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Exploring the scholarly writing development of master’s nursing students

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Exploring the Scholarly Writing Development of Master’s Nursing Students
by
Rebecca Red Wolf

Rossier School of Education
University of Southern California
A dissertation submitted to the faculty
in partial fulfillment of the requirements for the degree of
Doctor of Education

May 2022

© Copyright by Rebecca Red Wolf 2022
All Rights Reserved

The Committee for Rebecca Red Wolf

Dawn Janke
Kathy Stowe
Helena Seli, Committee Chair

Rossier School of Education
University of Southern California
2022

iv
Abstract
The purpose of this mixed-methods study was to determine how a 14-week intervention affected
students’ self-efficacy, task value, and writing performance. Bronfenbrenner’s ecological
systems theory was used to explore sociocultural influences on students’ writing development
and student perceptions of the intervention experience. The participants were master’s nursing
students enrolled in an existing one-semester writing course for health professionals. A quasi-
experimental mixed methods design was used to measure the difference between students’ pre-
and post-intervention scores on an IntelliMetric® writing assessment, and the SAWSES self-
efficacy survey. Qualitative data were gathered from semi-structured interviews with nine
student volunteers, then coded for thematic analysis. The quantitative results showed statistically
significant gains in self-efficacy and writing performance with large effect sizes. In the
qualitative interviews, students explained the perceived benefits they received from the
scaffolded instructional design of the course, balanced formative feedback from faculty, and the
practical writing strategies they were taught. The interviewed students discussed transformations
in their scholarly writing, critical thinking, professional communication skills, and confidence
after participating in the course. Students also shared the positive and negative effects of various
ecological environments on their learning. This study addresses the gap in nursing education
regarding the assessment of research-based writing interventions on students’ scholarly writing
capacity. Recommendations include implementing a required scholarly writing course in all
graduate-level nursing programs, promoting self-directed reflective learning with e-portfolio
assessment, using a sociocultural approach to instruction across the curriculum, providing
formative feedback in a supportive environment, and differentiating instruction with a flexible
scale of help to scaffold students’ cognitive and professional development.

v

Keywords: scholarly writing, nursing education, academic writing, writing intervention,
writing capacity, self-efficacy, writing in the disciplines, writing instruction, formative feedback,
writing across the curriculum, portfolio assessment, critical thinking, metacognition, reflection

vi
Dedication
To my husband, Andrew. You are the sun, moon, and stars to me. I could not have completed
this dissertation without your steadfast love and support. Thank you for being my thought
partner, life partner, and all-time favorite person. I love you!

vii
Acknowledgements
I must first acknowledge my mother, Sharon Schenk, and grandmother, Bessie Hill, who
took out a substantial college loan when I was 17 so I could lead the first generation of college
students from my family. I am forever grateful for your love and support. Your faith in me has
inspired my strength and determination to face every life challenge with the knowledge that I
come from a long line of Mohawk women who have the power and the responsibility to do what
must be done for the betterment of our world, our children, and each other.
Another thank you to my mom for taking care of me and the rest of the family as I
worked through my doctoral program, and for making sure we all had food to eat, our laundry
was clean, and that the children got to school and all of their activities.
Thank you to my husband, children, and younger brother for putting up with me on a
daily basis and not complaining about it too much.
I would like to recognize my first graduate professors at Clemson who saw something
special in me and convinced me that I could someday join their ranks as transformational
teachers, researchers, and leaders. Thank you Pamela Dunston, Victoria Ridgeway, and Kathy
Headley for choosing me to be your graduate research assistant, teaching assistant, and co-
conspirator at reading education conferences. I hope I have done my intellectual “parents” proud.
Thank you to my Quaker friends and community for holding me in the Light, for helping
me to see myself as a leader, and nurturing my spiritual gifts. I love our soul-nourishing
conversations, grounding embraces, and consensus-based community practice.
I want to acknowledge my Taco Tuesday friends for their never-ending support and
encouragement, even when I had to miss Taco Tuesday for classes or homework or Covid. You

viii
have been an anchor through my dissertation journey. I hope I can live up to my new nickname:
Dr. Hot Stuff!
To my dancing friends for always inviting me out for live music and dance breaks. The
joy we share through dance has given me ample motivation to finish my homework every
weekend. I promise my next doctorate will be in dancing!
I also acknowledge the support I enjoy from my writing coach team, Rebekah, Caren, and
Beata. I am so very proud of the cognitive tools, scaffolding, and endless encouragement we
provide to our students every day. I truly believe there isn’t any writing problem our brilliant
minds can’t conquer together! Additionally, I recognize all of the faculty who have co-taught the
Writing Workshop with me and especially for your willingness to try new instructional strategies
and deliver honest, clear feedback to our students. I acknowledge the loyal support of my Deans,
Kathy and Lydia. Without your dedication to scholarship and academic excellence, we would not
have such strong writing and student supports at our school. And a big thank you to Barbara
Ohrstrom for planting the seeds of writing pedagogy in my heart many years ago.
I am especially grateful for the hard-working school of nursing students I have the honor
to teach every day. Your commitment to providing your patients with the best possible care is so
kind and courageous. My hope is to empower you to become the future leaders and innovators
that our healthcare system so desperately needs.
Thank you to my amazing OCL Cohort 15. I have learned so much from each of you and
I cherish the friendships I have made with Joe (a.k.a. Huggy Bear), Sharon, Kristin, and Linh. I
want to thank Dr. Marc Pritchard for the first-semester pep talks and ongoing support throughout
my program. Whenever I felt lost or confused about coursework, I could always count on you to
help me figure things out! I would also like to acknowledge Dr. Laura Cardinal for helping me

ix
collect data for this study. You are one of the “expert others” who scaffolded my growth as a
novice researcher. I look forward to collaborating with you again in our shared efforts to improve
writing pedagogy!
Finally, I would like to thank my dissertation committee: Dr. Kathy Stowe and Dr. Dawn
Janke for your intellectual generosity and thought-provoking feedback. I am so proud of this
study and what I was able to accomplish with your help! And a huge thank you to the chair of
my dissertation committee, Dr. Helena Seli. You were the expert guiding me through a
transformational cognitive apprenticeship. I am indebted to your kindness and wisdom as you
accompanied me through a rewarding doctoral journey.
Nia:wen kowa!

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Table of Contents
Abstract .......................................................................................................................................... iv
Dedication ...................................................................................................................................... vi
Acknowledgements ....................................................................................................................... vii
List of Tables ................................................................................................................................ xii
List of Figures .............................................................................................................................. xiii
Chapter One: Introduction .............................................................................................................. 1
Background of the Problem ................................................................................................ 2
Importance of Addressing the Problem .............................................................................. 5
Organizational Context and Mission .................................................................................. 6
Organizational Goal ............................................................................................................ 7
Description of Stakeholder Groups and Stakeholder Group for the Study ......................... 8
Purpose of the Study and Research Questions .................................................................... 9
Overview of the Conceptual and Methodological Framework ........................................... 9
Organization of the Project ............................................................................................... 11
Chapter Two: Review of the Literature ........................................................................................ 13
Overview of Scholarly Writing in Nursing Education ..................................................... 13
Best Practices in Writing Instruction ................................................................................ 33
Bronfenbrenner’s Ecological Systems Theory ................................................................. 46
Conceptual Framework ..................................................................................................... 47
Summary ........................................................................................................................... 50
Chapter Three: Methodology ........................................................................................................ 52
Research Questions ........................................................................................................... 52
Data Collection, Instrumentation and Analysis Plan ........................................................ 56
Ethics and Role of Researcher .......................................................................................... 68

xi
Chapter 4: Results and Findings ................................................................................................... 70
Participants ........................................................................................................................ 70
Research Question 1: How Does a Discipline-Specific Writing Course Affect
Students’ Self-Efficacy, Task Value, And Scholarly Writing Performance? ................... 73
Research Question 2: What Are Nursing Students’ Experiences in a Discipline-
Specific Writing Course? .................................................................................................. 77
Research Question 3: How Do Nursing Students Perceive the Impact of
Microsystem, Mesosystem, Exosystem, and Chronosystem Environments on
Their Scholarly Writing Development? .......................................................................... 116
Chapter Five: Discussion and Recommendations....................................................................... 141
Discussion of Findings and Results ................................................................................ 142
Recommendations for Writing Instruction ..................................................................... 158
Limitations and Delimitations......................................................................................... 173
Recommendations for Future Research .......................................................................... 175
Implications for Equity ................................................................................................... 176
Conclusion ...................................................................................................................... 177
References ....................................................................................................................... 179
Appendix A: Course Schedule for the Writing Workshop Fall 2021 ............................. 198
Appendix B: Hierarchy of Writing Concerns ................................................................. 201
Appendix C: Final Rubric for The Writing Workshop ................................................... 202
Appendix D: Survey Questions ...................................................................................... 204
Appendix F: Descriptive Statistics for Task Value Survey Items .................................. 208
Appendix G: Interview Protocol ..................................................................................... 209
Appendix H: Students’ Interview Responses Regarding Transformations .................... 211
Appendix I: Student Definitions of Scholarly Writing ................................................... 222
Appendix K: Assignment Guidance for Final Reflection Paper ..................................... 228

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List of Tables
Table 1: Data Sources 56
Table 2: Demographic Data 71
Table 3: Pre- and Post-Test Scores on Self-Efficacy and Task Value 74
Table 4: Descriptive Statistics: Pre- and Post-Course Writing Assessment Scores 76
Table E1: Multigroup CFA Tests of Goodness of Fit and Measurement Invariance
on SAWSES 206
Table H1: Students’ Reflections on Changes in Their Self-Efficacy Scores 211
Table H2: Student Reflections on Improvement in Writing Performance
Assessment Scores 214
Table H3: Changes in Professional Communication and Critical Thinking 217
Table H4: Student Reflections on Overall Transformation 220
Appendix I: Student Definitions of Scholarly Writing 222
Appendix J: Student Reflections on the Peer Review Process 225

xiii
List of Figures
Figure 1: Conceptual Framework 50
Figure 2: Participant Flow Chart 72
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Chapter One: Introduction
Recurring issues with the lack of quality and development in student writing have been
noted by college professors from the early 1900s to the present (Bean, 2011). Nursing faculty are
no exception (Bickes & Schim, 2010; Gazza & Hunker, 2012; Oermann, 2013; Roberts & Goss,
2009). Common themes include a frustration with students’ lack of correct grammar and citation
style, inadequate synthesis representing a deep understanding of the research literature, problems
with writing coherence and clarity, as well as concerns regarding the lack of shared writing
expectations among faculty (Bean, 2011). Too often, graduate students progress through their
coursework to graduation without demonstrating sufficient mastery of written communication
and underlying critical thinking skills (Bickes & Schim, 2010; Roberts & Goss, 2009). In fact,
Cohen (2011) found the overall doctoral completion rates in nursing to range between 20 – 50%
with the majority of unsuccessful students not being able to finish writing their dissertation. (Lea
and Street’s (2006) investigation into writing issues that commonly plague graduate students
revealed problems with writing clarity, organization of ideas, paragraph construction, document
structure, and spelling or grammatical errors.
Despite graduate students’ difficulties with writing, it remains an essential skill for nurses
to master. Writing instruction has been shown to improve nurses’ critical thinking (Naber
&Wyatt, 2014) and is an important aspect of nursing practice. Research from the last two
decades showed that 65% of nursing errors were the result of poor clinical decision-making skills
(Brennan et al., 2004). Developing the foundational skills of critical thinking, clinical judgment,
and decision-making has become a priority within the nursing profession. Based on an-depth
review of the skills used by effective nurses, the National Council of State Boards of Nursing
(NCSBN, 2021) is dramatically revising their 2023 certification exam to focus on assessing the
2

clinical judgment of newly graduated nursing students. Clinical judgment is considered “an
observed outcome of critical thinking and decision-making” and is defined as “an iterative
process that uses nursing knowledge to observe and assess presenting situations, identify a
prioritized client concern, and generate the best possible evidence-based solutions in order to
deliver safe client care” (NCBSN, 2019, para. 1). Critical thinking and decision-making skills are
integral to nurses providing quality patient care.
Writing is also a vital communication skill for nurses. Clear writing is an important part
of documentation, patient education, and communicating with colleagues, particularly for
advanced practice nurses like nurse practitioners (McQuerrey, 2017). The World Health
Organization (2016) and the American Nursing Association (2015) have cited communication
skills as a core competency for nurses. Clear, effective communication between nurses and
patients is deemed critical to positive patient outcomes (Sibiya, 2018). Furthermore, Oermann et
al. (2015) asserted that master’s and doctoral level nurses need to learn how to share and publish
their results from evidence-based practice research in order to lead the profession forward.
Scholarly writing instruction is an important issue to address because it has been shown to
promote critical thinking and improve communication skills, thereby improving nursing practice
(Gazza & Hunker, 2012; Jefferies et al., 2018; Zygmont & Schaefer, 2006).
Background of the Problem
In addition to the importance of developing clinical judgment and good communication,
the use of evidence-based practice is another essential competency for nurses (American
Association of Colleges of Nursing [AACN], 2021). However, the most effective way to teach
these skills is still open for debate. There are several issues related to scholarly writing pedagogy
in graduate nursing school. First, there is a lack of a standardized requirement and approach to
3

teaching nursing students discipline-specific writing skills (Andre & Graves, 2013; Oermann et
al., 2015). Second, nursing faculty tend to fixate on grammar and formatting errors and take a
deficit approach to students’ writing (e.g., Johnson & Rulo, 2019; Shirey, 2013). Because the
majority of nursing faculty are not formally educated in writing pedagogy, they tend to rely on
the positivist-influenced instructional methods by which they were taught (Gimenez, 2012).
These methods are typified by a passive, impersonal style and the assumption that knowledge is
objective, existing outside of the realm of personal, subjective experience. In other words, there
is only one correct answer with little tolerance for nuance or “incorrect” attempts. This approach
negatively affects student motivation and is at odds with the art of nursing in delivering care
centered on patient needs (Gimenez, 2012). Third, amidst a global nursing shortage that affects
the teaching force (Zhang et al., 2018), many faculty are expected to work clinically as well as
teach (Worrall-Carter & Snell, 2003), leaving little time for the work of commenting on student
drafts or learning new pedagogical techniques. Lastly, many nurses do not see the relevance of
scholarly writing to their roles as practitioners (Borglin & Fagerstrom, 2012; Smith & Caplin,
2012; Whitehead, 2002). This low task value creates disengagement from scholarly writing
among clinical nurses, with a professional identity deficient of scholarship and research-related
pursuits.
The term scholarly writing is often confused with academic writing. There are
distinctions between the two, “where academic writing may be defined broadly as any writing
completed to fulfill university or college requirements, scholarly writing is produced to inform a
specialized audience of other scholars in a particular field” (Shannon, 2011, p. 2). Whereas
students may use academic writing to demonstrate knowledge, scholarly writing is the work of
scholars; this implies scholarship practices, such as the application of scholarly inquiry to real-
4

world healthcare problems (AACN, 1999). Nursing scholarship is defined as “the generation,
synthesis, translation, application, and dissemination of nursing knowledge to improve health
and transform health care” (AACN, 2021, p. 10). Because the goal of graduate school is to
nurture the development of nursing scholars who are capable of engaging in scholarship
activities to promote the profession (Oermann et al., 2015), the term scholarly writing is used in
this study.
Scholarly writing in nursing education has been examined in the research literature.
Troxler et al. (2011) performed an integrative review on writing programs employed by nursing
schools. They found five strategies that were recommended for teaching writing, including short
writing assignments, faculty training, sequential assignments, use of exemplars or rubrics, and
revision opportunities after receiving feedback. The authors found that writing across the
curriculum (WAC) programs were more likely to include all of these elements than stand-alone
programs, however, few articles reported outcomes on effectiveness, with most relying on
anecdotal evidence from faculty or students (Troxler et al., 2011). Later, Oermann et al. (2015)
completed a systematic review of 80 articles on writing programs and strategies used in nursing
education including WAC, writing courses, writing assignments, faculty behaviors, workshops,
and self-directed activities. The authors found reports on a range of writing assignments but a
lack of evidence regarding the effectiveness of specific writing strategies and a lack of a
program-wide approach to writing instruction. A curricular plan with the opportunity for students
to write increasingly complex material, receive faculty feedback on drafts, and evaluate writing
progress over time, has been recommended to improve the development of scholarly writing in
nursing (Oermann et al., 2015). To date, there remains little research measuring the effects of a
discipline-specific, WAC approach on the scholarly writing development of graduate nursing
5

students. Nursing organizations and educators acknowledge the importance of scholarly writing
instruction in preparing nurses for clinical judgment and decision-making but there is a lack of a
standardized implementation of best practices. This problem is due, in part, to insufficient
research regarding which methods are most effective. As a result, there is a need to explore
scholarly writing instruction that has the potential to improve nursing students’ writing and
critical thinking capacity.
Importance of Addressing the Problem
The problem of a lack of research-based scholarly writing pedagogy in nursing is vital to
solve for a variety of reasons. First, writing skills provide nurses with the competency to
communicate professional information and translate research to patients and colleagues (Johnson
& Rulo, 2018; Kavanoz & Yüksel, 2016). Tyndall and Scott (2017) suggested that an emphasis
on scholarly writing development improves students’ confidence to advocate for patients and
view themselves as competent communicators and leaders within the profession. Second, lack of
ability to communicate clear and accurate information decreases nurses' ability to provide safe,
quality patient care (Jefferies et al., 2018). Third, the process of scholarly writing helps students
apply evidence from research into practice (Roberts & Goss, 2009), honing the critical thinking
and decision-making skills necessary for effective clinical judgment (NCSBN, 2018).
Additionally, the AACN deems scholarship for nursing practice as a nursing essential, citing the
importance of “the generation, synthesis, translation, application, and dissemination of nursing
knowledge to improve health and transform health care” (AACN, 2021, p. 12). Scholarly writing
lays the foundation for nurses to engage in scholarship practice. Finally, nursing education
students are preparing to become nursing faculty and will need sufficient writing skills in order
to teach student nurses the tenets of scholarly writing, critical thinking, and nursing scholarship
6

(National League for Nursing, 2018; Nick, 2015 as cited in Gazza et al., 2018).
Organizational Context and Mission
The Lake Shore School of Nursing (pseudonym) is part of a private non-profit research
university in the northeastern United States. The school maintains a three-pronged mission of
nursing education, research, and practice, pursuing excellence in clinical and scientific learning,
discovery, and nursing care within an environment that embraces diversity and inclusion. The
school has several master’s programs that prepare students to become certified as nurse
practitioners, nurse leaders, healthcare managers, or nurse educators. These students are
generally registered nurses (although not required for the healthcare management program) who
have already obtained a bachelor’s degree. There are over 300 students currently enrolled in
master’s programs. Among the students, three-quarters identify as White, almost 10% as Black,
5% as Hispanic, 5% as Asian, 2% as two or more races, and less than 1% as Native American
(A. Wolf, personal communication, January 15, 2021). The majority of students are female with
10% of students identifying as male. Master’s students are expected to communicate in English
and international students must demonstrate English proficiency on the TOEFL exam. Nurses are
also required to meet the physical demands of the job. As a result, other-abled students do not
typically enroll in nursing school.
When master’s students enter the program, they are required to take a one-credit course
in scholarly writing, preferably during their first semester. Based on a computerized diagnostic
test, most students enter the course with weak baseline writing skills. A recent writing
assessment, scored by artificial intelligence, revealed 74% of students entering the master’s
program have writing skills at or below the level of an average student in an associate degree
program (A. Wolf and P. Edelblut, personal communication, September 10, 2019). According to
7

organizational data, approximately 70% of graduate students self-reported they are weak writers,
struggle with writing, or lack confidence about their writing skills (R. Greene, personal
communication, September 8, 2021). To address these concerns, academic leaders at the school
are in the process of implementing a Writing Across the Curriculum (WAC) initiative to improve
students’ scholarly writing skills. The one-credit writing course, titled the Writing Workshop,
was designed to be an introduction to graduate level writing expectations for the school’s
master’s programs. A course summary and course map are included in Appendix A. Throughout
the one semester course, students learn a variety of strategies: finding and reading research,
synthesizing themes in the research literature, organizing ideas, and substantiating claims with
evidence. Student learning is scaffolded through formative feedback from the same faculty
member each week. The final paper is divided into weekly tasks completed throughout the
semester. These tasks guide students through an iterative scholarly writing process, including
planning, researching, thesis creation, outlining, drafting, peer review, revision, and reflection.
Organizational Goal
By August 2023, the Lake Shore School of Nursing plans to improve the certification
exam pass rate for master’s students. In 2019, the overall pass rate for nurse practitioners ranges
from 75 – 100% with a mean of 88%. The goal is to improve the first-time pass rate to a mean of
90% with no program with a pass rate less than 80%. Pass rate thresholds are set by the New
York State Department of Education and the school’s accreditor, CCNE. Although 80% is the
minimum pass rate requirement, to remain competitive, the school aims to keep pass rates above
90% for all master’s programs. Regulating agencies are concerned with protecting the public and
their expectation is that the school is preparing nursing graduates for safe and effective care. In
order to demonstrate this, a high percentage of students must pass their certification exams. In
8

addition to these exams that assess decision-making as well as content knowledge, many of the
school’s programs require students to write a final capstone project and scholarly writing has
recently been adopted as a program learning outcome for master’s students (A. Wolf, personal
communication, March 22, 2022). For example, students in the nurse practitioner program are
expected to synthesize established and evolving scientific knowledge from diverse sources and
disciplines to contribute to the generation, translation, and dissemination of clinical scholarship
(R. Greene, personal communication, March 31, 2022). Students must demonstrate mastery in
research synthesis and elements of scholarship before successfully completing the program.
Description of Stakeholder Groups and Stakeholder Group for the Study
In the context of the organizational goal, the school of nursing has three different
stakeholder groups: school administrators, nursing faculty, and students. The school of nursing
administration is responsible for overseeing the school’s research, education, and practice
missions. Nursing faculty in writing intensive classes are expected to implement the school’s
WAC initiatives by providing formative feedback on student drafts based on a hierarchy of
writing concerns (this can be found in Appendix B) and using the school’s standardized writing
rubric for all formal academic writing assignments (the rubric for the Writing Workshop is
included in Appendix C). Finally, graduate nursing students must demonstrate proficient
scholarly writing skills on their capstone projects and meet the program learning outcome for
scholarship. The stakeholder group of focus was the nursing students in the graduate program
because their outcomes determine the school’s success with meeting nursing essentials for
scholarship (AACN, 2021) and certification exam pass rate goals. Successful graduates are able
to deliver effective patient care, contribute to the scholarly discourse of the profession, and
reflect on how to continually improve their practice.
9

Purpose of the Study and Research Questions
The purpose of this study is to explore the effects of a writing intervention on the
scholarly writing development of master’s nursing students. Because multiple factors are likely
involved within the complex process of learning, the study design employs a broad approach to
explore how various ecological systems influence students’ performance, motivation, and
experience of the writing intervention. Understanding how these factors impact the students’
learning experience can enable the Lake Shore School of Nursing to better support their graduate
nursing students’ success in achieving professional and master’s program competencies. The
study culminates with recommendations to support student writing proficiency. The research
questions guiding the study are the following:
1. How does a discipline-specific writing course affect students’ scholarly writing
performance, self-efficacy, and task value?
2. What are nursing students’ experiences in a discipline-specific writing course?
3. How do nursing students perceive the impact of microsystem, mesosystem, exosystem,
and chronosystem environments on their scholarly writing development?
Overview of the Conceptual and Methodological Framework
Bronfenbrenner’s ecological systems theory is the conceptual framework used to explore
the various environmental influences on the participants of this study. Bandura’s self-efficacy
theory is the basis for the scale used to measure students’ self-efficacy and task value.
Sociocultural theory was used as the theoretical framework for the design of the Writing
Workshop course. The methodological design is a concurrent triangulation of mixed methods.
This design is characterized by simultaneous collection and analysis of quantitative and
qualitative data in order to better understand the studied phenomenon and cross-validate findings
10

(Creswell et al., 2003). The study also uses a quasi-experimental, one-group pretest-posttest
design where the writing course serves as the intervention, or independent variable (Creswell &
Creswell, 2018). After students participate in the course, qualitative data from student interviews
were collected and analyzed for common themes. Quantitative data from students’ pre- and post-
writing scores, and responses to a pre- and post-course self-efficacy survey were analyzed for
differences.
The purpose of the Writing Workshop course is to provide graduate students with a
foundation in critical thinking, synthesis of research, and the APA style of scholarly writing.
Students use evidence from research articles to create a classic argument paper, with
recommendations, to address a real-world problem in healthcare. Faculty use a hierarchy of
writing concerns and timely, formative feedback to guide students through the writing process.
Student reflection is solicited throughout the course and concludes with a final reflection paper.
A course overview is included in Appendix A for further information. After the intervention,
which is a required course for all master’s programs, student volunteers were interviewed to
gather data regarding their learning experience in The Writing Workshop.
Definitions
● Scholarly Writing: “The purpose of scholarly writing is the advancement of
knowledge within a specific field. More than a demonstration of the author’s
expertise, scholarly writing is produced to add to the body of knowledge, extending,
challenging, or expanding what is known or believed within the field” (Shannon,
2011, p. 2).
● Scholarship: Scholarship in nursing can be defined as “those activities that
systematically advance the teaching, research, and practice of nursing through
11

rigorous inquiry that 1) is significant to the profession, 2) is creative, 3) can be
documented, 4) can be replicated or elaborated, and 5) can be peer-reviewed through
various methods.” (AACN, 1999, para. 7). According to Boyer (1990), scholarship
encompasses four areas: the discovery, integration, application, and/or teaching of
knowledge.
● Self-Efficacy: Self-Efficacy is the individual’s belief about their ability to “organize
and execute the courses of action required to produce given attainments” (Bandura,
1997, p. 3). In other words, it is a person’s belief about their ability to perform a
certain task.
● Sociocultural Theory: “There are three fundamental concepts that define
sociocultural theory: (1) social interaction plays an important role in learning, (2)
language is an essential tool in the learning process, and (3) learning occurs within
the Zone of Proximal Development” (Allman, 2018, Fundamental tenets section).
Organization of the Project
This study contains five chapters. The first chapter includes an overview of the problem,
definitions pertaining to scholarly writing, and a framework for the project. A description of the
organization’s mission, goals, and key stakeholders are provided. Chapter Two provides a review
of the research literature pertaining to scholarly writing and pedagogy within the nursing
profession. The importance of scholarly writing in nursing, a history of scholarly writing, current
challenges with scholarly writing instruction, and best practices are addressed. This chapter also
provides the study’s conceptual framework and an overview of the specific influences to be
explored. Chapter Three describes the methodology of the study, including details about
participants, data collection, and analysis. The data are presented and analyzed in Chapter Four.
12

Chapter Five presents a discussion about the results and findings with recommendations for
guiding practice and future research.
13

Chapter Two: Review of the Literature
This chapter presents an overview of the research literature pertaining to scholarly
writing within the nursing profession. The importance of scholarly writing in nursing, a history
of scholarly writing, current challenges with scholarly writing instruction, and best practices are
addressed. The chapter concludes with an overview of the ecological influences to be explored in
the study and a description of the sociocultural framework used in the design of the Writing
Workshop.
Overview of Scholarly Writing in Nursing Education
This section describes the important functions scholarly writing provides within nursing
education and the nursing profession. Theories of writing development and a history of scholarly
writing in nursing are presented. Current challenges with writing instruction in nursing education
are also discussed. Although significant bodies of research exist on writing instruction for
students who are English language learners, and to a lesser extent, students with learning
disabilities, these populations were not be specifically addressed. The reason for these
delimitations is because these students represent a small percentage of the master’s student
population. Students are required to demonstrate proficiency in English and very few students
provide the school with documentation of a learning disability.
The Benefits of Scholarly Writing Instruction in Nursing Education
Seminal national organizations consider scholarly writing as an essential skill for nurses
at all educational levels (American Association of Colleges of Nursing [AACN], 2021; National
League for Nursing [NLN], 2018). Not only is it the foundation for scholarship, but also
scholarly writing helps students develop critical thinking, written communication, a professional
identity as a nurse, and the ability to connect research to practice. Since 1986, the AACN has
14

