Applying Benner’s ‘novice to expert’ theory in wound care nursing higher education and practice: protocol for a qualitative multimethod research study to explore the wider effects of organisational policy enactment

Background
Benner’s acclaimed ‘novice to expert’ nursing theory assumes a relatively uninterrupted upward trajectory in knowledge and competence. However research findings suggest this career ladder cannot be easily reproduced in wound care nursing due to the significant inconsistencies in education provision, competencies, role description, pay grade and job title that exist across the UK. There is a lack of understanding about how relevant regulatory, health and professional body wound care policies are being implemented in higher education and in wound care practice and to what extent this impacts on Benner’s theory of achieving ‘expert’ status in wound care nursing.

Methods
A 3 phase sequential qualitative multimethod research design will generate the required different levels of data; policy, education and practice. Combining different methods of analysis of the same generic qualitative type, is suitable to explain ‘what is happening?’ by using a series of inter-related questions within the broad topic and is specifically designed to solve the overall problem.

Results
Each research phase is interdependent and together provides a more comprehensive picture than either would alone.

Phase 1 Critical Discourse Analysis (CDA) of pre-determined regulatory, health and professional body policy texts to obtain problematic concepts in wound care policy enactment and will inform in Phase 2.

Phases 2 and 3 will retrieve and analyse datasets from an e-Learning post-registration Level 9 wound care module delivered at the University of the West of Scotland.

Phase 2 Directed Qualitative Content Analysis (DQCA) of Secondary Data from retrospective students’ on-line asynchronous discussion posts to evidence Phase 1 concepts and develop instrument/topic guide for Phase 3.

Phase 3 Thematic Analysis (TA) of Synchronous On-line Student Focus Group will triangulate, unitise and develop findings to inform conclusions.

Conclusions
The design of the study depends on the results from the previous phase. Each phase cohesively informs and integrates with the next, moving from an understanding of how policy level informs wound care education and practice to reveal possible professional consequences on Benner’s theory and inform the development of a new wound care nursing education framework.