at the back, there were a few lectures in first year where I was running late, a bit later than usual, and I ended up sitting at the back, I couldn't hear hardly anything they were saying, people at that time were incredibly rude and speaking in front of you, and I felt like saying ‘I just can't hear what's going  on’. (Doreen, 38)

This illustrates that possession can be highly differentiated across a relatively small space, but is not simply a question of social interactions or power-relationships.  Both of these are self-evidently part of what is happening here, but spatial factors such as the room acoustics and the availability of seats in particular areas of the room are another part, and it is the interplay between all of these, and individual circumstances, such as the temporal problem of ‘running late’, which construct the overall sense of possession for the participant.   ‘Running late’ is a good example of a contributory circumstance because it emphasises the temporal aspect of possession.   Lefebvre (1991; 2004) draws attention to the ways in which the rhythms of everyday life condition responses to spaces.   In this case, the rhythm of arriving early in order to get a specific seat is interrupted, leading to a reduction in the student’s sense of possession. 

 

Another element of possession which also relates to student identity) is the taking of notes (Badger et al.  2001) and this example come from SC:

the lecture theatres were OK except for the MacRobert which we had to use two or three times, I felt sorry for the external lecturers walking in because they walked out onto a stage basically, and 180 people were spread out in this massive arena, it was just a waste of time, there was nowhere to take notes…trying to write, it was just a waste of time.  (Terry, 34)

Note –taking is an important activity, not only for its recording function, but because it helps to reinforce the relationship of proximity between student and institutional space by helping to bring the content of the lecture into the range of one’s concerns (Badger et al. 2001).  Note-taking also a contributes to possession, as a dialogical relationship between lecturer and students. Bakhtin’s concepts of polyvocality and positionality might be useful ways of relating acts of speech or writing to spatiality (Holloway & Kneale 2000).   Note-taking disrupts the notion that the lecture is a purely didactic process in which information flows unidirectionally, because the notes will resurface in essays, examination responses or in seminar discussion.   The participant’s frustration at not being able to take notes due to spatial constraints repositions him within the the narrative of the lecture, where his notes would normally be part of an ongoing dialogue.   The space effectively silences him, and although the proximity relationship holds (everyone is within the relevant range of concerns), there is a mobility problem in terms of the lecturers’ (in)ability to act over distance and the related (in)ability of the students to respond over distance.  

 

The following statement reflects the way in which the neutrality of spaces is challenged by bringing them into discourse via the research interview:

If we get lectures in the lecture theatre, that's fine, that's a good room, but sometimes we have to go to other rooms which aren't so suitable, but I haven't really considered the building in terms of problems... (Andy, 23)

Even here, the attribution of quality to rooms (‘good’ or ‘aren’t so suitable’) implies that, even in the absence of specific consideration, spaces are still seen as making a contribution to the overall success or otherwise of the learning process.   The next extract paints a similar picture:

I would view it [HC] as kind of minimally functional, that’s about all it is...it's a little bit claustrophobic when all 102 students are about, but it's minimally functional, it doesn't feel like a prison, it's actually quite nice and light and reasonably spacious, it doesn't feel.  ..  the lecture theatre feels a little claustrophobic because there are too many bodies in it, the rest of it is OK. (Doreen, 29)

The physical characteristics of the space could also constrain the ways in which students positioned themselves:

We used to sit along the walkway between the two halves [of the lecture room], you get a bit more legroom that way, some of the other people in the group were tall, and we like the legroom...  It's close enough to hear what the lecturer was saying and also see the screens as well. (Terry, 38)

The use of the first-person plural here indicates the strong group cohesion which was as much a part of the same-seat phenomenon as individual preference.   Furthermore, as a group with some social science knowledge, the students were well aware that they were developing habitual patterns of seating behaviour:

Yes we all do, yes we do, we jokingly say that we're institutionalised, we sometimes just ...for the fun of it,  just change seats, it's usually if, sometimes certain people are travelling and they opt not to come to some of the lectures, so you would move seats if they weren't there sometimes, but we do have a tendency to sit in the same seats most of the time. (Lynne, 37)

This self-deprecation reflected the sense of guilt felt by some of the participants in the pursuit of the desired seating arrangements, and the next extract shows one participant attempting to overcome this:

I just feel as a person that I've made it part of my thing to try to go across to speak to other people because I'm trying to train myself to be with people who don't particularly want to be with me, because they've got their own group .  The thing is, it is all divided up into groups now, And if you don't try to make an effort go over to other people you don't learn anything from other people, that's one aspect of it, and they don't get to know you as a person so prejudices can build up.  I don't like it when groups get into cosy wee niches , and  nobody challenges...  it can be a bit stressful…They might feel I've got some kind of ulterior motive, but I do think that if you communicate with other people you learn more from them. (Joanne, 21, emphasis added)

This extract highlights one of the problems which can arise with small groups, whether socially-contingent or tutor-instigated.   The ‘cosy wee niches’ have two opposing functions for the students.   They provide mutual support for their members, and they discourage non-members who make communicative demands, as above.   The ‘niche’ is a spatial metaphor which suggests hiding and shelter.   The group is in possession of its niche and resists attempts to invade it:

 

I like to go down the front because I can hear better, you're not asked so many questions...we tend to [go to the same seats each time] but not because it's our space, it's just that you get down the front as quick as you can, but we don't mind which side at the front, so long as it's the front.  ..there have been nasty looks at people who have got down the front before us, not nasty but, you know...’oh no I won't be able to hear anything’.  (Lynne,  43)

 

This quotation highlights that possession is negotiated.   The disclaimer (‘not because it’s our space’) indicates that there are explicit spatial issues for the students.   The first-person plural indicates that group cohesion is reinforced by the necessity, under a logic of possession, to be at the front in order to hear properly.   The acoustic qualities of the room and the variable presentation skills of lecturers contribute to a feeling of   being-at-home in the front, where problems are minimised.   Furthermore, the above statement points to spatially-differentiated perceptions of tutors’ attitudes:

It is the way it happens for a lot of the lectures, there are a lot of mature students at the front, and there are some of the younger students in the middle, but there is always the same group at the back, which has been noted (laughs).  There are always comments about it, ‘there are seats down the front, you know!’ They think that if you go down the front you are going to be asked questions, but you're not actually, if you go down the front you are not asked as many questions as if you go down the back, but I like to go at the front because I can hear better  (Lynne, 42)

This points to there being a differentiated sense of possession between sub-groups within the same course cohort.   The ‘same group at the back’ territorialises their ‘patch’ in opposition to the mature students at the front.   This is not an overt conflict, but an inevitable effect of the interaction of proximity, mobility and possession as it plays out over a specific space.   Students feel more or less engaged with the activity of the lecture , more or less able to communicate with the tutor, and more or less comfortable with their own situation within the space.   

Their spatiality cannot, therefore,  be addressed under a single heading, but must be considered along the three dimensions of proximity (one’s range of concerns) mobility  (action over distance) and  possession  (at-homeness}.   Even in a perfect auditorium, there would be a similar playing-out of the spatial dynamics of the group.  The embodiment of the participants renders the group interaction spatial.  

 

If concepts of ‘group dynamics’ are often weakened by the absence of spatial thinking, the meaning of a particular space, in this case a lecture theatre, is clearly constructed by social interactions and institutional rules, tacit or otherwise.    Its performance in that role, however,  is constrained by physical 'stuff', such as the acoustic properties of the walls and ceiling.   These are, in turn, the product of socially-determined knowledges, such as architecture and building technology (Markus 1993) and the physical properties of materials.    Institutions are financially constrained and are in most cases unable to optimise their physical spaces to suit diverse individual requirements, an increasing problem in terms of disabled access and mobility.   What emerges from the data is that important pedagogical issues, such as the responsiveness of students to questions during tutorial sessions, are affected by material parameters of spaces such as acoustics, sight-lines, the type of seating or the room temperature, or even the quality of the journey which the students make on the way to the session.   These parameters, whilst important in themselves, also illustrate the inter-relationship of proximity, mobility and possession.

 

An example of the difficulties involved in rationally planning spaces was the attempted provision of social space for the HC students by the University, which had set up a student common room equipped with a television, video recorder, stereo and vending machines.   According to the participants, it was rarely used, and the reason given for the room's unpopularity was that it 'lacked atmosphere', due partly to the small numbers of students free to use it at any given time, and in contrast to the hospital canteen in the main building.    Its emptiness was seen as giving rise to feelings of  insecurity, and as it was physically separate from the staff common room, it gave rise to few opportunities to mix informally with tutors, or hospital staff.   Atmospheres, however, can be cyclical, altering according to the ebb and flow of activity.    One participant, who was involved with evening classes, contradicted the above ‘reading’ of the room:

It can be quite relaxing , quite productive to go in there after about 6 p.m., when it's more relaxed...there are security staff around, it doesn't feel threatening in any way. (Anita, 17)

In contrast to the lecture room situation, in which practical elements like the acoustics played a major part in its usefulness, or otherwise, the less formal common room depended, almost by definition,  on its level of occupancy to establish an enjoyable atmosphere.   There are interesting comparisons with the library, which I discuss in Chapter 7.   The library has a ‘gathering’ function of its own, due to the necessity of borrowing books or copying journal articles, and is thus constructed as a social space by students, even although there are constraints and even penalties for doing so. 

Unlike the physics students described by Nespor (1994), the nursing students did not have spaces regularly given over to study groups, a feature of the ‘café society’ common to many US campuses:

At Berkeley because it is such a big campus, there tended to be large numbers of cafes very close to the campus, and we tended to have group discussions in there, although sometimes the acoustics weren't always helpful.  But the coffee was always excellent.   (Peter, 39)

The role of informal spaces in the formation of communities of practice has been noted by Wenger (1998), and such spaces were a feature almost entirely lacking at HC, and in short supply at SC, especially during term time.   The role of informal spaces parallels the role of social skills in enabling the sharing of tacit knowledge which would otherwise not be available to students.  Recent research in organisational learning has shown that conversation within firms is the medium for many significant exchanges of knowledge (Grant et al. 2001).  This can only happen if the spatial arrangements of the organisation make it possible to have conversations.   Recently , for example, Fiat has introduced simultaneous coffee breaks for its employees at one of its car plants, in order to facilitate conversation and work-team interaction, providing seating around coffee machines and stopping the production line at break times rather than running it  continuously.  This, according to management, has proved to be a useful innovation in terms of communication about production problems [12] .
Summary

The purpose of this section has been to trace some of the complex interactions between proximity, mobility and possession in three of the spatial settings experienced by nursing student.

It has shown how the embodied spatiality of the participants makes a difference to the way that they experience home, the library and the placement.   These are not neutral containers for activity but interact with the process of becoming a nurse in ways which are both subtle and complex.  What emerges is the part which each element of the PMP  framework plays in the students’ spatial relationships. 

 

The conclusion here is that the spaces of the university are, perhaps, necessarily heterotopic if they are to perform their function properly.  Achieving this heterotopic character is not solely a question of rational planning, because too much of what constitutes spatiality is contingent and individual.  This does not mean that spatiality can be neglected, however, because, as has been shown, that there are negative pedagogical consequences of ignoring the basic qualities of spaces, such as sightlines, acoustics, seating arrangements and ventilation.

The PMP framework is one possible way of analysing the student experience of spatiality in order to explore these consequences, and the next chapter looks at the consequences for the nursing students of another area of spatial experience, that of the placement.


Chapter 8-Placements


“…It is possible for a terrestrial to leave the City at any of numerous exits and strike out across country to Spacetown, where no barrier will stop him.”

(Isaac Asimov, The Caves of Steel )

 

Introduction

G iven the importance of the placement to nurse education, which I discussed in the literature review (May et al. 1997: 241-253; 263-265), it would be surprising if students had not raised a number of issues around it.    May et al. (1997: xii) define the placement as:

Community-based or clinical settings in which the student is placed for experiential learning purposes.

The intention of the placement is to integrate theory and practice, and to begin the important process of professional socialisation (Quinn 2000: 418).   As I will show, it is perceived by the students to fulfil these functions, sometimes at the cost of great personal effort.  The placement, considered spatially, is different from the lecture or essay-writing as a learning experience.  The placement is a world into which the student is ‘thrown’, (Heidegger 1962: 236) meaning that it is always already ‘up and running’ when the student arrives (and, of course, it continues to be so after her departure).  As a space, or set of spaces, its significance can be explored using the PMP  framework.   ‘Placement’ is a term which combines spatial and temporal meanings, and can be regarded as a time-space in which both meanings are present, if not always equally visible. 

 

The Placement and proximity

 

In the placement setting, the student is widening her ‘range of concerns’.   She is brought into a proximity relationship with previously unfamiliar objects and others.   This need not be the case in every placement, and May et al. (1997: 295) draw attention to the benefits of continuity where students have been able to return to a previous placement.  Students, thrown into these pre-existing situations, then ‘dwell’ in (and on) the placement, but the term ‘dwell’ has a special significance here, as I will explain, based on Heidegger’s use of the term (Heidegger: 1993a).  This significance is not merely an arcane philosophical digression, but can be linked to the nature of nursing itself, and is thus relevant to the experience of the students which I discuss here. 

 

Young (2000: 194) argues that there are two forms of dwelling in Heidegger.   First, there is an essential form of dwelling which ‘...is entirely independent of any feeling or experience’.  