published an essentials of nursing education document describing innovations within the
profession and recommendations for educators on how to best prepare new nurses for the ever-
changing landscape of healthcare. In the latest revision, AACN (2021) proposed ten domains
core to nursing education at the baccalaureate, master’s, and doctoral levels. Domains are
described as “areas of competence that, when considered in the aggregate, constitute a
descriptive framework for the practice of nursing” (AACN, 2021, p. 9). Scholarship is listed as
the fourth domain, and defined as “the generation, synthesis, translation, application, and
dissemination of nursing knowledge to improve health and transform health care” (AACN, 2021,
p. 10). The NLN competencies for nurse educators recommend students engage in scholarship
activities in preparation to function within the educational environment (NLN, 2018). Scholarly
writing skills are the basis of scholarship. Scholarly writing challenges students to think critically
to integrate evidence and knowledge and apply it to a defined problem. These skills can be used
to connect research and practice, in the service of making decisions or using clinical judgment to
impact patient care.
Writing instruction serves a variety of purposes within nursing education. First, scholarly
writing helps nurses develop critical thinking and communication skills. Second, nurses need to
understand research and apply it in evidence-based practice. This synthesis and application
process echoes the process of writing a formal thesis-driven research paper. Third, students write
to an intended audience of nursing colleagues and researchers, allowing them to visualize
themselves within the professional discourse community. Finally, writing offers opportunities to
develop reflective practice where a nurse can direct their learning, set goals, self-monitor, and
regularly evaluate their performance as a health care professional.
Scholarly Writing Develops Critical Thinking Skills
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Critical thinking and decision making are foundational skills for clinical judgment in
nursing (Martin et al., 2020) New nurses need to master critical thinking in order to deliver safe
patient care (Naber, 2014). Critical thinking is a collection of complex thought processes and
many definitions exist. For example, NCSBN (2018) defined critical thinking as using logic and
reasoning to evaluate potential health care solutions. Benner et al. (2008) described critical
thinking as an iterative process that involves the collecting, interpreting, and analyzing of patient
data to prioritize health needs; testing hypotheses based on empirical data, protocols, and
patterns; evaluating outcomes and revising plan of care as needed; applying relevant research-
based information, theories, ethics, and frameworks as the basis for decision-making; and self-
regulating thoughts and actions to improve reflective practice. This complex thought process is
essential for nurses to make evidence-based decisions. Critical thinking does not occur in a
vacuum either. The process is often shared with other members of an interdisciplinary team to
negotiate patient treatment and care.
However, a comprehensive literature review indicated that nursing students are not
adequately trained in critical thinking or decision-making, especially via experiences anchored in
real-world situations (Muntean, 2012). Poor critical thinking skills can result in not recognizing
patient deterioration, incorrect prioritization of acute needs, and medical errors detrimental to
patients’ health. In fact, the national board certification exam for nurses is being revised to
improve assessment of students’ clinical judgment and its “unobserved underlying mental
processes, critical thinking and decision making” (NCSBN, 2018, p. 3). This revised assessment
for certifying registered nurses is causing a shift in nursing education. Nursing schools are
moving to a competency-based approach to teach students how to think critically in real-world
situations, solve problems, and make decisions.
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Scholarly writing can be instrumental in faculty teaching to teach new nurses critical
thinking skills. Research suggests that scholarly writing is associated with critical thinking in
nursing (Goodman, 2011; Lavelle, 2013). Both scholarly writing and clinical nursing are rooted
in using evidence, reasoning, logic, determining a focus, interpreting data, and making decisions
to address a problem. As recommended by Borglin and Fagerstrom (2012), the development of
basic academic literacy skills among nursing students should include not just reading and writing
activities but also how to think, act, and communicate within the discipline. This approach
requires increasingly complex assignments designed to foster higher-order thinking skills over
time, with instructional support. Zygmont and Schaeffer (2006) described one school’s
integration of Wolcott and Lynch’s critical thinking model with writing assignments across a
four-year baccalaureate program with nursing students. In this model, the authors expected
students to reach step two by the end of their bachelor’s program. Step two is characterized by
the ability to view an issue from multiple perspectives, explore the various aspects of a problem,
and keep personal biases in check. Graduate students were expected to reach step four on the
critical thinking model, which is defined as demonstrating objectivity, flexible use of strategies,
the ability to critique a solution, and actively reflect on their problem-solving process. By using
Wolcott and Lynch’s model as a program-wide, theoretical framework, faculty were able to
consciously integrate these levels of critical thinking skills within their scholarly writing
instruction. The critical thinking steps were used as student benchmarks as well as an evaluation
of faculty’s success in achieving program goals in this area.
Scholarly Writing Sharpens Communication Skills
In addition to facilitating scholarship and critical thinking, scholarly writing helps
develop nurses’ ability to communicate effectively. Written and verbal communication are
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considered requisite skills all nurses must master in order to deliver quality care (AACN, 2021).
Lyndon et al. (2012) asserted that clinical communication among health care colleagues and
patients must be respectful, focused, and clear.
Because nurses must constantly interface with patients and their families, peers, and
interdisciplinary colleagues, oral and written communication is critical for patient safety and
teamwork. The Joint Commission (2021) listed improving staff communication as one of the
national patient safety goals for hospitals. A research study showed that 50% of nursing errors
were the result of some form of miscommunication, when combined with a lack of clinical
reasoning, the seriousness of the errors increased (Eltaybani et al., 2018). The abilities to think
critically, make evidence-based decisions, and communicate with others are essential for nurses
to develop. McMillan and Raines (2010) stated that written and verbal communication skills are
directly related to patient safety. Foronda et al. (2019) found that new nurses in particular had
lower communication scores and required education to improve their communication skills.
Nurses must hone their written and oral communication skills to liaise with other disciplines and
deliver quality patient care (Huston, 2014).
Scholarly writing assignments have been shown to improve nurses’ written
communication skills. Hunker et al. (2014) reviewed the literature discipline-specific writing in
nursing and created a list of knowledge, skills, and attitudes to enhance scholarly development at
the baccalaureate, master’s, and doctoral levels. Scholarly writing was one form of written
communication that not only fostered writing skills but also inducted students into the world of
nursing scholarship and thought. Stevens et al. (2014) implemented an online writing course to
help nursing students improve their lower-level writing skills, such as grammar and APA style,
as well as their higher-level writing skills, such as summarizing and synthesizing research. The
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faculty agreed that the course achieved its goals and that students’ professional communication
improved. Nursing research has shown that scholarly writing assignments help students improve
their communication skills (Gazza & Hunker, 2012; Luthy et al., 2009; Whitehead, 2002). The
same process used to organize one’s thoughts in scholarly writing can be transferred to other
genres of written communication, such as memos, emails, and clinical notes (Borglin, 2012;
Sasa, 2020).
Scholarly Writing Facilitates Research- and Evidence-Based Practice
Evidence-based practice is the foundation of nursing care, where research is translated
into best practice for an individual or a group. Evidence-based practice is defined as the
integration of individual clinical expertise with best available evidence, and patient preferences
and values (Sackett, 1997) to make decisions about individual patient needs as well as the
development of protocols and guidelines for groups of patients or healthcare workers (de Groot
et al., 2013). This decision-making process includes five steps: (1) formulate a searchable
question, (2) find the best available evidence, (3) appraise the evidence, (4) implement the
evidence into clinical practice, and, (5) evaluate the provided care (de Groot et al., 2013). In
nursing, scholars are expected to be both a practitioner and a scholar, adding yet another layer of
complexity to the writing task of graduate students (Ryan et al., 2013). Regardless of the focus
on practice or scholarship, the underlying purpose of scholarly activities in nursing is to improve
patient care (Mitchell, 2018; AACN, 2021).
Scholarly writing can be an effective way to teach students the decision-making process
of evidence-based practice. Jefferies et al. (2018) performed a systematic review of academic
literacy in undergraduate nursing students and found thesis writing led to an increase in students’
use of research, critical reading, and analysis—all essential components of evidence-based
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practice. Additionally, Gazza et al. (2018) developed a list of knowledge, skills, and attitudes
(KSAs) for scholarly writing and asked master’s students to self-assess their use of these KSAs.
The authors concluded that students were familiar with the KSAs and sometimes used them. The
authors suggested that adding a variety of assignments based on the KSAs could facilitate the
development of scholarly writing and the type of thinking needed to advance the profession.
Scholarly Writing Fosters Professional Identity Development
Scholarly writing facilitates nursing students’ socialization into the profession. In a
qualitative study of baccalaureate students’ experience with writing throughout their four years
of nursing school, Chaudoir et al. (2016) posited that learning scholarly and reflective writing is
an important way for students to “learn content, stimulate critical thinking, cultivate professional
identity, and assimilate into the discipline and profession of nursing” (para. 1). One of the themes
involved the importance of relationships in students’ writing development. Third-year students
discussed the importance of building a network with peers and support staff to improve their
writing. Fourth-year students noted that the most effective way to learn involved peer mentoring
first-year students in writing assignments they had completed in previous classes. The authors
recommended additional research to explore how the impact of writing assignments are affected
by the student-teacher relationship throughout a nursing program. Tyndall and Scott (2017)
interviewed nine registered nurses pursuing their bachelor’s degree in nursing. The authors
reported three phases of scholarly writing development: discovering what it means to be a
scholarly writer, using feedback and building writing capacity, and connecting scholarship with
their identity as a nurse. Their findings suggested that these phases of learning to write within the
discipline distinguished associate degree nurses from bachelor’s-prepared nurses, as well as
enabled their professional identity development.
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Writing assignments can encourage students to consider the professional context as they
construct meaning. Borglin (2012) recommended an academic literacy model for scholarly
writing instruction because it situates reading and writing skills within the thinking, speaking,
and acting that are characteristic of the nursing discourse. She also stressed that students’
identity, meaning construction, and issues of authority and power must be explored within
specific institutional settings, demonstrating an intentional link between the act of writing and
what it means to think and act like a nurse in their professional environment. Slomp (2012)
grounded his work in Bronfenbrenner’s (1999) bioecological approach. He advocated for
improving students’ writing ability by asking them to reflect on their knowledge of the genre,
rhetorical situation, subject-matter, writing process, and application of discourse community
knowledge as part of his grading criteria. This approach to assessing writing ability, based on
Beaufort’s (2007) five knowledge domains, fosters metacognition about writing as a process in
which nursing scholars engage as part of the profession. This model also accounts for the
intrapersonal, interpersonal, and institutional factors that may or may not support students’
writing capacity.
In Mitchell’s (2018) critical review of writing research within nursing, she proposed an
educational model rooted in social constructivism, where the interpersonal aspects of writing
within a disciplinary context are explored along with the writer’s identity and creative ways of
knowing. She argued that skills-based, deficit approaches to writing instruction do not help
students develop a professional identity, hence the need for greater subjectivity within scholarly
writing that she proposed. This vision included students centering their scholarly inquiry within
their positionality and experience as nurses, or their patients’, thereby supporting new ways of
knowing in addition to objective evidence. In their exploration of doctoral student writing
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capacity, Ryan et al. (2013) agreed with Mitchell’s assessment that nursing faculty often avoid
the complexity of the scholarly writing and identity formation process by teaching a positivist,
passive style of writing that denies graduate students the opportunity to develop their voice,
hindering the accessibility of nursing publications and relevance to the diverse population of
patients they are supposed to serve. The authors promote a loosening of the strict adherence to
objectivity in nursing publications and more intentional faculty mentoring of the compassionate,
diverse voices of new nursing scholars to enhance their writing capacity, identity development,
and, ultimately, the authenticity and sociocultural reach of nursing research. In this regard, the
pedagogy of scholarly writing in nursing has potential to be a more intentional method of
orienting students to the profession as well as embracing the diversity of students.
Writing Encourages Reflective Nursing Practice
Reflection gives nurses the opportunity to analyze their own experiences and improve
their practice; writing is a common way to guide students in this process. Prestia (2019)
discussed the power of reflection to enhance learning, professional growth, and resiliency in
nurses and nurse leaders. She credited the combined work of John Dewey, Donald Schon, David
Kolb, and David Boud with the theory of reflective learning. This theory forms a bridge between
theory and practice, where the practitioner reflects on past or current experiences, analyzes their
emotions, actions, and responses, then adds that information to prior knowledge to advance their
learning (Prestia, 2019). She promoted the benefit of journaling as a form of reflective writing to
help reveal biases, beliefs, possible courses of action, new insights, and growth as a practitioner.
In Gazza et al.’s (2018) study of the self-assessment of master’s nursing students
regarding their use of evidence-based knowledge, skills, and attitudes of scholarly writing, the
researchers used Schon’s theory of reflective practice as the study’s framework because
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reflection promotes self-awareness. Students were asked to self-evaluate their writing, giving
them an opportunity to think critically about their scholarly writing process and consider what
could be improved. The results indicated that these students generally used bachelor’s level
KSAs with the exception of prewriting, writing abstracts or summaries of research, identifying a
support network, and using strategies for managing emotions during the writing process. The
authors suggested the use of the writing scaffold, developed by Gazza and Hunker (2012) to
provide more writing opportunities for students as well as continued self-assessment of KSAs to
promote students’ reflection on their writing development, learning needs, and growth.
Other nursing researchers have described using journals or reflective-writing assignments
to increase students’ awareness of values, beliefs, practice, learning through experience, and
development of academic literacy (Billings & Kowalski, 2006; Binding, 2010; Carter, 2008;
Jefferies et al., 2018). Naber and Wyatt (2014) performed a study on the effects of reflective
writing on the critical thinking skills of undergraduate nursing students. The researchers used an
experimental, pre-test post-test design with 70 students from two nursing schools. The reflective
writing intervention group had significantly higher scores on the critical thinking skills test than
the control group, confirming the authors’ hypothesis that engaging in a regular, standardized
reflective writing process can improve critical thinking. Naber et al. (2014) completed a thematic
analysis of the students’ actual reflections collected during the parent study. The researchers
noted six themes across their sample of reflections: transfer of knowledge, centering care on the
patient, collaboration, recognizing how their actions and words affect others, examining their
strengths and weaknesses as nurses, and seeing the bigger picture. These findings aligned with
the quantitative results. The researchers recommended the use of reflective writing to be used as
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an instructional tool to improve the development of critical thinking and ongoing self-assessment
in clinical nursing students.
Lavelle et al. (2013) explored the connection between reflection and scholarly writing in
their factor analysis of 169 student responses to the Inventory of Processes in College
Composition. The authors found four writing structure types from the data: spontaneous-
impulsive, elaborative, procedural, and reflective. Previous validity studies of the inventory were
predictive of graduate students’ writing skills (Lavelle & Bushrow, 2007). High scores on the
reflective-revision measures predicted higher grades in freshman composition (Lavelle, 1993),
suggesting that students who reflect on their meaning construction and revision process are more
skilled at scholarly writing assignments, like research papers. On the other hand, students who
took more of a surface approach to writing, focusing on procedural writing or spontaneously
writing without any planning or deep reflection tended to have lower grades in composition.
A Brief History of Scholarly Writing in Nursing
Nursing grew out of a positivist tradition where empirical, objective data are favored over
subjective methods of understanding the world. This paradigm impacted nurses’ conception of
knowledge, how they approach research, and the style of writing that was adopted within the
profession. The expected style of nursing research defines the epistemological approach expected
among disciplinary discourse and impacts how students are instructed in writing and interpreting
research.
Disciplinary Epistemology
Nursing is a relatively new profession. Florence Nightingale is credited as the founder of
nursing but it took many years before it was taken seriously as a profession. Medicine is a
hierarchical world, with physicians at the top. The dominant worldview at the time of nursing’s
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inception was positivism (Gimenez, 2012). The positivist epistemology assumes only empirical,
objective observations, measured as precisely as possible and using the scientific method to
determine the relationship among variables are legitimate forms of knowledge (Creswell &
Creswell, 2018). In the 1950s, nurses began to break away from medicine and began to assert
nursing as a separate profession (Gimenez, 2012).
Gimenez (2012) created a study to discover how the epistemologies and
conceptualization of criticality, evidence, and impersonality affected student academic writing in
nursing and midwifery at the undergraduate level. Students reported three main problems they
encountered when writing within the nursing discipline: selecting sources, finding strong
evidence, and trying to reconcile the art of nursing with the science. Gimenez noted that all three
problems stemmed from the positivist approach that still dominates nursing and evidence-based
practice. Gimenez suggested that the positivist epistemology of nursing shapes the way
knowledge is framed. Criticality is primarily seen as problem-solving, evidence is a scientific
hierarchy with randomized controlled trials at the top and expert opinion at the bottom, and an
objective, impersonal style is valued and expected in scholarly texts (Gimenez, 2012). Because
nursing assumes the ontological position that the relationship between health and illness is best
explained by empirical means that exist outside of the individual based on cause and effect,
Gimenez argued these assumptions of the discipline must be explicitly taught in order for
students to become effective writers and members of the discourse community.
Currently, evidence-based practice represents a move to embrace some contextualized
elements of a sociocultural epistemology of knowledge, where the patient’s perspective and
values are considered as well as the practitioner’s experience, in combination with scientific
research and empirical evidence (Sackett, 1997). Even so, reconciling the art of nursing with the
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science of positivism remains a challenge for nursing students in the scholarly writing process
(Gimenez, 2012). As the epistemology of nursing evolves, so too, must the definition of
scholarly writing within the discipline.
Scholarly Writing and the Advancement of Disciplinary Thought
Scholarly writing fulfills many purposes for the profession, nursing faculty, and students.
The American Association of Colleges of Nursing (AACN) and the National League for Nursing
(NLN) recognize the importance of scholarship in educating nurses at all professional levels.
Scholarly writing is the foundation of nursing scholarship (Derouin et al., 2015). Researchers
have demonstrated links between scholarly writing tasks and critical thinking, written
communication, reflection, evidence-based practice, and identity formation. Nursing researchers
and faculty use scholarly writing to generate relevant information and to learn from others.
Nursing faculty use the scholarly writing of professionals to induct students into the profession,
teaching salient concepts and ways of thinking like a nurse. Writing assignments also serve as a
method to assess the developing knowledge of students and scaffold their learning. For nursing
students, scholarly writing is a way to construct meaning, better understand complex concepts,
explore problems, demonstrate knowledge, learn how to be a nurse, and join the professional
discourse. Ultimately, all scholarly writing in nursing is about improving patient care in some
way (Mitchell, 2018; Ryan et al., 2013). As suggested by Gimenez (2012), the positivist
epistemology may fundamentally be at odds with patient-centered nursing, education, and
research.
Despite the many purposes scholarly writing serves within the nursing discipline, the
underlying epistemology dictates the expectations and use of writing in the profession and in
education. There have been several calls for a reassessment of what is considered scholarly
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writing in nursing to welcome a wider range of voices beyond maintaining an objective tone
(Mitchell, 2017; Ryan et al., 2013). Mitchell (2018) suggested a move towards embracing the
“relational, contextual, identity-forming, emotional, and creative attributes” (p. 404) found in a
social constructivist model of writing for nurses. Ryan et al. (2013) asserted that a loosening of
the constraints in nursing scholarship would invigorate the profession by being accepting of
more diverse voices and engaging in dialogue with other disciplines. Currently, the expectations
among most nursing journal editors and nursing faculty remains rooted in positivist,
technocentric view of scholarly writing (e.g., Edmunds & Waldrop, 2018; Johnson & Rulo,
2019), which some argue, may not be in the best interests of students or the advancement of the
profession.
Challenges with Scholarly Writing Instruction in Nursing
Several challenges exist in teaching scholarly writing within nursing. First, the profession
lacks standardized writing requirements for students. Many students become nurses without
participating in a discipline-specific scholarly writing program. Second, many faculty take a
deficit approach to writing, where students’ weaknesses are the focus of instruction rather than
capitalizing on strengths or construction of meaning. Third, faculty spend significant time on
lower-order writing concerns such as grammar, spelling, and proper citations. Fourth, the
majority of nurses take a Eurocentric approach to instruction, which leads to the exclusion of
students from non-Eurocentric cultures or linguistic backgrounds other than English. Fifth, the
combination of these factors negatively affects the motivation and self-efficacy of students’
scholarly writing.
A Lack of Uniformity in Writing Instruction
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Writing across the curriculum (WAC) became popularized in the United States in the
1970s when professors started publishing about the importance of moving the teaching of writing
into disciplines other than English (Bazerman et al., 2005). WAC refers to the idea that writing
instruction is situated, extends beyond the writing classroom, engages students in critical
thinking, and that all students can become proficient writers (WAC Clearinghouse, 2014).
Writing in the disciplines (WID) is another principle of WAC, asserting that professional
socialization cannot be attained in a general composition class and students are best mentored
into discipline-specific scholarship from experts in the field with ample opportunities to receive
feedback and revise their work (WAC Clearinghouse, 2014).
In 2001, Cowles et al. described a writing across the curriculum approach used in a
school of nursing to improve student writing and enhance students’ conceptual knowledge.
Luthy et al. (2009) published information on how to support WAC and Zygmont and Schaffer
(2006) specified the importance of sequencing writing tasks for greater complexity throughout a
nursing program. However, most nursing schools have not adopted WAC. Troxler et al. (2011)
only found five curriculum-wide writing programs in undergraduate nursing schools and Andre
and Graves (2013) found five required discipline-specific writing courses in their survey of 81
Canadian nursing programs. Some programs required generic composition courses, but the
authors criticized this approach because it did not instruct students on the professional discourse
and expectations within nursing. Behrens et al. (2016) interviewed college faculty and students
about their perception of the purpose of academic writing in higher education. Although both
groups agreed that college writing should be formal and follow a certain format, neither could
clarify what “formality and academic quality” should look like, leading to faculty frustration and
student confusion.
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In addition to a dearth of required, discipline-specific writing courses and programs, the
quality of writing instruction remains debatable. Several studies have found inconsistencies
within nursing’s approach to writing education. Oermann et al. (2015) performed a nursing-
specific systematic review of educational programs and strategies for developing students'
writing and found an overall need for more writing practice and faculty feedback. Whitehead
(2002) found that nursing students reported a lack of support of, and emphasis on, writing.
Gimenez (2008) recommended that students need more explicit, discipline-specific writing
support for clinical and scholarly writing assignments due to student confusions and frustrations
with the complex task of writing. Slomp (2012) discussed the need for a shift in how writing is
assessed, arguing that only looking at writing as a product and having a technocentric approach
to feedback took the focus off of assessing students’ writing and thinking ability. He suggested
using an ecological theory of assessment that prioritized metacognition, effectively engaging in
the discourse community, and current advances in composition pedagogy. Although scholarly
writing is seen as an important part of the profession, a uniform approach to instituting writing
programs, clear expectations, and assessment standards is still missing.
The Deficit Model of Writing
The deficit model of writing, based on a behaviorist view of education, attributes a
student’s failure to learn as a personal deficiency within the student rather than as a result of
limitations within instructional delivery or socioeconomic influences (Oxford Reference, 2021).
In college writing instruction, the deficit model was employed by Harvard in the 1890s when
they required students to take a first-year composition course to “teach students the fundamentals
of writing academic argument” (Harvard, n.d.) as 50% of freshmen failed an entrance writing
assessment. Composition was meant to cure “deficient” students and teach them what professors
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expected them to already know. Currently, most colleges require students to complete a
composition course before their “real learning” can occur (Behrens et al., 2016; Skinnell, 2015).
Many faculty still blame students for their own failures, believing students’ struggles with
writing are due to their own deficits when writing is inherently a complex, context-specific
process (Brannon et al., 2008).
Faculty Focus on Lower-Level Writing Concerns
A major challenge with writing instruction in nursing is the amount of time faculty spend
attending to lower-level writing corrections. Lower-level, or local, writing issues are defined as
those related to sentence structure, word choice, punctuation, spelling, and APA style (Purdue
OWL, 2020). Higher-level concerns pertain to more global issues such as audience and purpose,
focus, development, organization, voice, and use of evidence. In writing pedagogy, the hierarchy
of writing concerns is a method to prioritize feedback and revision. By working on higher-level,
or global, concerns first, the author gains efficiency by saving the lower-level revisions for last,
after the bigger picture has been established (Bean, 2011; Harvard Writing Project, 2007).
Given the predominance of a positivist epistemology and nursing’s struggle to be
accepted as a profession independent from medicine, much of the research on scholarly writing
is focused on maintaining academic rigor through adherence to strict writing rules, without
exceptions. This perspective often leads to a misconception about the nature of scholarly writing
and how it is taught and assessed. Faculty tend to use a deficit model of writing and provide
feedback mainly on lower-level writing concerns that the students did “incorrectly.” Many
researchers seem to equivocate scholarly writing with lower-level writing concerns, often to the
exclusion of content and discipline-specific thinking. Borglin and Fagerstrom (2012) noted that
the majority of students they interviewed felt that faculty feedback focused primarily on
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formatting issues rather than their understanding of nursing content and critical thinking. Tesh et
al. (2014) and Stevens et al. (2014) described research on writing skills that mainly focused on
students’ ability to correct errors in grammar, mechanics, and APA style.
Many researchers have conflated scholarly writing with controlling discrete skills and
grammar. McDougall et al.’s (2015) research focused on the diagnosis and “remediation” of six
common error patterns of beginning scholarly writers. The six errors included passive voice,
nominalization overuse, overuse of third person, unclear pronoun referents, and use of
superfluous phrases or colloquial expressions. Shirey (2013) created a list of “major scholarly
writing culprits” which included lower-level writing concerns such as grammar, spelling, and use
of APA style citations. Likewise, Johnson and Rulo (2019) offered a ten-point list of strategies to
help nurses improve their writing ability, including 1.5 pages of grammar and APA “rules.”
Diekelmann and Ironside (1998) found that doctoral students became disengaged with writing
when faculty were overly critical and focused on errors in grammar and APA style. Students
reported feeling that no matter how hard they tried to write well, faculty would always find fault
without commenting on content or giving advice on how to improve their writing.
Language Bias as Exclusion Criteria
Perhaps the most alarming result of fixating on grammar and form in scholarly writing is
its inherent exclusion of populations who do not adhere to “standard English.” Rosa (2016)
argued that the idea of standardized American English is actually a raciolinguistic ideology that
equates English with being a legitimate White American. Those who are not White and do not
speak standard English are seen as incompetent non-persons, not only in need of “remediation,”
but as outsiders who do not belong in the U.S. Faculty unconsciously assess students’ grammar
to evaluate status and students who do not write in standard English are assumed to be
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“uneducated” and of a lower socioeconomic class (Bean, 2011). Brannon et al. (2008) posited
that teachers often force students in need of “remediation” to structure their ideas into restrictive
formats such as the five-paragraph essay or repeatedly drill them on grammar, leading students
to believe that writing is a mechanical task divorced from meaning or self-expression. The
authors concluded that these students “never experience the power of their ideas, of the
structuring of them within a larger conversation, never get the chance to use writing to think,
feel, and wonder” (p. 18). The concept of remediation is another result of faculty taking a
“deficit” approach to instruction rather than a sociocultural model that uses students’ strengths
and prior knowledge as a foundation for new learning.
This language bias extends into the clinical realm as well. DeBrew et al. (2014)
interviewed nursing faculty about the characteristics of successful students and the criteria they
used when deciding to pass or fail a student in clinical rotations where students work directly
with patients under direct supervision of a nurse preceptor. The results showed that international
and domestic students whose primary language was not English were the most likely to fail. The
authors hypothesized that faculty risked language bias in the clinical setting due to the subtle
nuances and insider language often used in practice. The faculty cited concerns about the failed
student to practice safely but when pressed for more information, their concerns revolved around
issues of fairness, language, communication, and viewing the student as an outsider to the
predominantly White, female, Eurocentric discipline of nursing. Practice bias is the belief that to
be “fair,” all students must be given the same treatment, regardless of the learning needs of the
individual (DeBrew et al., 2014). Faculty claim to be fair and judge all students by the same
standards. In practice, clinical instructors use students’ racial and linguistic differences to bar
these students from entering the profession (DeBrew et al., 2014; Rosa, 2016).
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Negative Effects on Students’ Motivation and Writing Development
In addition to challenges from faculty bias and curricular inconsistencies, nursing
students experience few opportunities for scholarly writing practice, feedback, and instructional
support, leading to disengagement and low task value for scholarly writing. The curriculum for
bachelor’s and master’s students is primarily focused on science and nursing-related courses.
Four-year programs typically require coursework in the humanities and often the ubiquitous
composition course, but many nursing classes are not writing intensive. This lack of writing
practice negatively affects students’ writing development. Gazza et al. (2018) asked nursing
students to self-report on their use of common knowledge, skills, and attitudes when writing. The
lowest ratings were for producing “scholarly writing in the form of a manuscript” and “I
participate in a variety of writing opportunities” (p. 353). A common refrain in the
recommendations for improving scholarly writing in nursing is to increase opportunities for
students to write and receive formative feedback (e.g., Andre & Graves, 2013; Gazza et al.,
2018; Jefferies et al., 2018; Oermann et al., 2015).
Students cite a lack of instructor clarity around expectations for writing, explicit
instruction, and meaningful formative feedback as leading causes for frustration with writing
assignments. Jefferies et al. (2018) found a few themes in their systematic review of academic
literacy in undergraduate nursing. First, they found that faculty have unrealistic expectations for
incoming students’ literacy level. Second, students needed guidance from faculty in order to
improve their writing ability. Third, students needed opportunities for formal writing to learn
critical thinking. Gazza and Hunker (2012) proposed the use of a writing scaffold to provide
clear guidelines and rubrics for assignments, sequencing assignments for greater clarity and
student support, and providing peer and faculty feedback to facilitate the development of
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students’ scholarly writing ability. Chaudoir et al. (2016) also found that students expressed
confusion at the inconsistent faculty use of writing nomenclature and assessment expectations,
and that students desired more reading and writing support from faculty.
Many nursing students have reported low task value for scholarly writing. A common
perception is that scholarly writing is only necessary in school and not something nurses use in
everyday practice (Johansen & Harding, 2013; Smith & Caplin, 2012). Whitehead (2002) also
noted a divide between theory and practice among the students observed. Borglin and
Fagerstrom (2012) found the nurses they interviewed did not deeply consider the purpose of
scholarly writing beyond completing required assignments.
Overall, many barriers exist to effective scholarly writing instruction. The paucity of
discipline-specific writing course requirements or programs leaves students with few
opportunities for explicit writing instruction or practice. The deficit model of writing, in
combination with a fixation on lower-level writing concerns gives students a false impression of
what writing is and at worst, creates barriers for racially and linguistically diverse student groups
from entering the profession. Furthermore, a lack of clear expectations, meaningful assignments,
and formative feedback contribute to student frustration and low value for scholarly writing. The
Writing Workshop intervention was designed six years ago to better address the writing needs of
master’s students. This study is an opportunity to evaluate the effect of this intervention on
students’ self-efficacy, writing performance, and overall course experience.
Best Practices in Writing Instruction
The field of composition and writing pedagogy offers theories to inform approaches to
scholarly writing instruction. Researchers have found that there are ways to scaffold students’
writing and clarify their expectations for student work. Because writing is a form of
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communication, social context and mediation is an effective method to improve students’
writing. Faculty can offer balanced feedback that addresses higher- and lower-order writing
concerns. Reflective writing within a discipline can be a way to help nurses develop not only as
writers but also as practitioners.
Writing Theories
There are many theories or models of writing. Hodges (2017) discussed the main four as
being cognitive process, sociocultural, social cognitive, and ecological theories. Researchers
formerly believed writing was a linear process, “choose a topic, narrow it, write a thesis, make an
outline, write a draft, revise, and edit” (Bean, 2011, p. 33). This positivist approach assumed that
all thinking work was done prior to writing. However, the cognitive process theory stressed an
iterative approach where authors revisit various parts of the writing process as they compose
their thoughts (Flowers & Hayes, 1981). This theory is based on four main points including the
thinking processes of writers, a higher-order method of organizing these processes, the
importance of goal setting, and the use of micro and macro goals (Flowers & Hayes, 1981). The
sociocultural theory of writing focuses on the social interaction between the author and more
experienced others during the writing process and is based on the work of Vygotsky (Hodges,
2017). In sociocultural theory, language, prior knowledge, and social interaction are the key
components in writing development.
Social cognitive theory is based on the self-efficacy work of Bandura. Self-efficacy refers
to one’s belief about how well they can perform a specific task (Bandura, 1997). Self-efficacy is
influenced by four things: how a person evaluates previous performances, observing others,
social encouragement, and emotional state (Bandura, 1986). Social cognitive theory informs
writing pedagogy because it underscores how the author’s belief about their own competence
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affects their motivation, and highlights the need for social models, practice, feedback, and choice
(Hodges, 2017).
The ecology theory implies that the author’s writing experience is shaped by the social
and cultural influences of their life (Hodges, 2017). Ecology theory emphasizes
the relationships between individual writers, their texts, discourses in the classroom with
teachers and fellow students, culture-specific norms and expectations for writing at
school, values and beliefs in the societies the writers inhabit, and writers' sense of who
they are or want to be in their writing. (Smidt, 2009, p. 117)
Writing is a complex, contextual process and each of these models can inform educators about
various elements of writing and contribute a range of strategies and approaches that can be
adapted to suit the purpose and context of the task (Hodges, 2017). For example, using an
ecological framework, an instructor would embed writing across the curriculum, giving students
daily practice to improve as writers, read and analyze the writing of seminal authors, and see the
cultural importance of writing within their learning community.
Ecocomposition takes this concept further by emphasizing the interrelationship between
environments (e.g., natural, political, historical) and discourse (Dubrin & Weisser, 2002).
Ecocompositionists speak to the “effects discourse has in mapping, constructing, shaping,
defining, and understanding nature, place, and environment; and, in turn, what effects nature,
place, and environment have on discourse (Dobrin & Weisser, 2002, p. 573). In this manner,
students are challenged to analyze environmental or sociopolitical issues by examining the
impact of language (e.g., debates, conversations, written texts) on how people within that
community write and think. Ecocomposition encourages writers to go beyond academic
discourse to address broader contexts and issues pertaining to the natural world as well as
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socially constructed ones, and how students’ activism can foster change and new ways of
thinking.
Wardle and Roozen (2012) discussed the importance of adding multiple measures of
ethnographic assessment and longitudinal assessment of writing. Drawing from ecology theory,
the authors asserted that because students develop literacy not just within a discipline but across
many communities of practice and a wide variety of contexts, more robust measures should be
used to assess these literary influences on students’ writing development. For example, a
portfolio assessment of written work, an ethnographic study of tutoring sessions, and a capstone
assessment within the student’s field of study would provide a more complete picture of writing
development. This multidimensional assessment would not only impact the student’s writing
identity, it would also help faculty better understand and use a wider variety of influences on
students’ writing development (Wardle & Roozen, 2012).
The Practice of Scaffolding Writing Development
Writing research reveals several ways to promote writing development through
instructional design. Ideally, writing assignments and writing-intensive courses should be
intentionally weaved throughout a program to create multiple opportunities for writing across the
curriculum (e.g., Hawks et al., 2016; Luthy et al., 2009; Oermann et al., 2015). The writing
across the curriculum approach is based on the following principles: writing is linked to thinking
and transformative learning, writing is contextual and requires learning discipline-specific modes
of discourse, and writing is the responsibility of all faculty and belongs in every class (McLeod
& Soven, 2000). There are many ways to implement a writing across the curriculum (WAC)
program at the university level. Since many nursing programs exist within schools of nursing,
WAC has been used as a method for implementing more intentional curricular planning school-
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wide. The term writing in the disciplines (WID) is also relevant because WID is a way to focus
WAC principles on giving students opportunities for thinking, writing, and practicing the
language of a specific discipline (WAC Clearinghouse, n.d.).
Several researchers have examined WAC/WID initiatives in nursing. Hawks et al. (2016)
performed a literature review of writing across the curriculum strategies in nursing. They found
successful strategies included “writing-intensive courses, online writing tutorials, structured and
prescriptive educational modules, in-class writing activities, librarian-led tutorials, and formative
assessment with faculty feedback” (Hawks et al., 2016, p. 266). The authors uncovered two
major deficits within writing instruction in nursing education. First, there were few tools to
measure the writing competence of nursing students. Second, most of the WAC strategies
reviewed did not evaluate the effectiveness of the intervention on students’ writing ability. Some
evaluated students’ perceptions but overall, these strategies have not been tested.
Troxler et al. (2011) performed an integrative review of writing strategies used to teach
undergraduate nurses writing. They identified five common elements across the literature: the
use of low stakes writing assignments, the importance of faculty training, sequencing
assignments, providing students with exemplars, using rubrics, and requiring revision after
feedback. The researchers found that program-wide writing initiatives were likely to include
more of these elements than stand-alone workshops or courses. Likewise, Oermann et al. (2015)
performed a systematic review of programs for developing nurses’ writing skills. They found
many examples of writing assignments being added to individual nursing courses to improve
writing, some instances of a specific course designed to address writing development, and
strategies for WAC. The authors recommended a more planful approach to how writing
assignments were designed across a nursing program because students need practice, as well as
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feedback and the opportunity to revise papers. Similar to Hawks et al. (2016), Troxler et al. and
Oermann et al. also saw a need for evaluating the effectiveness of writing interventions since
they were lacking in their reviews.
Luthy et al. (2009) described their implementation of WAC in a baccalaureate nursing
program. They found that breaking a paper into parts was helpful for both faculty and students
and that ongoing faculty feedback of students’ written work strengthened their writing ability.
They also reported that use of peer feedback on first drafts and rubrics saved time for faculty.
Gazza and Hunker (2012) created a writing scaffold to facilitate scholarly writing development.
Similar to Luthy et al., they recommended sequencing assignments, using rubrics, and providing
feedback from faculty, peers, and writing tutors as important strategies for nursing faculty to use.
Although the writing scaffold was not evaluated for effectiveness, the authors did note that their
strategies were evidence-based.
Zygmont and Schaefer (2006) discussed their school’s experience with implementing
WAC using Wolcott and Lynch’s critical thinking model as a conceptual framework. Their
report spanned several years. During that time, the faculty learned the value of communicating
with each other about students' strengths and weaknesses and started using portfolios to track
progress over time. The authors stressed the importance of using a model to guide the WAC
project, investing in faculty development, planning assignments across the program, and
presenting a united front to students to ensure their transfer of the critical thinking skills
promoted across writing assignments. Again, no evaluation of this method was mentioned apart
from the authors’ impressions and the student portfolios.
One WAC variation that is faculty-driven is the writing enriched curriculum (WEC),
developed by the University of Minnesota. WEC’s principles align with WAC’s, stating that
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writing is interconnected with thinking and that teaching writing is a shared responsibility among
all faculty (Flash, 2021). WEC emphasizes the importance of dialogue between content area
specialists in order for a department to arrive at a deeper, shared understanding of the importance
of writing in the discipline. In fact, WEC Director Pamela Flash (2021) stated that
“unchallenged, tacit-level conceptions of writing and writing instruction” (p. 20) interfere with
faculty’s ability to meaningfully integrate writing into the curriculum. The final principle
represents a departure from professional development as the occasional workshop, highlighting
the need that content area teachers have for ongoing support with partners outside of their
department. Heather Bastian (2014) described her experience of building a WEC-inspired
writing program at a small health sciences college. She pointed out the importance of building
connections with administrators, interviewing faculty, doing a thorough needs assessment,
making recommendations, and supporting the nursing faculty in creating a discipline-specific
WAC program that they are ultimately responsible for teaching and evaluating.
The Practice of Clarifying Writing Expectations for Students
Two studies examined standardizing writing rubrics to be used in a WAC program.
Minnich et al. (2018) reported high interrater reliability among faculty using the scholarly
writing rubric. Feedback from faculty participants was generally positive regarding the tool’s
consistency, emphasis on writing ability, and use as a teaching tool. Abbott and Shaw (2019)
shared their success of creating a hybrid standardized rubric for writing that had common areas
of assessment and individualized areas depending on the course’s focus. The authors felt this
rubric allowed for faculty’s academic freedom while still tracking standard areas for students
across the bachelor of nursing program.
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The use of exemplars, or model papers, was also recommended in the literature. Carter et
al. (2018) performed an integrative review on the use of student exemplars. They found that
students valued faculty use of exemplars because it gave them confidence and helped clarify
faculty expectations. Although students’ writing grades did not always correlate with exemplar
use, exemplars could still be an important way to scaffold students’ learning but more research is
necessary and perhaps a more standardized approach to using exemplars. White and Lamson
(2017) discussed their experience creating a writing resource program for nursing students. The
team consisted of one nursing faculty, a librarian, and tutors. The authors used a combination of
workshops, handouts, and exemplars to support students’ writing. Although few students sought
help from the team, they were busiest right before assignments were due. They also found that
students tended to use online resources more frequently than previously and that could be
another path to explore. Other researchers mentioned the use of exemplars but did not include an
evaluation of that practice (Behrens et al., 2016; Naber et al. 2014).
Overall, the research results indicated several best practices when designing writing
instruction. First, assignments should be sequenced for greater complexity over time, both within
a course and across a program’s curriculum. Second, faculty expectations should be made
explicit with rubrics, clear guidelines, or exemplars. Third, students need opportunities for
revision after receiving feedback from faculty, peers, or tutors.
The Practice of Socially Mediated Writing Development
Writing is a form of communication and as such, it implies social interaction. The social
context of writing includes communicating a message to an audience, understanding what
discourse format is required for the situation, and drawing upon prior knowledge (Bean, 2011).
Students learn how to manage these elements of writing with the help of knowledgeable others.
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McCutchen’s (1996) research results suggested learning from a more skilled writer is necessary
for many students to go beyond simple writing processes such as “retrieve and encode” to a more
interactive and recursive process. She explained that advanced writers constantly shift between
planning for the writing task, transcribing the actual words, and revising what has been written
based on their purpose and audience. Novice writers, in contrast, equate writing to only
transcribing words onto the page, without planning or revision work. Drawing on previous
research studies, McCutchen argued that many early writers will continue to use rudimentary
writing processes unless they learn strategic, recursive processes from more expert writers.
Similarly, Baleghizadeh and Gordani (2012) found in their research study of graduate university
students that conferences with faculty produced superior writing results compared to direct
written feedback. Overall, the development of inexperienced writers is significantly enhanced
with social mediation of the writing task by more experienced others.
In addition to the importance of mediation in improving students’ writing processes,
discipline experts are essential to inducting novices into the professional dialogue. Mitchell
(2018) argued that because writing is a social construct, writing can be used to teach students the
discipline-specific knowledge needed to successfully enter the profession. She contended that
nursing faculty must use writing as a way to expedite student development of their professional
identity within the scholarly community. Ivanic (1998) also recognized the influence of literacy
practices from multiple ecological contexts on a writer and their identity development, with a
goal of new members ultimately using their writing voice to challenge or support the various
communities they inhabit, and the beliefs and values therein. Scholarly writing can be used to
teach students about discipline-specific practices and writing can be used to influence and
change practices because of the dynamic social interaction involved.
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The Practice of Providing Balanced Feedback
A vital component of faculty-student interaction that enhances writing development is the
process of faculty giving, and students receiving, feedback on drafts (Jefferies et al., 2018). Ball
et al. (2009) surveyed students regarding faculty’s written feedback on their papers. Students
regarded faculty comments balanced with both strengths and areas to improve were valuable to
their learning. The students noted the importance of faculty providing sensitive comments,
focusing on positives, and reading their papers as supportive believers in their abilities. Chandler
et al. (2005) studied graduate students who were engaged in a writing workshop. Each week, the
students produced twenty minutes of freewriting, shared what they wrote, and gave feedback to
each other. The nursing students commented how surprising it was to hear positive feedback,
implying that they were accustomed to receiving criticism of their written work. The authors
adopted a version of the experiment in class to enable students’ thinking development and
creativity without fear of judgment or worrying about grammar.
Feedback from faculty should be honest but care must be taken regarding the classroom
environment. Edmonson coined the term “psychological safety” when she was researching
effective healthcare teams. Psychological safety is characterized by an environment where
everyone feels safe enough to share their ideas, questions or challenges, and take risks without
negative repercussions (Edmonson, 1999). She discovered that when people feel safe, they have
a higher chance for growth and collaboration. Likewise, researchers have found students
responded better when feedback included mitigating comments, where positives were included
as well as negatives, and framed in an encouraging way (Ball et al., 2009; Chandler et al., 2005;
Smith, 2008). As Bean (2011) stated, the goal of faculty “is to provide useful instruction, good
advice, and warm encouragement” (p. 321).
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In addition to praise and psychological safety, effective feedback is often presented
within a hierarchy of writing concerns. Bean (2011) advised college professors to be strategic
when giving students’ written feedback and to keep in mind the goal is to help students improve
their writing, not point out every error. To that end, he recommended using “a hierarchy of
concerns, descending from higher-order issues (ideas, organization, development, and overall
clarity) to lower-order issues (sentence correctness, style, mechanics, spelling, and so forth)” (p.
322) and to limit comments to two or three issues per draft. Once students have addressed
higher-order concerns, professors can continue to lower-order concerns. The Harvard College
Writing Program (2007) advocated for a similar approach, adding that faculty should point out
helpful and unhelpful patterns in student writing and “use a reliable format for structuring final
comments—for example, restatement of thesis, discussion of strengths, and discussion of
weaknesses” (p. 3). An organized approach to feedback guides faculty in attending to the most
salient issues first and guides students in the efficient prioritization of their revisions.
Practices for Promoting Reflection and Growth
Even though writing is a context-specific, socially-mediated task, encouraging students to
take ownership of their writing process is vital to their development as autonomous thinkers.
There are several ways to help writers examine their written work and ideas. Researchers have
found that reflection journals on clinical experiences can help students develop a reflective
nursing practice (Billings & Kowalski, 2006; Binding et al., 2010). Based on self-report data,
reflective writing has been shown to increase students’ belief in themselves as competent writers
(Carter, 2008). Lavelle (2013) found that students who reflected on their writing earned higher
grades and were more likely to engage in the revision process than students who did not.
Reflection encourages students to connect new learning and experiences with previous
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knowledge, analyze problems, and critically evaluate currently held beliefs and ideas. This
metacognition about one’s thinking enables nurses to assimilate and accommodate new
information and processes to become better practitioners.
Portfolio assessment is another high-impact tool faculty have used to promote students’
reflection process. Portfolios allow students to collect a variety of written work over time and
provide opportunities for students to reflect on their writing development, engage in revision,
create writing goals, and become more strategic writers who gain better mastery over their
writing craft (Slomp, 2012; Smith & Caplin, 2012; Zygmont & Schaefer, 2006). Portfolios can
include more than written work, but their reflections are typically written in response to
instructional activities and clinical experiences with patients, often including a rationale from the
students about what they did to meet program learning outcomes or competencies, and how those
experiences shaped their professional identity and development.
Discipline-specific writing can be a powerful way for students to improve their
competence and confidence as nursing scholars. Smith and Caplin (2012) performed a scholarly
writing intervention for baccalaureate nursing students. The students reported that the
opportunity to engage in scholarship activities helped them realize latent leadership qualities and
inspired them to join in the professional discourse by contributing to nursing journals. Mitchell
(2017) assessed the self-efficacy and paper grades of 173 baccalaureate nursing students enrolled
in a discipline-specific scholarly writing course. The results of the writing intervention showed
an increase in writing self-efficacy, and that baseline self-efficacy scores were predictive of final
paper grades. Although self-efficacy fluctuates depending on context and task complexity
(Mitchell, 2018), writing instruction has been shown to improve students’ self-efficacy and
writing performance (Mitchell, 2017).
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As a writer gains confidence and skill within a community of practice, nursing scholars
begin to shape their own professional identity and develop a unique writing voice. At first,
writers learn to master discipline-specific conventions as part of assimilating into the nursing
profession (Chaudoir et al., 2016; Tyndall & Scott, 2017). As students move into graduate and
doctoral programs, the focus becomes developing their own scholarly identity, analyzing
research, and asserting one’s place in the professional discourse. One example of this kind of
innovative dialogue can be seen in the qualitative research done by Ryan et al. (2013). The
authors stated that "scholarly writing for nurses often seems to avoid the active voice of caring,
competent experience, that nurses’ voices remain confined within a disciplined, insular dialog"
(p. 299). In response, the authors offer a vision of empowerment where nursing students are
encouraged to go beyond numerous citations and the pretense of objectivity to develop their own
voice and ideas. The authors encourage graduate-level nurses to engage in open dialogue with
other disciplines to share their unique perspective on improving patient care. By welcoming
more diverse voices, the authors posit that nursing will better accommodate the diverse patient
population they aim to serve. Ongoing critical reflection is a necessary skill for nurses to
innovate, drive the profession forward, and move dialogue outward to other disciplines.
In conclusion, there are many instructional strategies and best practices nursing faculty
can employ to foster the writing development of their students. Various writing theories and
research inform educators about holistic approaches that can be used to move beyond the deficit
model of writing instruction and assessment. Carefully scaffolded instruction delivered within a
social context for learning can facilitate students’ thinking and writing development over time.
Clear, encouraging feedback given within an environment of psychological safety, along with
opportunities for revision and reflection, can nurture the growth of each student as nursing
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professionals, able to represent the profession while engaging in interdisciplinary discourse to
improve healthcare delivery for all patients.
Bronfenbrenner’s Ecological Systems Theory
In his seminal work, The Ecology of Human Development, Urie Bronfenbrenner (1979)
described a theory of human development focused on the complex relationship between the
individual and various aspects of their environment. Drawing on developmental psychology,
sociology, and social policy, his theory offered a new way for researchers to examine the effects
of family, social life, and culture on a person’s development. Bronfenbrenner (1979) outlined
four socioecological systems that influenced the individual: the microsystem, mesosystem,
exosystem, and macrosystem. The microsystem is the environment immediately surrounding the
person and the one they are most actively involved in. As such, the person’s behavior is shaped
by the microsystem but this environment is also influenced by the person. Microsystem examples
include immediate family, the workplace, school, or a religious institution where the person is
active. The mesosystem is the next level and it represents the “interrelations between two or
more settings” (Bronfenbrenner, 1979, p. 209) that have an effect on the person. An example of a
mesosystem would be the impact of a parent-teacher conference on a child. The exosystem
indirectly affects the developing person but they are not an active participant in this system. An
example of this would be mass and social media, community agencies, school policies, or a
spouse’s workplace. The macrosystem includes the underlying beliefs, knowledge, ideology,
values, politics, or community practices of a culture or subculture that affects the individual’s
development.
Bronfenbrenner later added the chronosystem to account for the influence of time. The
chronosystem involves both the life transitions of the individual and any sociocultural changes or
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historical events occurring within the individual’s lifespan (Bronfenbrenner & Morris, 1998).
Examples of a life transition might be puberty or having children. Historical events could be a
country-wide economic recession or a global pandemic.
Conceptual Framework
Bronfenbrenner’s (1979) ecological systems theory informed the conceptual framework
for this study. The multidimensional nature of this theory lends itself to a critical exploration of
the many complexities of human development as well as offering insight into educational
research and practice. As noted in the literature review, several researchers preferred an
ecological model when examining students’ writing development. Wardle and Roozen (2012)
argued that an ecological model of writing assessment provided a much richer view of
polycontextuality, or multiple communities of practice that students engage in and are affected
by. Slomp (2012) concurred that a more accurate assessment of students’ writing development
and ability required an ecological approach. Onwuegbuzie et al. (2013) stressed the connection
between ecological theory and the use of mixed methods to gain a deeper understanding of the
many spheres of influence on an individual. Bronfenbrenner’s theory provides a useful lens to
explore the experiences of master’s nursing students within the environment of a semester-long,
online writing intervention.
Bandura’s concept of self-efficacy, as part of his social cognitive theory (Bandura, 1997),
was also be used to provide deeper insight into students’ writing development. Self-efficacy is
the idea that one’s beliefs about their ability affects their achievement. The literature review for
this study included several researchers who explored the influence of self-efficacy on students’
writing performance. Participants in the study were given a pre- and post-intervention self-
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efficacy survey on scholarly writing to better determine how self-efficacy affects performance
and measure any differences in self-efficacy after the writing intervention.
Sociocultural theory was used in the design of the Writing Workshop course several
years ago. Like the ecological systems theory, sociocultural theory is considered a developmental
theory; both explain changes in a learner’s behavior over time and both emphasize the
importance of external systems and social influences on the learner (Allman, 2018). However,
sociocultural theory differs in that it emphasizes the unique relationship between the learner and
more experienced other in shaping their cognitive development and higher order thinking
(Allman, 2018). According to Vygotsky (1978), the learner observes the social behaviors around
them, and with the help of a parent or more experienced person, eventually develops inner
control and mastery of these behaviors. Vygotsky (1962) posited that the external speech and
coaching that happens in the social learning context becomes the learner’s inner speech as they
learn to direct themselves through new behaviors; thus, inner speech becomes the basis for future
thoughts and ideas.
In the literature, sociocultural theory is also used to guide research and practice in writing
instruction. Hodges (2017) discussed the importance of recognizing the various social and
cultural factors and faculty interactions that comprised students’ writing experience. Just as
Vygotsky explained, the social interaction between the student author and more experienced
faculty during the writing process has the potential to inform the student author’s inner speech,
thought development, and strategic approach to the writing task. Combined with the prior
knowledge of the student author, faculty’s use of language during direct instruction, guided
practice, and individual feedback can shape the student’s approach to the scholarly writing
process and help them master discipline-specific expectations for presenting ideas to a specified
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audience. These theoretical assumptions were used as the foundation of the writing intervention
used in this study.
In the Writing Workshop, the inquiry and scholarly writing process was sequenced into
weekly assignments, with video and written instructions provided via the learning management
system. Faculty interaction was dictated by student needs with a range of scaffolded supports and
resources provided. As students read research, they were guided through synthesizing the results
of their inquiry and determining how to explain the development of their thinking process in an
organized manner that would stimulate greater discussion about real-world problems and
possible solutions with their audience. The Writing Workshop was designed to leverage the
social interaction between faculty and students by using weekly feedback to deepen students’
writing and thinking capacity.
In this study, effects on the students’ writing development were measured over 14 weeks,
using a mixed-methods approach. At the beginning and end of the semester, students’ writing
performance and self-efficacy of scholarly writing was assessed to determine influences within
the individual. After completing the writing intervention, student volunteers were interviewed
about their experiences with peers, faculty, and support staff within the context of the writing
course. The interview questions helped explore other ecological influences on writing
development, based on students’ perceptions. Figure 1 is a visual representation of possible
influences on master’s nursing students and their writing development.

