Mediating Scientific Knowledge into Health Care Practice: Evidence from Pre-Registration Programmes in Nursing and Midwifery Education, and Recommendations for Future Curriculum Design.

This paper summarizes ongoing theoretical work and the findings of a recent research project in nursing and midwifery education to understand the problems encountered with using scientific knowledge in actual health care practice and to address these problems with educational program redesign. Case studies and mini-studies are used to investigate the ways in which theoretical knowledge is taught and linked to professional practice in a variety of curriculum slots in education settings and the ways in which the use of theory is introduced in service settings. Some methodologies were found to be more successful than others. The main reasons for problems in practice include little mediation of theory in service settings, lack of clarity about the facilitation and location of use of certain learning objectives, insufficient provision for mediation in the curriculum plan, and inappropriate teaching. But even good teaching over a sequence of sessions cannot ensure appropriate use of theory in practice if crucial links in the mediation chain are missing. Problems were found to be the greatest in the biological sciences, where both understanding the context and appreciating its relevance cause considerable difficulty. This difficulty is believed to be a failure to sufficiently articulate the curriculum demands of teaching for theory use in addition to theory comprehension. It is highly recommended that every pre-registration program have an overall plan for coordinating the theory with the practice. (Contains 23 references.) (NAV)