A Dissertation Entitled a Narrative Analysis of Familial, Collegiate, And
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A Dissertation Entitled A Narrative Analysis of Familial, Collegiate, and Professional Experiences that Enhance the Formation of Civic Engagement and Mission Commitment among Catholic Health Care Nurses by Jennifer M. Discher Submitted to the Graduate Faculty as partial fulfillment of the requirements for The Doctor of Philosophy Degree in Higher Education __________________________________________ Lynne M. Hamer, Ph.D., Committee Chairperson __________________________________________ Richard R. Gaillardetz, Ph.D., Committee Member __________________________________________ Debra S. Gentry, Ph.D., Committee Member __________________________________________ Sue Easter Idczak, Ph.D., Committee Member __________________________________________ Dr. Patricia R. Komuniecki, Dean College of Graduate Studies The University of Toledo December 2011 Copyright 2011, Jennifer Marie Discher This document is copyrighted material. Under copyright law, no parts of this document may be reproduced without the expressed permission of the author. An Abstract of A Narrative Analysis of Familial, Collegiate, and Professional Experiences that Enhance the Formation of Civic Engagement and Mission Commitment among Catholic Health Care Nurses by Jennifer Marie Discher Submitted to the Graduate Faculty in partial fulfillment of the requirements for the Doctor of Philosophy Degree in Higher Education The University of Toledo December 2011 Educating for citizenship has pervaded the mission of higher education from classical Greece up to the present day. Colleges and universities increasingly encourage service learning and other curricular approaches that promote social responsibility and civic involvement. Other mission-oriented institutions, such as Catholic health care, grapple with issues of social responsibility and civic involvement as they discern their role in the community and face the challenges of a changing workforce. This dissertation examines, through narrative analysis, how mission commitment in a specific industry—Catholic health care—is influenced by higher education, and how higher education might learn from mission commitment development in that industry. The study explores how nurses understand their personal development of mission commitment with a specific focus on the way in which life experiences—familial, collegiate, and professional—have enhanced or driven their mission formation. Because higher education is an integral part of the process of nurturing and sustaining responsible civic engagement, this study first seeks to understand that process as a pedagogical endeavor. It next narrows this broad discussion of responsible and engaged citizenry to a iii more focused study of the specific discipline of nursing: first, its theoretical and practical curricular and co-curricular approaches to education, and then the expectations of a specific corresponding industry—Catholic health care— for its newly hired professionals. The Backward Design process frames the discovery of common ground shared by higher education and Catholic Health care in mission commitment formation. Participants in this study comprise a purposeful sampling of 13 nurses employed by a large Catholic health care system in the Midwest. These nurses are front-line, baccalaureate-prepared, and institutionally recognized, cited, or awarded for their mission commitment. Their collected narratives, analyzed through the lens of a model created by Labov and enhanced by the work of others such as Riessman, Coffey, and Atkinson, lead to recommendations for more effective mission formation practice in both Catholic health care and higher education. iv The academy should “make for less misery among the poor, less ignorance in the schools, less suffering in the hospital, less fraud in business, [and] less folly in politics” ~Daniel Coit Gilman For Luke, Alma, Joseph, and Ruth—my grandparents. You made for less misery among the poor, less fraud in business, and less folly in politics through your work and through your lives. Your commitment toward education in the service of others lives on in your children, grandchildren, great grandchildren and great-great grandchildren. For Mom and Dad. Thank you for valuing education enough to make it a priority. You have recognized, encouraged, and modeled for us the mandate to use our gifts and talents in service of those in our families, our communities, our nation, and our world who are in need. Remember: ―Just one more…‖ v Table of Contents Abstract………………………………………………………….………………………..iii Table of Contents………………………………………………………………………....vi List of Tables……………………………………………………………………………...x I. Introduction ……………………………………………………………..…………….1 A. Purpose Statement………………………………………………..