A Relational Approach of Experting Processes of Beginner Nurses through Joint Practices with Preceptors

Abstract

　The purpose of the present study is to analyze the beginner nurses’processes of becoming expert nurses in terms of the relational approach. Subjects were 12 beginner nurses whose clinical experiences with preceptors in an emergency hospital had been observed through field works, continued for 11 months. The approaches were done by the Socio-Cultural Activity Theory, originating with L. S. Vygotsky, being further extended by James Wertsch. Wertsch distinguished“appropriation”from “mastering”; the former implies the learning processes by learners’ use of variety of tools and symbols situated in their environments, while “mastering” implies the leaning by simply copying the expert behavior without noticing the situational factors which make the behavior appropriate.

　We found that beginner nurses were gradually “appropriating” the expert behaviors by making their own tools and symbols for themselves from their environments so that they could predict what would happen next, what would be needed in the present patient, what the preceptor were going to do next, and so on. We also found that the most crucial point for the appropriation was the joint attention to the patient, vital signs, and necessary tools, with the preceptor from the same vantage point, standing side by side with the preceptor; who would be distinguished for the clinical training, not being practiced in the schooling.