Cultural reproduction of knowledge and identity: Impact of a competency-based curriculum on knowledge engagement and identity construction in second year undergraduate nursing students in England – A constructivist grounded theory study

BACKGROUND: Nursing knowledge is neither fixed nor uncomplicated but outcomes driven and competency-based standards underpinning nurse education can result in the dilution of pedagogical principles and a prescriptive and cultural reproduction of knowledge in nursing students. AIM: To examine how student nurses navigate the second year of an undergraduate degree programme in the UK and how different learning environments (practice and university) and previous experiences influence their perceptions, meanings and identity. DESIGN: Longitudinal constructivist grounded theory design underpinned by symbolic interactionism and social realism using focus groups and individual interviews. SETTING: One Higher Education Institution in Northwest England. PARTICIPANTS: Year 2 BSc Nursing students (n = 11) FINDINGS: A substantive theory, 'Navigating the second-year landscape: How student nurses construct an identity and engage with knowledge in the second year of an undergraduate degree' was underpinned by six categories: (1) the perceived identity of year two; (2) re-evaluating past, present, future; (3) constructing and balancing identities; (4) engaging with knowledge; (5) reference groups: significant others and the generalized other; and (6) the hidden curriculum: professional socialisation. CONCLUSIONS: Students place importance on and seek familiarity in the clinical environment and this can constrain opportunities for deeper critical engagement and hinder the development of autonomous practitioners capable of independent, reflective and critical thinking. Year two marks a pivotal stage in professional identity development and students seek knowledge and guidance from 'significant others' - typically their peers. Informal and hidden elements of the curriculum can influence students' learning and professional identity formation. Findings may have wider implications for opening international discourse on competency-based education including potential transferability to other practice-based professions.