In this sense dwelling is ‘ek-sistence’ itself, and ‘[t]his quality one possesses regardless of whether one feels at home or alienated in one’s world’.  There is also an ordinary sense of dwelling, which is the sense under discussion here, and in this sense ‘dwelling preserves...[i]n this way, that mortals nurse and nurture the things that grow and specially construct [i.e. ‘build’] things that do not grow’ (Heidegger 1993a: 353).  Building and dwelling are, then, as Heidegger tells us, intimately related.   Building grows out of the dwelling which makes it possible, but at the same time also shelters that dwelling (Heidegger 1993a: 361-362).  ‘Building’ here, as Heidegger makes clear, is not to be thought of as the mere erecting of houses, but, in its etymological roots, as related to the Greek tiktõ, to bring forth or produce’ (ibid).    Both types of things, those which grow and those which are constructed, are in this sense ‘grown’, or ‘brought forth’ by mortals.

 

I might characterise dwelling, then, as a way of being t/here ( Dasein ) out of which something grows and is sheltered by that which does not grow.   ‘Growth’ here is not the unlimited (and also metaphorical) growth beloved of economists but an organic, cyclical growth which is limited by the essence of that which grows.   A rose grows, but only within the limits of being a rose.  ‘Growth’ as I use it here is not the increasing magnitude of some thing or quantity.   Nursing students ‘grow’ as they gain experience on placements, but remain within the limits of nursing.    By ‘limits’  here, I mean conceptual limits, not limits of performance or quality.   A nursing student would not suddenly emerge from a placement as an expert car mechanic, although an individual student might hypothetically decide that she had reached the limits of her growth as a nurse and decide that she would rather be such a mechanic.    As the introduction to a website (RIPG 2002) offering seminars on personal growth puts it:

Our mission is to empower individuals to discover, enhance, and develop inherent skills and mechanisms that enable them to triumph over life's challenges and experience multidimensional growth of the body, mind, and human spirit. (emphasis added)

The keywords here are ‘individual’ and ‘inherent’, meaning ‘inherent within the individual’.   Neither of these apply to the type of growth which Heidegger wishes us to read into ‘dwelling’.   Here, growth is inherent in a way of dwelling, not in those who dwell.   This is not to deny the idea that persons can grow individually, but to argue that the form of growth, as dwelling, which I am discussing here is not experienced as such, but is a phenomenon which can be reached through the study of experience. 

 

Heidegger’s example is, predictably perhaps, the peasant farmhouse in the Black Forest, which has evolved, been built or grown in tandem with a particular way of life, one which is responsive to the seasons and to the cycles of everyday life.   At first this ‘Black Forest kitsch’, as Borgmann (1996) calls it,  seems to bear little resemblance to the 21 st century hospital, with its management systems and complex machinery.   The point, however, is that nursing practice constitutes, according to Benner, precisely the reverse of this ‘commodified health care system that focuses on technical procedures and economics’ (Benner 2000: 297-298).   In Benner’s view, nursing practice ‘blossoms forth’ or ‘unfolds’ from the health care system, but does not embody its techno-rationalistic assumptions.   The health care system may, however, function to maintain and support nursing practice, and a large part of Chiarella’s study of the legal and professional status of nurses (Chiarella 2002) is devoted to questioning this relationship of nursing to the wider context in which it practices.   My aim here is to show that a different metaphorical conceptualisation of the relationship can have real consequences for an understanding of spatiality in general and the spatial experiences of nursing students in particular.

 

In the case of the Black Forest farmhouse, Heidegger comes to the phenomenon of dwelling by thinking through his experience of the farmhouse and its historical location.   He considers its roof ‘whose proper slope bears up under the burden of snow’ and its other homely features, which contribute to its ‘fitness for practice’.   The latter phrase is not Heidegger’s but is the title of a recent report on nurse education (UKCC 1999).   The house is fit for the practices of Black Foresters, just as the placement should be fit for the practices of nursing students.   The essence of ‘placement’ thus lies in nurturing and building the practice of nursing.  In the next section, I examine the practical realisation of this ideal.

 

Disappointments and rearrangements

The situation regarding placements for SC students was relatively simple, given the relatively high population density of the area and the presence of sizeable small towns in addition to Stirling (and its Royal Infirmary) itself.  Conversely, HC had one major hospital (Raigmore) as an acute care centre.  Although, as one of the participants puts it, Raigmore constituted a ‘huge resource’ in terms of placement opportunities, there was sometimes a feeling that the area did not have enough of the kind of ‘busy’ urban hospitals traditionally associated with nurse training:

(Q: Do you think that's an advantage that Highland campus has, because you can go to these placements in Wick or wherever? )

It depends, I did my training in Birmingham, among six huge hospitals, some of the placements you go on in Highland, you don't really do a lot, I know it you've got to do your basic nursing and that's important, but if you're doing six weeks of…if that's supposed to be your elderly care, and if you are six weeks in a nursing home, where no one has really anything but basic care, it’s six weeks where you feel that you're missing opportunities because elderly care down in Stirling may have a far larger range of conditions, possibly, I would assume so… (Helen, 69, emphasis added)

This desire for a more intense learning experience in a ‘traditional’ nursing environment is consistent with the research carried out by Heslop et al. (2001) into the perceptions of pre-graduation nursing students in Australia, although Tierney (1998: 82) notes that, in the profession generally, ‘community [nursing] has been emphasised increasingly over time’.  It is also consistent with a desire to be closely involved in team work, a desire which was expressed by several of the participants.   Remote settings reduced the sense of intra-professional proximity and ‘collective competence’ (Boreham et al. 2000) imparted by teamwork, and the sense of  ‘autonomy in clinical decision-making’ which Chiarella (2002: 212) sees as central to the re-definition of its role sought by nursing as a whole.   The lack of decision-making opportunities and autonomy in remote areas is counter-intuitive, since it would seem obvious that settings in which decisions had to be made ‘on the spot’ would lead to an increased sense of autonomy for the students concerned (Chiarella 2002: 9)  The low population density of the area, however, meant that much of the nurses’ time was spent in travelling and in what some saw as routine ‘maintenance’ work.  As with most of the issues here, this created risks and opportunities, as the next two extracts illustrate:

I went with the nurse at Torridon...we had one lady to go and see for the whole day , I know they don't like to call them social visits , but it was really just pop in and make sure she was all right...do you need an H-reg.  [nursing grade] nurse to do that?  Fair enough on another day she had a chap who is doing home dialysis in the middle of nowhere , and she was going in and checking on his sight and making sure he was all right, that was OK but I didn't notice anything that needed...  Maybe to co-ordinate...maybe someone to go to if you're worried, that if you were out of your depth there was something, but I thought they could probably get away with...  I know that sounds terrible but...  (Helen, 71, emphasis added))

The language used here contrasts with that in the extract below, which points to the opportunities which Highland region provides for the type of expanded nursing role discussed by Magennis (1999; see also Land et al. 1996).   In the above extract, the ‘whole day’ is spent ‘just [to] pop in’ on a patient for a ‘social visit’, leading to a sense of frustration about the need not just to be identified as a nurse, but to practice nursing.  Again, this resonates with Chiarella’s (2002) concern to problematise the legal and professional status of nursing and the spatially-located negotiations of power which accompany any such re-positioning (Magennis 1999: 35).  An attenuated sense of proximity and a differentiated sense of mobility, of acting over long distances,  is developed in the above extract by the experience of being ‘in the middle of nowhere’ as opposed to the archetypal nursing environment, the ‘huge hospital[s]’ mentioned in the extract above.   A similar experience of attenuation can, however, have different interpretations, as the next extract suggests:

(Q; So do you have a sense yourself of it being too quiet up here?)

In some respects...I have to temper myself down, because having come from theatre [nursing], it's very upbeat, which has big adrenalin rushes, you've got to be on your toes, you’ve got to know what you're doing, so from that kind of a rush, dash, get-things-done kind of thing, and then coming into an environment where it's more than just gaining your patients’ sense of confidence in a very short space of time, to gaining your patients' confidence over a longer period of time, developing the relationship, bringing them in as a whole person, you are saying, ‘oh well, you are here, you are this age, you are in for your appendix, this is what we are going to do’, you are looking at a bigger area of a person, so it is good in that sense, because you do appreciate people as individuals, as if they had a life before, whereas I don't know how much that has been taking in to consideration in a larger hospital in a larger city, so you would have that benefit, although it would be nice to have both sides of it, but I don't think it would happen, I'm not sure if it would exactly happen...  (Naomi, 37, emphasis added)

Firstly, here, the participant is ‘coming into an environment’, implying a conception of a bounded region distinguishable  from other regions, into which patients are brought.   The spatiality of the Highlands is being experienced as a different form of proximity, a different range of concerns from the spatiality of the city and the hospital where Naomi  was trained.   Significantly, all her previous training (which had been outside the UK) had been within the spatial confines of one  hospital, including various placements to specialist departments.   The extract contains significant contrasts between ‘short space of time’ , ‘bigger area of a person’ and ‘larger hospital in a larger city’, and these expressions – two spatial metaphors and one spatial comparison – map readily on to the idea that there are two different senses of proximity involved, two different spatialities experienced before and after coming to Highland region.

 

Going on a placement was thus a more significant issue at HC because of the geographical distances involved, and this spatial dispersion of students contributes to their senses of mobility and possession:

I see it [journey to Skye placement] as a bit of an adventure...there wasn't time to socialise, we were scattered around...we each went to different parts of the island...I didn't keep in touch [with anyone on-campus]...  (Andy, 22)

Andy was the only male participant from HC, whose characterisation of the placement as ‘a bit of an adventure’ provides support for the view that autonomy  was a gender issue.   More complex feelings about mobility were, however, expressed by a female participant:

That was ludicrously ridiculous beyond words, sending a single parent with two children to Kyle of Lochalsh...leaving home at 6:30 in the morning, thinking ‘what are you doing, silly woman, get a life’, but having done it, there were lots of positive things came out of it, and it was a huge learning curve, and staying in bed and breakfast was brilliant, but masses of organisation and planning, getting your children looked after, pack them off, pack their week's things, ‘when have they got piano? When have they got ballet?’ Lots of planning, you needed amazing organisational skills, but once you had done it, what a sense of achievement! (Doreen, 34)

Two intersecting concerns flow from this extract.  On the one hand, institutional circumstances dictate an inconvenient, and in some ways even dangerous, relocation.   On the other hand, this creates an opportunity for study time and freedom from distraction, and ‘a sense  of achievement’ for the student.   This sense of achievement occurs at the intersection between two roles, those of parent and nursing student.

 

Urry (2001a; 2001b) suggests not only that the right to mobility has become enshrined in contemporary citizenship, but also that this right carries with it duties of mobility.   Thus, we seek the technological means to commute long distances to work, and complain if these are not up to our expectations, but we are also encouraged to seek work at increasing distances from home by discourses of flexibility (Edwards 1997; Gray & Morgan-Klein 2000).  The PMP framework a possible basis for this paradox.  Increasing proximity, as an increase in that which is in one’s range of concerns, is  an effect of media saturation (Thompson 1995), in that there are few places left beyond the horizon of personal knowledge.  This in turn increases the desire for mobility, which in turn increases our sense of proximity, further accelerating the process, as both Urry (2002) and Adams (1999) have noted.  Fear of the unknown is increasingly unknown.  It needs to be emphasised that these processes are not unique to the early 21 st century but have historical precedents (Cavalli-Sforza et al.1995).

 

This perhaps explains the relative reluctance of the HC students to complain about the burden of mobility which is imposed on them by the local structure of nurse education, although their responses also suggest that travel time can be sometimes be enjoyable and may provide opportunities for learning.   The mobility and flexibility implied in Chiarella’s five identity stories (Chiarella 2002) is thus acted out in the embodied experiences of the students. 

 

Albertsen & Diken (2001) point to immobility as the necessary corollary of mobility, and for many of the participants in the study, the specific form of professional mobility required by the placement system resulted in periods of personal immobility, in which they found themselves restricted by shift patterns or work rosters, and were at the same time unable to study due to deficiencies in their accommodation, for example the lack of desks in tourist ‘bed & breakfast’ establishments.  The point here is again the contingent nature of the learning context that the institutional requirement for placements creates, with little formal recognition of the consequences for students.  Mobility and possession are thus bound up with the question of power-relations. 

 

In the same vein, another student emphatically expressed her dissatisfaction with aspects of the new and more varied role towards which current nursing policy was directed (Warner 1998) :

...the common foundation course, it was appalling, just ridiculous, I spent six weeks on a health promotion placement...  As far as I'm concerned, it had nothing to do with nursing...  ...  it would be good if there were beds because that would mean there might be a chance of a patient being there. (Joanna, 35)

This confirms a finding of May et al. (1997: 297) , one of whose respondents commented:

Health promotion...folk get sick of it, you are bombarded with health promotion in the first 6 months, people are not interested you know, I want to be a nurse, I want to look after sick people.

The issue here revolves around nursing students’ expectations that they will be involved in caring for patients.   Nursing is predicated here on a strong sense of proximity (having patients within the range of nursing concerns), a restricted sense of mobility (nursing operating over short distances) and a strong sense of possession of specific types of setting (acute hospitals).   This is not to criticise these expectations but to show that they involve issues of spatiality which can be explored via the PMP framework.

