Opening the black-box of person-centred care: An arts-informed narrative inquiry into mental health education and practice

Background: Nursing education has a history of encouraging students to know their patients and to negotiate the in-between of art/science, person/profession, and intuition/evidence. Nurse-teachers know that students may abandon some values and practices when they encounter practice environments that are complex and have competing agendas. We are concerned that nursing knowledge is black-boxed, invisible and taken-for-granted, in healthcare settings.

Objectives: Our research explores how nursing students and nurses are constructing and enacting person-centred care in mental health education and practice. We want to understand the nursing standpoint on this significant ontological issue and to make nursing knowledge construction and utilization visible; illuminating how person-centred theory emerges from practice.

Design: The process involved four 3-hour group meetings and an individual follow-up telephone conversation.

Settings: Students and nurses met at a tertiary-care mental health organization.

Participants: Fourteen nurses (Registered Nurses and Registered Practical Nurses) and nursing students (Bachelor of Science in Nursing and Practical Nursing) participated in our inquiry.

Methods: We used arts-informed narrative inquiry to explore experience through the arts such as metaphor, collage, poems, letters, and group conversations.

Results: The black-box is opened as the inquiry reveals how nursing knowledge is constructed, assumptions are challenged and new practices emerge.

Conclusions: Our research is significant for education and for practice and is transferable to other populations and settings. Nurses are affirmed in person-centred values and practices that include partnership with those in their care, role modeling for colleagues and mentoring students and new nurses. Students participate in transferring their learning from school to practice, in the company of experienced colleagues; together they open the black-box to show how nurses conceptualize and enact person-centred care.