Professional practice is an integral part of our highly specialised modern society. Knowledge and knowledge claims are central to this practice and information seeking and use can be seen as a basis for the individual's continuous learning from the workplace. Professionals' information seeking and use has also been a recurring theme within LIS (e.g. Leckie et al., 1996). The objective of this study is to gain understanding of the meaning specialist nurses' give seeking and use of information in their daily work, by studying nurses' descriptions of these phenomena. The nursing profession is the largest profession in the health care area, but not the heaviest user of formal information (e.g., Roddham, 1995). How can we regard the figures in quantitative research and understand the reality behind them as it is given meaning by the nurses themselves in their local settings? How do they experience the meeting between formal information and professional practice? How can these experiences be understood in the light of professional identity?
The gathering and use of information in working life is seen as a primarily social activity in this study and is therefore explored, as much as possible, in its social context through interviews carried out at the participants' workplaces. The nurses' descriptions of their information seeking and use are complemented with an analysis of the professional knowledge domain and an understanding of the prerequisites for seeking and using information at the workplace.
Professional development and its effects on professional communication is the scene from which nurses seeking and use of information are seen in the present project. The nursing profession has developed rapidly during the 20th century. In Sweden, nursing was formally institutionalised through the establishment of the Swedish Association for Nurses (SSF) in 1910. In 1957 nursing in Sweden was awarded formal legitimisation by the National Swedish Board of Health and Welfare, which gave nurses societal jurisdiction over their work (Bentling, 1995). During the seventies the nursing profession in Sweden start to strive for development of their own abstract knowledge base and thereby emphasise the difference between nursing knowledge and medical knowledge (Erlöv & Petersson, 1996).
Nursing education in Sweden has changed correspondingly: from a tradition where nursing schools used a mixture of medical cathedral lectures by doctors combined with an apprentice system where students where introduced to practical work by older nurses, towards an academic education together with an endeavour to develop an abstract knowledge base of their own (Erlöv & Petersson 1996). Today, a great number of students complete their education with a Bachelor's degree it is also possible to take a Master's degree in nursing and the numbers of nurses involved in doctoral studies are increasing (Bentling 1995).
As the development of a knowledge system proceeded and nursing education became more academic, the text-based tools that reproduce and mediate formal professional knowledge developed. The first issue of the American Nursing Research, the first peer reviewed nursing journal in the world, was published in 1952. The early Scandinavian nursing research journal, Vård i Norden, on the other hand, was not published until 1981 and the first Swedish dissertation in nursing was defended in 1978 (Bentling, 1995). There is now an increasing number of nursing journals, books and dissertations published which can be found through secondary information resources such as CINAHL and Medline.
The theoretical framework, here just briefly discussed, is guided by an interest in connecting information seeking and use to learning within professional knowledge domains that develop continuously in society.
The treatise of Berger and Luckmann, The social construction of reality (1966), forms a theoretical starting-point to an epistemological tradition that emphasises the social character of knowledge as opposed to viewing knowledge as a mirror of reality. This view places the communication between actors in focus and the empirical object is moved from the material base of knowledge to the discourses where knowledge is produced, communicated and used (McCarthy, 1996). Accordingly, knowledge is, in the present study, , defined as what a group of people connected to each other in some social practice , in relation to other groups, identify as knowledge and that is used by them to understand their practice and guide their discursive and physical actions.
Professionals' information seeking and use is, thus, seen as communication within more or less homogenous discourse communities. As a member of a profession the individual actor adopt, to a various degrees, certain values and attitudes, inherent in the professional identity, of what is regarded as important. The importance of how individuals identify themselves within a profession is therefore stressed. A professional identity is seen as a social identity and is, as such, created in relation to others. The sociologist Doyle McCarthy, defines a social identity in the following way: "A 'social identity' is the self signified as something or as someone, a signification addressed both to oneself and to others with whom one converses and where culture, in the form of language – concepts and discourses – operates at every phase of this dialogue" (McCarthy, 1996: 77). The way professionals talk about information seeking and use is here regarded as one aspect of the professional identity. The professional identity of individual nurses is constructed in the discourse community of nursing.
