Category: Mental Health Nursing

Option
2 | Service User Narrative (critical reflection of an online patient narrative)
Project
Guidelines
Students
are required to develop and complete a critical reflection of an online service
user narrative.  This is an independent
enquiry-based learning (EBL) project with a word count of 6000 words.
The
purpose and aim of this project are to identify, critically analyse and apply
evidence to nursing practice through the analysis of a service user’s
narrative, considering its relevance to an aspect (or aspects) of nursing
practice.
Note: You should not interview a service user/patient
for this project; you will listen to, and watch a service user narrative from Healthtalk.org
and use this for the basis of your final project.
The
service user narrative offers the student a chance to explore specific area(s)
of practice from the service user’s perspective.  It is important to choose a topic that is
relevant to your current field of nursing (i.e., Adult Nursing, Children’s and
Young People’s Nursing, Learning Disability Nursing, Mental Health Nursing) and
your future practice as a registered nurse. 
Why choose a Service User Narrative?
You
should choose this option if you want the opportunity to critically reflect on
the experience of listening to an individual talk about their experience(s) of
living with a condition, having a diagnosis, receiving treatment, and/or how
they access healthcare services. Service user preferences and values are an
essential component of evidence-based practice, alongside research evidence and
clinical expertise (Melnyk and Fineout-Overholt, 2011), making an important
contribution to informing healthcare. Listening to service users/patients can
give nurses invaluable insight into the lived experience and can inform our
understanding and enable us to make changes to our practice, resulting in
service users/patients having improved healthcare experiences and outcomes. 
What is a critical reflective of a service user narrative?
A
service user narrative requires you to watch and listen to an individual talk
about their health/healthcare experience(s). 
The narrative might be related to the individual’s health, illness,
disability, treatment, access to healthcare services and/or support.  The important thing is that you will be
listening to the experience (whatever it is) from the service user’s
perspective.  It requires you to actively
engage with what the individual says, and to consider how this perspective
relates to published literature and to informing healthcare practice generally
as well as your own practice as a qualified nurse.
Suggested Structure for your Service User Narrative |
Section Headings
Title Page
– please
use the title page format in the Module Handbook.  Your title should clearly tell your reader what the work that follows is
about.
Acknowledgments
– keep these brief and remember that they will be
read by people other than your markers and your family!
Contents
– the pages of your work should be clearly numbered
throughout and the different sections identified in the contents list, along
with the relevant page numbers.
Abstract
–
(approx. 200-300 words, not
included in the wordcount) – An abstract can help signpost your reader, and
provide a clear overview of your project. The abstract should provide a concise
summary of your work, using the format of the following project section
headings (Introduction, Method, Critical Reflection, Discussion). Your
completed project will also include a reflection on your learning (see below) –
but you do not
need to include anything about your reflection in the abstract.
Chapter 1: Introduction and background (approximately 1000 words) – The purpose of this chapter is
to introduce the reader to the service user narrative and its context, and to
the relevance of experiential knowledge to nursing practice.  In this chapter you should:
o   Critically explore the relevance and value of the service
user’s voice to evidence-based nursing practice.  You should draw on published literature and
policy recommendations, appraising a range of evidence that demonstrates your
knowledge and understanding of the contribution of experiential knowledge to
healthcare practice.
o   Draw on your critical appraisal of current evidence/policy
issues to provide some (brief) background to the service user experience that
is the focus of your work.
o   Provide a clear rationale / justification for your choice of
service user narrative – this should draw on current literature / evidence to
help explain your interest in this area of practice (for example, you could
choose a narrative which relates to an area you have experienced on placement).
o   End with the specific question(s) to be addressed through
your analysis of the service user narrative.
Chapter 2: Method (approx.
750 words) – The purpose of this chapter is to demonstrate how you have
undertaken the critical analysis of this service user narrative. You should:
o   Identify the source of the narrative(s) you have chosen,
explain why you chose to write about this specific service user experience. When choosing your service user narrative,
you may need to choose more than one video about the same person’s experience,
or choose a longer video as some of the service user narratives available are
very short and would not give you enough material to work with.  You may also use a number of service user
narratives about the same health topic/experience.  Please discuss this with your supervisor.
o   Consider ethical issues in using service user narratives.  For example, consider issues relating to
consent, confidentiality, and informed decision-making.
o   Outline the process
you have chosen to analyse and critically reflect on the service user
narrative. 
o   We suggest you use the reflective model as outlined by Rolfe
et al. (2011) to structure your
critical reflection.  If you want to use
a different model, please discuss this with your supervisor at the earliest
opportunity. 
o   Within this reflection, you could choose to undertake some
basic thematic analysis of the transcript of the narrative(s).  If you choose this, you should outline your
process here, with references.
o   The analysis and critical reflection will be in the next
chapter.  In this chapter, you are
describing the process/methods you used, and why.
o   This chapter should be structured, analytical and supported
by a range of appropriate literature. 
Chapter 3: Critical Reflection (approximately 2750 words) – The purpose of this section is
to provide a critical reflection on key aspects (e.g. themes) you identify
within the service user narrative(s), informing your discussion with published
evidence.  You may wish to organise this chapter
into sub-sections which relate to the key aspects you have identified.  For example, if you use a thematic analysis
and identify three themes, you could write approximately 900 words per theme.  You may be able to organise the key aspects
that you have identified differently, please discuss this with your supervisor.  When writing about each key aspect/theme, you
should structure your writing in line with the model you have chosen to
use.  For example, if using the model by
Rolfe et al. (2006), using the
sub-headings: What? So what? Now what, as
illustrated below:
Theme
1
·      
What?
o   What is the specific theme you have identified within the
narrative.  Why have you identified this
specific theme?  Why is this important?
·      
So what?
o   In relation to the theme you have identified in the
narrative, critically explore how what the service users says relates to
published literature on the topic.  For
example, does the narrative compare with published literature, or does it offer
a contrasting perspective?  Why might
this be?  What is the relevance /
significance of this?
o   How can you relate the service user’s perspective to your
experiences / observations in practice?  Does
the narrative compare with your experiences, or does it offer a contrasting
perspective?  Why might this be?  What is the relevance / significance of this?
·      
Now what?
o   Critically consider how learning from the service user
narrative in relation to the identified theme is relevant and can be applied in
healthcare practice.
o   Critically reflect on how listening to the service user
narrative has influenced your own thinking. 
For example, has it confirmed or challenged your views?  How will learning from the service user
narrative inform your own practice as a qualified nurse?
Chapter 4: Discussion (approximately
1000 words) – The purpose of this section is to draw the main debates and
findings together, and to make recommendations for how the learning should be
applied in practice, considering if future research is required. 
o   Summarise key aspects discussed, and draw main debates and
findings together.  Consider potential
benefits and limitations of service user narratives informing nursing practice.
Here you might want to think about the role that service user experiences play
in Evidence Based Practice.
o   Make recommendations as to how learning from the narrative
you have chosen can be applied in nursing practice.
o   Make recommendations for future research.
Chapter
5: Reflection on learning (approx. 500 words) – reflect on what you have learnt from undertaking
a critical reflection on a service user narrative. You could choose to use a
reflective model to help you structure this section.
o  
Critically reflect on your learning – what have been your
key learning points? 
o  
In this section you might also refer back to your
motivation/justification for undertaking this project.
Reference
list
using UWE Harvard
Appendices
– if appropriate. Don’t include
anything here which really needs to be in the main body of your project. You
might include, for example, the transcripts of the service user narratives you
have used (or excerpts if they are lengthy), or a diagram showing the EBP
triad.