Peer reviewers for Nursing Education Perspectives will often ask in their reviews of submitted manuscripts, "What theory was used in this research?" Authors will sometimes respond, "There was no theory," or they will add one sentence identifying a common learning theory, such as Bandura's, with no explanation or connection to the research. This is deeply problematic for the advancement of the science of nursing education. In 1974, Suppes argued that educators relying on "bare empiricism" leads nowhere and can create "chaos in practice." I would suggest that research in nursing education must be based in theory to generate knowledge that provides guidance in how educators teach and students learn. This is crucial for nursing education so that our science can ultimately impact patient care outcomes.
I would suggest that research in nursing education must be based in theory to generate knowledge that provides guidance in how educators teach and students learn. This is crucial for nursing education so that our science can ultimately impact patient care outcomes.
As so eloquently noted by Day (2017), "Although the investigator may not have been thinking of theory explicitly when he or she developed the research question or selected the intervention, theoretical thinking is the foundation to planning and implementing all meaningful research" (p. 13). Theoretical thinking is how the researcher makes connections between and among observed phenomena and provides a foundation for the generation of research questions and the design of interventions. Theories help nurses to understand and explain the world and, specifically for nurse educators/researchers, best practices in nursing education.
Unfortunately, in many schools of nursing nationally, graduate theory courses have been eliminated from programs, negating the important role theory plays in knowledge development and in one's clinical nursing and teaching practices. In my experience, few nurses or nurse educators get excited by theory. Likewise, for some nurse researchers, the thought of theory creates varied responses, for example, anxiety, fear, frustration, and confusion (Rasmussen, 2017). How can we lessen these feelings and make theory accessible to more nurse researchers? How do we make the relationship between theory and research an automatic and unquestionable component, capturing how researchers experience the world?
Understanding the role and uses of theory in and for research in nursing education is a starting point. The relationship between theory and research is dynamic and interrelated; theory guides research, and research informs theory. Theories provide explanations for the complexities of learning, as well as for the gathering of new data. There are various ways to use theory in research. A researcher might start with an interesting teaching practice question and examine the literature for relevant concepts and theories to support the research. Or the researcher might start with a theory that resonates with a personal worldview and epistemology and generate research questions from the theory. In this instance, the theory helps set the boundaries of inquiry. A third approach would be to build a theory using research. Most frequently, this approach is associated with grounded theory, but there are other methodological approaches to build theory.
Another way to decrease anxiety about theory in research is to examine some robust examples of theory application. In this issue of Nursing Education Perspectives, there are several examples of varying applications of theory in research. Schroers and colleagues conducted a two-site mixed-methods simulated medication administration study exploring interruption management and associative cues used by nursing students. The researchers incorporated two theoretical frameworks to underpin their study. The design and structure of a newly developed simulation for the research was based on the NLN Jeffries Simulation Theory, whereas the simulated intervention to capture interruption management was guided by the cognitive science theory model of Altmann and Trafton, Memory for Goals. This model guided data collection, analysis, and findings presentation of the associative cues used by students during interruptions. In addition, the researchers linked discussion and implications to the model, enhancing the heuristic value of the theory for teaching practice.
The generation of a theory to guide the development of a new instrument and the ability to generate data using that instrument to support the theory are highlighted in a study by El Hussein and colleagues. Their article includes the presentation of the psychometric testing of a theory-based clinical evaluation scale designed to measure clinical instructors' gut feelings about students' clinical performance. Based upon a grounded theory study conducted by the researchers, the study data provided the items for the initial development of the Gut Feelings Scale. The three core components - brewing trouble, unpacking thinking, and benchmarking - were based on empirical findings from the grounded theory study. The findings from the study presented in this issue further support the grounded theory of gut feelings.
A third article in this issue uses theory in yet another way. Drs. Watts and Hodges tested Purkey's invitational theory to evaluate the nursing education learning environment. The researchers argued that educators most commonly evaluate student learning but that it is necessary to understand the environment within which learning takes place. Testing invitational theory consisted of using the theory constructs as a framework for the study. The data that emerged from this study were interpreted through a phenomenological and invitational theory lens and presented using the five aspects of the learning environment proposed by Purkey. Implications for nurse educators are linked directly to the theory.
Hopefully, these examples will ignite your theoretical thinking as you design your next research study. Engage your colleagues and students in theoretical discussions. Theory evolves. Based on the information we get by using and testing theory, we can implement changes to our teaching practice based on evidence and theory, thus making these changes more meaningful. Although research in nursing education has made significant strides in the past two decades, there is still more work to be accomplished in terms of knowledge generation and its translation, including theory generation and application.
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