50

Figure 1
Conceptual Framework

Summary
This chapter provided an overview of scholarly writing in nursing. Scholarly writing
performs many important functions in preparing students to enter the nursing profession. A brief
history of scholarly writing in nursing and major theories of writing were reviewed. Best
practices emerged from the literature review to inform writing instruction and development. A
major theme noted in the research was the dearth of empirical studies to evaluate interventions
and their effect on students’ writing capacity. The chapter ended with an introduction to
Bronfenbrenner’s ecological systems theory, Bandura’s self-efficacy theory, and Vygotsky’s
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sociocultural theory to provide the conceptual theoretical framework for the study. Bandura’s
self-efficacy theory is used to operationalize Bronfenbrenner’s dimension of the individual.

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Chapter Three: Methodology
The purpose of this study is to explore the experience of master’s nursing students in a
discipline-specific writing course and how the course affects students’ writing capacity.
Specifically, the study examines the environmental influences on the students’ writing
development at the individual, microsystem, mesosystem, exosystem, and chronosystem levels.
This study is timely due to the lack of empirical studies in nursing that assess how writing
interventions affect students’ writing performance. This gap contributes to nursing faculty
relying on writing practices that may or may not support students’ writing progress. Because
scholarly writing is considered an essential goal of nursing education and an important method to
teach critical thinking, analysis of the research literature, applying research to practice, and
professional identity, the results of this study can help improve the quality of nursing education.
This chapter introduces the intervention, methodology, data collection, instrumentation, and
analysis plan for the study. I provide a description of my role as the researcher and how I
protected the integrity of the study and confidentiality of the study participants.
Research Questions
1. How does a discipline-specific writing course affect students’ scholarly writing
performance, self-efficacy, and task value?
2. What are nursing students’ experiences in a discipline-specific writing course?
3. How do nursing students perceive the impact of microsystem, mesosystem, exosystem,
and chronosystem environments on their scholarly writing development?
Overview of Writing Intervention
The Writing Workshop is designed to provide master’s nursing students with discipline-
specific writing knowledge and skills necessary to successfully write at the graduate level. The
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course overview (included in Appendix A) shows how the achievement of course learning
outcomes are supported by learning activities and course materials, delivered through 14 week-
long learning modules. The purpose of this fully online course is to provide graduate students
with a foundation in scholarly writing, critical thinking, and synthesizing research to make
research-based recommendations for practice. Faculty use timely, formative feedback, based on a
hierarchy of writing concerns, to guide students through the various stages of an iterative writing
process: (a) how to define a problem; (b) search the literature for applicable research studies; (c)
critically read, summarize, and synthesize the research results using a matrix table; (d) create an
outline and thesis; (e) participate in peer review; (f) develop a classical argument based on
evidence; and (g) use revision strategies to improve presentation of scholarly thinking and
argumentation. Paragraph organization, line editing, proper citation of sources, and use of APA
style are addressed throughout the semester. Faculty and students engage in three whole class
webinars and schedule individual writing conferences as needed. The students formally dialogue
with faculty, in writing, throughout the revision process and complete a formal reflection paper
at the end of the course.
The course is certified by Quality Matters (QM). QM is a system to ensure the quality of
online courses using a rubric with eight general standards. These standards include: course
overview and introduction, learning objectives (competencies), assessment and measurement,
instructional materials, learning activities and learner interaction, course technology, learner
support, and accessibility and usability (Quality Matters, n.d.). The course achieved certification
in 2017, exceeding the minimum of meeting 85% of the QM standards for online courses based
on a peer review process.
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The course is based on best practices in writing instruction. The final paper is chunked
into sequential weekly assignments that build on one another (Luthy et al., 2009; Troxler et al.,
2011). Discipline-specific writing expectations are clarified using detailed assignment guidance
and a standardized rubric for scholarly writing (Troxler et al., 2011). Formative feedback from
faculty is provided on each weekly assignment and students learn how to engage in peer review
(Oermann et al., 2015). Faculty use a hierarchy of writing concerns to guide students through the
revision process in an organized way (Bean, 2011) and target their feedback to the student’s zone
of proximal development. Faculty work with the same group of students throughout the
semester, providing them with specific praise as well as areas to improve (Ball et al., 2009).
These stable groupings allow faculty to guide and assess students’ writing and thinking
development over time. Revision strategies are modeled for students in synchronous webinars
and individual conferences. Social mediation of learning is promoted through weekly
interactions with faculty and a peer review process (Baleghizadeh & Gordani, 2012). Students
are asked to write a final reflection paper about their pre- and post-course writing test scores,
self-efficacy, writing development, what they learned as authors, how they can transfer these
new strategies to the workplace, and what their future writing goals are (Lavelle et al., 2013;
Naber & Wyatt, 2014; Prestia, 2019).
Overview of Methodology
A quasi-experimental, mixed method design was used for this study. Mixed methods
facilitate the use of quantitative and qualitative data sources in order to investigate a
phenomenon from multiple perspectives (Creswell & Creswell, 2018). All students in the
master’s writing course participated in a pre- and post-course survey to measure their task value
and self-efficacy of scholarly writing. With the school dean’s permission, I obtained the survey
55

data from the school’s Office of Institutional Effectiveness for use in this study. This quantitative
data provided an overview of students’ motivation for writing and facilitated my analysis of any
changes in students’ self-efficacy and task value scores after participating in the discipline-
specific writing course.
Quantitative data from a pre- and post-course writing assessment were also collected
from the school. A concurrent triangulation design of mixed methods was used (Creswell et al.,
2003). The qualitative data from student interviews were used to gain a broader view of the
participants’ experience of the writing intervention and any environmental influences on their
writing development. The quantitative data from the self-efficacy surveys and writing
assessments measured changes in confidence and writing performance at the end of the course
compared to these measures at the beginning of the course. Merriam and Tisdell (2016)
discussed triangulation as a strategy to confirm emerging findings by using multiple methods and
sources of data. In this study, data from surveys and a quantitative writing assessment were
compared with findings from participant interviews to triangulate data and explore influences on
students’ writing development and motivation. Table 1 includes a description of data sources for
the research questions guiding this study.

56

Table 1
Data Sources
Research Questions Pre- and post-
intervention writing
assessment
Pre- and post-
intervention survey
on motivation
Interviews with
students
How does a
discipline-specific
writing course
affect students’
scholarly writing
performance, self-
efficacy, and task
value?
X X
What are nursing
students’
experiences in a
discipline-specific
writing course?
X
How do nursing
students perceive
the impact of
microsystem,
mesosystem, and
exosystem
environments on
their scholarly
writing
development?
X

Data Collection, Instrumentation and Analysis Plan
In this quasi-experimental study, mixed methods with a concurrent triangulation design
were used. Qualitative data were collected from semi-structured interviews with nine student
57

participants who had just completed the writing course. Archival pre- and post-course data were
gathered and analyzed after the one-semester writing intervention was completed.
Existing Data: Writing Assessment
Students in the writing course normally complete a writing assessment at the beginning
and end of the semester. Students are given one hour to write a response to a persuasive essay
prompt scored by artificial intelligence developed by Vantage Labs. The prompt invites student
to select one side of an argument and write an essay explaining their rationale. A generic prompt
example would be to explain why the general public should or should not be allowed to travel in
space. A holistic score on a scale of 1 – 6 is generated based on a defined rubric. Analytic (trait)
scores are also generated on a scale of 1 – 6 in the areas of focus and meaning, content and
development, organization, language usage, and mechanics. I requested participants’ pre- and
post-writing assessment scores from the school’s Office of Institutional Effectiveness. The
writing assessment provided a baseline holistic score and six subscale scores that were compared
with the post-intervention score and the differences analyzed.
Participants
Recruitment was from master’s students enrolled in the fall 2021 semester of the Writing
Workshop course at the Lake Shore School of Nursing. The course has an average of 70 students
per semester. A convenience sample of these students was taken based on those who were
willing to participate in the interviews. A convenience sample is used based on participant
accessibility to the researcher (Pazzaglia et al., 2016). Archival data from the institution’s
collection of pre- and post-course self-efficacy surveys and writing assessments were analyzed
for the entire class. Participant demographics included healthcare professionals and registered
nurses between the ages of 25 – 65, with the majority of students identifying as White women.
58

