An exploration of the factors impacting on pre-professional identity formation during legitimate peripheral participation within nursing clinical placement

Pre-Professional Identity (PPI) development is a fundamental outcome of student nurse development. The process occurs as students engage in Legitimate Peripheral Participation (LPP), where a novice is involved in participating on the periphery of a work environment. From this position they navigate through existing Communities of Practice as part of their nurse education. The structured nature of the student clinical placement, with outcomes regulated by the Nursing and Midwifery Board of Ireland (NMBI), ensures their clinical placement experience is legitimate. Previous research has identified that conforming to existing practice, developing relationships with key stakeholders and gaining valued work based knowledge within a Community of Practice (CoP) are agentic tools used by new community members to assist their progression (Cobb et al., 2018). Equally, Lave and Wenger (1991) found that the CoPs that students join have existing characteristics and these are also influential in shaping students progression and ultimately their PPI. This work environment also has an existing workplace culture with historically accepted practices and structures of authority that students engage with during their learning experiences. Through this interaction, they are in a position to be influenced and to influence the working environment. A form of cultural reproduction emerges when students conform to a given culture and its power structures. However, students can also challenge the status quo though the personal agency they assert. The core contribution of this thesis is both theoretical and practical in nature. This research focuses on nursing students who undertook their third and fourth year of study in an Irish HEI in order to gain an in depth insight into their lived experience of their clinical placements and PPI formation. This was captured by gathering the perspectives of both students and preceptors. There was a dearth of research identifying and exploring the interplay between key factors within a CoP that influence the PPI of the student nurse. This research examined the existing factors that influenced PPI development on the one hand while on the other the process of how the students’ agency moderated these factors was also interrogated. The research explored how various other factors influenced this process and, in turn, how the students influenced the CoP they joined. Consequently, this thesis provides insights into the interplay between the key factors within the CoP that influenced the student nurse and the agentic tools the student utilised. The thesis contributes to our understanding how student nurses navigate the CoPs and how this affects their PPI development. It builds on existing theoretical models and contributes the development of theory and knowledge in this area.. The study adopted a constructivist approach where methods used were diaries and interviews. Findings demonstrated that whilst student nurses were, themselves, active in utilising tools available within the CoP, other factors outside their immediate control also influenced the ultimate ‘shape’ of their experiences and the emergent PPI. This work contributed to theory, knowledge and practice with respect to the healthcare environment. The influences exerted by the existing CoP on the students and the counter impact of student agency formed part of the nursing experience. As part of investigating this agency the concept of agentic tools as developed by Cobb et al. (2018) have been utilised. Additional knowledge in terms of this process of PPI development should increase understanding and influence change within healthcare organisation CoPs within clinical placements. It can also inform areas such as the relationship between the nursing student and their teacher within clinical placement as well as the experiences of student nurses.