In a sociocultural perspective on individual and collective learning, originating from the Russian psychologist Vygotsky, social practices of different kinds develop intellectual tools and physical tools that are used to understand and act in the world (e.g. Hjørland, 1997; Wertsch, 1991; Säljö, 2000). With an interest in professionals' information seeking and use, intellectual tools can be exemplified by concepts, sayings and theories within a knowledge domain and physical tools by databases, journals and other text-based resources. Intellectual and physical tools do not just represent knowledge or social reality, they have, primarily, a mediating and constitutive role in the way individuals understand and act in social practice. Säljö states: 'Tools serve as mediational means, i.e., they - metaphorically speaking - stand between the individual and the world' (Säljö 1995: 84).
Individual's learning should, in a sociocultural perspective, be seen as the individual's possibility to appropriate these tools and thereby participate in professional communication. A sociocultural perspective of the research phenomena places the focus on the relation between the development of the profession on a collective level and individual activities and experiences on the individual level. The link between individual nurses at the workplace and the collective development of the knowledge domain is, from a sociocultural perspective, established through communication. Through conversations, meetings, journals, lectures, books, databases and web-sites communication between individuals and the collective knowledge development of the profession takes place. Individual nurses can be said to participate in a discourse community and the physical arena for this communication is, for nursing practitioners, the workplace with its local resources and limitations.
A perspective on how different professions compete with each other and what strategies they use is taken from a theory of professionalization. This perspective problemises a consensus view upon what is regarded as professional knowledge in society. According to Abbot (1988), professions exist in a system where the success of each profession's jurisdictional claim changes continuously in relation to each other and the most important instrument in this competition is the profession's abstract knowledge. More successful professions claim to have jurisdiction, not just over the work as such, but over a well developed abstract knowledge system that is supposed to guide their social practice. Professions' claim to an abstract knowledge system as a base for their professional practice is crucial if you are interested in professionals' information seeking and use as a social practice related to power and rivalry. In nursing there has been a development away from a profession almost entirely dominated by its neighbouring medical profession. This development has been expressed in the struggle for higher professional independence, a struggle in which the development of mediating tools is important.
The overall research questions can, in accordance with the theoretical framework, be formulated as:
The interest in qualitative knowledge in the present dissertation project is to describe and to interpret, in order to understand, the meaning that nurses give to information seeking and use by interviews. This will be carried out by interviewing nurses. These interviews should, from a sociocultural perspective, be viewed from the individuals' participation in different contexts (e.g., Cole, 1996; Thunborg, 1999; Wertsch, 1991). An understanding of the local context and of the professional knowledge domain is, therefore, given an important contextual role. These contexts, or activity systems, provide both resources and limitations in the form of the intellectual and physical tools they offer. This study focuses therefore on the relation between the participants' individual experiences, the prerequisites of the workplaces, and the knowledge development of the profession
Recurrent interviews with twenty nurses forms the primary data gathering instrument in the project. The participants have been chosen, from a standpoint in qualitative research, because of their potential to give rich and varied descriptions of the phenomena under study, not because of their representativeness. The participating nurses are specialist nurses within anaesthesia, operation and intensive care that had a special responsible for quality assurance, routine and knowledge development at their respective workplaces. These nurses are particularly interesting since they often have one foot in academia and one in practice.
The interviews have been loosely structured and undertaken with the help of a checklist. The first interview with each participator concentrates on four themes: the participants' background, the participants' workplace (information environment), the participants' view of professional development and the participants' experiences of information seeking and use. The second and third interviews took their starting point in incidents that the participators have experienced that information seeking and use have played a part since the last interview. Three interviews were undertaken with fifteen of the participants and two with five of them. The interviews were tape-recorded and transcribed in detail. The first round of interviews was completed during Autumn, 1999. The second round during Spring, 2000. The third round will be completed during Autumn, 2000. The interviews varied in length and lasted, on average, 35-45 minutes.
Interviews have been criticised for not having the possibility to convey anything except the interview situation. For example, Säljö says that, from a sociocultural standpoint, interviews risk decontextualising human action by separating actions from the practice where they have their origin (Säljö, 1994). I have, therefore, made an effort to start from the participants' own experiences of actual incidents and from there to proceed to their conceptions, motives and strategies. The interviews were, for the same reason, undertaken at the participants' workplaces, in an environment where they could feel confident. Furthermore, I have endeavoured to use a language without theoretical LIS concepts, such as, information seeking and use which has been replaced by a language closer to the everyday life of the participants.