Instrumentation
Every semester, writing course students take a one-hour online writing assessment at the
beginning and end of the course. Students write a response to a persuasive essay prompt. The
automated writing assessment was developed by Vantage Labs using the artificial intelligence
called IntelliMetric®. This technology has been used to administer testing for a number of
educational institutions at the district, state, and higher education levels. For instance,
IntelliMetric® has been used by The College Board, Harcourt Companies, and the Secondary
School Assessment Testing Board (Elliot, 2003). Currently, ACT, GMAC, ACER, and ACARA
use IntelliMetric® and work with Vantage Labs for automated scoring.
The scoring system for each prompt was created by collecting hundreds of written
responses from community college students that were scored by faculty. The artificial
intelligence (AI) system was trained to recognize patterns in an effective persuasive essay and
calculate scores based on the faculty’s scoring of hundreds of essays responding to the same
prompt. The advantage to using assessment powered by artificial intelligence is that the scores
are generated within seconds, but still based on the grading patterns of teachers. Additionally,
machine scoring is 100% test and retest reliable. AI is more objective than a faculty grader
because the AI does not get tired, does not make mistakes, is not influenced by emotion, and
does not discriminate based on student appearance or behavior. The result is a cheaper, faster,
more accurate way to assess students’ writing performance compared to faculty grading.
The Intellimetric test was based on a six-level rubric created by writing specialists who
selected anchor papers from national exemplars for each score point, appropriate for college
student expectations. As such, this writing assessment could be considered a hybrid between
criterion-referenced and norm-referenced. The rubric generally defines a holistic score of three
59

as the equivalent of the writing skills expected of the average first- or second-year undergraduate
student, a four would correspond with a college senior, a five would be considered a master’s
level, and a top score of six would indicate doctoral-level writing (P. Edelblut, personal
communication, April 18, 2022).
According to National Council of Teachers of English (Anson et al., 2013.), there are
disadvantages to widespread AI writing test usage. These include the following: writing for a
computerized test is not a meaningful writing activity for students, AI cannot evaluate nuances in
reasoning or word choice, these tests discriminate against students less familiar with technology,
and computer scoring tends to rely on lower-level writing concerns as an indicator of “good
writing” and that can put certain students at a disadvantage (e.g., students who speak a primary
language other than English or students with learning disabilities). Furthermore, when used for
high stakes testing, automated essay scoring can encourage teachers to “teach to the test” and it
removes teachers from the assessment process. Additionally, the AI assessment used in this
study was developed using community college faculty’s assessments of their students’ writing.
This demographic varies in education level as well as age from the master’s students enrolled in
this writing intervention. Furthermore, the school of nursing faculty may evaluate student writing
differently from the community college faculty who participated in the AI test scoring.
There are several reasons why AI testing was used in this study. First, IntelliMetric® had
been chosen by this school of nursing to provide an efficient diagnostic assessment of incoming
Writing Workshop students as a way to create balanced faculty workload and provide a snapshot
of student writing at the beginning of the course. The test is not an admissions requirement nor is
it used as a summative assessment for the end of the master’s program. Second, even though the
AI test was designed with community college students, the Writing Workshop students’ pre-tests
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were solidly in the average range. These consistent data indicated an appropriate alignment
between this student population and the AI test. Last year, the IntelliMetric® test evolved into
being used as a post-test to measure students’ writing gains, compared to pre-test scores. Then, in
the summer 2021 semester, the pre- and post-test scores were used as data for the students to
consider in their final reflection activity. Because IntelliMetric® was only one of many writing
assessments within the course, it provided additional data points for faculty and students to use.
In this study, these archival data created baseline scores that were easily compared with
participants’ post-intervention scores without further imposition on the faculty’s time to grade
student essays. The students were also prompted to compare their pre- and post-course writing
scores and reflect upon why their score changed.
Data Collection Procedures
Writing assessment data were collected within the first week of the Writing Workshop.
All students were given the same prompt for the pre-test. The one-hour assessment is web-based
so it is hosted, scored, and stored on Vantage Labs’ server and reports can be downloaded by
school administrators. The post-intervention assessment was given in the last two weeks of the
writing course. Students were given a different writing prompt on the post-test.
Data Analysis
I collected the pre- and post-intervention writing assessment data from the Lake Shore
School of Nursing after the final grades were posted for the semester. The data sets were
analyzed using a paired t-test for dependent measures. Because the participants were tested
twice, there were two sets of scores, and the difference between the repeated measures was the
focus of the analysis. It was determined that the t-test for dependent means was the appropriate
test statistic (Salkind & Frey, 2017). The difference between the pre- and post-test scores were
61

analyzed to determine the t-value. A t-value that is statistically significant indicates that the
independent variable, the writing intervention, had a significant effect on the dependent
measures.
Validity and Reliability
The writing assessment demonstrates construct validity because the subsets measured are
subskills of the scholarly writing process. The subscale scores are based on the hierarchy of
writing concerns (Bean, 2011; Harvard Writing Project, 2007). These areas are divided into two
categories. The higher-order, or global concerns, are the meaning-based skills of focus,
development, and organization. The lower-order, or local concerns, include grammar, language
usage, and sentence mechanics. The hierarchy of writing concerns, sometimes called the
hierarchy of rhetorical concerns, has been used as a way to guide students through the revision
process, help instructors focus feedback at the level most needed by the student, and as a way to
assess writing performance (Bean, 2011). The Vantage Labs assessment measures similar
constructs: focus and meaning, content and development, organization, language usage, and
mechanics (Haisfield et al., 2012). The writing assessment has construct validity because it uses
the same constructs as the hierarchy of writing concerns and the writing rubric used for the final
paper in the course (the rubric is included in Appendix C).
One could argue that automated essay scoring (AES) is artificial and cannot take the
place of writing in a meaningful social context where the communication is intended to be read
by a human audience. AES technology cannot measure the author’s critical thinking, logic,
quality of evidence, or other subtleties employed by expert writers. As Deane (2013) stated,
“Objections to use of AES that focus on its failure to measure meaningfulness of content,
argumentation quality, or rhetorical effectiveness boil down … to the observation that AES
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systems do not measure the full writing construct, but rather, a restricted construct” (p. 16).
These reviews of AES in general do show some limitations. AES can even be manipulated with
repetition of content and intentional, but inappropriate use of hifalutin vocabulary words.
However, AES systems still maintain a high correlation with human scorers because
advanced writers have developed fluency with the basic processes that the AES system analyzes.
Bennett (2011) found a correlation of .80 between human raters who used two different rubrics
to score papers: one focused on fluency, coherence, word choice, and sentence mechanics text
features and the other geared at effective argumentation and critical thinking. It is important to
note that these reviews were of AES systems that used a much less sophisticated process for
scoring and these criticisms may not apply to IntelliMetric®. In short, AES can be a valid
measure of writing ability, especially when it is used as one point of data in triangulation with
other measures. The subscales are similar to the rubric used in the Writing Workshop so
students’ pre- and post-scores from Vantage Labs can be compared with the faculty’s assessment
of participants’ final paper as another triangulation check.
IntelliMetric® has demonstrated reliability and validity. Elliot (2003) summarized a
review of over 100 studies involving the use of IntelliMetric®, showing that this technology
aligns with the manual scoring of experts, is able to accurately score across multiple content
areas and grade levels, and provides stable results across various samples. Rudner et al. (2006)
examined IntelliMetric® prior to adopting it as a secondary measurement to human raters for
GMAT essays and concluded that IntelliMetric® scores matched human raters, the AI was able
to identify essays containing plagiarism, and the technology was “superior to simple word counts
or simple probability modeling” (p. 12).
Existing Data: Surveys
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The Lake Shore School of Nursing began deploying self-efficacy surveys in spring 2021.
Information about students’ confidence about writing has also been informally asked in the
course discussion board but the study used the school’s archival data from the formal surveys.
The same self-efficacy measurement was administered pre- and post-intervention and changes in
self-efficacy or task value were recorded and analyzed.
Participants
Survey participants were master’s students from the writing course at the school of
nursing. The course has an average of 70 students per semester. The students in the graduate
program are registered nurses between the ages of 25 – 65. Demographically, three-quarters
identify as White, almost 10% as Black, 5% as Hispanic, 5% as Asian, 2% as two or more races,
and less than 1% as Native American (A. Wolf, personal communication, January 15, 2021). The
majority of students are female with 10% of students identifying as male.
Instrumentation
The Situated Academic Writing Self-Efficacy Scale, developed by Mitchell et al. (2021),
was used in the creation of the school’s self-efficacy survey. The adapted survey can be found in
Appendix D. The scale was originally developed with nursing students and was later validated
with interdisciplinary undergraduate and graduate students. Both subscale scores and total scale
can be used. Students used a 0-100 sliding scale to indicate their answers. The school uses a 0-10
scale. The survey is divided into three subscales that address more complex features of scholarly
writing as students progress through the survey.
The first three questions assess “writing essentials” for subscale one, including questions
on students’ confidence with grit, word choice, and synthesizing evidence. The next eight
questions comprise subscale two on “relational reflective writing.” These items involve writing
64

for an audience, using feedback for revision, connecting ideas, monitoring, and reflecting on
their writing. The next four questions explore students’ advanced ability to express “creative
identity” in scholarly writing. These include questions about students’ self-efficacy with regards
to creativity, writing voice, and general confidence about scholarly writing. These survey items
measured students’ self-efficacy before and after the intervention.
Students’ task value for scholarly writing was also measured on the survey. Questions
from A Manual for the Use of the Motivated Strategies for Learning Questionnaire (MSLQ;
Pintrich et al., 1991) were adapted regarding the task value component of motivation. These
questions were framed within the context of learning scholarly writing in The Writing
Workshop. The six questions include two questions about utility value, two questions on intrinsic
value, and two on attainment value of scholarly writing. The summary of psychometric data for
the original MSLQ questions can be found in Appendix E.
Data Collection Procedures
The survey link was sent out through email and administered via Qualtrics to students
enrolled in the Writing Workshop. The school’s Office of Institutional Effectiveness sent out the
survey within the first week of class with a one-week due date. The process was repeated at the
end of the course. These measures allowed for a comparison of scores before and after the
intervention. Student surveys had a unique identifier so pre-course results were compared with
post-course results.
Data Analysis
The pre- and post-intervention survey data was analyzed for differences using a paired t-
test for dependent measures. Because the participants were surveyed twice, there were two sets
of responses. The focus of the analysis was on the changes in self-efficacy and task value
65

between the repeated measures so the t-test for dependent means was the appropriate test statistic
(Salkind & Frey, 2017). The difference between the pre- and post-test responses was analyzed to
determine the t-value and if it was statistically significant.
Validity and Reliability
The summary of psychometric data for the self-efficacy survey can be found in Appendix
E. According to Mitchell et al. (2021) the survey has high internal consistency based on
Cronbach’s alpha (.94-.95 for total scale), high parallel form reliability (r=.91 for total scale),
and concurrent validity (r=.59). A higher response rate improves the reliability of the measure
(Salkind & Frey, 2017). The summary of psychometric data for task value survey items can be
found in Appendix F. This set of questions also demonstrated high internal consistency with a
Cronbach’s alpha of .90. Response rates were encouraged by giving students a due date with
periodic email reminders.
Interviews
Upon completion of the quantitative data collection, semi-structured interviews were
used. This qualitative method allowed me to collect rich, detailed information (Morgan, 2014)
regarding students’ perceptions of environmental influences on their scholarly writing
development, self-efficacy, and task value. The addition of qualitative information helped
provide triangulation of data for a more robust view of student experiences with scholarly
writing.
Participants
Interview participants were recruited from students who completed the Writing
Workshop at the Lake Shore School of Nursing. The course enrollment began at 68 master’s
students in the fall 2021 semester. The participant pool included registered nurses and healthcare
66

managers between the ages of 25 – 65, with 77% of students identifying as White and 90%
identifying as women. A convenience sample of nine interview participants was obtained based
on student volunteers (Merriam & Tisdell, 2016).
Instrumentation
A semi-structured interview format was used (interview questions are presented in
Appendix G). Semi-structured interviews include an interview guide with a mix of questions that
can be used flexibly, without a prescribed order but that focus on a list of issues to be explored
(Merriam & Tisdell, 2016). Because I am currently one of the faculty members who teaches the
class, a CITI-certified qualitative researcher conducted the interviews for student volunteers from
my teaching group. This decision was made to facilitate students’ comfort and to encourage them
to speak openly about their experience with the course and the faculty without fear. A semi-
structured interview was used for consistency throughout the interview process while allowing
for the interviewers to be flexible about how and when to ask certain questions. The interview
included several categories of questions: work background, experience in the class, experience
with faculty and peers, experience with the writing coaches and librarians, and a closing section.
Patton’s six types of questions that focus on behaviors, opinions, feelings, knowledge, sensory
details, or background information (Patton, 2002) were used to stimulate a variety of responses
from the students and generate thick description. Probes were provided so the interviewers could
ask for elaboration if needed. The interview process allowed a better understanding of the
students’ experience of the class. The interview questions covered a range of topics: what
students valued from the experience; what environmental elements such as faculty feedback,
peers, work colleagues, or school supports influenced their learning; and how these experiences
affected their knowledge and confidence about scholarly writing. Interviews also provided
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information about students’ self-efficacy and task value of scholarly writing. Self-efficacy is the
individual’s belief about their ability to “organize and execute the courses of action required to
produce given attainments” (Bandura, 1997, p. 3). Task value, as defined by Jacquelynne Eccles
(1983), is how a student perceives the importance, usefulness, interest, and cost of a specific
task, in this case, scholarly writing.
Data Collection Procedures
Interview data were collected after the last day of class and after students had submitted
their final writing project. The data were collected via recorded Zoom sessions that were then
transcribed into text. The interviews were completed using a semi-structured format with probes
to allow for follow-up questions. An automated transcription company was used to transcribe the
interviews.
Data Analysis
The interview transcripts were coded. Thematic analysis was used to discover common
experiences noted across several interviews (Merriam & Tisdell, 2016). The ecological systems
theory guided the categorization of participant experiences using the qualitative analysis
technique from Creswell and Creswell (2018). The quantitative results from the writing
assessments and surveys were compared with the findings from the interviews to answer the
three research questions.
Credibility and Trustworthiness
A well-constructed and tested interview protocol has moderately high reliability and
validity (Johnson & Christensen, 2017). Two strategies were used to promote the credibility and
trustworthiness of this study. First, rich, thick descriptions from student interviews were used to
provide a clear explanation of the study context, and therefore, its transferability to other settings
68

(Merriam & Tisdell, 2016). Second, the interview data were triangulated with other sources of
data (e.g., writing assessment, surveys) to confirm findings (Merriam & Tisdell, 2016).
Ethics and Role of Researcher
All student participation in the interview process was voluntary. Interviews and thematic
analysis did not begin until after the course was finished and participants’ work was graded.
Students were made aware that participation in the study would not affect their grade in the
course and that their names would not be shared with administrators or other master’s faculty.
Pseudonyms were used for presenting data from the interviews to maintain the confidentiality of
students who participated.
A proxy from another institution was used to conduct five of the nine interviews. This
decision was made to promote students’ comfort by excluding their assigned course faculty from
the interview process so students could speak freely about all aspects of the course, positive and
negative. Choosing an alternate interviewer provided students with an objective listener,
potentially revealing more honesty and complexity regarding their perceptions of the writing
course.
My identity as one of the course faculty makes the data more personal to me. As an
instructor, I am invested in the course and believe that the instructional strategies have merit. My
30+ years as a literacy teacher has influenced my philosophy of teaching. I have learned many
lessons from the teachings of Lev Vygotsky, Maria Montessori, Marie Clay, and Marshall
Rosenberg. However, I am also curious and open-minded to the aspects of the course that
students may not find helpful. I strived to listen deeply to the students’ perspectives in order to
better assess the effectiveness of the course and learn from them. Writing a critical self-reflection
of my own “assumptions, worldview, biases, theoretical orientation, and relationship to the
69

study” (Merriam & Tisdell, 2016, p. 259) has helped me become more aware of my potential
blind spots when reviewing the interviews.

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Chapter 4: Results and Findings
The purpose of this study was to explore various influences on master’s students’ writing
development at Lake Shore School of Nursing. The questions that guided this study were as
follows:
1. How does a discipline-specific writing course affect students’ self-efficacy, task value,
and scholarly writing performance?
2. What are nursing students’ experiences in a discipline-specific writing course?
3. How do nursing students perceive the impact of microsystem, mesosystem, exosystem,
and chronosystem environments on their scholarly writing development?
Participants
The participants in this study were master’s students enrolled in the fall 2021 semester of
the Writing Workshop at the Lake Shore School of Nursing. Students from the nurse practitioner,
healthcare leadership, certified nurse leader, and nursing education specialty programs were
represented as well as students not yet matriculated into a program. Non-matriculated students
are not required to gain acceptance into a specific program before they enroll for core master’s
courses such as the Writing Workshop. Table 2 summarizes the number and percentage of
students from each of these programs, as well as demographic data of participants including
gender, race, and ethnicity. Reporting on race and ethnicity is based on National Center for
Education Statistics (NCES, n.d.) methodology for analysis and reporting of race and ethnicity.
Due to the low number of students from underrepresented groups and students who identified as
men, student demographics such as gender, race, and ethnicity were not collected for interview
participants to further protect their identities.

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Table 2
Demographic Data
Fall 2021 Demographics for Students Enrolled in The Writing Workshop

Attribute

Frequency

Percent
Gender
Female 58 90.6
Male 6 9.4

Race/Ethnicity
Hispanic 2 3.1
American Indian or Alaska Native 2 3.1
Asian 3 4.7
Black or African American 0 0.0
Native Hawaiian or Other Pacific Islander 0 0.0
White 54 84.4
2+ Races
a
2 3.1
Nonresident Alien 1 1.6

Academic Program
Nurse Practitioner 19 29.7
Certified Nurse Leader 7 10.9
Healthcare Leadership 15 23.4
Nursing Education 10 15.6
Non-matriculated 13 20.3

a
Of the two students identified here as 2+ races, one self-identified as Black and Native
American, the other as White and Asian.

Study Participants
Of the 68 students who took the course, data were collected on 64 students. Two students
withdrew from the class before the pre-test, and two students were excluded from the study
72

because they had taken the Writing Workshop previously and were enrolled in the course for a
second time. Of the 64 participants, 58 completed the course. One student did not complete the
writing assessment post-test and was removed from analysis, resulting in an n = 57 for that
measure. Ten students did not respond to either the pre- or post-test for the self-efficacy survey,
resulting in an n = 48 for that survey. Due to missing responses, one participant was removed
from analysis for the relational reflective writing subscale of the self-efficacy survey, and two
were removed from analysis of the creative writing subscale, so the n for these subscales were 47
and 46, respectively. Figure 2 presents a flow chart of participation throughout the study.

Figure 2
Participant Flow Chart

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Interview Participants
Nine students volunteered to be interviewed. The researcher interviewed four students
and another interviewer, who did not teach the Writing Workshop or work at the Lake Shore
School of Nursing, interviewed five students. This arrangement allowed students who had
worked directly with the researcher during the course to be interviewed by someone other than
their assigned faculty. Students from the leadership in healthcare program, clinical nurse
leadership program, and nurse practitioner programs were represented. A mix of women and
men were interviewed. Six students identified as White and three identified as either non-White
or as two or more races. Three of the interviewed students self-disclosed that English was not
their native language.
Research Question 1: How Does a Discipline-Specific Writing Course Affect Students’ Self-
Efficacy, Task Value, And Scholarly Writing Performance?
In order to answer this question, all students in the Writing Workshop were given a
survey during the first week of the course. The survey consisted of 22 questions regarding
students’ perceptions of their writing essentials (word choice, grit, and synthesizing evidence),
relational reflective writing (writing for an audience, using feedback for revision, connecting
ideas, monitoring, and reflecting on their writing), creative identity (creativity, writing in their
own voice, and general confidence about scholarly writing), and task value with regard to
scholarly writing in healthcare. (Appendix D presents the complete survey protocol).
Improvement in Self-Efficacy: Self-Efficacy Survey Results
A series of paired samples t-test was used to compare the pre- and post- self-efficacy and
task value scores. Cohen’s (1988) d was calculated as a measure of the effect size, with the
74

interpretation following Cohen’s convention: .20 (small effect), .50 (medium effect) and .80
(large effect). Statistically significant differences between pre- and post-scores were found with
respect to writing essentials (t (49) = 6.8, p < 0.001; d = .96), relational reflective writing (t (48)
= 7.7, p < 0.001; d = 1.1), and creative identity (t (47) = 7.8 p < 0.001; d = 1.12). All three sub-
scales for self-efficacy revealed significantly higher scores on the post-test compared to the pre-
test, with large effect sizes.

Table 3

Pre- and Post-Test Scores on Self-Efficacy and Task Value
Subscales

Test M N SD t df p d
Writing essentials Pre 6.08 50 1.69 6.8 49 0.001 0.96
Post

7.89 50 1.47

Relational reflective
writing
Pre 6.68 49 1.40 7.7 48 0.001 1.10
Post

8.25 49 1.10

Creative identity Pre 5.70 48 1.48 7.8 47 0.001 1.12
Post

7.72 48 1.48

Task value Pre 7.93 50 1.50 0.8 49 >0.05 0.11
Post 8.08 50 1.49

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No Change in Task Value for Scholarly Writing: Task Value Survey Results
The difference between task value pre- and post-course scores was not significant (t (49)
= 0.8, p > 0.05; d = 0.11). In other words, respondents reported approximately the same task
value score on the pre-test as they did on the post-test (Table 3 presents the task value data).
Task value indicates students’ perceptions of the importance, usefulness, interest, and cost of
scholarly writing (Eccles, 1983). The survey items related to task value measured students’
perceived utility value, intrinsic value, and attainment value of scholarly writing. It is notable
that survey respondents exhibited high task value for scholarly writing (7.93 out of 10) before the
course and that high task value remained consistent after the course (8.08 out of 10). The
interviewed students provided further description and examples of this high task value and these
are discussed in research question two.
Improvement in Writing Performance: Writing Assessment Results
During the first week of the course, students in the Writing Workshop were given a one-
hour writing assessment. Students wrote an argument in response to a provided prompt. The tests
were scored by Intellimetric®, the artificial intelligence software from Vantage Labs. The scores
included a holistic writing score and a series of subscale scores based on a range of writing
dimensions including focus and meaning, content and development, organization, language
usage and style, and mechanics and conventions. Students repeated the one-hour writing
assessment at the end of the semester, with a different prompt.
A series of paired samples t-test was used for comparing pre- and post-course writing
assessment scores, and Cohen’s (1988) d was calculated as a measure of the effect size.
Statistically significant differences were found between pre- and post-workshop writing
assessment scores, both in terms of subscale scores and the holistic writing assessment (Table 4
76

presents these data). All the effect sizes exceeded the conventional value of .80, and were,
therefore, interpreted as large, based on Cohen’s (1988) categorization. The overall, or holistic,
writing scores revealed an effect size of two. The average scores were all higher on post-test
scores, compared to pre-test scores, indicating a significant improvement in writing skills
following completion of the Writing Workshop (refer to Table 4).

Table 4
Descriptive Statistics: Pre- and Post-Course Writing Assessment Scores
Dimension Test M N SD t df p d

Focus and meaning Pre 3.18 57 0.83 -14.3 56 0.000 1.9
Post

4.70 57 0.91

Content and
development
Pre 2.74 57 0.72 -12.3 56 0.000 1.63
Post

4.14 57 0.83

Organization Pre 2.82 57 0.66 -12.2 56 0.000 1.62
Post

4.12 57 0.73

Language usage and
style
Pre 2.95 57 0.67 -16.2 56 0.000 2.15
Post

4.77 57 0.93
Mechanics and
conventions
Pre 2.82 57 0.66 -15.3 56 0.000 2.03
Post

4.47 57 0.85
Holistic Score Pre 3.19 57 0.81 -15.1 56 0.000 2.00
Post 4.79 57 0.92

