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From healthcare assistant to registered nurse



Public, Staff, Students, Alumni

Speaker: Dr Kevin Bryant

An exploration of the status of knowledge in the experience of role transition


This study explores the status of knowledge during the transition experienced by healthcare assistants (HCAs) becoming registered nurses. It also seeks to highlight the tension between the representation of ‘sacred’ and ‘profane’ forms of knowledge in nursing higher education and in healthcare practice.

Twenty former HCAs were interviewed. Eight were nurses who had taken the Diploma of Higher Education several years earlier and twelve were students currently taking the BSc in nursing. Bernstein’s knowledge code theory and Bourdieu’s theory of practice informed the theoretical basis of the research. Data analysis drew extensively on Maton’s legitimation code theory (LCT) (Maton, 2014) which illuminated the differences between forms of knowledge that are in play within HE and differentially identified by participants as forms of capital. The specialisation device of LCT was used to identify expressions of epistemic knowing and social knowing in participant interviews. The semantic device was used to identify expressions of semantic density and semantic gravity.

Findings show how knowledge affects the whole social, cognitive and statutory transition described here. It is a core component of the decision-making process from accessing the health care sector as HCA, to engaging in the project of becoming a nurse. Knowledge is also central to the expressions and attitudes of recognition or condescension received by HCAs in daily practice from patients, nurses and other health care professionals. It is an element of power used by nurses in particular to maintain occupational separation from HCAs.

Knowledge also formed the backdrop to various challenges encountered by former HCAs during the nursing course at university and when returning as a student to clinical placements. Findings suggest that nursing higher education frames HCA knowledge as the ‘wrong kind of knowledge’ and HCAs as the ‘wrong kind of knower’. This imposes a form of relegation of their embodied knowledge in the process of changing role and status within the health sector.

Findings are of interest to government agencies and the higher education and healthcare sectors.

About the speaker

Dr Kevin Bryant is a King's Teaching Fellow and a Visiting lecturer in the School of Healthcare Sciences, University of East Anglia.
His research areas of interest are language, status of knowledge and power in healthcare settings.

Kevin’s background is in biosciences, education and physiology research, vocational and adult education in the community college sector, and undergraduate and postgraduate nursing education in higher education.

He has formerly been a director of Uni4U at King’s College London and a member of: Specialist Interest Group, Biosciences in Nursing Education, Nursing and Midwifery Council UK (NMC), Forum for Access and Continuing Education (FACE) Researching, Advancing and Inspiring Student Engagement (RAISE).

His qualifications are: a BSc in Physiology and Biochemistry, an MSc in Behavioural Biology, and a Healthcare Doctorate in Sociology of Education.

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When and where

1.00pm - 2.00pmMonday 21st January 2019

MG26 Myddelton Street Building City, University of London 1 Myddelton Street London EC1R 1UW United Kingdom