 

The Highland experience was not, therefore one which suited all the students equally. The spatial differentiation between Highland region and other areas could sometimes lead to quite strong expressions of loyalty, or, in terms of the PMP  framework, a strong sense of possession towards the Highlands:

I want to stay in the Highlands, we're living in Nairn, I'd be quite happy to commute and do something like that, that doesn't bother me at all as long as I could get home, but a lot of the girls are going to go down south and get other places, Edinburgh, Dundee or Glasgow and Southampton, places like that, because I was teasing them about ‘all of you get trained up here and then go down there, down south and not give the advantage to up here’, but it was said half in jest (Helen, 72, emphasis added)

One of the purposes of Project 2000 was to stimulate reflection on the wider social context of nursing (UKCC 1986) but as the earlier extracts showed, the spatiality traditionally experienced by nursing students works against this by helping to maintain a group identity (‘the girls’) centred on collaborative activity within restricted or restrictive settings.  

 

The need for a combination of nurturance and re-siting in order to build nursing practice proved more problematic when the long distances involved in HC placements were taken into account.  In the case of the next participant’s placement, the arrangements for contact with tutors during the placement period bore out the desire of the students to demonstrate their autonomy as much as possible:

Initially, I discussed with my personal tutor, because I was quite confident and that kind of thing, ‘if I have any problems, I will telephone you’, because I knew there were a lot of girls who didn't have that kind of confidence and I didn't want to waste her time…yes, if there was a problem it would be relevant, but if  there  wasn't a problem, someone else could do with your help more than myself and there was a personal side to going away, and...  my personal tutor was very good and she phoned me up and said ‘are you O K ?’ a very short phone call, but very relevant, it really backed me up, it wasn't a problem, she trusted me enough to understand what I meant by it, so...  (Naomi, 23)

Having been ‘quite confident’ in this (earlier) placement, the lack of regular contact (caused partly by the unplanned absence of a fellow student who was due to share accommodation).in the second placement was highly problematic:

I had to have a placement that was quite far away, and I was by myself, and it was very lonely, horrible, there was no contact, although some of the staff you could speak to, but you couldn't speak to [anyone else], so you had like contact deprivation almost, you had four walls and you're bouncing off them, all you've got to do is your essay to concentrate on, you can only do that for so many hours without becoming nutty (laughs)… (Naomi, 24)

Two points emerge from these extracts.   Firstly, despite the attention given to supervisory arrangements in Project 2000 (May et al. 1997), the difficulties involved in providing equal amounts of supervision for all students in all placements mean that the students in the study were not always provided with as much support as they would have liked.   The placement, in this case, is sensed by the student to be at the furthest extreme of proximity to the university, being only just within its range of concerns.

 

There are conflicts here between the desire for autonomy, the desire to be mutually supportive and the desire to be supported.   It is not the physical distance between the placement and the institution so much as the quantity and quality of the time/space that the tutor is able to allocate (or which the student solicits) which determines the degree of proximity.   In the first case (above) the quality of the relationship is apparently high and ‘a very short phone call’ is quantitatively sufficient to maintain the mutual proximity of student and institution.   In terms of mobility here, it is not just the student who is highly mobile.   Rather, the institution maintains its proximity by caring for the student at a distance.

 

In terms of the academic role which the student has to maintain whilst on placement, the role of the essay in relation to placements is paradoxical.   Whilst May et al. (1997: 348) report that the need to be working on essays or other assignments can be unhelpful to students on placement, as it distracts them from the practical learning experience,  the stories told here were more complex.   In the extract above, the essay functions as a distraction from the stresses of a lonely placement, but only to a limited extent.   In the earlier discussion of the essay-writing process, this particular student reported that the spatial arrangement of information was an important issue for her.   In the placement situation her preferred spatial arrangement was more difficult to achieve, due to other issues around the nature of the accommodation and its spatial arrangements:

When I've been away, it's always been B&B [bed &breakfast] accommodation, there is just this feeling that it's not entirely your own space, because you're living in somebody else's house, and it's not your chosen surroundings...so far I haven't had television in my room, but there has been television in my B&B, and it's been a distraction.  I am actually staying in halls [of residence] in Wick this time instead of a B&B and I'm finding that better, because they've got the set-up, when you're in somebody else's house...you don't often have a desk, whereas this one has and it's a bit more equipped for students, so it's a bit better this time round...whereas in halls everybody shares, so it's a bit more like it's your territory… (Wanda, 8. 9, 10)

Again, the extract highlights the need for student accommodation to be fit for its purpose, but it also emphasises the importance of possession as a power relationship, the sense (or lack) of control over a space, or of having one’s own ‘territory’.   Student rooms in halls of residence form such a territory.   The essential characteristic is that the space conforms to the expectations of those who dwell in it, in other words that it is fit for its purpose.  In the extract above, there is a sense of reduced possession because the participant is having to study in a space which is geared towards relaxation and transient occupation.  The next extract also reveals that ‘fitness for purpose’ is linked to gaining a sense of possession.

It depends on the placement.  When I was up in Wick, it was a health promotion placement, and I took all my books up with me, I even took my word processor, and I did a lot of work, I didn't want to communicate with anybody, I just shut the door, the accommodation at Wick was very good, it was purpose-built for the nursing staff, we had our own space and shared showers and so on, but at this place I've just been so tired at the end of the day that after the first week I thought, there's no way I'm going to study, I'm not finished till half-past eight at night, I don't get back till quarter to nine and by the time I've had something to eat, you just don't feel like it, there's no point, you're just not taking anything in...(Susan, 35)

The workload of the placement sometimes meant that students were unable to focus on study in general and on essays in particular during their off-duty time.   On the other hand, the placement provided opportunities for some students, usually those with children, to spend extra time studying and writing, since they were relieved of their domestic workload.   This is the converse of the problematisation of ‘home’ as a study space, and one of the unexpected benefits of the placement here is the relative luxury (for students with families)  of being looked after in bed & breakfast accommodation – no bed-making, cooking or washing up (see extract Doreen, 34 above).   This was not a unique experience, as the student-tutor pointed out:

Yes, they do sometimes [enjoy it], to get some quiet evenings and time to be entirely a student, for a few weeks and not to have to worry about shopping and picking up the kids...(Anita, 37)

This is an experience often appreciated by mature students:

it [American exchange year] was an opportunity to get away from domestic commitments for a while and do nothing but be a student… (Peter, 20)

The change of domestic environment enabled an intensity of study not otherwise attainable, thus highlighting the constraints which often render ‘home’ a contested space for students.

...I went to a motel for the weekend once just to finish a big paper – loved that, a sort of caffeine binge and an escape from domestication.   A portable existence, no washing up or DIY.   So the space acted to keep out distractions and focus the work...(Peter, 22)

This might be an example of a gendered spatiality, but it also illustrates that studying as an activity is both portable and conditional on having a certain relationship to the available space(s).   I stress ‘available’ here because the institution was perceived to have a casual attitude towards finding accommodation for students on placement::

…really it is finding accommodation that's the big problem, because in the winter a lot of the places are closed down and in the summer all the prices are horrendous and you're working early shifts and things and a lot of the B&Bs [bed & breakfasts] you don't get any breakfast until 8 o’clock or whatever, so yes you can [find that a problem]… (Helen, 22)

 

sometimes people can go and tell you to stay in a certain place, but the whole thing is a bit shambolic…  (Susan, 34)

Given the marketing of the Scottish Highlands as a tourist destination, and its low population density, the problems identified above might be expected.   It provides more evidence, however, that mobility, this time in terms of a mobility of accommodation, is expected of the students as a duty rather than being seen by the institution as part of its duty of care towards its students, as the following extract shows

It doesn't create a problem[with domestic arrangements], because I'm pretty pragmatic about these sort of things, but it does annoy me that I've had to go away, because I should have had a placement at home, but there weren't enough placements so five of us got moved to the outlying district, so there could be an element of annoyance there, but it doesn't create particular difficulties for me with my home life, because my family are behind me...everybody has difficulties, but it's not particularly because I'm away. (Susan, 30)

In turn, this can be seen as expressive of the  ‘nurse as domestic worker’ story which, as Chiarella (2002: 98-100) shows, resulted in poor living conditions and a harsh disciplinary regime for many nurses until relatively recently.   As an experience of spatiality, accommodation problems can generate a diminished sense of possession.   Paradoxically, the experience of tourist accommodation can also generate a heightened sense of possession through the ‘luxury’ of relief from domestic chores and responsibilities.   This, however, is contingent on the geographical uniqueness of the Highland region, rather than a planned benefit organised as a matter of course.

 

The attitude of the institution to placements was thus a factor in students’ sense of possession of the placement space itself, whilst this, and the high level of student mobility, reflect both the ‘autonomous professional’ self-image of nursing discussed by Chiarella  (2002: 168-172.) and the ‘ministering angel’ image which in her view has frequently resulted in poor pay and conditions for nurses (ibid: 246), as the next extract suggests:

For me personally, the overwhelming impression I get is that they're [tutors] far too busy, and it's just the usual thing that you don't want to appear incompetent or  a nuisance, or particularly annoying, or rocking the boat , or [to be] pestering them, so I just feel I've got to be confident enough to ride this out for myself… (Susan, 39, emphasis added)

This returns once again to the importance of spatial metaphors in constructing nursing student identity.   The nautical metaphors here (‘rocking the boat’; ‘ride this [storm] out’) convey the tension between group solidarity and individual resilience.   Lakoff & Johnson point out that groups of metaphors are frequently used to promote inconsistent sets of ideas or worldviews (1999: 248; 345; 555)..   As the participant makes clear, this desire not to appear ‘incompetent...’ is ‘the usual thing’, as indeed it was for all the participants who expressed a view on the topic .

 

This suggests that the notion of ‘dwelling’ might be a useful foil for the pervasive metaphor of the journey through which the education process is conceptualised in everyday discourse.   Students want to ‘dwell’ in the placement and elsewhere but are frequently frustrated by material constraints such as the type of accommodation which is available to them or the need to perform other work, such as essay-writing, at the same time.   These constraints, and the action which is required to overcome them, are seen as themselves part of the pragmatic approach and compliant attitude expected of nurses, and are therefore not the subject of major protest.  This neglect of the embodied spatiality of the participants by the institution is not a deliberate act, nor is it due purely to its limited financial resources.  What I am suggesting here is that it is partially a consequence of operating under the paradigm of education-as-a-journey, rather than the paradigm of dwelling.  I cannot, of course, claim that this is the sole cause of discontent amongst nursing students, nor can I claim that such a paradigm shift would be easy to accomplish.

 

Summary

The above extracts suggest that the type of spatially-dispersed nursing activity practised in Highland Region requires specific educational and policy emphases in order to maximise its benefits for nurses and their clients.   These emphases might include better support and communication during placements, and more attention to the non-clinical aspects of nursing during both C.F.P.  and branch programmes.   The intentions of Project 2000, as set out by the UKCC (1986; 1987) and as modified in subsequent publications (UKCC 1999; DoH 1999), were to broaden the scope of nursing activity and to expand its range of settings.   As Cuthbertson comments,

Project 2000...has always had its detractors, established as it was under an unprecedented burden of criticism and negativity (Cuthbertson 1996: 1)

This level of negativity clearly continues in certain respects, although changes have been made, partly as a result of these and similar criticisms.  The evidence suggests that spatiality is a more important aspect of nursing than has hitherto been acknowledged.   None of Chiarella’s five ‘stories’ about nurse identity (Chiarella 2002: 23) is directly linked to a spatial location, and yet in the three examples above we have seen that the size and location of the campus, the presence or absence of acute hospital settings and the opportunity to be involved in direct patient care have a significant role in identity formation.   This is not to say that the examples given here point to generalisable conclusions about identity, as there are counter-examples for all of them, even within the sample used in the current study.   What the examples show is that the experience of spatiality is complex and cannot be reduced to a set of measurements.   The next stage in the exploration involves a further teasing-out of the relationship between the participants’ experiences of spatiality, which emerge from the data, and the PMP  framework, which is intended to clarify the meaning of those experiences.  In Chapter 8 I move from consideration of spatiality in settings which are overtly spatial, to examples of learning activities which are less obviously so.   The use of spatial metaphors, which has surfaced from time to time in this chapter, will be more closely examined, and the importance of embodied spatiality as a factor in learning activity will be re-emphasised.

 


 

Chapter 9-Spatial metaphors in nurse education

 


He was being driven back.  Against his will he was forced to turn his thoughts into the City, and since last night he dared not.  Certain questions battered at his conscious mind...he didn’t want to face the answers

(Isaac Asimov, The Caves of Steel )

 

Introduction

Previous chapters have described the PMP  framework which has acted as a heuristic framework for some of the spatial issues which affect nurse education in the context of the two sites specific to the current study.    In this chapter I will use the framework as a basis for discussion of two aspects of nursing student experience which are spatially  significant, but which are less site–specific.   The first aspect is the problem of self-directed learning vs.  structured or teacher-led learning, and the related tension between individual and collective forms of learning, and  the second aspect is essay-production.    These do not appear to be directly connected, since the first item concerns ‘a fundamental principle of adult learning’ (Jarvis et al. 1998: 78), whilst the second concerns a means of assessment.  I will argue in this chapter that both are related to the ways in which students experience space, and that lack of attention to these contingent spatialities has a negative effect on students’ experience of the learning process.   What I cannot do here is demonstrate links between the spatial issues and specific learning outcomes.  The findings which I report here are, however, consistent with those of other studies of student experience under Project 2000 and are relevant to some of the changes which have recently been made or recommended as a result of those studies (RCN 2003b).