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Summary
Results regarding how the Writing Workshop course affected students’ self-efficacy
revealed a large effect size, indicating students experienced significant improvement in their self-
efficacy for scholarly writing after participating in the course. Students expressed high task value
for writing prior to the course and those scores also remained high post-course but without any
significant difference between the pre- and post-course measures. Finally, students’ scores on the
post-course writing assessment demonstrated a large effect size, revealing significant growth in
writing performance compared to pre-course scores.
Research Question 2: What Are Nursing Students’ Experiences in a Discipline-Specific
Writing Course?
In addition to the quantitative results presented, students were invited to answer interview
questions regarding their experience of the Writing Workshop in the fall 2021 semester. Nine
students who were enrolled in various master’s programs at Lake Shore School of Nursing
volunteered to be interviewed (Appendix G presents the specific interview protocol). Thematic
analysis was used to code the transcribed interviews. The goal was to capture how the
participants experienced the course in relation to the theoretical framework of Bronfenbrenner’s
ecological systems theory, and to look for any other patterns in the participants’ responses. The
four themes that emerged from this thematic analysis, in the students words, were the following:
the importance of writing assignments “building block by block” through the course, the
“specificity of feedback” from faculty, how the course gave them writing “tools in my toolbox,”
and that, overall, the course “transformed my way of thinking.”
Theme 1: Helpful Instructional Design Elements, “Building Block by Block”
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Analysis of the qualitative interview data revealed a theme involving the design of the
course and progression of assignments. The Writing Workshop is a fully online, one-credit, one-
semester course that runs for 14 weeks. The final writing project is a six-page classical argument
where students present results and findings from research studies on a healthcare problem of
interest. In each weekly module, students submit assignments, receive faculty feedback on their
progress, and continue to build on their previously completed work. For example, students watch
prerecorded lectures about the writing process and critical reading, complete an analytic
summary of one published research study related to their problem of interest. Students then
create a literature synthesis matrix to organize data from the research articles they read, look for
themes, create a thesis and outline, participate in peer review, and write several drafts before
submitting their final draft and course reflection. A course overview, including course learning
outcomes, learning modules, assessments, and learning activities, is included in Appendix A.
Students shared several aspects of the course structure they found particularly helpful to their
writing development. The first theme presents student comments on the course design, the
assignment guidance they received, the multi-media content in the Learning Management
System (LMS), and the pace of the course.
Breaking The Final Paper Into Weekly Assignments
Six of the students shared how much they enjoyed the way the scholarly writing process
was organized into weekly assignments focused on a relevant skill or component of the final
writing project. Kairos said, “I was pleasantly surprised by how well structured it was.” Kairos
added, “And I think the fact that we did work on the same paper, and it was building on kind of
like, block by block each week, it was beneficial.” Noel shared a similar sentiment regarding the
careful alignment between each assignment, “I liked how we were working on our final project
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from the beginning. So we were like putting these pieces of a puzzle together to get the final
written report.” Eden, in discussing the course format, commented, “once I realized what you
guys were doing, I was like, oh, this is good. Like, we're just breaking this into chunks. I had a
great experience with it.” Students appreciated how the intricacies of writing an evidence-based
argument at the master’s level was divided into manageable chunks so they could better attend to
the discrete skills and “nice mix of the tools they were given” throughout the entire process.
Trinity indicated that breaking the project into steps made it less anxiety-provoking. Noel
appreciated the way the course guided everyone through an organized process and “put
everything together at the end,” and commenting, “Wow, this has kind of came together so
nicely.” Justice emphasized that “it was the organization of it [the course], and then kind of the
formula for how to put it together as a cohesive piece of writing.” Overall, the students
considered the organization of the course to be supportive of their ability to produce a final paper
they felt good about without the stress or anxiety of “finishing it in one fell swoop.”
Clear Assignment Guidance Is a “Game Changer”
Another element of instructional design that emerged from the data analysis was the
clarity provided at the assignment level. Five students remarked on the clear way that
expectations were communicated for each weekly assignment. According to their comments, this
was done in several ways. Each week, students watched a video lecture explaining the writing
step, strategy, or skill for the week. Then, students discussed receiving an assignment guidance
sheet that detailed what the task was, why it was important, how it should be performed, with a
template or worksheet. Finally, per student comments, a worked example was provided so they
knew the level of detail that was expected. Melody stated, “I felt like I was able to stay on track.
And I understood the assignments.”
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Other students expressed gratitude for receiving clear guidelines. Trinity shared that they
felt supported in the course because the professors “really walked us through what their
expectations were.” Eden appreciated the worked examples, commenting, “the examples before
the assignment being done, that's a game changer for me every time.” Kairos expressed similar
sentiments, “I really enjoyed this class because of the structure and examples, specific
examples.” Noel felt positively about the clear instructions provided, “I love how she gave so
much detail and every assignment guideline, that it was foolproof, you just literally had to read it
and follow through and do it.” Kairos added that “the examples, templates that we had, various
tools, and they were mixed really well just kind of like the amount of them, it wasn't
overwhelming ... I felt engaged because of that.” These students appreciated how the
instructional clarity and organizational tools supported their academic success and helped them
productively engage with the weekly assignments.
On-Demand Access to Multi-Media Instruction
The last instructional design element discussed by the interview participants was the
video resources in the Learning Management System (LMS). Students commented on how the
videos helped them “learn better” and they appreciated being able to revisit previous video
lectures to help them recall previous concepts or strategies. Lyric described how they enjoyed the
external resources provided in the learning modules, “those videos, the YouTube like you know,
like some people that they learn better when they watch it. They're visual learners? I don't know.
I think it's great. Yeah. Everything, how they put this class together. It's great.” Noel
remembered a specific YouTube video that assisted them in sentence-level revision, “And that
helped me a lot to just kind of rewrite the sentence in a way that it goes straight to the point. And
as simple as that, I remember watching that video a couple of times.”
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Trinity also shared about the importance of being able to review video instruction, “What
was great was ... that the modules were accessible to us through the whole class. So like, if I
forgot how to do something, I could go back and be like, Okay, this is what she meant.” Trinity
added that sometimes faculty would refer students back to a previous module for review. In sum,
these students used on-demand access to video lectures and external videos in the LMS to
reinforce their understanding of course content.
Students’ Comments on the Pace of the Course
The last element of instructional design noted by the students was the pace of the writing
course. Two students discussed how the course was more time-intensive at the beginning. Some
students shared how they felt the need to rush through the course content and the faculty’s
feedback when assignments were due each week. One student suggested fewer assignments and
another thought the course was more work than a one-credit course should be.
Eden and Jubilee described how the coursework was heavier in the beginning of the
semester, when they were searching for and critically reading research articles. Eden explained,
“So we already know it's front-heavy. So you do a lot of work in the beginning. … it feels like a
lot.” Jubilee shared their experience of the initial weeks of class, “Sometimes I would find the
weekly assignments frustrating. I feel like I didn't have enough time to get more in the beginning
because those ones are so heavy.”
Additionally, several students noted the effects of the weekly assignment due dates on
their learning. Cadence stated, “that was the biggest challenge was being able to get that
feedback in a timely manner.” Cadence clarified that an assignment was due each Tuesday and
“you'd automatically have to get started on the next assignment. But you may not get feedback
back until Sunday.” Cadence further illustrated “And now you have to go back and fix it and you
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have two days.” Similarly, Justice shared “sometimes I felt like it was a really quick turnaround
to the next due date, from when I would get feedback.” Kairos expressed the same challenge, “I
didn't feel at times, there's enough time to process all of the feedback. You're given some of the
feedback towards like the end of the week, and then you have to submit [an] assignment by
Tuesday night.”
Noel recommended decreasing the number of assignments to improve their ability to
focus on the content without rushing, “I think maybe just a little bit less assignments (laughter).”
Noel explained, “you're so focused on meeting the deadline that you tend to scan … because you
need to get it done by midnight, instead of taking the time to actually read through it, understand
it.” Justice opined “I feel like if you're going to do it right, and you put the time in, it's a lot more
than one credit.” Justice further commented, “I feel like one credit does the course, both you and
any of the students in it, a disservice.” These two students recommended either decreasing the
workload or increasing the number of course credits to rectify the situation.
Summary
Overall, seven students shared the impact of the instructional design elements of the
course on their ability to learn. Sequencing course assignments into discrete concepts and
strategies allowed students to not only divide a complex project into manageable parts, but it also
allowed students to slow down the act of scholarly writing to gain a deeper understanding of
each step and how it contributes to the final product. The second instructional design element
students found supportive to their learning was the use of assignment guidance tools. Faculty
expectations were conveyed via online lectures, assignment guidance sheets, templates, and
worked examples. Students appreciated how these tools took the mystery out of completing their
assignments, allowing them to write without anxiety and engage more in the work. The third
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supportive component of course design was the constant access to multimedia content in each
weekly module of the LMS. Lastly, some students expressed a desire to space out assignments so
they had more time to absorb course content and apply faculty feedback to their work.
Theme 2: “Specificity of Feedback” From Faculty
The second theme that emerged from the qualitative data was regarding the quality of
student interactions with the faculty. In the Writing Workshop, each student was assigned one
faculty to work with throughout the course. The rationale for this decision was efficiency
because faculty would be familiar with the students’ progression of thought from the very
beginning. Ideally, this arrangement would facilitate a cognitive apprenticeship between the
faculty and student. Students commented on the quality of feedback they received from faculty,
the positive acceptance they experienced from their faculty, the value of individual conferences
with faculty, and specific strategies faculty used to deepen critical thinking.
Quality Faculty Feedback
All nine interview participants discussed the profound impact faculty’s feedback had on
their writing development. First, students valued how the faculty’s comments were constructive
and helped them improve how they communicated their ideas. For example, Melody expressed
how their faculty helped them to reorganize their writing to greater effect, “I thought it was good
feedback. And nothing I would have noticed myself, like to move those sentences up so they're
not buried... Not that it was incorrect content, it was just because it's more impactful.” Trinity
appreciated the quality of faculty constructive comments that accelerated their growth and
success as a writer, “But anything she gave me was legit. Like, she wasn't nitpicking on this. …
It was to make it the best possible paper I could write.” Trinity further noted their trust in the
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expertise of the faculty, “The feedback was great. I think I was receptive to the feedback because
I understood, like, this is coming from someone who knows how to write.”
The second commonality across student interviews was the level of detail provided by the
faculty in their comments and the focus on reasoning and critical thinking. Kairos shared
examples of the feedback they received,
I really appreciated that feedback was very specific. ... "Look at your logic, because it
doesn't make sense," kind of like, "don't draw your conclusions yet because you have not
shown the reader there is a connection between the two – you're losing your reader," you
know, like "shorten it, take it out because it doesn't serve the purpose here." That
specificity of the feedback was very helpful.
Lyric also expressed appreciation for clear faculty feedback on how to organize their writing
based on their stated goals and priorities, “I was trying to address the training, I was trying to
address the healthcare, so many things. ... So Professor X always pointed out to me, ... you need
to focus on your thesis. … that's the most valuable feedback.” Eden commented on how the
faculty highlighted areas for improvement without being prescriptive, “So she would give me
specific things, ‘Why don't you look at this?’ She wouldn't give me the answer or how to write it.
She'd just say, ‘...try to make this sentence work out a little better.’” Eden added that the number
of faculty’s suggestions felt manageable, “So I liked it. I didn't feel overwhelmed by the amount
of corrections, though she was thorough, like more thorough than any other teacher I've ever had
on a paper.” In general, students agreed that the quality and quantity of feedback they received
from their assigned faculty was useful in improving their thinking during the revision process.
The final comments students shared were in regards to the praise and positivity from
faculty. Cadence described their experience with faculty who “focused on the positive, no matter
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how bad my writing could have been, they still focused on the positive.” Cadence noted the
effect these encouraging comments had on their self-esteem, “I just felt so good. Like, you know,
when you're not competent in something, to have somebody just be able to build you up, instead
of break you down [laughter], when you're already beating yourself up, was really very helpful.”
Justice expressed that they heard many positive comments, along with some constructive
criticism, “most of the feedback that I got was positive, with a few caveats. Like, I got that part
right. And yet, still room to grow, there's still some changes that need to be made.” Justice
remarked that this type of faculty feedback was affirming of their hard work, “overall, it was
positive and encouraging, which was nice, because when you work hard at something, you hear
back that you did okay with it. That's good to hear.” Eden found the faculty feedback to be
“pleasantly surprising.” Eden shared, “none of them [the comments] were discouraging, none of
them were required. All of them were just suggestions. She's like, ‘this might work better for
you, take a look at this. Here's a resource.’ You know, it was nice [laughter].” These students
expressed enjoyment and satisfaction with faculty who responded to their writing like a good
coach – full of praise, optimism, and feedback tailored to their individual performance needs.
This approach seemed to have a positive impact on students’ engagement and scholarly
writing success. Jubilee clearly summarized the general student sentiment regarding the effect of
consistent faculty feedback on their scholarly writing, “I feel like honestly, this is like the one
writing course that I actually learned more from, because I was getting constant feedback on
every single thing I submitted. And I would make, like, changes every single time.”
Faculty Accepting “Who I Am” to “Encourage Learning”
All nine participants reported feeling positive regard and acceptance from faculty. Many
students found this warmth facilitated a productive working relationship, inspiring them to put
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forth greater mental effort. Others felt that the faculty’s knowledge and acceptance of their
approximations and “strong suits” to be validating, allowing them to take risks and persist
through the course. For instance, Kairos thought the faculty seemed “relaxed” and
“approachable” on the video lectures. So, when the professor requested an individual conference,
Kairos “felt like I already knew her” and “didn't have any hesitation to meet with her and she
was very supportive.” In fact, Kairos reached out for additional conferences because the “first
one I found to be very helpful.” Lyric also mentioned the “empathy and compassion” they felt
from the professor and credited their learning to that safety, “She would work with me and that's
how I think I improved. It's that she make me feel so comfortable to just write whatever I feel
right to write. I think that helps ... me learn in this class.”
The students reported that the support and attention from faculty was motivating for
them. Cadence felt boosted by the faculty’s encouraging comments, “No matter how bad my
writing could have been, they still focused on the positive and … Just that positivity makes all
the difference in the world.” Cadence added, “However, Professor X does it, she does it well ...
in a way that [laughter] made me feel good. Like, okay, I can do this. So it was good.” Similarly,
Noel was motivated to carefully review their writing, knowing the professor would respond to
each assignment and that “impacted me greatly because it just made me read something, you
know, more than twice and just make sure that it makes sense.” In reflecting on their experience
of faculty feedback, Noel stated, “Like, it sounds simple, but um, it just made me want to
improve my writing and make it sound more professional. If that makes sense. That's how it
impacted my writing and I think that was powerful.”
Not everyone began the course with a positive faculty relationship though. Jubilee
characterized their initial faculty interactions as “a little rough, to say the least [laughter]... I
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wasn't used to having somebody give me constant feedback like that. So I was ... thrown off
guard and kind of so used to the way I used to write.” Jubilee recalls, “as the course progressed,
my interactions got a lot more positive. And now ... I feel like we have a lot better relationship. I
really appreciate all of her revisions and recommendations. And, yeah, we got a lot better.” With
time and continued support from their assigned faculty, Jubilee reported becoming accustomed
to receiving feedback and using it to improve their writing, “I started to understand more why
she was giving me certain revisions and what she was really looking for from my writing that I
just didn't, you know, see before.” By the end of the semester, Jubilee expressed appreciation for
the faculty’s feedback and responded that it had a “significant” impact on their learning.
Lastly, faculty encouragement and acceptance of students’ less-than-perfect attempts at
scholarly writing behaviors helped students to persist in their learning, even in challenging
circumstances. Eden recalled how their faculty emailed her group and encouraged them to send
her their writing, even if it was not finished, because she just wanted to see how they were doing.
Eden’s response was, “I hope all teachers are like you guys. That'd be great. It's a completely like
180 degrees from my associate's degree in nursing. You guys encourage learning.” Lyric shared
how essential faculty acceptance of their writing attempts were in their ability to be vulnerable
and take risks to grow, “I feel okay, if I make mistakes, I feel okay my papers are not perfect. I
think that's the biggest part for me to grow in her class, ... showing her why I feel so unconfident
in writing.” Trinity described their experience of the faculty’s ability to assess their current
progress while capitalizing on personal strengths, “I think she took from me what my strong suits
were, and built off those knowing that I'm not going to be ... writing a PhD paper. I can tell you
that right now.” Trinity added, “I think she accepted what I was, and did, and worked on that and
improved me, of like, who I am. Am I a better writer? By far.”
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Value of Individual Conferences With Assigned Faculty
In addition to written feedback, students reported on the opportunities they had to
schedule writing conferences with their faculty member at any time during the semester. These
conferences could be initiated by faculty or students and generally lasted from 20 – 60 minutes.
Due to COVID-19 precautions, all conferences during the fall 2021 semester took place
virtually, via Zoom. Six of the nine interview participants experienced at least one conference
with their faculty. The students described a similar flow to their Zoom conferences: they would
look at the paper together, the professor would ask meaning-based questions to clarify ideas, the
student would ask the professor questions, there would be some revision work at the paragraph
or sentence level, and someone would take notes and/or record the meeting for future use.
Students communicated an appreciation of the opportunity to dialogue directly with their faculty.
Most students used the conferences as a way to clarify written feedback and ensure they were
making progress. Students also noted faculty using individualized strategies to scaffold their
learning during their conferences.
First, students enjoyed how faculty made themselves available for conferences. Noel
stated, “I like how the professor was available. Like she would just say, you can call me, text me,
email me. And we'd do Zoom meetings, and just look at the paper together.” Cadence indicated
how conferences were a special benefit for them, “I think the biggest piece, and the best part was
meeting with my professor, and being able to get that feedback, and her explaining why we
needed it [how to revise] ... It was a very positive interaction and very, very helpful.” Trinity also
found value in conferencing with their faculty, “When we would meet face to face is where I
benefited the most from it. Because for me to read it, I was like, all right, but then I would forget
what I did.”
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Second, students discussed how they used conferences with faculty for clarification and
validation. Melody shared that their conference was “a brief meeting just to review my paper
structure and content. And just to get some in-person clarification on some of the feedback I had
received. How to improve my writing piece. And it was it went very well.” Trinity stated, “But it
just helped ... to see it on a broader picture of what she wanted and what her expectations were.
And it did help me with everything. Every revision I got, I had to revise less and less.” Kairos
found the conferences reassuring as “a non-native English speaker, sometimes I still was not sure
you know, like, maybe about the format or something like that, the kind of like simple things, but
I just wanted to be sure.” Kairos further explained, “So like, I think the one-on-one meeting was
beneficial just to get that feedback, okay, like you're on right track, just like getting that
reassurance from her.”
Third, students recalled how the conferences allowed faculty to be “here in my head” and
coach them through the thinking and revision process. Noel described their experience
conferencing throughout the semester with their faculty,
And we'd do Zoom meetings, and just look at the paper together, and she will give me her
feedback and, or she will type something differently. And I'm like, Oh, why didn't I think
of that? You know, it was kind of like, almost just here in my head saying, Well, what do
you think about this sentence instead? Or what if we just turn it around a little bit? Or
she, you know, she will just kind of make you really think about what are you really
trying to say? And can you make that, can you write it in a simple way? You know, like,
it doesn't have to be complicated.
Lyric shared an appreciation for the opportunity for open dialogue during their conferences.
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And the thing I like Professor X, she always asked me, “Why you choose that?” Instead
of, like, telling me oh, this is, you should do this. You should do that. Like, maybe the
way I did it, it's not the most appropriate for that paper. But she always very open to hear
me first. And, yeah, I like that a lot. Like, I feel like, um, that kind of helps me to, to feel
more comfortable, to open up to her about why I don't have confidence in writing.
Lyric used the faculty’s curiosity about their thought process as an invitation to share deeply –
about the topic, about their thought process, about their writing choices, even about their writing
insecurities. Although students appreciated faculty’s written comments, it was only during the
writing conferences that this level of deep dialogue and creative idea sharing was relayed.
Similar to Noel and Lyric, Cadence described their cognitive interaction with faculty
during conferences,
Okay, so she may pull up my paper, she might share the screen, and we would be able to
go through paragraph structure, and she would make some notes. … So I would have that
information. And really, she would ask really good open-ended questions and make me
have to think about what I needed to do. And did it make sense? And how could I change
things and go back to my journal articles and really go in there and, you know, pull out
some information that I might not have thought was that important. And then after the
class, she would be able to send me the notes so that I would have them and be able to
work from there.
Candence described the effect these supportive interactions with faculty had on their motivation,
“It was a very positive interaction and very, very helpful. I never came away feeling defeated.”
Overall, the students found great value in their writing conferences. Students appreciated
how the faculty made themselves available for lengthier discussions and reported that these
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meetings helped provide clarification of written feedback and faculty expectations as well as
providing reassurance about their writing development. Finally, students felt the opportunity to
discuss their questions and writing challenges with faculty allowed them to engage more
deliberately with their topic and consider the reasoning behind their written claims. Faculty
Provided Scaffolds That “Made Me Think Deeper and More Critically”
Students mentioned several techniques used by faculty to facilitate their understanding of
the writing process, argumentation, and presenting a synthesis of the research literature. Students
shared examples of faculty modeling revision strategies, organizing ideas, scribing, and using
open-ended questions as a way to foster deep, critical thinking. Noel shared that faculty
requested three conferences throughout the semester. The first was for thesis clarification, the
second was to revise the introduction, and the third was to examine the refutation and
conclusion. In the initial meeting, Noel stated,
she wanted me to kind of tell her more about my thesis, and to see how we could make it
better. So we review our articles, the ideas that I have put in there, and she helped me
help me fix it. So it was a very simple fix too but it was like, Aha, that sounds better than
what I wrote.
After revising the thesis together, Noel was more satisfied with it. Noel then described the
second meeting, “she had questions about my background, and what information I can move or
switch over from other areas to kind of make the background better.” The faculty demonstrated
how to reorganize information based on a scholarly writing structure. Noel recounts the purpose
of the final meeting,
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And then the last meeting we had was to go over my refutation and conclusion part and
she just gave me her input and tell me what, where exactly is it that you're going with
this? Like, what are you really trying to say? And then just help me see it differently.
The faculty used clarifying questions to help Noel focus their writing and consider how to end
the paper effectively. Noel’s summary of the three conferences showed how the faculty gave
ongoing writing support, as needed, to ensure the student understood the purpose of each section
of the paper and how to effectively revise and reorganize each part.
Trinity discussed how the faculty used a technique customized to the student’s strengths
and needs. Trinity shared how this was done during a conference, “And the ones that were great,
where I got the best was, she would type while I was talking to her because she knew that was
my strong suit – I can talk. And that's the way I communicate.” Trinity explains why the strategy
of dictating was so helpful, “Because by the time I got it out, if I went back to my computer,
whatever, I would have forgotten what I was talking about.” Since Trinity was experiencing
difficulty getting their ideas onto the page, the faculty became the intermediary scribe so the
student could successfully capture their ideas before they were lost.
Lyric and Cadence discussed their faculty’s use of open-ended questions during
conferences. Lyric had several meetings with their faculty and emphasized the importance of
questioning during this process.
I really enjoyed those Zoom meetings with Professor X. I know, we discuss a lot of ideas,
she asked me. I like those questions she asked me. Um, like those questions. Like, she
always asked me, Why you choose that? Why you put it that way? And that, I feel like
the questions is a very good way to guide me, the questions. Not always just feedback.
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Sometimes these questions professor asked me, I'm like, when she asked me and I had to
really think about it. What's the rationale?
The faculty’s questions challenged Lyric to explain their writing choices and the thoughts behind
those actions. Lyric recognized the value of this strategy to deepen their thinking and consider if
the rationale behind their chosen words truly matched their intention, as the author.
Cadence shared a similar experience with faculty’s questioning technique during their
writing conferences and in their written comments.
The feedback really made me think. Again, her questioning made me think deeper and
more critically...I’m kind of an on-the-surface, you know, I get it, but if I, you know, I
will dig deep if I am really forced to, and she forced me to dig deep and really look at
things with a critical eye. So, I think that was a big piece of it, that I really had to look at.
Cadence credited the faculty’s use of questions as an effective way to go beyond blind
acceptance of the research literature and engage with critical reading and writing in a deeper
way. The faculty’s questioning modeled the trait of scholarly curiosity and never accepting a
claim without sufficient evidence and reasoning.
Summary
Overall, students described numerous positive effects from the consistent formative
feedback they received from course faculty throughout the semester. First, the faculty comments
provided specific, individualized suggestions for each student based on their writing needs.
Second, the ongoing, positive commentary from faculty encouraged students to persist at the
complex task of scholarly writing. Third, conferencing was an opportunity for clarification of
feedback and additional coaching through one-on-one interactions. Faculty leveraged strategies
like modeling, guided practice, scribing, and questioning within the context of written feedback
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and/or conferences to stimulate critical thinking and scholarly writing development. Students
credited faculty feedback for fostering their capacity to think and write at the graduate level.
Theme 3: “Tools in My Toolbox”
In addition to discussing faculty’s feedback and instructional design, students shared
which writing-specific strategies were most instrumental to their scholarly writing progress.
Students also discussed how their understanding of the writing process developed throughout the
course. Students reported these strategies were so beneficial, they wished they had learned them
before entering graduate school.
Effective Higher-Order Writing Strategies
In presenting the data regarding specific strategies, I will share higher-order writing
strategies named by the participants and then provide student comments about lower-order
strategies because writing concerns are commonly divided in this way. Higher-order writing
concerns generally refer to establishing a focus, developing ideas, considering paper and
paragraph structure, organization techniques, and promoting clarity of thought (Bean, 2011;
Harvard Writing Project, 2007). Lower-order concerns involve issues related to grammar,
sentence mechanics, spelling, and citation style (i.e., APA format).
Student-Identified Strategies Pertaining to Focus and Paper Structure. Eden
reflected on how a clear thesis is the first step to organizing a paper, “Making sure everything
tied into the thesis statement; it is really important, but I had never looked at that prior to you
guys teaching us that.” Eden further commented how the paper structure must be aligned to the
thesis, “paper structure -- where your opening paragraph should tell you the rest of the paper, and
each paragraph should lead into the next ... [and] should still come back to that main thesis,
100% that is now stuck in my brain.” Lyric agreed that creating a structure for the entire paper
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was essential to good writing, “So, first is the structure ... I think the step one is, I need to have
the structure, what the skeleton I need for my paper.”
Student-Identified Strategies Pertaining to Paragraph Structure. Another writing
strategy many students discussed was the basic paragraph model. Justice gave his definition of
this paragraph organization technique, “it's a topic sentence, then your supporting evidence, and
then … further explanation if need be, and then transition. I feel like that's a very simple formula
to follow, but still leaves enough room for expansion.” Jubilee used a similar method to organize
paragraphs, “first give a little background on what the study is, because the reader doesn't know
what the study is, and then talk about your evidence, and then cite at the end.” Jubilee remarked
that this technique allowed their evidence to “flow very nicely” and they “would use this in all
my other papers” because “it makes perfect, logical sense.” Cadence explained how paragraph
structure helped them present their ideas more effectively, “I would just kind of jump into a topic
… But making sure that I had the structures and the organization, either the paragraphs needed to
be reorganized, or the sentences … .to make that make sense.”
Student-Identified Strategies Pertaining to Evidence and Synthesis. Another effective
writing instruction strategy discussed by the participants was the importance of using evidence
from the research literature to support their written claims. As Trinity discussed, “With this
graduate level work, I really had to focus on what the evidence, they were providing and how it
was going to relate to my topic. I couldn't just put fluff pieces in.” Cadence remarked, “I had to
have the data and the research to back it up.” Melody reflected on using the literature matrix, a
table used to organize the research articles students read, “When it came down to the actual
writing of the paper, it made it much easier. I didn't know initially ... the purpose of it, but in the
end, I could clearly see … how helpful it was.” Likewise, Justice reported that the matrix was a
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useful strategy, “all the research that you found, it was nice to be able to kind of organize it very
succinctly, very compactly.” Cadence credited revisiting the matrix with helping them “connect
the dots,” and “once I realized that's why I had the synthesis in there, that I can use that in my
paper … It started, definitely pulling in.” The literature matrix helped these students organize the
evidence they read into themes, which could then be used in their writing.
Effective Lower-Order Writing Strategies
After noting useful higher-order writing concerns, students described the strategies they
learned to address lower-order concerns. Three students shared about using transitional devices
to improve the flow of their writing. Three students discussed methods that helped them revise
and re-order sentences for maximum impact. Three students commented on learning the seventh
edition of APA style.
Student-Identified Strategies Related to Transitional Devices. Students found
transitional words and sentences improved the flow of their writing. Eden recounted, “So the
biggest thing that sticks in my brain is transition sentences. That [transition words] chart, like,
blew my mind. I was just like, this is great!” Eden’s faculty provided the transition words chart
and where more transitions were needed in Eden’s writing, “She [the professor] said this
paragraph, you know, you could use more transitioning, and it would flow better. So it was more
comfortable because I had the tools.” Melody expressed satisfaction with using transition
sentences, “I actually really enjoyed learning how to create those transition sentences and make
that transition. … so it was easier for the reader to understand my thought process from one topic
to the next.” Jubilee “was noticing that my transitional sentences and closing sentences, they
would very nicely flow into the next piece of evidence or my argument or opposing arguments,
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any of that.” All three students found that transitional devices improved the flow of their writing
and signaled the reader to a new section or idea.
Student-Identified Strategies Related to Sentence Revision. Learning sentence-level
strategies like where to put the stress point in sentences was another lower-order writing strategy
students discussed. Cadence shared, “I learned a lot about the sentence structure on how to make
where the emphasis needed to be in the sentence, to reorganize the words and to really make it
sound more scholarly.” When asked how the course impacted their writing, Noel responded, “it
[the course] definitely improved the way that I organize my idea. And the way that I will
organize sentences, definitely.” Justice also commented on learning sentence-level strategies, “’
So I felt like that sentence structure formula, if you want to put it that way, was again, simple to
follow. It laid out a nice little framework.”
Student-Identified Strategies Related to Using APA Style. The Lake Shore School of
Nursing uses the American Psychological Association’s (APA) style guide for formal writing
assignments. APA style writing and citations are taught and practiced throughout the Writing
Workshop. Trinity shared their experience with trying to learn seventh edition APA style, “And
then once I started getting the drafts in, it was more like fixing, you know, some revisions, as in
like, I'm using APA. … They changed it so much that I'm still in the sixth version of it.” Justice
also expressed frustration with needing to learn a new APA style but recognized it was
something he gained from taking the course, “Yeah, so for me, those were the two …
development and organization, and then APA, just because APA changes, I feel like every six
months!” When Kairos was asked about what they remembered from the class, they responded,
“there's so much, just logic, how to cite, … grammar, spelling, anything and everything, like
APA format, like the structure.”
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In summary, students reported on many strategies that enhanced their writing
development. Students shared about learning new, higher-order writing strategies such as
creating a thesis, attending to the structure of the paper, shaping paragraphs, and synthesizing
evidence to support claims. Students also gave examples of lower-order writing strategies that
were helpful, such as how to use transitional devices, sentence revision, and APA style. Students
acquired a wide range of writing tools throughout the course.
Using a “Step-By-Step” Process for Scholarly Writing and Revision
In addition to learning how to use practical writing tools, seven students described a new
appreciation for process writing. Although few students used revision before the course, many
reported on the benefits of dividing a large writing task into smaller steps, revisiting their written
work, and refining their message. For instance, Kairos was nervous about scholarly writing but
shared how the weekly assignments helped them internalize the step-by-step tasks involved in
the inquiry process, “I was very insecure about my abilities. But the fact that we were, every
week, working on and building on what we learned. It really helped me to kind of like, see
through the whole process.” Cadence declared the procedures they learned in the course
completely changed everything. … understanding all of the steps and being able to pull
the reviews and … read a research document … and pull out the information that's going
to be pertinent to your paper and … [crafting a] thesis statement, and … synthesizing the
data and, you know, all of those stages that we did, I'd never done before. And I mean,
even down to APA. … I think, knowing now these steps, I'm going to be using these
steps over the next few years while I'm writing papers for other classes, just because it
made a lot of sense.
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Justice explained how, prior to this writing course, “I've never really been taught … the entire
process of it, … step-by-step, and really delved into specifically how to handle each step.”
Trinity said the tools and the steps learned throughout the course made their writing feel “easy”
and effective. Trinity compared breaking down the complex procedural knowledge involved in
scholarly writing to “the same equivalent as me telling you to come in and put an IV in, you'd be
like, wait a minute. But if I gave you the steps you needed to do it, you'd be like, I can do this.”
Students also embraced revision as an important part of the writing process. Eden had
never allowed themself the chance to revise until this course, “the idea that I can write more than
one draft before submission, … I know that sounds simple. But before … I thought, I'm going to
write this and then submit it, but now there's a process.” Lyric found freedom in not worrying
about lower-order writing concerns until after they had spent time developing their ideas, “I
finally got it … don't overthinking about the grammar … those are important but … those things
will get fixed when you have … a better version of your … paper.” Jubilee described how
writing a letter of response to their faculty, an assignment where students were asked to provide
a written response to their professor’s comments, was an effective way to organize their revision
process, “going through and having to write down each [faculty comment] … in a separate
document, and then write what I changed. … helped me organize it all better, and kind of see
why it was beneficial to change it.” Justice explained how revision allowed them to hone their
ideas until they were ready to be presented to a wider audience, “this [process] just helped me
kind of organize what it is that I want to say, so it's not verbal diarrhea. It's succinct and can be
focused and stay on topic, which I think, professionally, is helpful.” In general, these students
enjoyed how the course introduced them to the various steps of the writing process, including the
opportunity for strategic revisions.
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“Wish I’d Taken This Class Before”
Another theme among interviewed students was regret for not learning these scholarly
writing techniques earlier. Three participants strongly believed that the Writing Workshop
should be the very first course students take in the master’s programs. As Noel explained, “It was
a very helpful class. … I just wish I would have taken it in a summer before I started the
program, because I think that it would have helped me do a lot better in my previous classes.”
Trinity concurred, “it would benefit everybody if they had it right off the bat. Because you get
these tools, like you're all-ready, you know?” Trinity further clarified “I think it's so beneficial
for everything, even like PowerPoints and things like that, just the way you organize your
thoughts and stuff. That would be my one caveat was this class should be given at the beginning
[of the program].” Kairos also wished they had known this information sooner, “there's a couple
of classes for public health, this class would have been helpful to take prior to that, or infection
prevention, like epidemiology, when we had to write a white paper.” Kairos was grateful to take
the Writing Workshop prior to completing the summative assessment in the final semester, “I am
glad that I took this class before capstone because capstone is more important to communicate
what you have worked on and … all of the theories and research that I have done … to present
that to my professors.” Kairos believed that the communication tools from this course would be
invaluable for other courses but especially when preparing their capstone project – the
culmination of everything learned in their master’s program.
Another common sentiment was the idea that this information should be taught in
