Teaching boundary setting in Canadian nursing programs : unveiling the hidden curriculum

Abstract

Background: Several studies discuss boundary setting as a skill for health professionals in therapeutic relationships. This study seeks to understand how the skill is taught in public post-secondary nursing programs and then experienced in a work setting. Objective: The purpose of this study was to explore the experiences of psychiatric nursing alumni and clinical instructors so as to support the evolution of boundary setting education and evaluation practices in post secondary institutions. Methods: This was a narrative inquiry study using virtual storytelling interviews which were transcribed. Alumni within 5 years of graduation and nursing instructors from a Canadian post secondary educational institution were eligible for participation. Participants were encouraged to share their experiences related to learning, teaching, and evaluating boundary setting as a therapeutic nursing skill. Findings: Through the analysis of the data, nursing alumni participants voiced not being ready to set boundaries in their workplaces, whereas nursing instructors were unable to identify specific curricular objectives, educational strategies, or evaluation tools for teaching boundary-setting. Conclusions: Students find boundary setting to be an emotional experience, not all students feel prepared to set all types of boundaries once in a workplace, and the curriculum objectives and evaluation tools for clinical instructors teaching boundaries were not explicit for either clinical instructors or program administrators. My recommendations were separated into curriculum and professional development strategies. Strategies included having program administrators set specific curricular objectives related to boundary-setting and ensure these objectives are being adequately assessed by clinical instructors, develop, or provide professional development opportunities for clinical instructors related to boundary setting and teaching boundary setting.