 

Self-directed–learning: journey without a pause?

In what follows, I discuss the concept of self-direction and what it means for the students, with the aim of bringing out its spatial, rather than pedagogical (or andragogical) significance.   The contextual use of language will prove to be an important part of the evidence for the spatial experience of self-direction and the other issues to be discussed.  To introduce this section, here is a participant statement which raised the issue of ‘direction’:

You're not used to school any more, you've been living in a different world, even some of the girls who've just left school were finding it totally different to their...how they were at school, and yet they're all self directed now at school, in the 5th & 6th year, aren't they? ...they were saying,’ Well, we don't know how to go about it, where do you start?’  so I mean if, OK, I've learned things on my own that I've wanted to learn , but it's still nice to know where to get started...(Christine, 76)

This dissonance between perceptions of the school experience and perceptions of teaching and learning in higher education introduces an important metaphorical construction, that of ‘learning as a journey’.   The key phrase here is ‘where to get started’.   This is such a deeply embedded spatial metaphor that it is hardly recognisable as such.   The idea of self-direction is based on a similar spatial metaphor – learning as a journey, requiring navigational skills and a location from which to begin.   The advent of modularity, self-direction and other ‘flexible’ (Edwards 1997; Morgan-Klein & Gray 2000; Edwards & Clarke 2002) modes of learning has altered the nature of the journey.   There is no longer a recognisable ‘Class of '99’ with whom one can complete the journey through university.   As the data reveal, students sometimes form groups around individual course modules but these are transient and disrupted by family commitments or the placement process.

 

Earlier literature on self-direction in adult learning (SDL) draws on humanistic psychology (see e.g. Rogers 1994; Quinn 2000: 51; Tennant 1997) and would not appear to be overly concerned with spatiality.    Rather, in a reflection of the discursive regime of 1950s America, humanistic psychology is concerned to emphasise the potential autonomy of the individual in relation to society (Law & Rubenson 1988).   The essence of SDL does not lie in its content or in the instructional method, but in the locus of control of the learning (Quinn 2000: 52).   In true SDL, control of content, pedagogy and assessment would all lie with the learner. Furthermore, as Edwards (2000: 39) indicates, the ‘learning needs’ of individuals, which are supposed to drive their (self-directed) learning activities, are themselves products of discursive regimes.   In this view, learner autonomy is an illusion, as the qualities called-for in the lifelong learner are in fact symptoms of, amongst other things, the externalisation of costs under the regime of justification of industry (Boltanski & Thévenot 1991: 203).   Humanistic principles of adult learning, however, attribute importance to individual ways of experiencing phenomena.   The learners under discussion here are self-directed in some, but not all, senses, of the term.   Clearly their education is neither ‘compulsory [n]or universal’, the two criteria which Jarvis et al. (1998: 77) see as definitive of education other than ‘adult education’. It is, however, compulsory in the sense that they cannot pursue their chosen careers as nurses without some form of it.   They are therefore ‘self-directed’ (in terms of career path) into a process where they are ‘other-directed’ (in terms of the structure of their professional education) and then, from time to time, ‘self-directed’ in relation to the performance of various learning-related activities.  

 

The notion of self-direction, however, is itself a spatial metaphor.  As I discussed above, it draws on the ‘learning-as-journey’ schema (Lakoff & Johnson 1999: 193).   The self is conceptualised as an object which can steer itself along a path.   This is, of course,  what embodied humans do in negotiating their environment.  Because the metaphor is so deeply embedded in the educational process, the student experience is conditioned by the metaphor, and the learning experience can suffer through institutional ways of thinking which often draw on contradictory philosophical paradigms (Lakoff & Johnson 1999: 546).   What I wish to show here is that within educational discourse, self-direction is both a spatial metaphor and a spatial problematic.  

 

The participants’ perceptions, according to the data, are of being ‘in’ the University or college in order to be ‘guided’  by its ‘structure’.   Whilst there was a certain amount of choice involved in the nursing courses under discussion, this was largely limited to choice of branch specialisms (Adult, Mental health, Learning Disabilities or Paediatric) or of modules within branches.   Otherwise, students perceived themselves as having little control over course content and a very limited amount of control (via staff-student groups and course evaluation forms) over pedagogical and assessment issues.   May et al.   (1997: 268) found that considerable efforts were being made to make the educational process ‘student centred’ in the institutions which they evaluated, but the issue here is the spatiality of self-direction, which is not synonymous with student-centredness.

 

In this context, ‘self-direction’ meant that students were expected to exercise initiative in terms of collaborative working and in terms of locating information for essays and other assignments.   Thus, self-direction meant, for them, the absence of constant supervision or clear structure for learning activity.   May et al. (1997: 337)  report, however, that the students in their study made:

[l]inks between formative feedback and self-directed learning, i.e.  their tacit acceptance of their responsibility to be self-directing.

In view of the increasing professional autonomy of nurses and the related use of the research evidence base to support practice, the ability to learn without supervision and to locate appropriate materials is clearly important.   What is less clear is the relation between individual learning and assessment, and group support or collaborative working, with students unsure where collaboration ended and plagiarism began.  Thus, the stress on self-directed learning combined with encouragement to form study-groups sometimes led to confusion:

There's been a lot of bitching about the academic side,  but then when they're asked about it they [students] won't say [anything].   Now I will say - nicely - ‘I'm getting really confused about this essay because one nurse says one thing and one says another’...I don't say ‘Oh, so-and-so told me this,’ I don't try and cause trouble...and so long as you don't go ranting and raving people are alright...there is a bit of ‘Oh well, it is self-based learning...  but you still need guidelines ... (Lynne, 75, emphasis added)

 

[ B]eing among nursing students all the time can be both an advantage and a disadvantage.   You can talk to each other about essays, we didn't at first because people thought it was against the rules, but we soon  learned, now we have some really good discussions on essays, but other times you feel you're getting pushed in the wrong direction .  I sometimes feel you're sat in groups and felt that the person who was the loudest has pushed everybody into his or her way of thinking.  (Lynne, 38, emphasis added)

Thus, whilst group-learning and mutual support were encouraged, students detected that there seemed to be an underlying conflict between the processes required to produce autonomous learners and those required to produce collective outcomes.  On the one hand, the university espouses a culture of individuality, in terms of its assessment criteria.   On the other hand, as Boreham et al. (2000) have suggested, nursing and other healthcare professions require  cultures of ‘collective competence’ in which the team is more significant than the individual.   Whilst participants were conscious of the need to function effectively in teams, their perceptions were that the institution did little to encourage awareness of team process as distinct from individual outcome. 

 

My purpose here is to  explore the spatialities which feed into this conflict.   The repetition of ‘pushed’ in the extract above is an interesting example of a metaphor derived directly from the embodied  world of action, with ideas, ways of thinking, or the self as its object (Lakoff & Johnson 1999: 240).   Ideas, in this metaphorical schema, can be ‘kicked around’ or ‘thrown out’ or ‘picked up’, whilst, in a continuation of the journey metaphor, one can be ‘pushed in the wrong direction’ in terms of one’s thinking.   Ideas are also conceptualised as a fluid body:

we have a bantering session where we discuss what we found and what we hadn't found and ‘what do you think of this’ sort of thing, so we are also learning from that, but it is also very confusing, because some people will go really in depth into something, whereas other people will just skim the surface…   (Naomi, 14, emphasis added) 

The surface/depth metaphor has a long history in adult education, following the work of Marton, Entwhistle and others (Marton et al. 1997) which suggested that it was possible to distinguish ‘deep’ and ‘surface’ approaches to student learning.   Indeed, May et al.   refer to this research in their discussion of the effects of assessment methods on the learning of Project 2000 students (May et al. 1997: 343).

 

As Haggis (2002; see also Atherton 2003) has suggested, the deep/surface distinction is overly simplistic and is of limited application, but the pervasiveness of the metaphor is such that it is easily understood and resonates with a wider cross-section of the educational community than, for example, the related, but now obscure, distinction between ‘sylbs’ and ‘sylfs’ (Parlett & King 1971).   Moreover, as with many such binary distinctions, it has an evaluative function (Michelson 1998), as can be read off from the opposition between ‘really...’ and ‘...just’ in the above extract [13] .  The relevance of this to the present discussion is that the deep/surface distinction is effectively a continuation of the journey metaphor.   In the above extract, some participants are prepared to journey further (or deeper) into the knowledge-field (or forest) than others who wish to remain on the edge (or surface).   This is an additional source of confusion for students who are already caught between the devil of sedimented practice and the deep blue sea of the evidence base.   Knowledge is experienced spatially here, as something to which one can be in greater or lesser degrees of proximity.

 

The next extract also employs the  common spatial metaphor of ideas-as–objects to illustrate a point about the need for navigation through the system:

it [staff nurse course] also allows me to see where the tutors are actually going , with their education, because at first I was very confused, and I was thinking, now why are they teaching all this stuff? They were like, putting everything into boxes , and I thought about it for quite a while, because I was quite confused as to why they were putting things into boxes, because I was thinking, realistically nursing is not about boxes , it comprises a whole picture ...  After coming out of CFP,  you’re putting everything into practice, and they're taking you through that stage, and I started a year ahead of them in my thinking, so I had to withdraw myself right back , to be able to pass everything that they were giving us, and now I've kicked into the stages of building up the blocks and getting a nice big wall with every block in place. (Naomi, 32/33, emphasis added)

This passage uses a rich selection of spatial metaphors to make its point – the journey, the box or block and the wall, but with the overall visual metaphors (nursing as ‘a whole picture’, ‘a nice big wall’) counter-balancing the structural separation of knowledge into discrete units.   Because there was insufficient pre-course information, the ‘boxes’ could not be brought into a proximity relation with the student – they were beyond her range of concerns and thus could not be understood as a Heideggerian ‘region’ (Young 2000) or ‘referential totality’. The ‘whole picture’ is built up from the physical metaphors of ‘taking you through’, being ‘ahead’, ‘withdraw[ing]...right back’ and ‘kicking into...building up’.   In other words, it is a visual representation of a journey, during which events happen and companions fall behind.   There is an expressed desire for navigational aids, or landmarks, to help in the initial stages, corresponding to the participant’s experience of arriving at HC for the first time:

...  I remember my first day, and I remember the first person I spoke to, I was standing there, and I thought to myself everyone is feeling the same way as I am, so I reassured myself in that fashion, and then we had second years who took us around and pointed out particular areas of interest , so although it was too much to take in the first day, because you're so hyped-up and everything, as you absorb the information and it became like long-term memory, so you could take in further information and be at ease with what you started with, although when you first started its you're like OOOH, all uptight and tense and everything, and then  you got over that, that went into long-term memory, you take on the next...  Like a loaf of bread , you're cutting it up and as you're going through it, you become more and more comfortable with the new ways that you have got to do things but...familiarising yourself. (Naomi, 21, emphasis added)

The need for navigation and the gradual unfolding of spatial understanding parallel the unfolding of understanding of the tutors’ strategy in the previous extract, and yet another metaphor of division (‘a loaf of bread’) is used to make the same point as the ‘blocks’ metaphor.  

 

The above extracts represent a recurring theme in the data, that of initial disorientation on entering a space (or, more accurately a collection of spaces) followed by a process of familiarisation, acculturation or, in some cases, increasing discomfort (or dis-ease?) over time.   This is not the same as ‘de-familiarisation’, since there may be parallel processes of increasing spatial familiarity combined with social alienation or increasing discomfort.   Possession is thus a way in which spaces are differentiated from each other as individuals and groups move through them on journeys or dwell in them.

 

Almost by definition, self-directed learning takes place outside traditional institutions (Jarvis et al. 1998: 79).   The use of the term for activity occurring within institutions is thus misleading, but the principles extracted from early research have been transferred into these settings.   As I noted at the beginning of this section, these principles have been absorbed into the rhetoric of enterprise and lifelong learning, an unsurprising move since pioneers such as Knowles and Maslow were known for giving motivational seminars to business audiences (Wilson 1972).   Again, my purpose here is to show that spatiality is a relevant factor in any consideration of self-directed learning.   The individual is ‘thrown’ with others into the institution and its spaces and is thus always already confronted with social situations.   There is a complex interaction between individual, social situation and space in relation to the metaphorical and spatial idea of the university as a structure for ‘guiding’ learners, as this extract demonstrates:

…even although the university isn't  structured as such, you've got the formalisation of going to lectures…people are teaching you, you go to the library…to support what you’ve supposedly been taught, in the classroom, so there's more control there, whereas outside it’s more...  autonomous in a way, in that it's up to you to do it, but it's less formal, I don't know if it's to do with my age, and the way that I was taught, but I do prefer a more structured teaching environment, rather than just ‘Oh well you can go to a class if you want to, if you don't want to then you don't have to’, I find I learn better if someone gives me structure , as opposed to it not being .  .  .  So I prefer it in the classroom… (Lynne, 17, emphasis added)

Self-direction was thus seen by this student as contrary to her perception of the function of the University, a theme which  had previously emerged with non-nursing students on a part-time degree programme.   There, the feeling of the students was that self-direction had to follow an initial structured phase of learning, preferably in a classroom or other defined space.   In discussing the metaphor of access to HE as ‘climbing over a wall’, one of the students pointed out that once one had climbed the wall, and reached the other side, it provided ‘something to lean on’.  The conflict here is a proximity issue, because in order to be within the range of concerns of the students, and thus be in proximity to them, the university has to play a large part in defining those concerns.   The structuring and legitimating effect, or the civil regime of justification which the university system provides, is needed in order to keep it within the proximity of the students.