undergraduate school. Cadence admitted “all of those [writing] stages that we did, I'd never done
before” in their undergraduate program. Eden stated “I . . .wish I'd taken this class before my
bachelor's program. Because it taught me how to write a … thesis sentence, and it taught me how
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to break down a paragraph and lead one sentence into the next sentence.” Eden continued, to
learn about scholarly writing in graduate school “felt like I did things backwards. This [course]
would have been helpful in the last three years.” Justice posited that this information should be
taught to teachers as well as to students before entering college, stating “having been an English
teacher for high school kids, I wish that [knowledge of scholarly writing] was something that I
had when I was teaching. It would have been extremely helpful.” As Eden proclaimed, “I feel
like a lot of these techniques, they should teach earlier, not just master's level, you know, it
would be beneficial to the world [laughter]! Although students varied in describing the perfect
timing for learning the process of scholarly writing, they all agreed that this information would
have benefitted them in previous courses – ranging from high school, to undergraduate school, to
the beginning of their master’s program.
Summary
In summary, the interviewed students discussed the many writing “tools” they learned in
the Writing Workshop. These included higher- and lower-order skills, writing and revision
strategies, and the opportunity to experience the entire writing process, step-by-step. The final
prevalent viewpoint was that learning these writing tools prior to graduate school would have
helped them become better writers sooner, as well as more successful students.
Theme 4: “Transformed My Way of Thinking”
Each student interviewee shared their reflections on the many ways the Writing
Workshop affected them. For example, students noted changes in their self-efficacy about
scholarly writing based on their confidence level before the course versus after. During the
interviews, students also compared their pre-course writing assessment scores with their
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improved post-course scores. Finally, students discussed how the course impacted the way they
think and write as nurses and leaders in the workplace.
Student Reflections on Changes in Their Self-Efficacy
There was a range of reactions among students when they discussed changes in their self-
efficacy before and after the course. Self-efficacy refers to a person’s belief in their ability to
successfully accomplish a specific task (Bandura, 1997). Self-efficacy was explored in this study
because it is a significant predictor of motivation and performance (Bandura, 1997). Students
rated their self-efficacy before the Writing Workshop and after on a scale of 0 – 10. The survey
used was the Situated Academic Writing Self-Efficacy Scale and students scored themselves on a
total of 13 statements based on three subscales: writing essentials, relational reflective writing,
and creative identity (Mitchell et al., 2021). The survey also included six questions on task value.
In the interviews, students were asked to reflect upon any changes in their survey responses and
their confidence in their writing ability over time. Some students indicated that they started with
very low levels of self-efficacy but made substantial gains throughout the course. Other students
began with moderate confidence and felt that their confidence greatly improved. Two others
started with high self-efficacy and while their scores did not change much overall, they did
recognize a shift in the depth of their understanding of writing. And the last group did make
gains but felt uncertain about their ability to be independent with their new writing skills.
Seven students indicated an increase in their self-efficacy and overall confidence in their
scholarly writing ability. Cadence and Noel shared how low their self-confidence was at the
beginning of the course. Cadence had been out of school for “a long time” and felt, “in the
beginning, I had nothing.” But now, Cadence reported “my confidence increased, definitely.”
This student experienced success using what they learned in the Writing Workshop to complete a
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paper in another course, “I followed a lot of the same process. So developing my thesis, knowing
my topic, finding the papers to back it up, all of those things, I was using those strategies. So I
know that it definitely works.” Cadence applied these writing strategies and found “that part …
did boost my confidence.” Noel stated, “I didn't feel confident at all at the beginning. And then at
the end I feel confident that I can write an essay, and start writing it, no problem.” Noel
expressed assurance in their new skills, “I just know how to start it and kind of how to organize
those ideas … and use my resources, the librarian.” Furthermore, Noel felt pride about their
performance in the Writing Workshop, “And I told my husband … how well I did on the essay
and, how proud I felt. He was like, ‘Yeah, I'm proud of you!’ It felt great. Just to see how much I
progressed in the class.” These students shared significant gains in their self-efficacy and ability
to use the writing skills they learned in the course to successfully write scholarly papers.
Lyric, Eden, and Melody also reported improvements in their confidence at the end of the
course. Lyric stated, “I think I'm more confident now. I think the reason I become more
confident is I just enjoy writing.” Lyric posited the reason for their lack of confidence and
enjoyment of writing in English was they previously spent time too much time worrying, “I think
like sometimes, the lack of confidence is, it's just because we're overthinking it.” Lyric shared
that “I used to be very self-conscious about my accent, … now I'm just like, as long as people
understand me, I think that's okay.” Lyric indicated the class helped them focus on sharing their
message and communicating with others as opposed to fixating on grammar, “That's the purpose
of the language is to deliver what you're trying to say … and you can perfect that through the
practice. I think this is the biggest lesson I've learned for this class.” Melody did not have the
same worries that Lyric experienced but still had a noticeable improvement in self-efficacy, “I
definitely feel more confident...I believe I rated myself [at the end of the course] I want to say
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maybe a nine? … It was quite gratifying.” Eden remembered starting with lower self-efficacy
scores, “I was definitely fours and fives for confidence. … by the end I'm probably seven, eight
or nine depending on the topic. So 100% now, I don't feel afraid submitting my writing.” These
three students relayed feelings of enjoyment, gratification, and improved confidence about their
scholarly writing after participating in the course.
Justice and Jubilee did not necessarily note big changes in their self-efficacy scores but
they did notice other differences. Justice, for instance, explained that “coming into the course I
felt fairly confident as a writer … so that stayed as an eight” and “I went up one digit, … I can
successfully use scholarly and academic words and phrases, … same thing with combining and
synthesizing multiple sources, I went from an eight, and grew to a nine.” So, in specific areas,
Justice recorded an improvement “but the overall confidence stayed at an eight.” Justice
explained that even though he is a confident writer, “there's probably still some room for
growth” and hence the reasoning for not rating their self-efficacy as a 10 out of 10. Likewise,
Jubilee “didn't notice a big change in their post-course responses” but did discuss noticeable
differences in the new skills they acquired. Jubilee described what they experienced during the
post-course self-efficacy survey, “I noticed I was more confident, but in a different way of
thinking, like, … I'm more confident in the fact that I can write a well-structured paper, and I can
use plain language better.” Another new area of confidence was using fewer quotes and
paraphrasing more effectively. As Jubilee recounted, “I always had an issue with using a lot
more quotes from articles” fearing that their words would not be as understandable as the
original source and worrying about plagiarism due to improper citing. Jubilee continued, “But
this time, when I took my post survey, I was really confident in the fact I could look at an article,
use plain language, and it still sounded fine.” Both Jubilee and Justice started the course with
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relatively high self-efficacy in writing but grew in their confidence of using newfound skills and
strategies learned during the Writing Workshop.
Trinity and Kairos reported improved self-efficacy after the course but also felt that there
was room for improvement in their mastery of scholarly writing. Trinity claimed their confidence
about writing increased “by far, because I know now what's expected of me.” Trinity attributed
this new knowledge and confidence to “the one-to-ones, and the program layout and stuff like
that, really lays out the expectations of what a graduate paper should look like, and what our
expectations are as a critical thinker, critical writer in a graduate program.” Trinity
acknowledged what they learned in the Writing Workshop is “going to help me with all my other
papers and my other classes and things like that” but admitted “I'm still not as confident as I
would like to be” and “I'm still a little anxious.” Trinity claimed it was too early to fairly
evaluate their self-efficacy after only one course, “I think I need subsequent classes, like papers
to write and things like that. We'll talk at the end of the program, and we'll go from there
(laughter).”
Kairos also shared feelings of uncertainty related to their confidence in writing, stating, “I
did not change this [self-efficacy] score. It was seven, just because of [the] overall feeling of my
struggles of being a non-native speaker just because I feel like, with time, that will come in more
practice.” Kairos believed that the “class, the clear expectations, the outline, tools, and the
feedback that were given to us, it made it clear how it all kind of fits together … I know that this
class helped me a lot” and “demonstrated that it's something I can be successful with.” However,
Kairos expressed concern about losing the writing skills they gained, “I'm just more worried
about, I'm just hoping it doesn't go away, because I know that practice makes it better.” Kairos
confided, “I am still feeling shaky, that I can do it by myself, without the feedback, without those
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tools. I will keep applying it … the things that I learned.” Even though Kairos experienced
success in the course and learned helpful skills, they are still worried about writing in English
because they are a “non-native speaker.” Kairos also felt uncertain in their ability to use these
strategies “by myself, and run with it.”
Overall, each interviewed student described how their success in the Writing Workshop
impacted their writing self-efficacy. Some students noticed greater gains in their post-course
self-efficacy scores and this seemed to be related to their perceived ability to master new writing
strategies within the course, and their desire for future practice and support. All students
indicated feelings of success within the course but two were less sure of their ability to be
independently successful as writers without further practice or support. Appendix H provides the
complete responses from students regarding perceived changes in their self-efficacy.
Student Reflections on Improvement in Writing Performance Assessment Scores
All nine interviewed students reported an increase in their one-hour post-course writing
assessment score compared to the pre-test. Three of the nine students achieved the highest score
possible on the test – a “six out of six.” The other interview participants increased their post-test
scores to “fours and fives” from “twos and threes.” Students credited the improvements to their
participation in the Writing Workshop. Two students described how differently they approached
the post-test versus the pre-test. Four students commented on how their change in scores was
validation of the writing skills they gained. Two students discussed which strategies they
believed were most instrumental in improving their writing scores. One student, who expressed
anxiety about taking the test, felt like the assessment was not the best indicator of their growth
despite a modest improvement in their final score.
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Two students described differences in their attitude and approach to the post-test
compared to the pre-test. Noel reported feeling confused and did not know how to respond to the
prompt on the pre-test, stating, “When I took the first assessment, I got a two as a score. And I
like kind of just froze for most of the time, like, where do I start? Like, okay, what should this
intro be like?” After spending three months in the writing course, Noel discovered their reaction
to the writing test had significantly changed, “the second time around, I was able to … create a
little outline and how I was going to approach that and I went from a two to a five.” Noel was
able to quickly and effectively devise a plan for their written response by “working on my intro,
and then … I'm going to talk about this in this paragraph as to why this is a good idea. And as to
what people may think that's not a good idea.” Compared to the initial test, Noel noticed the
post-test “just felt a lot easier, like, more natural to start writing that essay.”
Eden shared a similar pre- and post-test experience. On the pre-test, Eden expressed
confusion about the expectations for the essay and “wrote, like, maybe 15 sentences? It was not
organized at all, it was just a blurb of words, my thoughts going into this thing. So, all of my
scores were threes on that.” Three months later having learned all these things, Eden commented
on “having learned all these things” in the writing course, “I actually made paragraphs and it led
into the next one. And it was this big, long thing. And … now I had sixes on everything.” In
reflecting on achieving the highest test score, Eden stated, “I was happy with that. … I was like,
well, that improved! … So after learning the skills, I was like, ‘Hey, I could write a properly
formatted essay now!’” Both Eden and Noel described how their initial confusion about
responding to the initial writing test disappeared because they had learned scholarly writing
skills and used them for the post-test. Both students shared a three-point jump in their final
scores.
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Four students discussed the progress they saw in their pre- and post-writing assessment.
Lyric stated, “So we had a writing assessment tool, we use, I think the maximum score is six, my
initial one was two. And at the end of the class, I got four.” Cadence similarly shared “my score
increased by one. … I got a three the first time and a four the second time … so I feel okay about
myself (laughter). I increased … which … I was hoping I would.” Kairos described their pre-
and post-test scores as “my first one was two and second one was four. … when I got four. … I
was like, Oh, I guess you know, like, it's not that bad.” Kairos explained their reaction to the
increase in scores, “for me, it was confidence of knowing that there is progress. And that it
wasn't intentional. You know what I mean? That the improvement just was organic.” Jubilee’s
pre-test score “was a four … so I actually didn't do that bad. So my writing's not too bad. I was
like, I just need to work on some things.” After the course, Jubilee remarked, “when I did my
post-test, it was a six … so definitely I got better.” All four students expressed relief when
reviewing their post-test score improvements and considered the scores as an affirmation of the
writing progress they made during the course.
Melody and Justice also saw gains in their post-test scores and attributed this to learning
specific strategies. For instance, Melody “started out at a three and ended at a five.” Upon
reflecting on the two-point increase, Melody surmised “I think it was really just the organization
… and sticking to how you meet all the points that are expected in a writing piece, and then
putting it together and helping it to flow.” Melody also commented on their awareness of the
audience and that an effective author writes “so the reader best understands what you're trying to
get across.” Justice also believed that the focus and organization techniques they learned in the
course played an essential role in the improved test scores, “I think that's the basic paragraph
model … in looking at … my post-course assessment, I think that was super helpful.” Justice
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posited that using the basic paragraph model to organize his ideas, “I think that alone may have
been what changed my scores from threes and fours, to fives and sixes.” Justice believed the test
results matched the progress he observed in himself, stating, “I felt like, you know, in terms of
my overall organization, development and focus, that those were the areas that I improved most.”
For him, the assessment affirmed how he had “grown and changed as a writer” able to keep his
ideas “focused and organized in a way that's succinct and not word salad all over the place.”
Both students reflected on the importance of learning specific strategies to organize their ideas
and present them in a focused way that engaged their audience.
One participant, Trinity, expressed their displeasure with the writing assessment. They
found the tests to be “the least impactful thing on me … because I was so stressed by the time
constraint of it that I did poorly on it.” Trinity noted “I did improve my next one [test score] by
one point. And I think it was only because I slowed it down and realized, okay, I had a whole
hour.” Despite the modest gain in scores, Trinity felt “it was still anxiety-provoking [and] …
wasn't a great showcase of how I write or what I learned in the class.” Trinity pointed to other
assignments as more valid indicators of their growth, citing “the reflection paper and relating it
to what I learned in the class, my revisions, my drafts, … and how, at the end of the class, how I
saw myself grow … was better.”
All nine interviewed students shared their positive and negative experiences with the
writing assessments. Overall, the majority of students found the test to be an affirmation of their
growth as scholarly writers. All students saw improvements from their pre-test scores. Only one
student reported anxiety during the post-test and cited the improvement in their drafts over time
and the reflection paper as more indicative of the growth in their writing capacity. Others saw an
increased ability to use specific strategies from the Writing Workshop to organize and develop
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their ideas more effectively during the one-hour post-test. Appendix H includes students’
complete responses about the changes in their writing scores.
The Writing Workshop’s Effect on Students’ Professional Communication and Critical
Thinking
Another question students were invited to reflect upon was the impact the writing course
had on the way they think or act at work. Although the interview participants did not mention the
need to write formal papers in their current jobs, they did note several areas where their
experience in the Writing Workshop affected their work life. The first area was in everyday
communication, such as email or communicating with patients. The second area was writing
proposals. And the third was in preparation for leading meetings and making presentations to
staff and students.
Kairos, Melody, and Lyric shared how they approach work communication in a different
way now. Kairos related how what they learned in the course, “going back to work, or what I do
now, it helps me to put my messaging together.” Kairos reflected, “it's really just kind of in daily
life, to put that concise email together and get that message across.” Kairos explained the new
considerations they have when writing for work include, “The body of my email or whatever
piece of writing that I'm putting together, the logic behind it, the examples, how I start my email,
the proof that I put in, and how I finish it.” Kairos stated they now look at the task of responding
to emails as an opportunity to clearly communicate their thoughts, “it's really in the messaging.
And making sure that I'm getting my point across.” Kairos contended that it is a two-way street,
“it's the same kind of expectations the sender has for me, not just responding to the email, but
really reading it, what are they looking for, taking time to understand what the task, or ask is.”
Melody’s comments reinforced a similar idea that their writing is more intentional now, “I think,
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depending on how I'm communicating, via email to someone, I might rethink how I word things.
I just might think more about it now than in the past.”
Lyric made a similar connection between using what they learned to improve their work
communications, “after taking this class, I understand … the better you write, the better you
communicate. … especially in the medical field, communicating is so important with patients,
with family members, with your providers.” Lyric also commented how the writing course gave
them the confidence to share their ideas by focusing on content of the message, “writing was not
just helping me to communicate, the communication part is also the confidence to go there, just
address what you're trying to say.” These three students demonstrated a greater awareness of
how powerful carefully crafted words can be when they are communicating with others in the
workplace.
Noel, Cadence, and Justice relayed their experience with applying what they learned in
the writing course to work proposals. Noel described “as far as having the experience of
improving my writing, I am part of a committee now. And we have to submit this proposal to
help at the patient primary care center.” Noel acknowledged that these new writing tools allow
them to assuredly embrace the proposal writing task, “obviously I know where my resources are,
and I feel confident about submitting ideas. So … just being able to go ahead and start typing
and feel good about, you know, it makes sense (laughter).” Cadence conveyed a recent example
as well, “I had to put a grant proposal together last week, and I needed to have some research.”
Cadence used their new research and citation skills to complete the task, "I found with the grant
proposal and doing some of that research and citing it and putting the references in there
appropriately, because it was going to the university, was actually, you know, very helpful.”
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Justice explained his experience developing a new program proposal in his clinic. In
presenting the project to the leadership team, Justice said, “You had to have … evidence for why
this is something we should do … I had to present my ideas in a similar way to how we've talked
about things in the course.” Justice outlined how the process was similar to what he learned in
class, “You know, here's the major argument, and here's the evidence to support it. And this is
why it's going to be good. So … presenting ideas to my leadership team, goes very much through
the same process.” These three students described how their course learning was beneficial to the
proposal writing they did as healthcare professionals.
Trinity, Eden, and Jubilee discussed the impact of the course on the way they prepared
for meetings, presentations, and teaching. Trinity shared how they realize the importance of
substantiating their claims with evidence, “I think that's where I've kind of taken the most from
this course, is … you have to back it up with evidence … And I do it every day.” Trinity
explained how they accomplish this at work, “now when I have a meeting, and I have an agenda
… I write it out, … these are the topics that I want.” Trinity further detailed, “I have my broad
topic, patient safety, per se. And then we go into, like [patient] falls, right? I lay it out in the
same way as if I was going to write a paper.” One lesson Trinity took from the course is the
importance to provide evidence when presenting a rationale for proposed action, “So in my day-
to-day career in life, I just, I try to put as much evidence as I can to support what I need to get
accomplished.”
Eden recounted a recent experience preparing presentations for the staff. Eden shared
how they automatically used organizational strategies from this course to create the PowerPoint
slides, “I'm actually thinking like, ‘Oh, I should say this. And this should lead into this.’ And it's
not a paper. But it's still something that I have to write before presenting.” Eden recalled being
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surprised at their automatic response to this task, “now my brain will associate some of those
techniques into that, and nobody will ever read it. It's just me speaking.” Eden stated the benefits
of using these writing strategies to improve the presentation of their ideas, “to me, it's now more
well-organized, and it flows better. And I think the point will get across faster than me just
rambling. And I think in that sense, my job for those [presentations] will be impacted.”
Jubilee reported experiencing a similar transfer of learning. Jubilee explained how their
jobs in clinical trials and as an instructor requires “my reading articles and understanding
scholarly writing and then transitioning it to me reading it as somebody from the outside.” As a
teacher, Jubilee also stated, “I feel like I'm more conscious about using plainer language.” This is
important because “my students are trying to learn from me. … And they don't understand
everything yet. So I have to use plainer language. So the fact I had to use it in my paper helps
me.” Jubilee discovered work-related uses for their newly acquired skills to translate research
and convey concepts in a way that facilitates student learning. Overall, each student described
specific ways they used techniques from the writing course to improve the organization of their
thinking and consider how to effectively convey their messages and requests to others. Appendix
H provides the complete responses from students regarding the impact the Writing Workshop
had on their work communications.
Student Reflections on Overall Transformation
At the end of the interview, students were invited to reflect upon any transformations
they noticed after participating in the course. All nine students discussed an increase in their
confidence as a noticeable change. Five students reported feeling more confident about
themselves and their ability to write papers for the rest of their master’s program. Four students
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expressed greater confidence in their ability to communicate professionally, and two students
discussed feeling more capable in understanding and interpreting research.
Five students shared the biggest transformation for them was having more confidence as
scholarly writers. Melody stated, “I know that I will have many more papers to come.” After
witnessing evidence of their writing development, Melody explained, “I feel much more
confident in knowing I can tackle those based on the results I've seen in my own personal
progression through the course.” Noel responded similarly, “I will say it boosted my confidence
in writing a lot.” Noel always felt supported by their husband but it was not until “I proved that I
was capable of doing that” and could see their writing improvement and success in the course
that they could believe in themself. Trinity took pride in their coursework, “with everything
going on and stuff like that, it kind of made me proud. Like, I got this, I did this, this was all
me.” Despite taking many previous writing courses, Trinity declared “this one is the most
impactful of any paper I've ever written. And I have tools, I just know what to do now.”
Cadence reported struggling with low writing self-efficacy at first but believed the course
“has transformed me, in a sense, just because I think it's built my confidence.” Cadence was
feeling anxious about returning to college after a long absence, stating, “when you're middle age
and going back to school … I was really thinking, this is really stupid. … And now, I can't wait
for the next class!” Cadence felt relieved to complete the writing course first because “without it,
there's no way I would be able to survive any other classes knowing there's going to be more
papers.” Kairos also felt transformational pride and confidence at the end of the course, sharing,
“You know, just coming from barely speaking English to being able to write paper that I'm proud
of. You know, it made me feel good about myself and my abilities.”
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Justice, Lyric, and Jubilee noticed improvements in their communication skills after the
course. Justice explained what they learned in the course, “It's organizing what you say so that
it's focused and driven and to the point.” Justice reasoned how these skills affected his ability to
communicate, “if you say things succinctly in an organized way, people are going to listen a lot
more readily than if you just kind of spew.” Lyric discussed feeling “self-conscious” with
writing documentation notes at work out of fear of being misunderstood. Lyric described how
they use revision techniques from this course to improve their documentation, “And now I just
put whatever you want to say there first, and then read three times. … I just read to myself and
then change there, or it's like rewriting for this class. So that helps.” As a result of learning how
to draft and then revise to improve their written communication, Lyric shared, “I think. …
documentation and even like communicating with patient and with providers, I feel more
confident now.”
Jubilee and Eden described significant changes to their thinking, communication, and
understanding of research as a result of the course.
It [the course] made me a better not only student, but it made me a better nurse. I feel like
I'm more confident now in communicating with, you know, nurses that maybe are more
knowledgeable in certain fields. I can go look at things and study them and organize my
thoughts looking at different evidence and be able to interpret it better and communicate
it to somebody else. And then just the fact that I'm more confident in my writing. So that
transformed me a lot.
Eden also discussed how the course “increased my confidence in my writing … It transformed
my way of thinking on how to approach writing about a topic.” Eden’s self-efficacy in writing
about nursing research “made me more confident to pursue maybe more scholarly writing,
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possibly my DNP [Doctor of Nursing Practice], … maybe try to publish. … I'm not so fearful of
that now, I feel like I could probably do that now.” Eden’s transformation included viewing
themself more as a nursing scholar, someone who could contribute to the research literature and
the betterment of the profession.
Overall, each student discussed how the course transformed their confidence as scholarly
writers and successful master’s students. Four students described how the course impacted how
they professionally communicated. Two students shared changes in their ability to understand
and use research. One student felt confident enough to consider publishing and pursuing doctoral
work in the future. Appendix H provides the students’ responses about how the course was
transformational to them.
Summary
Theme four included students’ reflections on how participating in the Writing Workshop
impacted them. Students discussed how the course improved their self-efficacy as scholarly
writers by reviewing their pre- and post-responses to the self-efficacy survey. Students evaluated
the changes in their writing performance scores from the beginning of the course compared to
the end, noting specific strategies they used to be more successful on the post-test. Students
described how the course affected their critical thinking and professional communication. Lastly,
students shared transformations about their self-efficacy, communication skills, ability to use
research, and newfound potential to contribute to the field of nursing as scholars.
Research Question 3: How Do Nursing Students Perceive the Impact of Microsystem,
Mesosystem, Exosystem, and Chronosystem Environments on Their Scholarly Writing
Development?
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The final research question in this study relates to Bronfenbrenner’s ecological systems
theory and how master’s nursing students perceived the effects of these systems on their writing
development during the Writing Workshop. The students reported chronosystem effects on their
work and home life related to the historical contexts of the COVID-19 pandemic and the global
nursing shortage. Some students discussed macrosystem, or cultural influences that impacted
their writing progress, particularly the “non-native English speakers” that were interviewed. In
the exosystem, the educational institutions of nurses maintain a dominant culture and expectation
for scholarly writing. The resulting policies and pedagogy influenced students’ experiences in
previous nursing courses as well as their ideas about scholarly writing within the nursing
profession. The instructional pedagogy The mesosystem refers to the combination of two or
more ecological systems collectively affecting the individual student. Although as adults, these
students did not note experiencing the mesosystem forces combining to directly act upon them in
the manner purported by Bronfenbrenner (1979), they did mention that balancing their
interactions within various microsystems did affect the amount of time they could dedicate to
schoolwork. The microsystems that impacted students’ writing development were: school, work,
peers, and family. This chapter will end with a summary of the typical student’s journey through
the Writing Workshop.
Chronosystem: Effects of a Global Pandemic and Nursing Shortage on Learning
Hayes et al. (2017) explained the chronosystem as the influence of historical context and
changes over time on the individual. The worldwide COVID-19 pandemic began in 2020 and it
still affects the world in 2022 in terms of widespread illness, supply chain issues, and a transition
to more employees and students working from home. The pandemic affected nursing students in
various ways. Within the Lake Shore School of Nursing, the pandemic led to higher than usual
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numbers of nursing students withdrawing from courses, and taking leaves of absence from spring
2020 to the present (A. Wolf, personal communication, March 14, 2022). For example, eight
students withdrew from the Writing Workshop in the fall 2021 semester and two students were
retaking the course due to previous withdrawals whereas the previous fall, only three students
withdrew and no one needed to retake the course. The students who remained in the fall 2021
course reported how the pandemic affected them and their ability to participate.
Students shared the direct and indirect ways the pandemic impacted their scholarly
writing development. Noel disclosed that they contracted COVID-19, along with their husband,
during the semester. This affected Noel’s physical health, family responsibilities, and
schoolwork completion. Noel reported, “I was ill. And then when he was ill, I had to take care of
the kids. So I didn't have that quiet time to work on my project.” Noel fell behind and did not
complete an assignment, “I was not able to be part of the peer review assignment because I was
late submitting my first draft.” Cadence shared their challenge with being homebound, “I worked
remotely … the worst part is coming back down … in my basement, and sitting here and having
to work all day … then come back at night and write in the same spot.”
Prior to the pandemic, the world was experiencing a nursing shortage. The pandemic
exacerbated the shortage of nurses as many became sick or left their jobs. Eden and Trinity
expressed how the demands of nursing work affected them. Eden explained, “work is always a
disaster for me. There were staff that quit, so I'm training new staff, I have to run two clinics …
it's a very high turnover rate.” Despite work challenges due to staffing problems, Eden reported
being able to keep up on schoolwork, only mentioning, “it would have been easier if I just
worked my regular hours.” Trinity, on the other hand, admitted to struggles at work that led to
their feelings of “moral distress.”
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I had a horrid, so not only am I working in a pandemic, we're also working with a severe
nursing shortage. We're also dealing with the mandates from the states of vaccination.
We lost a lot of staff because of that, which is a moral distress too, because, you know,
those nurses left, they had to leave. But I'm also here to deal with the emotions of the
staff that they left behind. So as you can tell, I get very emotional by this. So that was the
hard part in writing the paper, my paper was about moral distress. And it's what we were
feeling right now. And not just me, like, I think all of us in nursing. It's not what we want.
It's not what we want to provide our patients with, but we're doing the best we can.
The pandemic and nursing shortage affected students’ work life, family life, physical health, and
mental health, that influenced their experience as students to varying degrees. All of the
interviewed students were able to successfully complete the Writing Workshop, but as Jubilee
stated, “The pandemic is affecting everything, sadly.”
Macrosystem: The Influence of Language on Scholarly Writing Development
Bronfenbrenner (1977) defined macrosystems as “the overarching institutional patterns of
the culture or subculture, such as the economic, social, educational, legal, and political systems”
(p. 515). The social and cultural influence of language was of particular importance for the three
“non-native” English speakers who were interviewed. All three students noted challenges writing
in English and about the importance of having someone to share and discuss their writing with
throughout the writing process. Lyric described how their relationship with the faculty allowed
them to take risks like “thinking in English” rather than always translating, and focusing on
communicating their ideas rather than worrying about grammar mistakes. Kairos mentioned the
importance of feedback, clear communication, and understanding the weekly course objectives.
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Kairos revealed that “anything related to writing in English. It's something that I am
insecure about. … when it's not your native language, it's kind of like your knowledge overall, is
not as strong.” Kairos described three elements of the course that were particularly helpful to
them, as a “non-native” English speaker from another culture. The first was “the one-on-one
meetings were beneficial just to get that feedback” and clarification from the faculty. The second
was “the tools that I got were essential to help me to grow overall in this class.” And the third
was the clear communication and “outline of our objectives for the week was very helpful.”
Although Kairos discussed the importance of these supports in their writing growth as a non-
native English speaker, they did express some uncertainty about their ability to write in English
after the course, “I think my situation was a little bit unique just because of … being non-English
speaker that when I think about writing, I'm still nervous about it, because I know that I'm not
that good at it.”
Noel also shared some hesitancy about their scholarly writing related to their language
skills. Noel admitted to asking their husband to proofread papers because “he is an English major
and English is not my primary language.” Noel further explained, “I do find that when it comes
to writing a paper, I've always struggled a little bit with that.” In writing a paper for the Writing
Workshop, Noel chose a topic “related to me and my family” and researched solutions for
patients “struggling with English not being their first language and having that interpreter
available for them.” Noel recounts that learning more about this issue “helped me to advocate
more at the workplace, making sure that they have that resource that they, it's their right, and it's
there for them. And you shouldn't take it away from them.”
Lyric was the third interview participant who discussed the impact of language on their
writing development. Lyric stated, “I was very nervous about this class because English is my
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second language. And I came to the States 10 years ago, and I was already age of 25-26.” Lyric
confessed that learning English is “kind of hard for me” and that in academic writing, “I'm
constantly struggling with finding the words, like the right words” and that “[before this class] I
didn't like writing at all.” Lyric’s initial approach to writing was to start in their native language
and translate everything into English, but they were not satisfied with this “beginner” method.
Lyric believed, “I will benefit more because if I am writing in English initially, I might struggle
more, but it helped me to, how to say, think as an English speaker.” Lyric credited biweekly
conferences with the faculty to help them feel comfortable enough to stop translating, “In this
class? I wrote English first, because Professor X … set up a Zoom meeting at least once a week,
… and she helped me go over the grammar” and “I was not like, that nervous about, oh, if it's not
perfect.” Lyric stated, “since I get to know her, better and better, I feel more comfortable”
because “she knows my background and she kind of knows what is my weakness. What is my
strength.” As a result of the support Lyric received in the course, Lyric experienced a change in
their attitude about writing in English and taking risks in communication, “I think I enjoy more
writing now. … Professor X … has been really helpful … to guide [me] through this process. I
feel more comfortable to try new things.”
These three students demonstrated how navigating a new culture or a new language
impacts scholarly writing development. Because one-third of the interview participants identified
as “non-native” English speakers, these language-related challenges were able to be highlighted
in this study. As “non-native” speakers, these students generally reported feeling less confident
about their writing and expressed challenges with grammar, diction, and conveying their ideas.
However, these students were similar to the other interview participants in commenting on the
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benefits of receiving feedback on their writing and being able to discuss their work with
someone else, particularly a trusted faculty or family member.
Exosystem: The Influence of Previous Writing Experiences at Other Institutions
According to Bronfenbrenner (1977) the exosystem includes “the world of work, the
neighborhood, the mass media, agencies of government (local, state, and national), the
distribution of goods and services, communication and transportation facilities, and informal
social networks” (p. 515). In this study, the interview participants discussed the influences of
previous writing experiences at other educational institutions, on their writing development.
Students also shared their conception of how scholarly writing is used within the discipline of
nursing.
Students expressed a wide range of scholarly writing experiences from other educational
institutions and described how this impacted their writing process. All students indicated that
prior to the Writing Workshop, the faculty support they received was scant and not particularly
helpful in improving their writing capacity. Another theme was how students noticed the general
lack of being taught, or guided through, a clear writing process, and how students were generally
left to complete writing assignments on their own, as a solitary venture.
Four students discussed the lack of helpful feedback from faculty prior to this course.
Jubilee described the effect this had on their development, “I never got constant feedback like
that in my previous program. So for me just submitting something and getting a grade from it, I
wouldn't really understand ways to fix it.” Additionally, Jubilee explained how these low
expectations for faculty interaction impacted their initial progress in the Writing Workshop, “I
think the reason in the beginning that I was so stressed out about it [faculty feedback] is because
I wasn't used to that.” Jubilee stated they were used to “just checking in with your instructor.
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And saying, ‘Okay, am I on the right track?’” So receiving regular feedback initially “stressed”
them out because faculty at previous institutions did not provide that.
Similarly, Kairos reported only receiving “generic feedback” such as, “look at your
grammar, look at your spelling, and you need to show more proof” prior to this course. Lyric
described what being a student was like in their country of origin, “You just have to suck it up
and try your best.” Lyric expressed feelings of demoralization, stating, “I knew, okay, I'm a fail.
And that I didn't want to talk to my supervisor or my professors.” The norm for Lyric was not
being able to communicate or receive support from faculty. Likewise, Eden tried to explain their
experience obtaining their first nursing credential, “Nursing schools are brutal. They're just, it's
ridiculous how much pressure they put on you. I came from a nursing school where if you
weren't perfect, you failed.” Eden continued, “it's a bad joke, but I always said that going to my
associate's degree was like Nazi boot camp because it was terrifying. Like, you just thought you
were going to fail every step of the way.” Faculty feedback for these four students was either
nonexistent or not useful to their writing development.
Four other students commented on the understanding of the limited writing process they
developed from attending other educational institutions, prior to this course. Cadence described
using the same method they learned in high school to write papers in college, “identify whatever
research you want to do, go to the library, find magazine articles, or find microfiche, and put it in
a paper.” Justice recounted a similar, basic approach to writing, “Previous to this [course], it was
alright, here's your research. Right? What's your argument? Now write.” Melody could not recall
a specific process, “I would say I didn't really have a true format other than knowing my basic
introduction, my body, and my conclusion.” Trinity explained their previously learned writing
process, “I would research my topic through the library, getting articles and things like that.
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Undergraduate stuff, I used more like any research. I was using stuff from the internet for that.”
Sometimes Trinity would ask their husband to “proofread” it, but they did not discuss receiving
formative feedback, “I never did drafts. It was, what it was, I handed it in.” Overall, these
participants discussed their limited interactions with faculty and the rudimentary knowledge they
were provided about the writing process prior to the Writing Workshop.
