Collaboratively Creating a Training System for Novice Nurses through Boundary Crossing: An Activity Theory Based Analysis of the Dialogue Process

Abstract

This study constituted action research that nurses and researchers tried to change
a training system for novice nurses by building a community of dialogue that went
beyond existing frameworks. First, we interviewed the administrator, clinical educa-
tor, and preceptor who were concerned with newcomer education and the design of
the training system, and we analyzed the differences or gaps among their perspectives.
Second, we planned and tried a cross-boundary method whereby the nurses exchanged
knowledge and created a new training system for newcomers, negotiating the bound-
aries among wards or between researchers and hospital staff. The micro-process of
creating new knowledge through dialogue was examined using discourse analysis and
activity theory. The results were as follows: new knowledge was generated; and the
training system became multilateral. This was achieved through a process of continu-
ous context transformation: from past-oriented interviews to a context on the border
between past-oriented and future-oriented activity, then to a context of making con-
tradictions visible, and so on. In this process, a ‘nonsense proposal’by the researcher
(facilitator), one that nurses had laughed at and denied, also emerged as a springboard
for new, important knowledge. The discussion also describes what was created, and its
associated or conflicted heterogeneous historicity. This is discussed from the viewpoint
of concepts of zone of time perspectives (ZTP) and inter-historicity.