 

The above discussion of the experience of self-direction in the context of nurse education has problematised the ways in which spatiality and spatial metaphors interact in the experience of participants in self-directed learning, and the metaphor of the journey was again shown to be important to this spatial experience.  This is not to say that self-directed learning is in itself problematic, but to say that spatiality, and the PMP framework, provide a way of exploring concepts such as self-directed learning from a different perspective.  In the next section, I will move on to discuss the spatiality of essay-writing within the context of nursing student assessment, again using the PMP framework as an analytical tool.

 

The essay – bringing it all back home?

 

In nurse education, the essay as assessment method has featured in the critical literature (May & Domokos 1992, May et al.  1997) following the introduction of Project 2000 and the consequent shift towards academic assessment practices.   The use of the essay as assessment method reflects a trend towards evidence-based or research-based practice and the need to assess ‘higher levels of cognitive functioning, such as application, analysis, synthesis and evaluation’ (Quinn 2000: 207; p.565) with a related desire on the part of teaching staff to encourage students to access and critique the relevant literature.   The essay does not at first seem to involve spatial issues, being a literary form, although as such it can be regarded as a kind of space (Blanchot 1989) and therefore as a way of arranging ideas,   As such, its production involves spatial activities, both physical and metaphorical, even for the solitary thinker in her study, and it is this aspect of the essay which makes it of interest here.  Urry refers to ‘the notion that academic and political writing can itself be conceived of as a journey’ (Urry, 2001b: 240), thus situating the essay within sociological discourses of mobility and proximity.   In the interviews, participants were asked where they wrote their essays and how they went about the process of gathering relevant information.   Whilst methods varied from student to student, the process centred on two main features.   Firstly, the participants described space-time patterns of collecting and assembling data, centred around the library: and secondly they described their writing techniques, which often involved access to, and familiarity with, computers,

…what I tend to do is gather the material in the library, then take it home in note form and type it up at home. (Terry, 7a)

 

This is the process in its simplest form -collect, condense and construct.  The above extract was from one of the students who made most use of ICT at home, and who found it useful:

...a lot of journal articles, especially nursing journals, are on the Web, I can access that from home and also from the University.  Psych-info [an electronic database] and things like that are pretty good.  (Terry, 5)

The availability of material on the Web has not  yet eliminated the need for library visits, however, even for the more advanced users of ICT.    Even if all the necessary materials were to be made available on-line, the collection process would still be required, albeit within a different set of spatial ‘co-ordinates’.   Brickell (1993), in discussing the design principles of on-line learning environments, shows that these spatial and ‘navigational’ metaphors are essential to their function.  The essay-writing process is thus one in which the student gains proximity to the materials, exercises mobility in accessing them, and takes possession of their essential content.   I will now look at each of these elements in turn, with reference to the interview material which refers to the essay-writing process.

 

The essay is generally regarded as a summative assessment method, meaning that it marks the culmination of a process rather than (as in formative assessment) being part of a continuous process. There are three points to make before I begin to explore the essay-writing process in the interview material.   The first is that, although the essay has only recently gained a role in nurse-education, it emerges from the data as being problematic in the context of nursing practice.   Secondly, it is an assessment method still widely used in other disciplines, and hence the discussion here may be of interest outside the context of nurse education.   Thirdly, the term as used here also applies to forms of written assignment, such as research reviews, which the students regarded as being essay-like in form and in terms of the methods used in producing them.   The purpose of the discussion here is thus to relate the essential elements of the process to the participants’ experience of spatiality.   The following extract gives a sense of this:

 

A normal pattern when I’m doing an essay [would be to] start collecting research and material, this is probably a bit naughty but I...  I tend not to read it and assess it as I go along , but leave it all to the end and then I do the reading, I was talking to another student today, and he was saying the same, I'm a slow reader, the reading thing is very laborious and also the concentration thing...  Writing things down , then assessing it, analysing it, deciding what you're doing, I used to do about four drafts, whereas now I'm down to about two, doing one [essay] is just such a learning experience I think, and it makes a difference if you're enjoying the subject, if you know the subject, it's just writing it up, tidy it up , and thinking about the layout , what you're trying to say and structure and all that… (Karen, 52, emphasis added)

The ‘materials’ in this context need not be confined to written texts, but can also include the results of informal learning, such as discussion with other students.   Whilst this is what might be expected in a ‘community of practice’ (Wenger 1998), there are additional issues which make the situation more complicated.   As I discussed in relation to self-direction, students were often confused about the difference between group collaboration and individual assessment, with resultant problems during the essay writing process:

It's [student group] completely not structured, but I think students inevitably talk about what's on the agenda for today, and essay questions always bring up a flurry of thoughts and actually lead to more anxiety than less...

everybody seems to have different ideas about how to go about it, it tends to make people anxious and just talk about college when we're here. (Doreen, 13/14)

[I] put in an essay, is it going to pass, is it going to fail? Stuff like that, especially because this is new to me, it’s 17 years since I studied, any serious studying… (Lynne, 21)

The second extract reflects the anxiety commonly felt by mature students returning to education (Wakeford 1994), an anxiety which arises as a result of (amongst other things) comparisons with the perceived abilities of others.   These comparisons are relevant to issues of possession, since being in a space with others results in varying degrees of knowledge about the abilities and techniques of the other, leading to corresponding attributions of power and influence over the space, a phenomenon most marked in the library and computer lab.

As with the question of self-direction, there were issues over the provision of ‘navigational aids’ to the essay-writing process

 

Yes, I think it would be good to have, not group tutorials, but discussions about the essays which were coming up to see if we were going in the right direction, because a lot of people have said they thought they were going in the right direction and they have followed the guidelines and when they've done the essay they’ve been told ‘no, you have not tackled it the way we wanted it’ but they have followed the guidelines, the guidelines are very vague and it's very easy to get yourself off on a tangent… (Helen, 39)

The process is again conceptualised metaphorically as a journey where one can go ‘off on a tangent’ and thus end up at the wrong (conceptual) destination.   It is another example of the tension between the collective ‘we’ and the individual as the unit which is assessed, and the tension between form and content which characterises the essay as an assessment method.   One of the students recalled an occasion when a tutor had told her that her essay would have received an ‘A’ but for its introduction not conforming to the set format, which reduced it to a ‘C’.   This is in agreement with the finding of May et al. (1997: 339)  that students found marking inconsistent and frustrating, but more  importantly, it reveals a problem with the spatially-derived metaphorical schema which drives the essay process.   Moves towards greater use of formative rather than summative assessment in the theoretical component of nurse education (Howard 2001) are an acknowledgement that different metaphors may be required in future.

 

The spatiality of the essay is not exhausted by metaphorical analysis of the overall process.   In terms of students’ information sources, which frequently consisted of piles of photocopies and books, information is spatially arranged and remembered, rather than being ‘listed’ in some linear way as text.   Thus, as one participant put it::

…I've got a table, it can be a small diameter table or a long table, it doesn't matter, as long as I can see my papers, I put my papers in particular piles, and just looking at them will trigger off what I want to say, so as I go from each section, I tend to use that as a triggering response and then I take that article as I’m going to refer to it, jot it down as the reference.  It's a continuous cycle kind of thing…

(Q: That's interesting, so that the layout of the stuff on the table is important for you?)

Yes, very important for me, it's like a triggering response. (Naomi, 1)

 

At home, I do like to spread out, it's more  visual, I like to see it as it builds, as it were, my bed is covered with all the stuff that’s in the first draft, and the table is covered with all the stuff that isn't in yet, just chaos, but organised chaos…  (Karen, 56)

There are several interesting points in these statements.   Material is gathered (in the physical form of notes or photocopies) in one place and transferred to another.  A parallel process takes place metaphorically, in that ideas are gathered together, sifted, compared (‘weighed-up’) and finally formed into an argument. Information is seen here as the base ingredient which the essay, through the student’s prior understanding, transforms into knowledge:

...if I’ve found the information that I’m looking for, it’s a feeling of relief for knowing that I’m on the right track for writing an essay, if I’ve found the right information or I’ve found good information, you know, that’s just a feeling of ‘Oh, good, now I know what I’m doing’.   It’s not relief at getting away from the place [SC], it’s just relief at getting information...  (Lynne, 28, emphasis added)

The essay-writing process is characterised as a journey from uncertainty (‘where is the information?’) to certainty (‘I’m on the right track’).   The following table (figure 5, overleaf) summarises the situation:

 

 

 

 

 

 

Figure 5: The Essay-writing process as a journey

 

 

 

Essay                                                                                                                               Spatiality

Uncertainty

Source

Question or

Quest schema

Element of PMP framework

Uncertainty over finding information

Library, IT lab, www,

tutors, students

What will I look for?

What am I concerned with here?

proximity

Uncertainty over which way to go with it

Essay structure

 

Which path will I follow?

How will I get to my destination?

mobility

Uncertainty over its reception

Feedback

What will I find when I get there?

Will my quest end in a good or a bad place?

possession

 

 

This is, of course, a structuralist view of the essay-writing process which draws upon the work of Propp (1968) on folk-tales or of Lévi-Strauss (1964) on myth.    A different interpretation is given  by Holloway & Kneale (2000: 74-75) who suggest that the work of Bakhtin provides a way of relating space and spatiality to the dialogical situation of self and other.   In this view, the essay is not a closed text but is both open to its socio-cultural context and ‘polyvocal’, that is, it speaks not only in the voice of its author but in the voices of, for example, the research communities which inform it.    To the extent that it is addressed to another (the course tutor or examiner), it also speaks in the voice of that other, that is, it reflects back the language which calls it forth.   In doing so, it sets up a spatial relationship between the participants in a dialogical situation.  The essay-writing students are literally placing themselves in the community of nursing, through their adoption of its own specific voice within language.

 

Neither Holloway & Kneale (2000), nor Bakhtin himself in the original work upon which they draw (Bakhtin 1981; 1984a; 1984b; 1994), explore this spatial relationship in detail, since its make-up depends by their own definition on the particular dialogical situation which sets it up.   In the context of this study, however, the data suggest that the essay-writing process is experienced by the participants as both a metaphorical journey and a real spatial journey (Library/web -  home/lab - tutor).   Bakhtinian theory supports this, suggesting that the essay has ‘positionality’ (Holloway & Kneale 2000: 77), in other words it  ‘voices’ the spatial relationships between the participants in the dialogue (or, more accurately, ‘polylogue’).   Next, it is necessary to examine the data more closely to see how these relationships might reveal themselves, and how the PMP framework might contribute to a fuller understanding of their importance. 

 

The following extract gives a sense of the contradictory spatial practices which can arise in the essay-writing process:

There's a tendency not to use the library because there's lots of to-ing and fro-ing, and there's a tendency if they're all doing an essay, for them all to be in there, it's more like a social event, so you will say ‘how’re you getting on’ and anything interesting rather than sit down and study… (Wanda, 2, emphasis added)

Previous discussion of the spatiality of the library emphasised this paradoxical combination of roles, but the interesting point here is the third-person characterisation of the  others as ‘they’, which is unique to this section of the interview.   Elsewhere the participant refers to others in the first person plural (‘ we are quite a large group ’: Wanda, 6).    This reflects the perceived dichotomy between the essay-writing process as a solitary activity (the traditional ‘writer in a garret’) and as the outcome of dialogue and social interaction.   The specific element of the PMP framework which is visible here is that of (dis)possession – the occupation of the library by others results in the participant being dispossessed of her share in the communal space.   This can, of course, work both ways, and other students might appreciate the chance of meeting others and thus of increasing their possession of the library.

 

This individual/collective dichotomy was reinforced by the problem of gathering the correct materials:

...as soon as the lectures are there, there's about four or five people who go immediately to the library and take out four books, of the books that were mentioned, so they've got the four books, and nobody else can get them, and all right the teachers have put them on short term loan and...  but everybody needs them at the same time...  (Susan, 17)

The journey thus begins with a struggle over limited resources, but in terms of the polyvocality of the essay, the information which speaks in or through the essay is being drawn from sources which are less than optimum:

...but the other annoying thing is...you look a book up, and there is nothing that great but you think ‘I'll have this one’, and you go to the library and she'll say ‘Oh, it's there’, but you'll go to the shelves and it's not there and she'll say ‘oh someone's taken it’, that's really annoying, that someone's taken them, in fact they've stolen them.  That's really annoying, but I mean, they just can't keep buying books all the time.  (Susan, 17)

In terms of proximity, even the less desirable information is within the range of concerns of the participant, but beyond her reach.   The starting-point of the journey is thus rendered problematic, and the voices of the essay will speak differently.

