Context: The study highlights that within health care work, caring can be perceived as a 'threshold concept'. This is because the perceptions that health care students have of health care work change as they begin their careers and encounter experiences that challenge their initial perception, including in ways that can sometimes cause them discomfort.
Aims: The author provides a discussion of some of the moral and ethical dilemmas that students face upon entering employment as a health care worker. The author refers to the accumulation of new experiences as 'troublesome knowledge', which challenges students' preconceived ideas of health care work.
Methodology: Data are drawn from two different research projects:
- A three year study focusing on the professional socialisation of occupational therapy students - interviews were conducted with 12 occupational therapy (OT) students over the duration of their undergraduate degree. Participant observation and documentary analysis of course material was also adopted to develop an awareness of the context in which students undertook their studies.
- An action research project investigating the use of online discussion forums - the capacity of such forums to enable peer support among undergraduate physiotherapy students undertaking clinical placement for the first time was examined.
Findings: Students have a diverse range of challenging experiences, among them the burden of responsibility for making decisions for patients, finding that the 'care' element in institutional policy or other health care professionals is lacking, and balancing worries they have about being responsive to patients with their own wellbeing. Students might also question their own capacity to care if they feel they are detached from the experiences of patients. The study asserts that "going through the caring threshold has something to do with being touched personally by events so that students connect with those for whom they care as a human being" (see p. 512). As such, having an awareness of ones' own feelings can affect the professional identity of students, and help them to better cope with the distress experienced by patients, and demonstrate empathy. In this way, the "threshold refers to the point of entry into or out of a space that is 'transformative' and therefore liminal in nature" (p. 513).
Core argument: The author argues for a revisit of how students are prepared during their studies to undertake work as a health care professional, including in terms of developing emotional capacity and nurturance of a personal framework for caring.
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Caring as 'threshold concept': transforming students in higher education into health(care) professionals
Date: 2005
Author: Clouder, L.
Location: United Kingdom
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Caring as a salutogenic aspect in teachers' lives
Date: 2015
Author: Nilsson, M.; Ejlertsson, G.; Andersson, I.; Blomqvist, K.
Location: Sweden
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Caring for "Others": Examining the Interplay of Mothering and Deficit Discourses in Teaching
Date: 2012
Author: Hauver James, J.
Location: United Kingdom
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Caring for students: Pedagogy and professionalism in an age of anxiety
Date: 2010
Author: Huber, M.
Location: USA
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Caring in an institutional context: can it really occur?
Date: 1995
Author: Hamovitch, B.
Location: USA
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Caring in the Ivory Tower
Date: 2010
Author: O'Brien, L.
Location: USA
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Caring teacher and sensitive student: is it a gender issue in the university context?
Date: 2018
Author: Lu, H.
Location: Hong Kong
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Carry on caring: the work of women teachers
Date: 1995
Author: Acker, S.
Location: Canada
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Case Study Report: Supporting School-University Pathways for Refugee Students' Access and Participation in Tertiary Education.
Date: 2015
Author: Naidoo, L.; Wilkinson, J.; Langat, K.; Adoniou, M.; Cuneen, R.; Bolger, D.
Location: Australia
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Casualties of Schooling? 18 to 22 Year Old Students in a Tertiary Bridging Programs
Date: 2010
Author: Whannell, R.; Allen, B.; Lynch, K.
Location: Australia
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Catching Them before They Fall: A Vygotskian Approach to Transitioning Students from High School to University
Date: 2016
Author: Goggins, T.; Rankin, S.; Geerlings, P.; Taggart, A.
Location: Australia
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Centering social justice in the study of higher education: The challenges and possibilities for institutional change
Date: 2010
Author: Osei-Kofi, N.; Shahjahan, R.; Patton, L.
Location: USA
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Challenges in Understanding and Assisting Mature-Age Students Who Participate in Alternative Entry Programs
Date: 2006
Author: Cullity, M.
Location: Australia
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Challenges of Diversity for Widening Participation in UK Higher Education
Date: 2008
Author: David, M.
Location: United Kingdom
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Challenging Cultures? Student Conceptions of 'Belonging' and 'Isolation' at a Post-1992 University
Date: 2003
Author: Read, B.; Archer, L.; Leathwood, C.
Location: United Kingdom
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Challenging discourses of aspiration: The role of expectations and attainment in access to higher education
Date: 2018
Author: Harrison, N.; Waller, R.
Location: United Kingdom
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Changing lives: improving care leaver access to higher education
Date: 2019
Author: Wilson, J.Z., Harvey, A.; Mendes, P.
Location: Australia
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Changing Policy Discourses on Equity and Diversity in UK Higher Education: What Is The Evidence?.
Date: 2012
Author: David, M.
Location: United Kingdom
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