Knowledge of the social and historical aspects of the knowledge domain of nursing has contributed to an analytic framework for the interviews. To understand the knowledge domain that nurses participate within by their information seeking and use is, from a sociocultural perspective, crucial, as collective knowledge development has an á priori relation to the individual experience. Within LIS, for example, Hjørland has, from a perspective of activity theory, developed a methodological concept for the analysis of knowledge domains, which he calls domain analysis (Hjørland & Albrechtsen, 1995). Therefore, as a complement to the interviews, an analysis of the knowledge domain based on secondary literature is important. Such an analysis will help me to identify, describe and interpret the nursing profession with special attention to professional communication. The secondary literature is mainly taken from Swedish nursing research.
Field notes have been prepared for each interview in order to get a glimpse of the participants everyday work. These notes contain the primary interpretations and descriptions of the participants' workplaces. The field notes are therefore used to gain insight in the participants' roles at their respective workplace and also to get a picture of the local, physical information environment. The filed notes should, however, be seen as a complement to the interviews rather than as an independent method, even if they can be regarded as a necessary complement.
The three data gathering methods, interviews, a literature study and field notes have, in spite of a preference for interviews, complemented each other.
|Individuals||20 specialist nurses with special responsibility for quality assurance and knowledge development||Primarily interviews, but also field notes|
|Workplaces||17 wards: emergency wards, surgery wards and intensive care units||Interviews, field notes and, to some extent, internal documents and secondary literature|
|Profession||The nursing profession, including specialist areas for operating- room nursing, anaesthetist nursing and intensive care nursing||Secondary literature and, to some extent, interviews|
In LIS, as in other social science research, the view of the individual as an undivided and coherent ground for analysis has been criticised (e.g., Budd, 1996; Talja, 1999). This criticism has been formulated within a broad movement that problemises the capabililty of language to mirror phenomena outside language (Alvesson & Kärreman, 2000). I consider, but remain, at the same time, pragmatic to this, frequently named, "linguistic turn" in social science. Instead, different analytical levels are identified and used during the analysis in order to create a multiple understanding of the phenomena under study. This attitude is advocated by for example Alvesson and Kärreman (2000), Alvesson and Sköldberg (1994), Coffey and Atkinson (1996) and Kvale (1995). Alvesson and Kärreman expresses this view in the following way:
Hence, we want to emphasize the partial ability of language to convey something beyond itself and to stress the variation in the relative consistency and value of utterances as clues to phenomena beyond themselves. Variations in interview responses, for example, do not necessarily mean that they do not point at something outside the contexts of the speech acts. Rather than illustrating the unreliable nature of accounts, they may indicate an ambiguous and inconsistent organizational reality; a varied, even contradictory, set of beliefs or values informing respondent perceptions; or merely the nuanced complexity of the issues in question. In research practice, this means remaining reflective and skeptical, but not categorical, about the discursive level in research. (Alvesson & Kärreman, 2000)
Instead of choosing a one-side perspective of outside reality, the internal reality, or discourse is here a consciousness of the differences between the analytic levels encouraged. I presuppose three levels in the analysis: a descriptive level, an interpretative level, and a discursive level. The participants' stories can accordingly contribute in providing descriptions of the world they work within, interpretations of how they experience this world, and how these experiences should be understood against the background of the possible discourses within the knowledge domain. It is neither the individual as such nor the knowledge domain that are in focus – it is the relation between them.
The process of analysis started with a thorough reading of each interview. Thoughts and reflections were written in the margins. Then, a comparison of the participants' narratives, through coding and retrieval, has played a central part. A participant's experience of a specific phenomenon has been compared with the other participants' experiences of the same phenomenon. Tesch calls this decontextualisation and recontextualisation (Tesch, 1990). In decontextualisation a certain passage in the interview is taken out in order to be recontextualised in a new text together with passages from the other interviews on the same phenomena. The differences and similarities that appear are interpreted, within the theoretical framework, and constitute one of the bases for the analysis. Coding and retrieval has facilitated the sorting and structuring of the empirical material. Categories, which have then been developed from the codes, will be used to generate dimensions. An interview passage can, thus, be interpreted from what other participants say about the same phenomena and from each interview in its entirety. As a complement to the work with categories, which might defragmentize interviews, case studies of each participant has therefore been constructed.