 

It might be argued that this is merely a way of re-describing problems of resources and access to information which affect the majority of students in Higher Education and elsewhere.   Why should this be seen as a spatial, rather than a problem of  economics or management? The two approaches are not, of course, opposed in this way, and what I am suggesting here is that spatiality provides a way of understanding both rhetorical strategies and material problem, because the same spatial conceptualisations which underlie the essay process are also underlying assumptions of the  education system itself.  

 

Students are metaphorically described as ‘going through the system’, ‘making progress towards their degrees’ and so on.   They make a journey which begins  with them walking into the University and ends with them walking offstage at a graduation ceremony.   This is set within the cultural conception of life-as-a-journey which is so prevalent in Western thought (Lakoff & Johnson 1999: 193-194).   The problem with the journey schema in this context is that it positions students as travellers and thus their problems with the library, for instance, become  ‘failure to overcome obstacles’ rather than ‘experiencing a lack of materials’.

 

This metaphorical conceptualisation, however, can only be seen as such if it can be opposed to some alternative paradigm.   That paradigm might be provided by Heidegger’s thinking around the topic of ‘dwelling’ which I used earlier to build up the concept of possession.   ‘Dwelling’ does not simply weld space and time together, but as the human expression of Zeitraum, time-space, provides an opening out of which time and space can both be experienced.   ‘Dwelling’ is not something which comes to an end or has a beginning.   Rather, it is that out of which something temporal and spatial, such as a journey, can emerge and subsequently re-enter.   The essence of dwelling is to free something into its essence, to build (Heidegger, 1993a: 349-351).   To construct something, whether a building or an essay, is to free it from the earth, to bring it into a world.   Heidegger’s language in the essay from which this thinking comes forth is poetic, almost lyrical – ‘earth is the serving bearer...’ but a wider reading takes the concept of earth to mean the undifferentiated ‘stuff’ out of which the (human) world is ‘built’ and ‘maintained’ (Inwood 1999: 50-51).   Maintenance is required because earth and world are in continual struggle, and ‘dwelling’ is the site of that struggle.   Thus, the activity of essay-writing is an attempt to build meaning, or knowledge, out of undifferentiated ‘information’  Books on a shelf or text on a web-page are inert objects, which only acquire worldly significance as equipment when used by someone as tools and materials for some purpose.   The essay,  as a purposeful construction, shelters and gathers the thought of its multiple voices and writers.

 

The aim of this further excursion into Heidegger’s writing has been to show that to conceptualise essay-writing as a journey is to miss its significance as an activity which maintains a certain way of being-in, or dwelling-in, the-world.   As such, I am not setting up an opposition, or a hierarchy, between the two conceptualisations.   Breathing, for example, is related to air, but the two are neither opposites nor do they form a hierarchy.   From a linguistic perspective, they cannot be compared, since one is an activity and the other is a mixture of gases.   But by breathing air from the earth we can continue to dwell in the world.

 

A simpler version of the above argument might, therefore, be to posit essay-writing as a site of struggle rather than as a journey towards closure, just as a building-site can be a site of maintenance rather than a journey towards a  new house or school.   The pedagogical implications of this might be, for instance, that essays are never regarded as finished but instead become works-in-progress, around which dialogue continually takes place.   An extension of the building-site metaphor also points to the need for the constant availability of materials via the web to replace the haphazard availability of library books.  Essay-writing thus contributes to the spatiality of  nursing students, and a spatial model of essay-writing would address the proximity of information, the mobility of information acquisition and the (dis)possession of institutional space which results from the process. 

 


Summary

 

I have suggested in this chapter that two disparate educational activities are experienced spatially by nurse students.   Self-direction, as distinct from notions of student-centredness, and as limited by its institutional context, is problematised because it conflicts with the students’ desire for structure and guidance.   The metaphor of the journey encourages educators to over-value learner autonomy, when the ends of the educational process might be better served by acknowledging and supporting the gradual acquisition of the spatial sense of possession which enables autonomy.  In terms of the early professional learning of probationary nurses, or other professionals such as teachers, this process of gaining possession is not well understood (Kirpal 2003), largely because the learning-as-a-journey metaphor encourages the university-work transition to be seen as a line or clear boundary rather than as the vaguely defined process of gaining possession which is suggested by the material here.

 

Essay-writing is similarly affected by the metaphor of the journey and can be connected, via the metaphor, to the PMP framework.  It involves activities such as ‘gathering material’ which are simultaneously physical and metaphorical, and the obstacles which arise in the physical realm are also obstacles to the cognitive activity of ‘assembling’ the essay.

I also argued that a Bakhtinian approach which saw texts as ‘polyvocal’ and ‘dialogical’ can be used to relate essays and other written assignment tasks to the PMP framework, by situating the essay in the context of a community with its own voice within language.  Finally, I discussed how Heidegger’s conception of dwelling might provide an alternative way of thinking through the student experience in order to overcome the limitations of the journey metaphor.

 

In the concluding chapter, I will expand on the findings of the study and discuss how the application of the PMP  framework to spatial situations might enhance our understanding of them.   I shall also suggest alternative ways in which this  research might have been conducted, and will speculate on how it might contribute to future work in the field.

 

 

 

 


 

 

Chapter 10-Conclusions


He paused a long moment and said, “Yes, it is quite interesting, and now I can form a consistent whole of the data.” (Isaac Asimov, The Caves of Steel)

 

Introduction: forming a whole

 

The objective of this chapter is, as the epigraph suggests, to form a consistent whole from the data and the theoretical framework which has been used to make sense of it.  I attempt to form this ‘whole’ into a set of conclusions, and  I also examine whether the study could have been done differently, its strengths and weaknesses, and what I have learned from doing it.  Finally, I will argue that the study has produced answers to its research questions, and that these are a useful contribution to the field of social research, particularly the kind of ‘phronetic’ social research advocated by Flyvbjerg (2001).  That is, it does not attempt to provide epistemic knowledge, in the sense of generalised scientific ‘facts’ about phenomena.  Neither does it attempt to provide technical ‘know-how’ about the performance of tasks.  Rather, it provides what Flyvbjerg calls ‘practical wisdom’ derived from, and applicable to, one specific set of spatio-temporal circumstances.  Although the concept of practical wisdom includes an element of intuitive judgement, it also incorporates detailed examination of circumstantial evidence.

 

As Flyvbjerg suggests,  phronetic research takes account of the complexity of human life and its embeddedness in a material world.   Embodiment is thus an essential  element of the study, and I  argued that it is meaningless to explore ‘spatiality’ in the context of student experience (or any other context) unless it is  taken  to mean ‘embodied spatiality’.  Using this as a starting point, I developed a theoretical framework, based on the interlocking concepts of proximity, mobility and possession.    I argued that these can be used to make sense of the issues and practices which emerge from various forms of data.  Spatiality thus represents the collective effects of being-in-space for embodied human beings.   This is not to say that there are no imaginary spatialities, for as Anderson (1983) suggests, even nations are imagined spaces, but my argument has been that spaces mediate activity and interaction, and that this mediation generates a sense of spatiality in a complex reciprocal relationship between individuals, groups and cultures.  

 

The proximity-mobility-possession (PMP) framework suggested here does not constitute a  ‘theory of space’, but rather, it suggests what the pre-conditions for being able to apprehend, or to ‘grasp’ space(s)  might be (Lefebvre 1991: 40). In other words, it enables the rather fuzzy concept of space to be discussed with greater precision and insight.  In describing a house, we might use the word ‘big’, but if we unpack this by specifying the architectural style, the  number of rooms, the floor area and ceiling height andits distance from the road, we begin to grasp it in its materiality spatiality.  In this way, the three-dimensional PMP framework was helpful in analysing the interview data, but the question here is whether it can be re-used elsewhere.  Within the concept of phronetic research, the framework, as a sense-making device, is a tool for use within located and bounded situations.   Other users of the tool may come to different conclusions, or produce different answers to different questions, but the essential form of the tool should remain the same.  As Burden (1998: 17 ) puts it, describing a similar small-scale study:

the value of this methodology...relates to its ability to focus in detail on a small but significant facet of a broad and complex social setting.   While it may be argued that such detailed examination prevents replication and extrapolation to the wider population, this kind of study has the potential to contribute exemplars of social action to the institutional setting.

These ‘exemplars’, or patterns, of social activity are, in this case, underlying spatial assumptions, metaphors and practices which influence, but cannot predict, behaviours.  These assumptions apply as much to the researcher as to the researched, and I have argued that this is not a ‘pure’ phenomenological study in the Husserlian sense, in that I am unavoidably bringing both theoretical and personal assumptions to bear on the material.    The study is about foregrounding these assumptions and their impact on the lives of the students concerned.  In itself it has little or no predictive value, but the perceived importance of predictive value is itself symptomatic of a set of assumptions about the rule-governed nature of reality and the appropriateness of particular research methodologies (Flyvbjerg 2001).  The concepts developed here have proved to be useful in understanding the spatiality of other research situations e.g. in organisational learning  and the early professional development of teachers.  Equally,  some existing studies of nursing student experience refer implicitly to some of the spatial issues raised here, and those which draw on empirical evidence from nursing students support my conclusions about the ways in which their experience is problematic, particularly in relation to placements.  Using the framework to re-examine existing research thus confirms its value as a sense-making tool.

 

Proximity, Mobility and Possession  

I have shown above that the proximity-mobility-possession framework (PMP)  is a useful way of approaching empirical data concerning space & spatiality. As Soja (1996) points out, there are references to at least 90 different ‘species’ of space in Lefebvre’s The Production of Space (1991), some of which are in common use, such as physical-, social-, personal-, mental-, literary- and cyber- space.  This unmanageable heterogeneity of spaces, in my view, is best understood through the use of the PMP framework, although there is an argument, which I have touched upon above, that being able to ‘manage’ something implies a certain way of looking at the world, a techno-rationalistic paradigm characterised by Heidegger (1993b) as ‘enframing’ (Gestell).   Conversely, if the meanings of all these spaces are incommensurable, for example if there is nothing in common between physical space and literary space, then why call them ‘spaces’?     This is where Husserlian ideas about essences were useful in thinking about what the essence(s) of space might be, or whether there is an underlying framework which enables us to have a conception of space which can equally well handle the school playground (physical space), James Joyce’s Ulysses (literary space) and the internet (cyberspace)? The framework which has been developed here can do this. 

The table below (figure 6) demonstrates some  possible parallels:

 

Figure 6: The PMP Framework and types of space

 

Proximity

Mobility

Possession

Playground (physical space)

School, shops, busy road, parents, teachers

Disabled access, crowding, timetabling

Teacher/pupil relations, smoking area, bullying

Ulysses (literary space)

Identification with characters, situatedness of text (in Dublin; in historical context)

Literacy (ability to move around in text)

Text as cross-cultural object

Feeling at home within text, using text as basis for other writing

Internet (cyberspace)

Awareness of interesting websites

Computer literacy, access to hardware/software

Own website, prominence in search engine results

 

It is noticeable that the parallels between  these spatial types themselves depend partly on the use of spatial metaphors.   The discussion of spatial metaphor and the work of Lakoff & Johnson (1999) and others (Merleau-Ponty 1962; Gibson 1979; Sanders 1999; Kelly 2000) suggests that the embodiment of spatiality is the key to understanding why it has such a basic role in both mundane action and language.   To construct a typology without attempting to understand this basic role in more depth risks the ‘unmanageable heterogeneity’ to which I referred above.  As Lakoff & Johnson (1999) have suggested, cognitive activity is inseparable from embodied activity, and is connected to it via embodied metaphors.    Although the evidence from this study does not relate directly to cognitive activity, it supports their views about the importance of embodied spatiality as a basis for the manipulation of ideas (as in the metaphor I have just used).   The use of spatial metaphors can be shown to have physical-spatial consequences.    The notion of self-direction in the metaphorical space of learning becomes problematic when students are disorientated in physical space.   Gathering material for essays is stressful because, like gathering fruit, the best examples are sometimes hard to reach.   Yet students are not supposed to be spoon-fed because that would position them as baby-like and helpless.   The point here is that consideration of the metaphors used to communicate ideas can reveal entire schemas, metaphorical domains which determine how we think and therefore how we act.

 

Learning should not, then, be seen as a purely cognitive activity, which happens to, or is performed by, a disembodied mind.    Both in a practical and a conceptual sense, learning is inseparable from spatiality and embodiment (Michelson 1998).    Jarvis et al.  (1998: 27) point out that certain forms of learning can be performed satisfactorily using a behaviourist model.    Their example is, fortuitously, the ‘square-bashing’ by which military recruits learn drills and disciplines.    This is a prime example of learning which is entirely predicated on spatial arrangements and embodied activity, but it is not part of the adult education ‘repertoire’.  More relevant models of learning style, such as the ‘deep/surface’ distinction, or ‘field dependence/ independence’ depend on spatial metaphors for their explanatory power, as I have argued above, but do not in themselves address the issue of the spatiality of learning.  The conclusion which can be drawn from the current study, however, is that the embodied spatiality of the student affects the performance of activities related to learning.   This is not the same as saying that spatiality affects learning outcomes, which is not a question within the scope of the present study, because it would have been necessary to have an a priori concept of spatiality, and probably a longitudinal study, in order to establish whether this is the case.   Such an a priori concept was not available, but the framework proposed here goes some way towards providing one.    For ethical and practical reasons, it would be difficult to set up an experimental study which compared the learning outcomes of two or more groups using different spatial models (Moore et al.  2003).   The present study gives a certain amount of support to the idea, based on the differing experience of students across two campuses, that spatialities affect the experience of learning, but that is not the same as affecting learning outcomes.

