Nursing students' reactions to a graphic novel: A multi-national descriptive qualitative study

Lisa Williams; Carina Werkander Harstäde; Natalie Anderson; Ashwini Deshmukh; Alison Gayton; Merryn Gott; Ping Guo; Jane Nicol; Tatiana Tavares; Susan Waterworth

doi:10.1016/j.nedt.2024.106229

Nursing students' reactions to a graphic novel: A multi-national descriptive qualitative study

Nurse Educ Today. 2024 Apr 25:139:106229. doi: 10.1016/j.nedt.2024.106229. Online ahead of print.

Authors

Affiliations

¹ University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. Electronic address: la.williams@auckland.ac.nz.
² Linnaeus University, S-352 52 Växjö, Sweden. Electronic address: carina.harstade@lnu.se.
³ University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. Electronic address: n.anderson@auckland.ac.nz.
⁴ University of Birmingham, Birmingham Research Park, 97 Vincent Drive, Birmingham B15 2SQ, UK. Electronic address: a.deshmukh@bham.ac.uk.
⁵ University of Birmingham, Birmingham Research Park, 97 Vincent Drive, Birmingham B15 2SQ, UK. Electronic address: a.gayton@bham.ac.uk.
⁶ University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. Electronic address: m.gott@auckland.ac.nz.
⁷ University of Birmingham, Birmingham Research Park, 97 Vincent Drive, Birmingham B15 2SQ, UK. Electronic address: p.guo@bham.ac.nz.
⁸ St Richard's Hospice, Wildwood Way, Worcester WR5 2QT, UK. Electronic address: JNicol@strichards.org.uk.
⁹ AUT University, Private Bag 92006, Auckland 1142, New Zealand. Electronic address: tatiana.tavares@aut.ac.nz.
¹⁰ University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. Electronic address: s.waterworth@auckland.ac.nz.

PMID: 38691902
DOI: 10.1016/j.nedt.2024.106229

Abstract

Background: Undergraduate nursing programme teaching and learning methods and content must evolve to meet the changing evidence base, healthcare context and needs of new generations of nurses. Art-based and narrative methods have been employed to help student nurses explore complex issues, including patient experiences of health and illness, person-centred care and social determinants of health. One creative visual teaching tool is the graphic novel. However, little is known about student perceptions of graphic novels and how they facilitate student nurses' reflection, engagement and learning. Gaining such an understanding may be of especial value for teaching Generation Z students who are used to interacting with complex visual imgery and prefer alternatives to text-heavy documents.

Objective: The objective was to explore student nurses responses to Vivian, and graphic novels in general, as teaching resources in undergraduate nursing curricula in England, Sweden, and Aotearoa New Zealand.

Design: A social constructionist critical framework informing a descriptive qualitative study.

Setting and participants: Undergraduate nursing students in Sweden, England, and Aotearoa New Zealand.

Methods: Data were collected using focus groups and semi-structured interviews. Braun & Clark's method for thematic analysis was used to analyse the data.

Results: Three themes were developed: 1) reflections on clinical practice, including reflections on palliative care, holistic care for older people and communication between patients and staff; 2) graphic novels' usefulness as a teaching resource, in which students regarded them as an alternative way to learn; and 3) Vivian as a form of the graphic novel.

Conclusion: The graphic novel Vivian helped nursing students engage in critical reflection and with challenging theoretical concepts. It, and graphic novels in general offer an alternative to print-based texts, which may heighten their appeal to Generation Z learners.

Keywords: Gender; Generation Z; Graphic novels; Nurse education; Palliative care.