Student Conceptions of the Role of Scholarly Writing in Nursing
During the interviews, students were asked to define scholarly writing and explain how
scholarly writing is used in nursing and healthcare. Although this prompt did not directly relate
to the research questions, the student responses revealed information about their conception of
scholarly writing and what role writing plays within healthcare. Because the interviews occurred
after course completion, it cannot be determined whether the course influenced students’
definition of scholarly writing. There were some common themes. For example, every student
mentioned research and evidence as the foundation for scholarly writing. In general, students
characterized the writing style to be clear, organized, professional, and persuasive. Finally,
students noted the purpose of scholarly writing is to communicate new ideas from the research to
professionals with the goal of improving patient care. Students’ complete responses are
presented in Appendix I.
Mesosystem Challenges
Hayes et al. (2017) described the mesosystem as the “communication and interactions
between the various elements of the individual’s microsystems” (p. 7). Because
Bronfenbrenner’s ecological systems theory is often used to contextualize the various influences
on a child’s development, the mesosystem is characterized by the combined effects of a group of
microsystems acting upon the child. For example, the “interactions among family, school, and
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peer group” (Bronfenbrenner, 1977, p. 515) and how those externally influenced the child.
Although the adult learners in this study did not indicate any mesosystem influences on their
scholarly writing development, they did discuss difficulties with balancing their attention
between the microsystems of work, school, and family. These challenges will be individually
reviewed at the microsystem level.
Microsystem of Lake Shore School of Nursing
A microsystem is defined as “the complex of relations between the developing person
and environment in an immediate setting containing that person (e.g., home, school, workplace,
etc.)” (Bronfenbrenner, 1977, p. 514). The participants in this study were all students within the
microsystem of the school of nursing. Within this microsystem, the bulk of reported student
interaction occurred with faculty. Due to the online format, students engaged primarily with their
assigned faculty. These interactions were primarily addressed under research question two.
However, the interviewed students did share how their participation in other courses, taken
concurrently with the Writing Workshop, influenced their writing development. They also
discussed how their interactions with the school’s librarian and writing coaches supported their
writing progress within the course.
Concurrent Courses
Five of the interviewed students stated they had taken another course in the same
semester that they participated in the Writing Workshop. Four of these students expressed time
management challenges related to taking two concurrent courses within the school of nursing.
One mentioned using the techniques learned in the writing course to help them write a paper in
another course.
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Time management and scheduling issues were discussed by Jubilee, Kairos, Melody, and
Noel. Jubilee explained, “I was taking another class with this, which was a hard science class, it
was not nursing application. It was all just memorization and tests.” Although both courses
required effort, Jubilee noted that assignments and tests were both due on Tuesday and “I was
having a hard time, like doing this chunk here and knowing it had to be due on Tuesday, but I
have a test on Tuesday as well.” Jubilee shared “toward the end, it got easier” but “at times, I
wish that I had like, longer than a week” to work on their writing assignments. Kairos also
reported “the other class I had was time-consuming” but did not mention the same issue with
competing due dates.
In addition to taking two courses, Melody was returning to school after many years.
Melody described, “some obstacles that I definitely faced were the fact that I was taking another
class. And this was my first semester back to school. That was huge. That was hard.” Noel
posited, “If I would have taken this class alone. Just the one class, I think it wouldn't feel … so
stressful to get the work in and on time.” Noel theorized, “I would have been able to participate
in a peer review and kind of get that experience as well.” Noel was not able to participate in the
peer review because they fell behind and did not have a draft to exchange when others in the
writing class did. As a result, Noel missed that learning activity. Noel’s advice to other students
was, “Don't take two classes. If you're busy, if you have a busy family and a fulltime job, it's
going to feel overwhelming (laugh).” Noel added, “it's going to be worth it at the end” but in
retrospect, expressed that it would have been easier to complete assignments on-time and
participate in the peer review process had they taken the writing course alone.
Cadence took two courses during their first semester in the master’s program, “the
writing workshop, and … a HR [human resources] management course.” Cadence did not
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discuss time management issues but did share success with using the techniques they learned in
the Writing Workshop to complete the final paper in their management course. Cadence
explained, “I had a final paper that I had to research. And I followed a lot of the same process.
So developing my thesis, knowing my topic, finding the papers to back it up, all of those things.”
For Cadence, the experience of taking the writing course with a management course gave them
an opportunity to apply writing “strategies” effectively, noting, “I know that it definitely works.”
Overall, students did describe time management issues with taking a course concurrently with
the Writing Workshop but the situation did not impede their ability to successfully complete both
courses and for one student, was a beneficial way to use writing strategies for other assignments.
School Resources
Another area of influence mentioned by students was their engagement with school
resources. Three of the nine interviewed students described their positive experience working
with the school librarian. One student discussed their positive interaction with the school’s
writing coach team.
Trinity described their experience contacting the school’s librarian for assistance. Trinity
stated, “I did work with a librarian when I was having some issues, running some journal articles
for some reason, and I was just in the wrong server.” Trinity explained what occurred during
their session, “they just showed me how to just better search things, search articles and things
like that, which helped me and I took notes.” Cadence met several times with the school’s
librarian, “just to learn how to use the system, so that I understood between PubMed and
CINAHL, on the different search engines, to do the research. … But that was definitely very
helpful.” Cadence commented that the librarian was always available and “that was really very
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helpful in the beginning. So I'm really glad I did that. Otherwise, I would have been completely
lost.”
Noel also had a positive experience requesting support from the school’s librarian. Noel
recounted, “I worked with the librarian at the beginning of the class to help me find the articles,
or just to help me search the resources that we had there that I didn't use.” Noel shared how the
librarian helped them to focus their search, “it was good that she asked me, ‘What was I looking
for, what was I doing in class?’” Noel then described how the librarian helped them narrow their
search “so you can kind of get the better, the most information out there.” Noel remembered the
librarian “emailed me the links with the things that she had found when we were in the session.
… So that was great.” Noel summarized how helpful and available the librarian was and they
intended to continue to use that resource, “I knew we had libraries and stuff, but like, that wasn't
my go to. But now it is.”
Cadence shared their experience requesting writing support through the school’s writing
coaches team. Cadence stated, “the writing coach through CAPS was, again, very positive, very
upbeat. She really helped me with my thesis statement. … trying to figure out how to condense it
and make it make sense.” Cadence explained how the coach asked questions and they
determined how to write it together, “She's just like, Okay, so what do you want to say? So I just
said it. And then we kind of put it together and went from there. So that was very helpful, too.”
Overall, these students shared positive interactions with the school’s librarian and writing coach
that supported their work in the writing course.
Microsystem of Work
Seven students discussed how the microsystem of the workplace affected their
performance in the writing course. Some students expressed how their coworkers were helpful in
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reviewing their drafts or being flexible about work scheduling. Other students shared how their
workplace was demanding but did not negatively affect their academic performance. Two
students described how their work environment made it difficult for them to spend time on
schoolwork.
Cadence and Justice explained how their coworkers were supportive of their writing
work. Cadence shared, “I had a coworker, she said, use all of the resources that are available.
And I said, Oh, I never would ask for help. For anything. It was just that source of pride.”
Cadence recalled using that advice for the writing course, stating, “I learned really fast in this
class, I had to ask for help.” Not only did Cadence use that coworker’s advice but Cadence also
described using their coworkers as peer reviewers, “Now I use all of my resources, I use my
coworkers, my family to read and give me feedback.” Similarly, Justice shared how his
coworkers and workplace environment helped him focus on his writing progress, “the amount of
downtime I had in an outpatient clinic allowed me to do work while I was at work. Which, you
know, probably saved me some time late at night. So that probably contributed to my success.”
Justice also discussed how the support of his colleagues with flexible scheduling was helpful,
“Also, the folks that I work with, we work really well as a team. … If I had to do something, I
just spoke with her and, Yep, I'll cover for you.” These two students reported positive
interactions in the workplace that assisted them in their writing work.
Three students discussed how their work situations were demanding but did not keep
them from being successful in the writing course. Eden shared how work was busy and
sometimes required overtime, “So work definitely got in the way only in the sense that I would
work full days, if not some overtime.” Eden clarified, “Nothing got in the way of me submitting
my assignments on time or being able to sit down and complete them.” Eden claimed, “It would
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have been easier if I just worked my regular hours” but they stated they were still able to learn
and perform within the writing course.
Kairos explained, “I feel like work is work. It's always there and … you know, it's not
something, it wasn't like a contributing factor.” Even though Kairos did have to attend to a job,
they claimed that it was not something that negatively affected their ability to write throughout
the semester. Melody described their work environment, “My work has been very stressful. I've
been taking on additional responsibilities for two different areas. So that's been a lot.” However,
Melody stated, “I don't feel like it was an ultimate hindrance. I feel like it was still a successful
class.” Although these three students experienced demands from work, they did not recount
those as being detrimental to their writing performance.
Noel and Trinity explained how the stress from their workplace negatively impacted their
academic work. Noel explained, “Working overtime at work and being short staffed, so that that
affected a lot.” The demand to work overtime due to nursing shortages made it difficult for Noel
to complete assignments on-time “because you just get more stressed out trying to meet the
deadline. I need to get this in but I don't have the time to finish it all.” Trinity explained the stress
they experienced as a nurse while trying to write,
I was handing in my last revision. And I had worked a 12 hour shift. That morning, I
found out my grandmother passed away. And then, my literally last act of the day, was
putting a syringe right through my finger, giving a patient [an injection]. So now I had to
deal with HIV testing, hepatitis tests. So a lot of factors like that.
Trinity recounted that it was “a hard time” but that researching and writing a paper about moral
distress allowed them to “deal with my staff who was going through moral distress themselves.
And how it affects us, you know what I mean?” Trinity expressed deep emotion when discussing
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the moral distress that they were experiencing as a nurse, “I mean, look, I'm a blubbering idiot.
I'll go out there, and they won't even know I was crying in my office. Because it's just something
we deal with, you know?” To summarize, Trinity stated, “If I wasn't dealing with work-related
things, … I think I would have probably not been as, like, crazy, I probably would have been
able to organize my thoughts a little bit better.” Trinity did successfully complete the course
despite the emotional toll that their workplace took on them and their staff.
Microsystem of Peers
Another microsystem students discussed involved their role as peers with other students
in the program. Six students shared their positive experiences with the peer review process
within the writing course. Three students gave examples of peer interactions outside of the peer
review process, two involved peers within the course and one was with a peer in a different
course. Lastly, four students expressed a desire for increased peer interaction within the course.
Student Reflections on the Peer Review Process
Six students described their reflections on the peer review process. Four students found
benefit in receiving feedback from other students. Eden initially had misgivings about a peer
reviewing their work, “I thought I was going to be judged, like, this girl doesn't know what she's
talking about. She doesn't know how to write or you know. It was just, it was hard for me
(laughter).” Eden felt their peer was kind and helpful in their review, “she was gentle. And …
she did get some good points and she had brought up something, she was like, Oh, this paragraph
is about this. And I'm like, I didn't think it was about that.” The peer review helped Eden view
their writing from a different perspective and that was beneficial to improving their paper, “So I
actually had to change my paragraph because … I was trying to write something different and
she actually took it a different way.” After that first experience, Eden “got over” their fear of
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peer review, “I think it's beneficial, and it should be done all the time. … I feel like the more
feedback you can get from other people, other than the teacher who's grading, it's beneficial.”
Justice was more accustomed to soliciting feedback from others on his writing and
remains an advocate, “I'm big on always having somebody else revise your writing, … whether it
be a coworker, my wife … just so you can get a new set of eyes on it.” Justice explained how, as
an author, they can develop a certain blindness to their work, “as the person that's been
researching and writing, you've seen it 1000 times. So for you to try and catch changes … it's
difficult. But when you can get a fresh set of eyes, it is helpful.” Justice noted their preference
for holding peer review meetings face-to-face, as opposed to merely sending your partner a letter
of analysis, “I wish that we had had … the opportunity to sit down and discuss with that other
person.” Unlike Eden, Justice feared their partner would take their feedback too harshly, stating,
“I didn't want to be too critical because I was like, man, I hope she doesn't think that I'm just
beating up this piece of writing because it's pretty good.” Justice’s challenge was how to provide
constructive criticism without “crushing” their partner’s paper, “but there's definitely some areas
that need, you know, some changing or, … further development.” Justice asserted that the
“person-to-person” conversation would allow them the opportunity to deliver the feedback in an
honest, yet supportive way.
Lyric and Cadence also found benefits in the peer review process. Lyric found that they
could understand the professor’s comments better after being a reviewer for someone else, “And
so after reading my peer’s paper, when I come back to read the comment, the feedback Professor
X gave to me, it make more sense. So I was able to see the big picture.” Cadence stated, “I really
liked the peer review because it made me clue in, when I was reading somebody else's paper, to
things that I needed to change on my own, before I even got my peer review information back.”
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The process allowed Cadence to read their own paper with new eyes and use the revision
strategies, based on the hierarchy of writing concerns from the course content, to improve their
own writing. Cadence shared, “I could … start making the changes because I could identify it
from the list of recommendations that the professor had provided to us for the hierarchy of
concerns and going through that … made a huge difference.” In essence, Cadence was able to
become their own peer reviewer as a result of using the revision strategies to analyze their
partner’s paper.
Three students expressed their enjoyment of providing feedback to their peers. Kairos
noticed their partner did not provide sufficient evidence to support their claims, “So I suggested
to her, Okay, show me why? There's a lot of, I felt like, there's a lot of opinion. And the proof
was lacking, just kind of like, Okay, but why is this good?” Kairos commented, “It's funny
because the person that reviewed my paper thought that I had too much proof in my paper, that I
had to take it out. And I felt like she didn't really have enough proof.” Kairos found the peer
review was a welcomed relief from their own writing, “it was just interesting to read something
else, because you get tired of your paper or your topic, it was a nice break.” Cadence also
enjoyed the process, “So the peer review I absolutely loved and being able to write up some
feedback for that person.”
Trinity stated they were not initially excited about completing the peer review because
they were already working “60 something hours a week.” Trinity found the opportunity to
dialogue with a peer who was also experiencing work stress to be comforting, “when we did that
peer reflection, to find somebody who was dealing with the same thing I was dealing with, and
that knowing that it's not just me, was very impactful.” The other benefit Trinity noted was the
realization that their writing was on par with their partner’s, “So when we were able to see
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somebody who was on the same level as us, … It was nice, because you can see, … I'm not that
bad. Like, she had the same issues.” For Trinity, the peer review was an experience of
camaraderie, “I enjoyed the revision process, with the peer review.” Overall, each of the six
students explained how they thought their interactions during the review process was beneficial
to their development as writers. Appendix J includes the complete reflections from students
regarding the peer review process.
Other Peer Interactions
There were five students who shared examples of peer interactions outside of the peer
review process. Three students gave examples of peers discussing course content. One student
had a few interactions with peers who were in other courses. One student noted minimal contact
with peers.
Noel, Eden, and Trinity described conversations with their peers within the writing
course. Noel mentioned one of the three “team meetings” held via Zoom where students worked
in breakout groups on revising text using strategies taught in the course. Noel stated, “we went
over the sentence outline, and she would just have us read it and ask us if that makes sense to us.
And then, Well, how would you fix it?” Eden explained a similar process, “In … one webinar,
you broke us up into groups, and we get to talk to each other that way. And then the second one,
we did the same thing.” Eden described enjoying the opportunity to engage with peers
informally, “It was kind of nice to see how everybody else was doing before we get talking about
the actual information. So it was neat for that.” Trinity shared that several of her nurse friends
were taking the writing course at the same time. The three students would “talk back and forth”
about assignments and “regular, freaking out over texts, things like that.” Trinity gave examples
of the course-related discussions, “did you write in first person for this reflection paper? … How
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many headings did you have? How much? How many journal articles did you add, you know?
We were like, your references this and that.”
Cadence described receiving advice from a friend who had already taken the course and
how they helped out a friend in another course. Cadence reported how a friend suggested
contacting the librarian for help, “And that was advice from my coworker [who had already
taken the writing course] saying, set this up before class even gets started, so that you're ready to
hit the ground running. And that was good advice.” The other example involved a friend from
Cadence’s management course, “She called me, and she was behind on everything. And she said,
you wouldn't have an article on resilience? And I'm like, Oh, yes, I do! And I sent her a bunch of
articles.” These three students shared specific examples of how peer interactions within the
course, and outside of the course, were supportive in their writing work.
In contrast, one student discussed how they did not have significant interactions with
peers. Melody stated, “As far as the peer interaction, I don't feel like I had a whole lot other than
the peer review piece, which was honestly, quite brief and abbreviated. So I don't feel like I
gained anything from peer interaction.” Melody did clarify that they felt like dialogue between
peers was not a core part of the course learning experience, “But I think that's also because the
course wasn't really set up to have a whole lot of peer interaction.”
Desire for Increased Peer Interaction
Although students did discuss benefits from the peer review process, four students
expressed a desire to have even more opportunities for peer interaction. Lyric explained that they
enjoyed the peer review and would like to see more group work in the course, “I feel probably
more like group assignments, … I enjoy it. I had that one session, the peer assignment with my
group. Yeah, I think it would be great. If I could have more.” Lyric noted that more peer
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interaction may be difficult to add to the writing course, “it’s online class. The group
assignments would be, it's not like practical.” Similarly, Eden stated, “It was nice talking to the
peers. I kind of wish there were more of that though, which was weird, but it's an online class, so
I get it.”
Justice and Cadence posited that more peer interaction would be helpful and that face-to-
face classes might give the course a different flavor. Justice recalled, “I didn't really interact a
whole lot with our peers other than, you know, the few zoom meetings that we had. It was good
to hear, both the good and frustrating.” Justice added, “I'm used to the traditional classroom
setting where you meet once a week, twice a week, and you see the same people … and there's
small talk before and after class and getting to know people that way.” Although Justice “felt like
[peer] interactions were limited,” overall, “I think that's more of the format of the course than
anything else.” Likewise, Cadence stated, “I think the big thing that was missing is, we only met
really two times as a class online.” Cadence believed if the course were in-person, more student
interaction would naturally occur, “it probably would have been a completely different class if it
was in-person. Because we would be … having an exchange and people feeling like they can ask
questions, we can learn from each other.” In sum, these students expressed a desire for increased
peer interaction and pondered how the format of the course might affect their ability to connect
and learn from peers.
Microsystem of Family
The final microsystem noted by the participants concerned the influence of family on
their writing development. Four students described receiving writing support from family
members. Seven students discussed how family responsibilities affected the amount of time they
could spend writing.
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Four students discussed how they felt supported in their academic endeavors by their
family. Cadence explained that they did not have any distractions from children because “my
kids are out of the house.” Cadence further shared that they use family members as reviewers of
their writing work, “Now I use all of my resources, I use my coworkers, my family, to read and
give me feedback.” Justice had already been in the habit of asking his wife to read his writing,
“my wife who's in the field of education, I always have her take a look at things, just so you can
get a new set of eyes on it.” Justice also mentioned that his wife was supportive of him studying
in the evenings, “my wife, she understood that, Okay, kids are in bed, we've watched our show
or whatever together, you know, he is going to go do his work now.”
Eden explained how they felt very supported in improving their writing capacity. Eden
explained, “my husband reads everything I write. He loves it. I don't know why, but he does. He
loves to edit it, from like, the little grammatical stuff, you know? So he looks at everything for
me.” Eden expressed gratitude for their husband’s editing help, “I'm very fortunate to have him, I
really am. … He's made me a better writer.” Similarly, Noel related how they asked their
husband to review their written work, “I use my husband a lot to proofread and have him read it
and see if it makes sense for him. He is an English major.” As a “non-native English” speaker,
Noel also received support in clarifying their written ideas, explaining how their husband would
“give me his thoughts on it or say, well, this doesn't make sense and highlight it and just, I would
try to go to him and expand more on that idea. But this doesn't make sense and explain this.”
These four students described specific ways their family supported their writing development.
Seven students detailed how family obligations took significant time, impacting the
amount of time they could spend on writing work. Trinity explained how balancing work,
family, wellness, and school, amidst a pandemic, was complicated,
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I'm working 60 something hours a week, we're in the middle of a pandemic, I'm trying
not to get sick. I have a husband and two kids -- three kids -- two of them live at home,
one's at college, but I said, you know, it was hard to put everything together.
Melody commented on the difficulty of managing family and school, “I do have a family and
that made things difficult because I did find this very time intensive.” Justice also brought up the
many family commitments that come with parenting, “I feel like I'm juggling nine different
things on any given day. My kids are involved in sports and in scouts, and I'm involved with
them. I help coach, I go with my son on scouting trips.” Although Justice admitted that these
obligations impacted his writing time, they were all self-chosen, “it's just trying to find the time
and find the balance to do all those things. So yeah, there were things that affected my writing,
but those are things that I brought upon myself.”
Noel also described how family responsibilities affected their ability to attend to
schoolwork. Noel explained how they and their husband contracted COVID-19, “I was ill. And
then when he was ill, I had to take care of the kids. So I didn't have that quiet time to work on my
project.” Noel discussed how the combination of parenting, work stress, illness, and schoolwork
took a toll, “this year, it's just been, it's been really, really rough for me. So honestly, I feel like
I've just been taking it one day at a time, just trying to take my courses and pass them.” Noel
continued, “But it's definitely has been a lot harder than I thought it would be. Obviously, I have
three little ones. So that doesn't make it any easier.”
Kairos, Lyric, and Jubilee gave examples of other family responsibilities that affected
their engagement with writing. Kairos shared, “I was definitely affected by a death in the family.
I actually asked for extension, because my father-in-law passed away. And that was a big one.”
Lyric was relocating at the beginning of the semester and that presented challenges, “I was still
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trying to navigate this new place and new work, new job environment, everything. That was a
little bit hard. There's some logistic difficulties. And I was living in a hotel for two weeks.” As a
nurse, Jubilee offered to care for their grandmother during the semester,
My Nana was living with me for a while because she, we are pretty sure she has dementia
but it's not diagnosed yet. So she can't stay at home with my papa right now who's 89 and
she's 86. So I took her in for a while and I was like, I just can't focus, I can't get anything
done.
These three students experienced significant life and family events that negatively impacted their
ability to write and complete assignments. The students commented on reaching out to their
professors to ask for extensions and noted they were all able to finish the course successfully,
despite the complexity of their family lives.
Overall, these students shared examples of how the microsystem of family negatively and
positively affected their writing performance in school. Some students received direct writing
support from spouses and family members who served as reviewers and editors. Some students
described the challenges of balancing parenting with school and work responsibilities during a
pandemic. Three other students shared how stressful life and family events weighed on them as
they attempted to engage in the writing process. In sum, there were significant family variables
that students needed to balance and manage in order to succeed in their scholarly writing.
Transformation of the Individual: A Hero’s Journey
In reviewing the data from this study, a common pattern of scholarly transformation
could be seen from the experiences shared by the interviewed students. This pattern is akin to the
hero’s journey (Vogler, 2007). Vogler modernized Joseph Campbell’s original depiction of the
hero’s journey to include three basic stages: departure, initiation, and return. In the departure
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phase, the hero is called to adventure, refuses the call, meets with a mentor, and then crosses into
the threshold of another world. During the initiation, the hero meets allies and enemies, and is
tested in an ultimate ordeal. Finally, the hero returns with the hard-won reward of treasure or
wisdom.
Students told a similar story as they related their experiences throughout the semester. In
the beginning of the course, the majority of students were starting the first year of their graduate
program. Many expressed a reluctance to begin the journey and engage in the writing process.
Each student was assigned to work with a faculty member for the semester and so embarked on
their writing journey. Throughout the course, students encountered frustrations with their writing
and numerous challenges from work, other classes, family, and the pandemic. Students also
discovered new strategies and resources, worked with peers, and ultimately succeeded in writing
a master’s level scholarly paper.
Students noted significant transformations by end of the Writing Workshop. In reflecting
upon their pre- and post-course scores, most students reported a significant increase in their
confidence and skill level. These gains were confirmed in the quantitative data analysis. Students
shared how they were applying the techniques from the writing course at their workplace to
improve their thinking, written and oral communication, use of evidence, and strategic awareness
of their audience and intended purpose. These findings aligned with the high task value students
demonstrated for scholarly writing on the surveys. Despite their initial reluctance and the hurdles
they had to clear, the students proclaimed that the transformation they witnessed within
themselves made the journey “very rewarding” and worthwhile. In the end, students perceived
themselves as new initiates in the world of scholarship – capable of wielding the tools of the
trade, with an aim to make important contributions to their profession.
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Chapter Five: Discussion and Recommendations
Scholarly writing instruction is valuable in the promotion of critical thinking,
communication skills, reflective practice, and the professional identity development of nurses.
Nursing researchers have made recommendations about improving scholarly writing pedagogy,
but few have measured the effect of these on nurses’ writing capacity (Oermann et al., 2015).
This study has evaluated an existing writing intervention that curated best practices in writing
instruction to meet the needs of students in graduate nursing education. A summary of these
recommended practices used in The Writing Workshop include the following:
• intentionally sequenced assignments to guide students through each phase of the
writing process, slowly building up to more complex tasks;
• clear assignment guidance (written, video instruction, templates);
• weekly opportunities for students to receive and use formative feedback;
• rubrics and exemplars to communicate expectations;
• faculty use of balanced feedback, praise, and cognitive tools;
• honoring students’ strengths, prior knowledge, and unique voice;
• multimodal, direct instruction of revision strategies and cognitive tools;
• offering various levels of scaffolded instruction based on student needs and ZPD;
• focusing on the construction of meaning and higher-order writing concerns first;
• using a hierarchy of concerns to guide revision and focus faculty comments;
• social interaction with faculty, and peers (via structured peer review);
• providing relevant assignments where students use discipline-specific texts,
writing expectations, and style (known as writing in the discipline);
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• warm encouragement from faculty who accept students’ approximations, build on
strengths, and are available for support, as needed (psychological safety); and,
• multiple opportunities for students’ goal-setting, metacognition, and reflection.
This chapter presents a discussion of those results and findings centered in the
sociocultural context of scholarly writing development and the reviewed literature. Four
recommendations for improving writing pedagogy within the discipline of nursing are also
provided. The limitations and delimitations of the study are discussed along with implications for
future research and equitable instructional practices in scholarly writing.
Discussion of Findings and Results
The purpose of this research study was to explore how a one-semester writing
intervention affected the scholarly writing performance, self-efficacy, and task value of master’s
nursing students. The research literature on best practices in writing, including research specific
to nursing education, was reviewed, analyzed and used as the foundation for this study. The
results and findings aligned closely with the research literature. The qualitative data confirmed
that the students perceived increases in their confidence and writing capacity. No significant
changes were noted in task value but the pre-intervention scores were already high. Students’
task value for writing was demonstrated when they shared during the interviews how they
applied writing strategies in the workplace.
The quantitative data gathered showed that this intervention had a significant impact on
improving students’ self-efficacy and writing performance. As discussed in chapter three, the
Intellimetric® writing assessment defines a holistic score of three as the writing skills of the
average first- or second-year undergraduate student (P. Edelblut, personal communication, April
18, 2022). The pre-course holistic mean scores on the writing assessment were 3.19, indicating
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the average Writing Workshop student entered the course at an early undergraduate writing level.
In comparison, the mean for the holistic post-course writing assessment scores were 4.79. The
post-course scores reveal that the average student had improved their writing skill a bit beyond
the level of a college senior (score of 4) to approaching master’s writing expectations (score of
5). Based on this interpretation of students’ scores, the Writing Workshop effectively brought the
average students’ writing performance from approximately a first-year undergraduate level to an
early master’s level in one semester. These quantitative data demonstrate the instructional
potential of a required writing intervention course in successfully preparing master’s nursing
students for graduate level writing.
Although Bronfenbrenner’s ecological systems theory was used to examine the influence
of various systems on students’ writing development, sociocultural theory is a useful lens in
which to view the discussion of findings and analyze why the intervention was successful. The
assumptions underpinning sociocultural theory are the following: social interaction is essential to
learning, learning occurs within a social and cultural context, cognitive tools can be used to
enhance thinking, and learning occurs within the student’s zone of proximal development with
the aid of a more experienced person (Allman, 2018). In the discussion of the study’s findings,
various aspects of sociocultural theory are highlighted: the impact of cultural context, the role of
social mediation in writing pedagogy, effective scaffolding practices, and how the course
supported students’ internalization and transferred use of cognitive tools.
The Impact of Cultural Context in Nursing Education
The nine students interviewed in this study described a number of ecological systems that
had an influence on their learning and writing development. Students specifically shared how
factors aligned with the chronosystem, macrosystem, exosystem, and microsystems affected their
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learning experience during the Writing Workshop. Additionally, students discussed how the
learning environment of the writing course played a role in their writing progress.
Effect of Ecological Systems on the Nursing Student
There were significant external stressors that nursing students faced during the fall 2021
semester. Globally, the COVID-19 pandemic placed a heavy burden on healthcare, with nurses
bearing a significant portion of the extra workload. Many nurses left the profession or retired,
adding to the nursing turnover and contributing to an already existing worldwide nursing
shortage. During the period of the study, many nurses had to manage historic staffing shortages,
and several contracted COVID-19 or had to care for family members sick with the virus.
Participants in the study often expressed moral distress from work challenges caused by the
pandemic. These chronosystem-level influences negatively affected nursing students. Eight
students withdrew at the beginning of the course, some fell behind in their classwork and missed
the peer review assignment, and others expressed difficulty with time management due to extra
work obligations. At a more personal level, the students discussed various microsystem
obligations that also competed for their time such as other courses, parenting responsibilities,
significant life events such as moving or deaths in the family, and taking care of elderly family
members.
At the macrosystem level, language and culture-related issues disproportionately affected
students from other cultures and those who described themselves as “non-native” English
speakers. Three of these interviewed students discussed the impact language had on their
scholarly writing capacity. They expressed concerns about their baseline writing skills, noting
challenges with vocabulary, grammar, comprehension, and communication.
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Another ecological system impacting students was the exosystem of nursing and prior
educational experiences. All of the interviewed students relayed a limited understanding of the
writing process and a lack of formative feedback on their drafts prior to the Writing Workshop
course. According to the students, faculty feedback was primarily focused on having sufficient
citations, good grammar, and proper APA style formatting. Two students shared detrimental
examples of educational experiences, one stating their nursing program was like a dictator’s
“boot camp” and another explaining how solitary and unforgiving their professors were and
“You just have to suck it up and try your best.” Many of these students entered the writing
course with a lack of writing instruction, negative writing experiences, and the misconception
that writing occurs without a clear purpose or social context.
The research literature in nursing education corresponds with these findings. Challenges
identified by other authors include a lack of standardized writing instruction, a deficit model of
teaching, a fixation on lower-order writing concerns, and narrow, exclusionary views of students
with raciolinguistic differences has contributed to students’ low self-efficacy for writing and the
lack of a clear path into scholarship for students not able to unlock the writing code on their own.
With so many detrimental ecological influences, it is not surprising that a schism between
practitioners and researchers exists (Borglin & Fagerström, 2012; Smith & Caplin, 2012;
Whitehead, 2002) and nursing has not been able to bridge the racial concordance gap (AACN,
2019). This study illustrated the numerous deleterious effects that ecological factors have on
students’ self-efficacy, writing development, and cognitive load.
Effect of the Learning Environment
The second cultural context in nursing education to consider is the learning environment
itself. By learning environment, I mean not only the physical space in which learning occurs, but
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also virtual spaces and organizational structures shaping the context of learning (Irby, 2018). All
of the interviewed students in this study commented on how the structured interactions with
faculty and peers positively impacted their learning. For example, student highlighted the
acceptance and positive regard they experienced with their assigned faculty. Students described
how faculty created rapport via lecture videos and seemed “approachable.” All of the students
knew the faculty were available to talk or meet with them on an “as needed” basis. Students
reached out to meet with faculty when they needed “clarification” of feedback or support. When
faculty initiated writing conferences, students expressed appreciation and comfort with the
interactions. Some students had several conferences with their assigned faculty throughout the
semester, others did not require any. Students characterized the faculty as having “compassion
and empathy” and that safe environment enabled students to take risks and grow from their
mistakes without feeling penalized.
Rather than taking a deficit approach, where students who are not successful are deemed
deficient, the prior knowledge and strengths of students were used as a foundation for new
knowledge. Students mentioned how faculty invited students’ drafts, providing the students with
encouraging praise and constructive feedback on their writing-in-progress. Students shared that
faculty’s acknowledgement of their hard work and approximations was “affirming” and focusing
on the positive increased their self-efficacy and desire to carefully review the work they
submitted. Faculty were able to help students clarify and refine their nascent thoughts in a way
that was perceived as supportive and encouraging of their learning. These findings align with
research about the importance of encouraging students’ effort and establishing psychological
safety in promoting the learner’s growth and development (Ball et al., 2009; Chandler et al.,
2005; Edmonson, 1999; Smith, 2008). In this regard, the cultural context of the learning
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environment, as well as other environmental influences on the learner, have an impact on how
successful an instructional intervention can be. Educators cannot control the effects of many
ecological systems but they can shape the learning environment.
The Critical Role of Social Mediation in Developing Scholarly Writing Capacity
In addition to considering the cultural context of the learner, this study demonstrated the
importance of social mediation in helping students improve their writing ability. One of the main
principles of sociocultural theory is that learning is social by nature. Vygotsky (1978) defined the
zone of proximal development (ZPD) as the area of learning where an individual can accomplish
a task with help, but has not yet achieved independent mastery. With appropriate support from a
more experienced person, Vygotsky posited that a learner can eventually become proficient with
a task they previously could not accomplish alone. In other words, learning occurs within a
social context and learners benefit from the guidance of individuals with more knowledge and
expertise. Because writing is a form of communication, it is also an inherently social act that
presupposes a specific audience, format, and message to deliver (Bean, 2011). In this section, the
importance of faculty feedback, cognitive tools, and other social influences on students’ writing
capacity will be discussed.
The Value of Formative Feedback During the Writing Process
The interviewed students discussed the effect of receiving regular, formative feedback
from faculty on improving their writing capacity. This theme was confirmed in the literature.
Formative feedback from a more experienced writer enabled students to enhance their
understanding of writing as a strategic, iterative task used to communicate meaning to a wider
audience and improve their writing development (Jefferies et al., 2018; McCutchen, 1996).
McCutchen found that without social mediation, many writers would not become strategic and
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would continue to view writing as merely putting words on a page without consideration of the
rhetorical context or use of a recursive writing process to refine their thinking. The interviewed
students in this study commented on their lack of previous writing instruction and how the
tutelage they received during the Writing Workshop allowed them to significantly improve their