 

Current educational research in different contexts does not provide answers to these questions.   For example, Blatchford et al. (2003), in a comprehensive re-assessment of school class-size research, make no reference at all to the spatial aspects of the classroom, yet Horne’s (1999) unpublished research  suggests that spatial factors may be significant variables in determining learning outcomes in relation to class-size.   The present study provides evidence for spatial effects which warrant further research. In the discussion of the research questions below, I discuss how the spatial agenda might be taken forward in the context of nurse education.  Firstly, however, I critically examine possible objections and alternatives to the way in which the study was conceived and executed.

 

Objections and alternatives

The four main features of the study are that it takes ‘spatiality’ to be worth investigating, it used a theoretical framework based on the concepts of proximity, mobility and possession, it focused on the experience of nursing students, and it used qualitative, interview-based methods to obtain data.  It is, however, important to consider what the alternatives might have been.  I have already discussed the reasons for choosing to focus on the experience of nursing students, so will concentrate here on the theoretical framework and the methods used to collect data.

 

 

The objection can be raised that the analytical framework used here is imposed on the data  rather than being grounded in it.    This can be answered in two ways.    Firstly, there is a sense in which any research project imposes a framework on the data by virtue of asking a particular question about it, or indeed by virtue of defining something as ‘data’ in the first place.    The question for this study was a question about the experience of spatiality amongst a specific group of students, and even in a general sense this involves several assumptions about the nature of experience and the nature of space, in addition to assumptions about what it means to be a ‘student’.   Deriving additional themes from the data can, of course confound these assumptions but only via a process of interpretation which itself involves assumptions about meaning. 

 

Secondly, the framework is a heuristic device which provides a basis for interpretations of the data.    There might well be other possible ways of analysing spatial experience, but the criteria for using insights derived from these alternative methods will also be different.    To use an analogy, a chef, a food technologist and an environmental campaigner might regard the same bowl of soup in three distinctive ways.    The chef sees combinations of flavours, the food technologist sees production methods and storage characteristics and the environmentalist sees an endangered species [14] .  Each imposes a pre-existing framework on to the ‘data’, and each analysis contributes to a field of knowledge about the dish without negating the contribution of the others.   Bell (1992), for example, proposes a framework for the study of social phenomena based on the concept of embodied ritual, which might have served instead of the framework used here.  Equally,  a framework based on the construction of gender might have produced interesting results.  Thus, the proximity-mobility-possession framework which I use here contributes to a field of knowledge about  student experience without excluding the possibility of alternative modes of analysis. A further insight here is that temporality and spatiality are interwoven, and had I started from a temporal perspective, space would have unavoidably opened up alongside it.  The choice of spatiality as a topic was a fortuitous one and, along with temporality,  it remains a rich and complex source for further work.

 

Equally, the study has been concerned with the spatial practices of a small but vital part of society, rather than theories of space, which have arisen in physics, mathematics or philosophy. Nor has it been concerned with images and symbols of space, a task which has been addressed by Markus (1993) in relation to built space.   It has argued, however, that the dominant conceptualisations of space to which Lefebvre (1991) refers are related to some of the assumptions which underlie current educational practice.  The dominant assumptions amongst these are that space and spaces are homogenous, neutral containers of activity and that their manifestations as spatiality are not important objects of study.   

 

Lefebvre (1991) has argued against this spatial neglect, and another approach to the framework would have been to use Lefebvre’s distinction between spatial practice , representations of space and representational spaces.  (Lefebvre 1991:39; see also Soja 1996).     The notion of a trialectical relationship between these three terms, the perceived, conceived and lived, is itself an interesting theoretical move, overcoming as it does the limits of binary approaches to power and space.    Lefebvre suggests (1991: 38-39) that ‘the spatial practice of a society is revealed through the deciphering of its space’.  Whilst this is what I attempt in the current study, there are questions as to how far this repeats the detached ‘view from nowhere’ (to use Nagel’s (1989) phrase) which is critiqued by Haraway (1995).  Lefebvre  further argues that  representational space is  ‘space as directly lived through its associated images and symbols’.   Thus, in medieval Christian societies, the images of Heaven and Hell,  the cosmology which maintained those images and the sacred architecture of churches and cathedrals formed a whole within which a certain set of spatial practices made sense.  These spaces were themselves not the result of representations, whereas under capitalism,  representations of space are, as conceptualised space, ‘…the dominant space in any society (or mode of production)’.   Thus cities are shaped by a planning process based on a set of technical  conditions and aesthetic judgements  which in turn depend on a specific mode of production.   Lefebvre points out that it is not his intention to create an abstract model of spatiality, but to find a way of grasping the ‘concrete’ (1991: 40).  His work certainly offers a rich source of spatial insights, some of which are applicable to the issues under consideration here [15] .

 

Doreen  Massey (1992) has also pointed to some of the political (in the widest sense) tensions resulting from the neglect of the spatial in favour of the temporal and the social, which she argues is the result of  both a false binarism in separating the two, and a gendered denigration of the ‘chaotic’ materiality of the spatial (Paechter 2003).   The results of the study support this view, although it has not attempted to focus specifically on the gender implications of spatiality.   Spatiality is, however, messy, paradoxical and cannot be tidily ‘optimised’.  A library may be too overcrowded for one student and too quiet for another, resulting in loss of useful working time for both of them.  A long journey to work  can be constructed as ‘heroic’ or ‘insane’ or ‘normal’.   Nor can space be ‘tidied-up’ by pretending that it has been abolished, as is the logic of the trend towards on-line education in its various forms.   The world-wide web has increased the chaos of the spatial, bringing multiple worlds to the desk-top.   This is creative chaos, and the point of Massey’s argument is that, in one sense, this is what spaces are for.  In this spirit, the current study thus attempts to reconcile the elements of Lefebvre’s triadic model and, in producing the PMP framework, to suggest a useful way of continuing to explore spatiality in the emancipatory spirit which underpins his work (Lefebvre 1995: 238) and which also underpins much nursing research (Francis 2000).

 

In terms of the research method, one conclusion of the study is that spatiality need not be an explicit element within discourse in order for it to be an important element in the underlying experience.    I am assuming here that there is such a thing as an underlying experience-of-action, even although its meaning may well be constituted as such by the discursive act itself.    The fact that an action may be described in a number of different ways does not mean that it has no existence outside of those descriptions, merely that its meaning   has no existence outside linguistic descriptions (Searle 1995).    Consequently, conversations about experiences of activity are the most accessible way of developing shared meanings (Davis & Harré 1990).   Furthermore, the experience of embodiment, even although it may itself be differentiated, forms a basis for the understanding and analysis of such shared meanings.

 

The question is whether the same outcomes, in terms of student-related issues, could have been generated differently.    The answer is probably ‘yes’, as many of the issues raised by students might have been elicited by questionnaire-based research of the type often used to evaluate courses or other institutional activities.    In fact, research of this type was carried out (for a different purpose) at an early stage in the project (Gray 2000), and helped to frame some of the questions in the interview schedule.  Questionnaires, however, cannot substitute for the depth of a conversation.    This itself is a spatial issue – questionnaires are generally completed in the absence of the researcher, who therefore ‘loses’ possession of the space in which they are completed, subject to distractions.    The social frame of the interview situation generates different senses of possession for researcher and researched, but these are, at least in principle, accessible to the researcher.

 

Moreover, interviews have the advantage that participants can reflect on their intentions in performing particular actions.   Conversely, interviews are artificial situations whose direction is inevitably skewed by the researcher, even if there is a sufficient degree of ‘participatory consciousness’ (Hesushius 1994) for the interviewee to be able to ‘own’ her contribution. Some researchers (Hormuth 1990; Kesby 1999; Edwards & Clarke 2002) have used methods other than direct interview in similar projects.    These have involved graphical media, such as auto-photography, token-based diagrams or hand-drawn maps to elicit participants’ sense(s) of space in relation to specific issues.    I did not feel that these methods would deliver sufficiently fine-grained information for my purposes, and that there would be at least as much, and probably more, uncertainty over the interpretation of photographs or maps as there was in the interpretation of texts.    Additionally, as a novice researcher, I was apprehensive about approaching students at all, and felt that requests to draw maps, keep diaries or take photographs would add to the burden which I was imposing, a view confirmed by other researchers who have experimented with these methods (e.g. Clarke 2004).  This is not to say that such methods are of no use, and with hindsight, a method such as map-drawing might have been valuable. 

 

Does the study answer its research questions?

Figure 7 sets out the research questions which were first posed in Chapter 1 (p.14):

Figure 7: The Research Questions revisited

Question

Reason for asking

Body of knowledge to which study might contribute

What is meant by ‘spatiality’?

Own interest

Theories of space

What is meant by spatiality in the context of nurse education?

Attempt to cross disciplinary boundaries, reinforcing and deepening analysis of previous research in field

Theories of space, nursing literature

How does spatiality affect  lives of nursing students?

Desire to enhance student experience, lack of attention to spatiality in nursing literature

Literature of student experience within nursing literature

 

The first question seeks the meaning of spatiality. Has this small-scale study of an apparently specialised aspect of spatiality led to an enhanced understanding of this elusive concept?      I have argued that spatiality, as the human way of experiencing space and spaces, comprises three elements or dimensions, all of which relate in some way to embodiment. My central argument here has been that spatiality is part of what it means to be human, in the same way in which sexuality, identity and other relational concepts are parts of being human.   Not only does spatiality interact with other relational concepts, however, it also provides the means to think about them and the terrain on which they are enacted.  

 

By stressing embodiment as a necessary precondition for experiencing spatiality, I also acknowledge the existence of a physical reality (‘earth’, to use Heidegger’s term) which grounds and supports embodiment, but distinguish it from ‘world’.    ‘Worlds’ are networks of meaningful relationships, and humans are beings-in-the-world, and in order to function, or even just to be-in the world, the following three elements are essential.    The first element is proximity, which establishes the possibility of distance. Proximity can describe the networked characteristics of experience, as a measure of the intensity of a network relation. Proximity also provides a way to move beyond ideas of ‘inside’ or ‘outside’ in relation to institutions.  The second element is mobility, which is the possibility of action over distance enabling distance to have meaning in terms of action.    The third is possession, which is the product of engaging with space over time, and is an interpretation of affective relationships to the space(s) set up by proximity and mobility. Mobility is important in providing a means of understanding some of the socio-economic assumptions which go towards establishing a spatial paradigm.    Using Boltanski & Thévenot’s (1991;1999) model of ‘regimes of justification’, and the work of Urry (1999; 2000; 2001a; 2001b; 2002) and Adams (1999) on mobility, I argued that some very strong assumptions are embedded in our everyday understandings of mobility.    These understandings are themselves indicative of power-relations which the spatial paradigm  helps to reproduce.    Specifically, institutional assumptions about individual mobility have tended to ignore  issues of, for example, gender, age and ability, although the latter is increasingly a concern under the provisions of the Disability Discrimination Act [16]      Parenting, for example, is a major constraint on mobility which appears to be largely ignored by institutions, yet it has a significant impact on the learning experience for those involved, as the study revealed.   The term ‘learning environment’ has increasingly been used to describe software, such as WebCT , which provides access to various content, discussion and assessment resources on-line, and there are few discussions of learning environment from the point of view of embodied spatiality.  Notable exceptions are Gordon et al. (2000) and Nespor (1994) and there has been subsequent work which begins to take account of the realities of spatial existence (e.g. Clayton & Forton 2001; Holloway 2001;  Clarke et al. 2002).  Previous writers have tended to conceptualise this ‘environment’ as constituted by the interplay of power and identity issues in  a ‘spaceless’ situation.

 

Possession offered another set of insights into the spatiality of the learning process. By ‘possession’ I intend to convey a sense of ‘being-at-home’ in a situation, a sense which can, of course, be a negative one, since spaces can generate a sense of dispossession as well as possession.     Frequently, students stated that they felt apprehensive about entering specific spaces such as computer laboratories, because they lacked a familiarity with the equipment which others seemingly possessed.      The labs became a site for exchanging knowledge about ICT, but even this apparently beneficial quality of the space had a downside for those students whose time was taken up by requests for assistance from the less-experienced.    Possession here was thus a complex interaction between knowledge, communication, altruism and curiosity. There is an existing literature which discusses the professional socialisation of nurses, but this is generally presented as a unidirectional process of assimilation into teams or ‘communities of practice’ (Lave & Wenger 1991).  Possession complicates the idea of a homogenous community, and provides a way of engaging with the positive and negative dynamics of socialisation and community.

 

What emerges from the current research is that there is a subtle interplay, not only between issues of power and identity, but also between power, identity and physical spatiality.    This interplay is not  a matter of pure social construction, but social construction grounded in physical embodiment.  In the following section I discuss the second and third questions, regarding the role of spatiality in nurse education.

 

Spatiality in the context of nurse education: How does spatiality affect the lives of nursing students?

