Developing nursing students’ knowledge in breastfeeding [DESTINI] Project

<p dir="ltr"><b>Background: </b>Globally, healthcare providers, including Registered Nurses, often lack the expertise needed to fully support breastfeeding women, contributing to unmet World Health Organization breastfeeding recommendations. Many new nurses frequently feel unprepared to assist in neonatal and paediatric settings. Furthermore, the growing diversity among nursing students requires innovative approaches to meet varied learning needs. Legitimation Code Theory (LCT) offers a promising framework to address these challenges in nursing education.</p><p dir="ltr"><b>Aim:</b> The aim of the Developing nursing students’ knowledge in breastfeeding [DESTINI] Project was to explore how LCT could inform the design and development of an online breastfeeding education module. Specifically, the project focused on how nursing students developed knowledge and investigated their learning experiences of the LCT informed learning materials.</p><p dir="ltr"><b>Methods: </b>A case study methodology approach was used to achieve the research aims. The thesis was organised as a series of four published papers. Paper 1 explored nursing students’ knowledge of breastfeeding and the sources of that knowledge. Paper 2 reviewed the application of LCT in the biological and health sciences and assessed its suitability as a framework for nursing education. Findings from Paper 2 also informed the design of the breastfeeding module and the analysis of the research project data. Paper 3 described the LCT-based design of the breastfeeding module and presented a thematic analysis of students’ experiences, based on semi-structured interviews. Paper 4 reported on students' knowledge development during the breastfeeding module, analysing both coursework artefacts and interview data.</p><p dir="ltr"><b>Findings: </b>The project revealed that while nursing students had a solid understanding of lactation physiology, they struggled with practical breastfeeding support. Nursing students’ knowledge sources included both personal experiences and formal education. The LCT informed breastfeeding module was well-received, with students appreciating its unique structure. The Specialization dimension of LCT provided insight into how students fluidly integrated personal experiences with theoretical knowledge illustrating a non-linear path towards becoming the 'right kind of knower' in nursing practice.</p><p dir="ltr"><b>Discussion: </b>The project demonstrated the effectiveness of LCT as a framework for course development and analysis in nursing education. It highlighted the significance of bringing students’ informal knowledge into conscious awareness, allowing them to critically examine and consider these insights. This process created opportunities to align informal knowledge with formal learning experiences, particularly in skills like breastfeeding support. Integrating personal experiences into nursing education proved valuable for building both knowledge and professional identity. The dynamic, non-linear nature of knowledge acquisition and knower development revealed by the Specialization dimension of LCT, offer new insights into the learning process for nursing education.</p><p dir="ltr"><b>Conclusion: </b>The DESTINI project demonstrated that applying LCT in nursing education can effectively support the development of both disciplinary knowledge and professional identity. The module structure, based on the concept of the semantic wave, enabled students to bridge the gap between abstract theoretical concepts and practical applications. The Specialization dimension illustrated that knowledge development in nursing is not a straightforward progression, instead students moved dynamically between different forms of knowing, meaningfully integrating personal experiences with theoretical knowledge. These insights have implications for nursing education design and delivery.</p>