……………6 B. Working Hypotheses and Significance of Study……………………...............7 C. Theoretical and Conceptual Framework………………………………………8 D. Scholarly Context……………………………………………...….…...............9 E. Research Questions……………………………………………..……………10 F. Research Site and Participant Selection……………………………………...11 G. Methodology………………………………………………………………....12 H. Data Collection, Management, and Analysis…………………………..…….12 I. Delimitations…………………………………………………………………14 J. Limitations……………………………………………………………..…….14 K. Definitions………………………………………………………………..…..16 II. Literature Review…………………………………………………………………….19 A. Backward Design…………………………………………………………….20 B. Social Theory of Education……………………………………...………..…21 a. History of Higher Education and Civic Engagement……………..…24 b. Professional Education and the Liberal Arts…………………...…....32 c. Student Learning, Outcomes, and Development.……………………34 d. Narrative Learning……..…………………………………………….46 vi e. Nursing Education…………………………………………………...50 C. Catholic Health Care..…………..…………………………………………....55 a. Continuation of Mission and Sponsorship….……………………..…63 b. Engaging a Diverse Workforce……………………………………....69 c. Mission-Minded Behaviors and Characteristics……………………..73 D. Conclusion…………………………………………………………………...77 III. Methodology…………………………………………………………………………79 A. Strategy, Genre, and Rationale………………………………………………80 B. Research Site and Participants…………………….…………………..……..81 a. Site Selection and Access…………….………………………..…….82 b. Participant Selection……..…………………………………………..83 C. Researcher‘s Role and Ethical Considerations…..……………..……………87 D. Data Collection, Management, and Analysis…..…………………………….90 a. Data Collection…………..…………………………………………..91 b. Data Management…….……………………………………………...92 c. Data Analysis……….………………………………………………..93 E. Trustworthiness………………………………………………………………98 IV. Analysis……………………………………………………………………………..103 A. Participant Demographics…………………………………………………..104 B. Analysis…………………………………………………………….……….105 a. Understanding Mission……………………………………………..110 b. Familial Influences………………………………………………….123 c. Becoming a Nurse………………………………………….……….131 vii d. Collegiate Experience………………………………………………145 e. Civic Engagement and the Public Face of Nursing………………...163 C. Conclusions…………………………………………………………………170 V. Findings…………………………………………………………………………….172 A. Summary and Backward Design……………………………………………173 B. Research Questions…………………………………………………………174 C. Narrative Methodology and Learning…..…………………………..………179 D. Discoveries in Light of the Literature Review……………………………...182 a. Social Role of Education…………………………………………...182 b. Liberal and Professional Education in Nursing Education…………185 c. Student Learning, Outcomes, and Development…………………...189 d. Intellectual and Moral Conversion………………………………….196 e. Mission-Minded Behaviors and Characteristics in Catholic Health Care…………………………………………………………197 E. Recommendations for Practice……………………………………………..200 a. Programmatic Evaluations………………………………………….201 b. Evaluative Considerations………………………………………….203 c. Environmental/Cultural Considerations……………………………204 F. Implications for Further Research………………………………………….207 a. Legacy of Nursing in Families……………………………………...207 b. Quantitative and Qualitative Research……………………………...207 c. Undergraduate Program Development and Frameworks…………...209 d. Organizational Culture and Structures……………………………...210 viii G. Final Thoughts……………………………………………………………...212 Afterword……………………………………………………………………………….213 References………………………………………………………….…………...………215 Appendices A. Sample Intake Form………………………………………………………………...235 B. Sample Interview Questions and Probes……………………………………………236 C. Labov‘s Elements of Narrative Analysis…………………………………………...237 D. Participant Demographics…………………………………………………………..238 E. Mission Commitment Narratives…………………………………………………...239 F. Familial Influences………………………………………………………………….249 G. Becoming a Nurse Narratives……...……………………………………………….250 H. Collegiate Narratives………………………………………………………………..259 I. Civic Engagement and Public Face of Nursing Narratives………………………….265 ix List of Tables Table 1. Amanda‘s Mission Commitment Narrative………………………….……….110 Table 2. Kim‘s Mission Commitment Narrative……………………………………...114 Table 3. James‘s Mission Commitment Narrative…………………………………….119 Table 4. Terri‘s Familial Influences Narrative………………………………………..123 Table 5. Sarah‘s Familial Influences Narrative……………………………………….128 Table 6. Craig‘s Becoming a Nurse Narrative………………………………………...132 Table 7. Maria‘s Becoming a Nurse Narrative………………………………………..136 Table 8. Lyn‘s Becoming a Nurse Narrative………………………………………….141 Table 9. Amanda‘s Collegiate Experience Narrative…………………………………146 Table 10. Kristi‘s Collegiate Experience Narrative………………………………..…...149 Table 11. Sarah‘s Collegiate Experience Narrative………………………………..…...156 Table 12. Ann‘s Civic Engagement Narrative……………………………………..…...164 Table 13. Lyn‘s Civic Engagement