It was predicted that nursing students would be  good sources of data, for reasons connected with health-care policy and practice.    This turned out to be the case, and I am extremely grateful to the participants for providing such rich accounts of their spatial experiences.    The complexity of their relationships with spaces, however, is probably not unique.    I believe that it would have been equally productive to interview, for example, student teachers, the police, or long-distance lorry drivers.   The spatiality of newly-qualified  teachers is, in fact, one focus of an on-going study (McNally et al. 2003).  It is much harder, in fact, to think of a group whose spatiality would not have been of any interest.   The participants had come to nursing with complex ‘geo-biographies’, and as I argue in Chapter 5 the tendency to ignore embodiment and to focus on ‘purely’ psychological or social elements of the learning  process has detracted from the usefulness of some previous research in the area.   Nursing students were a worthwhile group to research, not only because of the richness of the data which they willingly provided, but because of public, professional and political concerns about their recruitment and training.

 

The study has therefore shown how the  use of spatial tools has the potential to address topical issues within nurse education and elsewhere.  Recruitment and retention rates for nursing students and qualified nurses are a source of concern within healthcare policy discourse (RCN 2003), and the evidence here is that specific spatial problems can influence morale.   These problems include difficulties with placements in relation to domestic circumstances, difficulties in accessing library resources and even the problem of being able to hear lectures properly. The results from this study suggest  that there are also interesting connections between travel and learning.   The perception of travel as transparent and unproblematic (except under ‘breakdown conditions’)  hides the diverse roles of transport in providing group study space, space for relaxation, or in facilitating placement opportunities in remote areas. The study shows that spaces open up for learning in unpredictable but creative ways.  Public libraries become substitutes for computer labs.   A placement becomes an ‘adventure’.    A car-share is not merely a way of getting from A to B,  but affords an opportunity for group learning and the exchange of ideas. In some situations, train travel provides study opportunities, but it is clear from the data that public transport generally was not helpful, and that there was therefore differentiation between car owners and others.

 

In respect of on-line learning and the use of  ICT in nurse education, a spatial approach suggests that on-line activity should be problematised by referring to the material circumstances of learner engagement with ICT.   Far from being de -spatialised, as suggested by the rhetoric of distance learning enthusiasts, such learning is re -spatialised, whether into corners of bedrooms, cramped computer labs or under-funded public libraries.   Even the advent of mobile technologies, whilst ostensibly decoupling learners from the need to be co-present in specific spaces, colonises new spaces for learning and thus removes the possibility of creating spaces of resistance to the idea of all-pervasive lifelong learning (Tett 2002).

Given that we are in a transitional phase as far as the adoption of ICT is concerned, its spatial effects do not simply take the form of the ‘space-time compression’ beloved of  modernist writers such as Harvey (1989) and Giddens (1991).    At the micro-level of student experience, ICT has not yet delivered its potential benefits, because it has been added on to a traditional model of student learning, consisting of lecture-based delivery and essay-based assessment.    Indeed, it sometimes adds to the frustrations and workloads of students, by introducing an additional set of skills to be learned, skills which, at least for the students in the current study, are insufficiently supported by institutions.    The ability to act at, or over, a distance is frustrated by the location of the technology.    Students are often required to be as physically mobile in order to access ICT as they are in accessing other forms of information.    Additionally, the knowledge that ICT is ‘out there’ creates frustration when other delivery systems, such as inter-library loans, fail to meet student expectations.   This is a dynamic and evolving situation, and it is likely that current students will be more familiar with the technology and more likely to have personal access to it ( The Independent , 26/10/03).

 

There are thus several features of the nurse education process, as it is currently conceived, which have spatial implications.    In addition to those mentioned above, these include the geographical location of the relevant institutions, the relation of nursing and midwifery departments to other parts of the HE system, and, most obviously, the practice placement.    In addition to these, there are less obvious spatial elements in the assignment-writing process, in the implementation or perception of self-direction and in the way that lectures are conducted.    Again, the conclusion which can be drawn from the study is that generalisations about any of these features of nurse education need to be qualified by local knowledge.    Even when such knowledge is available, and in certain instances it has been provided by the participants in this study, the implications of taking it into account in determining practice may be considerable.    It is clearly difficult, for example, to avoid long journeys to placements when the available settings are as widely dispersed as they are in the Highland situation.  A longitudinal study on a larger scale than this one would be required to determine whether the spatial aspects of professional socialisation were significant in terms of, for example, learning outcomes or student retention.

 

The discovery of complexity in the relationship between nursing students and the spaces in which they learn offers, therefore, useful insights for nurse education.  The study is not, however, written from a nursing perspective, and is not primarily about nursing or nurse education.    It has thus been able to focus on spatiality and to relate this to wider sociological issues, such as mobility, in a way which might not have been possible within the methodological conventions of nursing research.    It has, however, been informed by nursing research which has suggested topics of current concern within the field.  Nurse education benefits in that its practices and assumptions  have been scrutinised by a ‘professional stranger’ or ‘outsider’ (Agar 1996; Merriam et al. 2001).    The central conclusion to be drawn is that embodied spatiality matters, and must be taken into account when considering attrition rates, student recruitment and other pressing issues (RCN 2002).  It is characteristic of nursing students,  both according to the literature and as revealed in their conversations, that they are highly motivated, flexible and  reluctant to complain.   Research such as this gives them the opportunity to articulate concerns about the process of becoming a nurse which might not otherwise be voiced publicly.    It also shows that several of these concerns result from institutional reluctance to acknowledge that spatiality is  differentiated, whether for students or for staff.   This differentiation is most marked in terms of mobility, and the experience of mobility manifests itself in complex ways, as both a risk and an opportunity.   

 

Questions are, therefore, raised by the study which intersect with current policy issues around the spatial and professional expansion of the nursing role.   Within this expansion, nursing students are experiencing dislocation, which is ‘an unfixed, diverse and contradictory phenomenon’ according to Edwards & Usher (2000: 40).   They are not simply being asked to work outside the hospital setting, which in any case has never been wholly their ‘own’ or their sole territory (Rafferty 1996), but are being thrown into ‘[a] complex future’ (UKCC 1999: 18).  

The following diagram,  (figure  8, overleaf), sets out some of the issues:

 

 

 

Figure 8: The complex future of healthcare – the paradoxes

Health care in the future will be characterised by:

More money

AND

...continuing relative shortage of resources

 

Central/regional strategy

AND

Growing local diversity of provision and roles

Emphasis on prevention

AND

Great demand for cure and palliation

Continued dominance of hospitals

AND

Considerable emphasis on care close to home

 

Public reliance on professionalism

AND

Greater lay assertiveness

More, well-educated and assertive patients and clients

AND

Continuing need to serve those with little  

personal access to information

Greater demand for high tech medicine

AND

Growing demand for complementary

approaches

Demand for                                              

high technical competence and ‘scientific rationality’

AND

Continuing need for ‘human’ qualities  and the time to express them

Blurring of professional boundaries

AND

Separate professional traditions, organisations and public expectations

Greater incidence of the diseases

of old age

AND

Continuing demands from younger people

 

Continuation of old moral certainties

 

New and challenging environments in which to

apply them

The core expectations of nurses

and midwives will be little altered

AND

Nurses and midwives are not immune to

the other social changes outlined above

 

(Adapted from Dargie et al. 2000)

An understanding of spatiality can help to unpack some of the contradictions expressed in this table, because spatiality, as a central theme, gathers together a range of material concerns about the future of healthcare which would otherwise be dispersed across a range of discourses and problem areas.  The dimension of ‘proximity’ suggests ways in which awareness of new possibilities is spatially mediated, whilst the dimension of ‘mobility’ helps to understand how the ability to deliver or to receive services at a distance might be socially and economically differentiated.  Finally, the dimension of ‘possession’, which I have developed here, provides a framework for understanding how the re-siting of nurses and other health care workers can contribute to their sense of autonomy and professional identity.

 

A concrete example of this is the current (2003) controversy over the Edinburgh Royal Infirmary.  This institution was recently re-located from central Edinburgh, where it occupied a rambling collection of Victorian and modern buildings, to a ‘purpose-built’ greenfield site on the outer suburban fringe of the city.  Complaints about the new site have ranged from bed shortages and difficulties in navigating around the building, to the expensive and restricted parking arrangements and poor public transport facilities ( Edinburgh Evening News , 09/12/03).  All these are spatial issues, which have apparently been neglected or down-played for a variety of economic and managerial reasons ( Edinburgh Evening News , 04/12/03).  Resources are not, of course, unlimited, but a more spatially-focused approach to user needs might have enabled resolutions of some of the issues at an earlier stage.  This is not just about convenient access, but ethical issues have also arisen, such as the proximity of women who have suffered miscarriages to those who have successful births ( Edinburgh Evening News , 27/10/03), giving rise to considerable distress for those involved.   A spatial case study of the project using the PMP framework is, unfortunately, beyond the scope of this thesis, but would produce interesting results.

 

The above discussion has dealt with the use of the PMP framework as a tool within a particular social science tradition, that of phronetic research as described by Flyvbjerg (2001).  It has shown that the study answered its research questions, and it has also shown that what I call ‘spatial neglect’ is an important issue in health care policy and research.  In the final section, I draw the discussion to a close.

 


Concluding the conclusions: as closure beckons, another spatial metaphor appears.

Spatiality is part of human being, and it is important for institutions not to ignore the spatial realities of the student experience. The philosophical grounding of the concept of spatiality is complex, and the discussion of it here is not, and could not have been, exhaustive.  The central theme of the whole study is, however,  that attention to the specifics of spatiality is worthwhile in terms of understanding important and socially useful areas such as the nursing student experience.  In a recent RCN report   nurses are compared to an ‘amalgam’, a connecting substance for a collection of functions (RCN 2003: 15).   The experience of nursing students is that they ’amalgamate’ a wide range of spatial settings and situations in the course of their studies.  The journeys which they make, the knowledge-gathering processes which they use in essay writing, the ways in which they form social groups for study purposes and their engagement with the placements on which they are sent, all contribute to this amalgamation process.

 

A different process of amalgamation is at work in the production of this text.  Here, as will have become apparent, there is an attempt to reconcile two very different approaches to spatiality.  The spatiality of theory, whether it is derived from the ‘smooth and striated’ spaces of Deleuze and Guattari (1988), or the ‘non-place’ of Augé  (1995), or the ‘in/different spaces’ of Burgin (1996), makes for fascinating reading, but is ultimately as heterotopical and chaotic as Lefebvre’s lived-space  itself.  This is not to say that spatial theories are useless, but rather to say that they are tools amongst others, as is the PMP framework proposed here.

 

The mental map provided by the empirical research is somewhat different.  As with most students, nursing students are in constant motion, but across a very different landscape.  Theirs is a terrain of enclosed spaces, of wards, consulting rooms, libraries, cars, kitchens and halls of residence.  The journeys between these, in the main are journeys as means to ends rather than objectives in themselves, unlike, perhaps, my excursions into theory.  Nevertheless, the use of the PMP framework helps to reveal many of the assumptions which underlie the educational experience of nurses and others.  The journey metaphor, which is central to the spatiality of education as currently practiced, is predicated, for the nursing students, on the overcoming of obstacles, in the form of ( inter alia ) difficult placements, crowded libraries and noisy lecture theatres.  Yet there are also spatial compensations; the Highland scenery and quality of life, the greenery of the Stirling campus, and the companionship of long drives with colleagues.

 

A one-line summary of the research outcome might therefore be ‘spaces are important in nurse education, and everywhere else’.  This is, in one sense, obvious, but the evidence points to an increasing disregard of spatial considerations in policy and practice.  The controversy currently surrounding the new Edinburgh Royal Infirmary is just one example, but there are many other cases of what I would wish to call ‘spatial neglect’.  Many of these are linked to issues around mobility and sustainability, issues which will assume steadily greater prominence as climate change begins to be perceived rather than conceived.  The outline of nursing student spatiality here provides a sketch map of a relatively small area, but the intention of the study is that it will contribute to a greater understanding of the spatiality of everyday life. This is an understanding which will become increasingly essential, in a future, which is as uncertain for nurse education as it is for the world as a whole.

 

Taking a wider view of the project, the study of spatiality was itself intertwined with the spatiality of study, a spatiality which was discontinuous, chaotic and yet creative.  The postgraduate process is one in which two forms of becoming are potentially combined.  The becoming of the research project overlaps the becoming of the researcher in a form of apprenticeship which is both informal and highly significant.  Other projects come and go within the long stretch that lies between commencement and completion.  These inform the final shape of the main project, sometimes too late to make a difference.  The point at which one is best placed to undertake the study is therefore at its end.   The conceptualisation of the process as a journey is only partially useful, since there is also an element of dwelling, of haunting a particular set of spaces until possession (perhaps as employment) is gained.  The idea of dwelling holds out against closure, which in the case of spatiality is highly appropriate.  Spatiality is the basis for both closure and openness, and as such, is an inexhaustible topic.  This study cannot claim to provide a definitive analysis of spatiality, but it has attempted to open up the study of spatiality in a useful and timely way. 

 

 

 

 

 

 

 

 

 

 


References

 

 


Adams, John (1999), ‘The Social Implications of Hypermobility’ in Project on Environmentally

Sustainable Transport (EST): The Economic and Social Implications of Sustainable Transportation: Proceedings from the Ottawa Workshop   (Paris, Organisation for Economic Co-operation and Development).

Agar, Michael (1996), The Professional Stranger: an Informal Introduction to Ethnography

  (San Diego & London, Academic Press).

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Appendix One: List of nursing student identities