writing and thinking performance by the end of the course. Additionally, all of the interviewed
students were able to provide a nuanced definition of scholarly writing and discuss the
importance of writing within the discipline of nursing. This aligns with research reviewed on the
impact experts can have to introduce students to discipline-specific conventions and rigor of
scholarship through intentional, socially mediated writing instruction (Ivanic, 1998; McCutchen,
1996; Mitchell, 2018).
Additionally, students noted the value of receiving faculty feedback that balanced praise
with specific writing recommendations. Interviewed students expressed frustration with previous
writing instructors who pointed out weaknesses without offering praise or ideas for improving
performance. In contrast, these students explained how receiving mitigating comments that
included constructive criticism and encouraging, specifc praise boosted their confidence as well
as their writing capacity. These findings were congruent with the research literature asserting that
students responded better to balanced feedback as opposed to hearing only criticism (Ball, 2009;
Bean, 2011; Chandler et al., 2005; Smith, 2008).
Developing Scholarly Writing Capacity With Cognitive Tools
In addition to receiving regular, balanced feedback from faculty, the findings from this
study revealed the value of students learning specific strategies to increase their writing capacity.
According to Vygotsky, social mediators and symbolic mediators can be used to help students
master new learning processes (Kozulin, 2002). Each of the nine interviewed students described
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various writing techniques, or symbolic mediators, that they attributed to improving their scores
on the writing assessment. Students named the hierarchy of writing concerns as integral to the
revision process they learned in the Writing Workshop. This hierarchy, divided into higher-order
and lower-order writing concerns, allowed them to approach revision in an ordered way with
clear priorities. This organizational approach to writing and feedback has been discussed by
other authors (e.g., Bean, 2011; Harvard Writing Project, 2007).
On the topic of higher-order writing concerns, students recounted the usefulness of
writing strategies that improved their focus, use of evidence, and organization. With regards to
focus, students explained the importance of learning how to craft a thesis statement and using the
thesis to ensure the main points of their argument were logically presented. Students also
described using a literature synthesis matrix as a helpful way to organize and analyze evidence
from research articles. Organizational strategies included the classical argument structure and the
basic paragraph model. Students commented on how important these techniques were in teaching
them how to present evidence in a focused, organized, impactful, and professional way to their
audience. In sociocultural terms, the socially mediated strategies students learned in this writing
course became what Vygotsky would consider “cognitive tools” or a structured system of
thinking that became internalized (Kozulin, 2002, p. 19). The more experienced faculty writers
provided students with writing strategies, or cognitive tools, and demonstrated how to use these
tools generically as well as within students’ own writing. These new strategies then became
internalized, allowing the student writer to flexibly apply these tools to guide communication
tasks in other contexts.
Other effective revision techniques allowed students to hone lower-order writing
concerns. Students discussed learning how to construct sentences for greater effect, use
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transitional devices, select words to better represent their thoughts, delete unnecessary words,
remove passive voice, and correctly employ APA citations and style. Students expressed
appreciation that the faculty waited until their ideas were sufficiently developed and organized
before these finer issues of writers’ craft were addressed. As noted in the literature review,
nursing students became disengaged when faculty focused on lower-order concerns without
providing guidance on how to develop or organize ideas (Diekelmann & Ironside, 1998).
Students in this study noted that they would not have been able to apply these strategies without
faculty initially directing them to use specific techniques in certain areas of their writing. Many
of the interviewed students thought these strategies were so helpful that they wished they had
learned them earlier in their educational career. According to Marie Clay (1991), as a student
adopts these tools as their own, they will eventually create a self-extending system whereby use
of these strategies will continue to enhance the student’s writing capacity.
Other Social Influences
Students explained that they received the most salient writing advice from their assigned
faculty in the Writing Workshop. However, students shared that feedback from peers, coworkers,
and family members was also solicited to help them review their paper in a more objective way
and consider how another person may interpret their written communication. Librarians and
writing coaches were school resources that some students chose to use. Again, this feedback is
an example of how writing instruction is socially mediated.
In addition to peer influences on student writing, students’ participation in other social
contexts affects their writing development. The term polycontextuality describes other social
environments where learners may draw other literacy experiences from (Wardle & Roozen,
2012). Students in this study discussed how their initial understanding of writing came from
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undergraduate experiences and they discovered that the expectations and methods used in that
environment needed to be revised in order to write successfully at the graduate school level.
Likewise, as these master’s students move forward in their various programs, if they have
developed a self-extending system, they will transfer and apply the writing tools from this course
into their program specializations.
Effective Scaffolding Practices in Writing Instruction
This study illuminates the vital role that scaffolding has in developing students’ writing
capacity. According to Wood et al. (1976), scaffolding are supports teachers put in place to
simplify a learning task to ensure it stays within the learner’s current capacity. Just as a physical
scaffold provides temporary, adjustable support to buildings that are being constructed, an
instructional expert can scaffold a learner in completing a task they have not yet mastered
(Allman, 2018). In this writing intervention, students received support through instructional
design, clearly written expectations, and differentiated instruction.
Instructional Design as Scaffolding
Students from this study recognized multiple structured elements in the online course
which simplified the learning task and enhanced their learning. For instance, they mentioned
how helpful it was that each assignment built upon the previous one and how the writing project
was divided into weekly assignments that slowly built on each other. This method was also
discussed in the reviewed literature (Gazza & Hunker, 2012; Luthy et al., 2009). The one caveat
students added to this technique was to ensure that the weekly assignments were manageable or
spaced farther apart so students had sufficient time to engage with each task without feeling
overwhelmed. In addition to the benefits of scaffolding, this method may have supported
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learning by ensuring that instructional activities were not too complex, thereby reducing
cognitive load (Sweller, 1994).
Students also mentioned the importance of structuring the course in a way that led them
through the writing process “step-by-step.” Current thought on writing instruction acknowledges
that writing is iterative rather than linear (Bean, 2011). However, students were sequentially
guided through explicit skills in the Writing Workshop: basic literature search methods, critical
reading, defining a problem, summarizing and notetaking, APA citation, basic synthesis, thesis
development, logical reasoning, creating a sentence outline, drafting, peer review, revision, line
editing, and reflection. Assignments built upon one another but students were encouraged to
revisit previous assignments or reread articles as required by the iterative nature of their writing
journey. The direct instruction of discrete skills involved in the writing process gave students a
clear picture of what was required at each stage and ample, guided practice as they applied each
new skill to the development of their argument.
Lastly, the students shared the benefits of being able to access instructional videos and
resources within the learning management system. The writing intervention in this study was
peer-reviewed by Quality Matters using best practices in online instruction. This review process
helped to ensure a clear course design that was ADA compliant and adhered to principles of
online pedagogy.
Clarifying Writing Expectations
Another example of scaffolding noted by the students and in the research literature was
the importance of faculty clarifying writing-related expectations. In the writing course, students
received detailed assignment guidance each week that explained what they were being asked to
do, why the work was important, and how they might proceed with accomplishing the task. The
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“how to” portion was usually accompanied by a template or worksheet, along with a student
model or worked example, so the expected level of detail was clear. The rubrics and checklists
used for grading were also provided although students were encouraged to use faculty feedback
as a measure of their progress rather than fixate on weekly grades. According to the students,
these supports took “the mystery” out of faculty expectations and gave them a suggested
structure for how to approach and complete each assignment. The research literature
corroborates the importance of clarifying student expectations using these methods as well
(Behrens et al., 2016; Carter et al., 2018; Gazza & Hunker, 2012; Naber et al., 2014; Troxler et
al., 2011).
Differentiating Instruction With a Flexible Scale of Help
The other method faculty used to provide individualized scaffolding was through a scale
of help. The term scale of help was developed by Marie Clay (2005), founder of Reading
Recovery®, to categorize the level of scaffolding a teacher provided from least to most help. The
baseline of help given to students in the Writing Workshop was the multi-modal content,
assignment guidance tools, peer review, and written feedback from faculty on each weekly
assignment. For many students in the course, this level of support was sufficient. The next level
of group support was delivered via three synchronous webinars: an orientation to the unique
course design, another on paragraph formation, and one on line editing. In the webinars, direct
instruction and guided practice was furnished to the whole group. The third level of help used by
faculty was making a video recording of feedback that was sent to students along with the
written feedback. This method allowed faculty to expand on their written comments, model a
strategy they wanted the student to use, or walk students through necessary formatting changes.
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The students’ perceived the most supportive level of help to be the individual writing
conference. When initiated by students, the purpose for conferences ranged from clarifying
written feedback, asking a question, discussing an idea, or helping the student determine the best
way forward in a confusing situation. When faculty initiated conferences, the purposes included
reviewing and correcting unintentional plagiarism, checking reading comprehension of a
research article, asking clarifying questions about an assignment that did not meet standard
expectations, guided practice of specific revision strategies, or setting up a plan for students who
fell behind with assignments. Sometimes students emailed about simple questions but most
writing conferences were via phone or video conference.
The scale of help allowed faculty to customize the course to meet the needs of students
from a broad range of backgrounds and literacy experiences. Although the majority of students
were fairly independent, this scaffolding format accommodated students who needed regularly
scheduled appointments to those who only had an occasional question via email. Because faculty
had the ability to request interaction with students from a flexible scale of help, students were
able to receive the amount of support required to maximize their learning within the ZPD and
alleviate excessive periods of frustration or inactivity. The reviewed literature confirmed the
value of scaffolded, social mediation in improving students’ writing development (Baleghizadeh
& Gordani; McCutchen, 1996). Differentiating learning within a required, discipline-specific
writing course supplied even the most fragile writer with the level of instruction they needed to
succeed without the notion that they were “remedial” students or less capable than their peers.
This curricular approach assumes writing is developmental rather than remedial and requires
direct instruction as opposed to assuming students should enter college as fully developed writers
(Hathaway, 2015).
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Supporting Reflection and Metacognition
The Writing Workshop provided clear instruction, scaffolding, and social encouragement
to master’s students possessing a wide range of language skills. This intervention had a
significant effect on their writing capacity, self-efficacy, communication skills, and their identity
development as advanced practice nursing professionals and healthcare leaders. In sociocultural
theory, learning occurs when content and use of cognitive tools are appropriated and internalized
by the student (Kozulin, 2002). This process requires intentional instruction regarding the
generalizable use of these tools in other contexts (Kozulin, 2002) and is a part of metacognition.
Metacognition is defined as “the process of reflecting on and directing one’s own thinking”
(National Research Council, 2001, p. 78). Interviewed students demonstrated internalization of
the writing process and cognitive tools as well as generalization of these tools within the
workplace. In addition, reflection was an effective method used to stimulate students’
metacognition about their writing progress, self-efficacy, and transferred use of cognitive tools in
the workplace (Gazza et al., 2018; Prestia, 2019).
Reflections on Gains in Writing Performance
The first activities students in the Writing Workshop completed were setting a writing
goal they wanted to achieve by the end of the semester, rating their self-efficacy, and taking a
one-hour writing assessment. Interviewed students in this study were asked to share their
reflections on their post-course scores as well as any transformation they may have experienced
as a result of their participation in the course. Reflection has been used in nursing instruction as a
method to promote critical thinking and self-assessment of learning development (Naber et al.,
2014). Student responses were based on evidence from a review of their pre- and post-course
self-efficacy survey and writing test scores, which showed significant improvements in their
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confidence and writing performance. Students attributed these positive effects to a number of
things: a deeper understanding of the scholarly writing process, warm faculty encouragement,
regular balanced feedback, and the specific techniques they learned that were customized to their
individual strengths and weaknesses.
Reflections on Writing Self-Efficacy
Another transformation students noticed was in their writing self-efficacy. Bandura
claimed that self-efficacy is influenced by four things: a person’s experience of mastery,
vicariously observing the behavior of others, the social encouragement they receive, and their
emotional state concerning the task (Bandura, 1986). The Writing Workshop provided students
with experiences in each of these areas: successfully writing a scholarly paper, learning
vicariously through faculty and peer modeling, receiving praise from faculty and peers, and
feeling more positive and less anxious about writing by the end of the course. The quantitative
results from this study show a significant effect on students’ post-course self-efficacy scores.
Vygotsky would add that a learner’s motivation and confidence is affected by how successful
their experience was in the ZPD (Tudge & Winterhoff, 1993). The findings from student
interviews revealed a solid understanding of scholarly writing, transfer and application of
learning to the work environment, and the ability to aspire. One of the interviewed students
proclaimed the writing course changed their thinking process as a nurse. Another stated that they
were considering doctoral work due to their success in the course. Others commented on how
learning scholarly writing helped them feel like they could present ideas to other professionals
and “be taken seriously.”
Transfer of Learning to the Workplace
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When asked to reflect upon how the course transformed them, the students responded
with how significantly their confidence and self-efficacy increased and how they noticed changes
in their writing, thinking, and communication in the workplace. All students expressed a greater
awareness of rhetorical context and gave examples of how they applied their newly acquired
cognitive tools to improve written and spoken communication. For instance, they reported
attending more to their word choice in emails, revising their thoughts as they wrote, and thinking
critically about the correspondence they received. In addition, they reported using the
organizational techniques from the course to improve their presentation of ideas to other staff,
understand the importance of using evidence to support any claims they make, and provide
citations to give credit where it was due. These changes indicate a deep, transformational
learning that affected students’ professional communication skills and strategic use of cognitive
tools adopted during the writing course.
Orientation Into a Community of Practice
In the analysis of qualitative data, interviewed students shared definitions of scholarly
writing. These definitions evidenced a solid understanding of the purpose of scholarly writing
and how it fuels the discourse and innovation within the healthcare profession. These data
revealed that students’ understanding of disciplinary writing in nursing is developing. Since this
was the first master’s course for many students, they will continue to need opportunities to
engage in scholarly writing with other experts in the field. Lave and Wenger (1991) coined the
term legitimate peripheral participation. This term means that novices participate at the edges of
the profession in order to learn cultural practices and expectations. As sociocultural theory would
predict, novices who interact with colleagues and mentors gradually internalize the knowledge,
skills, and beliefs required to become full, active members of the community. The reviewed
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literature bears witness to the importance of experienced mentors to socially mediate learning
experiences and reflection to successfully enculturate novices into the profession (Chaudoir et
al., 2016; Tyndall & Scott, 2017). This study has shown that a well-designed, scaffolded,
discipline-specific writing course instructed by compassionate, experienced writers can help
orient master’s students to become confident, skilled, reflective authors able to engage in
legitimate peripheral participation within the professional discourse of practitioners and scholars.
Recommendations for Writing Instruction
Based on the discussion of results, findings, and reviewed literature, I have four
recommendations for enhancing the writing instruction offered in graduate nursing programs.
Using sociocultural theory as a framework, these recommendations address ways to prepare the
learning environment, foster social mediation, increase levels and types of scaffolding, and
encourage a self-extending system for scholarly writing students. This section concludes with a
description of an integrated recommendation that combines the four recommendations into a
bundled implementation plan.
Recommendation 1: Attending to Sociocultural Influences and the Instructional Setting
The interviewed students in this study described the many external influences from
various ecosystems that affected their ability to succeed in school. Graduate nursing students are
adult learners who are balancing many responsibilities in addition to school. Faculty cannot
control global pandemics or what students’ primary language might be. However, nursing faculty
can shift the tone for the classroom environment away from “boot camp” to a psychologically
safe place where students can experiment with developing ideas through the written word.
Psychological safety is defined as “a condition in which you feel (1) included, (2) safe to
learn, (3) safe to contribute, and (4) safe to challenge the status quo— all without fear of being
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embarrassed, marginalised [sic], or punished in some way” (Clark, 2020, p. 2). Because many
students expressed anxiety about scholarly writing, the course faculty used principles of
autonomy-supportive teaching to emphasize student choice and control as a method to create
psychological safety and promote student ownership of their written work.
It is an unfortunate but common practice that some faculty equate a structured classroom
with teacher-centric control (Reeve, 2009). With this mindset, a controlling style is typified by
the teacher’s perspective being the “right” one that students must adopt, intruding on students’
thoughts or actions, and pressuring students to think or behave in a specific way (Reeve, 2009).
An example of this style is when a teacher might “impatiently cross out a student’s passive
verbs, label it as bad writing, and require that he use active verbs” (Reeve, 2009, p. 161). The
negative effects that this controlling approach has on student motivation and learning has been
discussed by students in this study as well as in the research literature (Borglin & Fagerström,
2012; Brannon et al., 2008; Diekelmann & Ironside, 1998).
In contrast, an autonomy-supportive and student-centered approach increases student
motivation, learning, and develops an inner locus of control. Autonomy-supportive instructional
practices include letting students make active choices based on interests, providing rationales for
teacher requests, using observational language as opposed to controlling language, giving
students the time needed to engage with tasks, and hearing student frustrations without judgment
(Reeve, 2009).
In the Writing Workshop, students’ autonomy was supported in many ways. For instance,
students chose their paper topics, rationales were provided for all assignments, students were
given reasonable extensions when negotiated with the faculty, and the student was always
respected as the author of their own work. Faculty made suggestions and provided resources,
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strategies, and tips as formative feedback to the author but the revision choices always belonged
to the student. During conferences, students and faculty set the agenda together and students
thoughts and feelings about their writing were always solicited first. Students submitted drafts to
peers and faculty with a cover letter that explained what the author thought was working well in
the draft and what was challenging them. The cover letter served to focus feedback on the most
salient concerns held by the author as well as prompting a dialogue with the reviewer. Students
were scored out of ten points for weekly assignments and needed to achieve an 80% by the
fourth and final draft. The course was pass/fail to minimize students’ concern about grades and
keep the focus on the writing process.
As evidenced in the student interviews, this autonomy-supportive and student-centered
approach to writing instruction produced many benefits. Students were able to take risks with
their writing, share their perceived weaknesses with faculty, learn new skills, and produce
scholarly papers they were personally invested in and proud of. The aim of the first
recommendation is to emphasize the importance of considering the sociocultural, ecological
influences on students’ lives as well as how to promote the psychological safety and autonomy-
supportive environment necessary to deeply engage students in scholarly writing.
Recommendation 2: Fostering the Social Mediation of Learning
Social mediation has been shown to be an impactful method of teaching complex
cognitive processes such as scholarly writing. The social mediation of learning is a fundamental
principle of sociocultural theory whereby a learner’s interaction with a more experienced other,
and/or cognitive tools, facilitates their development and skill mastery. The results of the study
highlighted the success of this writing course and the findings from student interviews confirm
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two forms of mediation as integral instructional components: social mediation of the writing
process via an experienced scholarly writer, and the use of writing-specific cognitive tools.
First, balanced formative feedback on students’ drafts is vital in writing instruction. The
reviewed literature and study findings reveal several important components to this form of social
mediation. Students noted that the feedback they received from their assigned faculty was valued
the most because they were expert writers. Students did solicit input from peers, coworkers, and
family members but attributed their writing growth primarily to the faculty’s weekly comments
on their thinking process and writing assignments throughout the semester. Feedback from an
experienced scholarly writer is strongly recommended in the research (e.g., Andre & Graves,
2013; Gazza et al., 2018; Jefferies et al., 2018; Oermann et al., 2015).
Second, students valued formative feedback that focused on higher-order writing
concerns. The hierarchy of writing concerns was used to guide the revision and feedback process
in the Writing Workshop. This enabled faculty to participate in the evolution of students’
thinking about their chosen problem of interest from the beginning of the inquiry process.
According to sociocultural theory, a student develops “inner speech” from the advice whispered
into their ear from a more experienced person working beside them. It is through this inner
speech that students become enculturated into new ways of thinking.
In this manner, faculty were able to offer individualized instruction within each student’s
ZPD. For example, faculty regularly challenged students to think critically about what they read,
consider other perspectives, clarify their thesis statement, reorganize their ideas for greater
impact, and so on, based on what the student needed at that time. This intellectual generosity
gave students a window into the scholarly writer’s craft. As a result of this regular social
interaction with a writing expert, students engaged in deep, complex thought about their topic as
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well as the writing task. Not only did this high-level of weekly feedback help students produce
well-reasoned and supported arguments, it also taught them how an expert approaches the
scholarly writing process. Based on sociocultural theory, this is how interaction with faculty
transforms students’ approach to scholarly thinking, communication, and discourse within the
profession.
Third, mediation of learning also occurs through the use of cognitive tools. The other
component to students’ success in the writing course was instruction in strategies specific to
scholarly writing. The interviewed students shared a number of strategies that they used as
cognitive tools to help them control the writing process. The hierarchy of writing concerns was
an overarching framework for the revision process. Students were provided with several pages of
revision strategies divided by area of writing concern. These strategies were modeled in video
lectures, during webinars, and sometimes in written or video feedback to students. Students
practiced using the strategies during webinars, the peer review process, and in their weekly
assignments, as was relevant to the task. An important caveat is that faculty never provided more
than two or three strategy suggestions at one time. This reduced cognitive load as well as
reducing faculty workload and the need to comment on everything at once. Mastering these
cognitive tools allowed students to improve their performance and self-efficacy during the post-
course writing assessment. Students reflected on how anxious and confused they felt during the
first assessment. In contrast, they remarked at how confidently they approached the last
assessment because they developed a writing process and had mastered many cognitive tools
throughout the semester.
In summary, the goal of this recommendation is to provide students with the formative
feedback and cognitive tools to increase their writing capacity. The ideal feedback is given
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throughout the writing process, includes a balance of praise and constructive criticism, focuses
on higher-order concerns first, and is generated by an experienced scholarly writer. In this
context, the essence of social mediation is to combine the intellectual generosity of experts with
relevant, effective writing strategies modeled to students as they need them. If the goal is to
nurture the development of scholars and practitioners, warmly treating graduate students as
future colleagues and potential junior faculty is a consequential precedent to set, especially in
combination with Recommendation 1.
Recommendation 3: Increasing the Levels and Types of Scaffolded Instruction
There are several ways to scaffold the writing development of graduate students. In order
to maximize learning with the ZPD, it is crucial to differentiate learning among students as much
as possible. Unlike in a tutoring situation, being responsible for the progress of dozens of
individuals can be a daunting task. In nursing instruction, a commonly held belief is that all
students should be treated equally, despite differences in language, experience, and skill. Known
as practice bias, this idea conflates “fairness” with treating all students in the exact same way
(DeBrew et al., 2014). However, there are numerous problems with practice bias. First, students
differ from one another in many ways (e.g., learning needs, cultural background, experiences,
language, abilities). To provide students who possess multiple differences and needs with the
same instruction and expect them all to succeed is to perpetuate existing inequities. Second,
although clinical faculty claim to fairly assess students by the “same” standards, in reality,
students who are racially or linguistically different from the White female majority are failed
because they do not meet the same cultural, racial, or linguistic “standards” as White, English-
speaking students (DeBrew et al., 2014). The most equitable response is to provide scaffolding
and promote the success of every student.
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This recommendation includes three types of scaffolding. The first is scaffolded course
design. The second is providing clear expectations to students. The third recommendation
involves using a scale of help to differentiate instruction.
As previously noted, instructional design is one effective method to support student
learning. Several researchers advocated for the use of sequenced assignments and breaking larger
tasks into smaller assignments (Gazza & Hunker, 2012; Oermann et al., 2015; Troxler, 2011).
Likewise, interviewed students commented on pertinent aspects of the writing course’s design
and stated the importance of dividing the large paper into shorter exercises and sequencing these
assignments so each part of the writing process was addressed. Students clarified that having
sufficient time to engage with the activities in each module would be helpful. Other aspects of
instructional design were access to lectures through recorded videos, external resources, and an
organized learning management system. Quality Matters is one review method to ensure courses
are meeting standards for online pedagogy and ADA compliance.
The second aspect of instructional design that students valued was clear expectations.
There are numerous ways to clarify instructions. Assignment guidance sheets can be used to
provide students with a rationale for the assignment as well as outlining important parameters
such as number of resources, page length, and citation style. Worked examples, templates, and
worksheets helped interviewed students understand expectations as well. Finally, providing
carefully constructed rubrics clarifies faculty’s grading methods (Gazza & Hunker, 2012; Luthy
et al., 2009; Troxler et al., 2011). Ideally, these assessments should align with course outcomes
so students understand not only how the learning is being evaluated but also how the assignment
is helping them develop a core competency or skill.
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The third element of instructional design is providing for differentiated instruction.
Because students have a wide range of abilities, strengths, and weaknesses, using a scale of help
is one recommended method to accommodate multiple students within their ZPD. In other
courses, it may be more difficult to assess students’ ZPD. With writing instruction, it is fairly
easy to observe how successfully students are mastering various aspects of the assignment. Using
the hierarchy of writing concerns and a rubric based on course outcomes is an important tool for
faculty to use in determining the top two or three priorities for each round of feedback. The scale
of help allows faculty to assess how much support students need to accomplish the task
successfully and which cognitive tool may be of most benefit. A sample scale of help for writing
instruction, going from least to most help, could include the following: (1) whole class
instruction, with scaffolded instructional design and use of clear expectation methods, (2)
modeling use of a strategy, whole class (3) guided practice session with the whole class, (4) a
strategy lesson delivered to a small group of selected students, (5) written feedback to one
student, (6) video feedback modeling use of a selected strategy for one student, (7) a writing
conference with one student to address an urgent or specific need. John C. Bean’s book,
Engaging Ideas (2011), and The Harvard College Writing Program (2007) are two excellent
faculty resources on how to provide strategic, formative feedback on students’ writing.
In summary, the crux of this recommendation is to consider the different options
available to scaffold student instruction. In combination with Recommendations 1 and 2, course
and assignment design can used to support student engagement with writing. Similarly, several
ways for clarifying expectations for written assignments have been offered. Finally, a scale of
help can be employed to maximize learning within the students’ ZPD.
Recommendation 4: Supporting Self-Directed Learning Through Metacognition
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Adopting the first three recommendations will poise students for internalization of the
inner speech of scholars and the appropriation of effective cognitive tools used by writers. The
final recommendation involves helping students cultivate self-direction and greater autonomy by
developing their metacognitive skills. According to Ambrose et al. (2010), the cycle of
metacognition involves several steps: “assessing the task at hand, evaluating one’s own strengths
and weaknesses, planning, monitoring performance along the way, and reflecting on one’s
overall success” (p. 216). This five-step cycle is critical for students to learn in order to continue
to monitor and control their own learning. In the writing intervention, students were given many
opportunities to engage in metacognitive reflection.
The first step in the metacognitive cycle is to assess the task at hand. Students in the
Writing Workshop were supported in this assessment with clear assignment guidance, rubrics,
worked examples, and templates. The writing task was also broken down for them throughout
the entire semester. Another way to support students’ understanding of writing projects is to ask
them to rewrite the objective and describe the necessary steps in their own words (Ambrose et
al., 2010). The second step is to evaluate one’s strengths and weaknesses. In the writing course,
students were given a pre-course survey to assess their writing self-efficacy and task value as
well as a writing test to assess their writing performance in the areas of focus and meaning,
content and development, organization, language usage, and mechanics. This, along with
formative feedback, gave students a more objective view on their writing ability. Metacognition
could be further enhanced by explaining to students what each of these performance areas means
so they could better understand their strengths. Use of self-assessment and practice tests are other
instructional strategies to facilitate this step (Ambrose et al., 2010).
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The third step is planning an approach to complete the assignment. If students have a
false sense of their strengths and weaknesses, they may not plan enough time to study or they
may feel defeated before they begin. In the writing intervention, a plan for completing the final
writing project was already provided and sequenced for students throughout the semester.
Students also had opportunities to set their own goals. For example, at the beginning of the
writing course, students were asked to set an overall goal for their writing development. During
the peer review, student authors outlined specific areas where they desired feedback. At the end
of the course, students wrote a reflection paper where they were asked to describe the writing
process and strategies they used throughout the semester to write their paper and evaluate how
well they met their initial writing goal. Another method to teach the skill of planning is to create
an assignment where the objective is for each student to describe their plan of attack and strategy
usage for a specific problem, without requiring students to implement the plan (Ambrose et al.,
2010). This strategy emphasizes the importance of planning.
The fourth step is monitoring performance and application of strategies. In the Writing
Workshop, this was accomplished in a few ways. For example, the peer review process was an
exercise that guided students through reading a peer’s paper, providing balanced feedback,
making two higher-order recommendations for improvement, suggesting the use of two revision
strategies, and checking if the citations in the paper were included in the references. Many of the
interviewed students claimed that after the peer review, they were able to apply the same process
to revising their own work, thus learning an effective method to monitor their own revisions.
Students also wrote cover letters that accompanied their first draft to peers and then to faculty.
These letters prompted student authors to share what they liked about their paper and what was
still challenging. Faculty responded to these cover letters and the dialogue was continued with
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the students’ letter of response to faculty, discussing how they chose to incorporate faculty
feedback (or not) into their revision process. One interviewed student mentioned this letter
exchange as the most impactful tool they used for monitoring their revision process. Lastly,
students were provided with a line editing webinar and a checklist of 19 common errors to guide
their own proofreading before submitting the final draft. These are all practical methods to teach
students how to monitor their writing and strategically apply new cognitive tools.
The fifth step in the metacognitive cycle is reflecting on one’s success and adjusting
course as needed. A structured process for reflection enhances metacognition and strategic
transfer of skills. For example, to improve test taking skills and content knowledge, faculty can
use exam wrappers after tests. These exam wrappers ask students to notice the types of errors
they made, how they studied, and how they might better prepare for the next exam (Ambrose et
al., 2010). In addition to the elements of metacognition infused throughout the writing course,
students wrote a final reflection paper with several prompts (this assignment is presented in
Appendix K). The self-analysis of pre- and post-course self-efficacy and writing test scores was
an opportunity for students to witness their gains in confidence and writing capacity as a result of
their hard work. The reflection paper encouraged students to set new writing goals and determine
what strategies might help them reach those goals. Interviewed students responded with a range
of academic and professional goals, along with a curated list of writing strategies they found to
be most effective and how they plan to use them in novel contexts like writing proposals,
preparing presentations, or even sending an important email. Ideally, students would have the
chance to continue this goal setting, planning, and evaluation process throughout a program of
study with a systematized process to scaffold their metacognitive development.
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Using this metacognitive cycle is a practical method to teach students how to become
self-directed learners. Goal setting, reflection, and opportunities for evaluating one’s
performance not only teach an important skillset, but it also encourages strategic use of cognitive
tools and helps students develop healthier beliefs about intelligence, such as fostering a growth
mindset. As opposed to a fixed mindset where a learner believes they are either born with the
innate skill to be a good writer or not, a growth mindset attributes success to effort, study skills,
and behavior the learner can actually control (Dweck, 2006). High self-efficacy and a growth
mindset have been shown to positively influence students’ motivation, including time-on-task,
perseverance, and active choice to engage in a specific activity (Hodges, 2017). Since a main
goal of graduate education is to impart deep, nuanced learning that promotes students’ entry into
a new community of professional practice, teaching students how to be self-directed learners is a
vital part of ensuring their continued success in their graduate program and beyond.
Integrated Recommendations
Scholarly writing instruction can be an effective method to orient students into a
discipline and encourage students to find and use their own voice (Mitchell, 2018). Perhaps the
most obvious recommendation, based on the promising results and findings of this study, is for
all nursing programs to require students who are returning to school for a bachelor’s degree or
graduate degree to complete an appropriately leveled writing course as an introduction to the
principles of scholarly writing within the profession. Furthermore, embedding these research-
based writing and instructional techniques throughout a program of study has the capacity to
yield even greater gains in students’ cognitive development over time.
Even though every student who completed the study intervention improved their writing
performance scores, some of the students who received the most support harbored concerns
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about their ability to maintain growth on their own, and rightfully so. Requiring a discipline-
specific writing course like the Writing Workshop equips every student with foundational
cognitive tools in scholarly thought and writing. However, one course is not enough; it is only an
introduction to scholarship. To ensure the continued success of even the most fragile writers, an
integrated writing across the curriculum approach is highly recommended in the research
literature (e.g., Cowles et al., 2001; Hawks et al., 2016; Luthy et al., 2009; Oermann et al., 2015;
WAC Clearinghouse, 2014; Zygmont & Schaefer, 2006).
Writing across the curriculum (WAC) is a research-based method to integrate the four
recommendations presented. WAC, in its simplest definition, is an organized and sustained plan
to support faculty in their intentional use of writing (WAC, n.d.). The underlying assumptions of
WAC are that writing is connected to thinking and transformative learning, writing occurs within
a sociocultural context, and therefore, writing belongs in discipline-specific courses and is the
responsibility of all program faculty to teach (McLeod & Soven, 2000). A suggested WAC
model for nursing schools, based on the aforementioned study recommendations, would focus on
a writing in the disciplines approach to help students master specific nursing or healthcare-
related competencies throughout a program of study. A basic plan would begin with a required
scholarly writing course and include a sequence of writing-intensive courses through a master’s
program, ending with a multimodal capstone project that emphasized writing. Writing-intensive
courses provide students with opportunities to receive formative feedback on drafts and complete
revision work. This model predicates the need for faculty of writing-intensive courses to be
trained in writing pedagogy (Cardinal, 2021). A writing enriched curriculum approach could
engage faculty in deeper conversations about their values and beliefs regarding scholarly writing
but external support is recommended to guide these endeavors (Bastian, 2014). One approach to
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provide faculty with external supports is commonly known as the “push-in” method in K-12
education. The Lake Shore School of Nursing has trialed a co-teaching model where writing
support specialists “push-in” to writing intensive courses. These specialists work with faculty to
revise writing assignments and assessments and create opportunities for students to receive
formative feedback. Because the specialist is more familiar with the course as a co-planner and
teacher, they are better able to assist students with their discipline-specific writing. This method
also provides professional development and instructional design services for nursing faculty
without detracting from the time they need to teach and assess other nursing competencies.
While some coaching models require students to solicit writing help outside of class, this
approach perpetuates disparities because the students who could benefit the most from additional
support rarely participate (Fry et al., 2019). In contrast, the co-teaching model benefits all
students because the writing support is embedded within the course. This model benefits faculty
by promoting the cross-pollination of ideas, so nursing faculty learn more about writing
pedagogy and writing specialists learn how to support students with writing in the discipline.
Additionally, it maximizes the time of nursing faculty, who are in short supply and often have
the expectation to work clinically and/or produce research. Furthermore, writing-intensive
courses can be sequenced to grow in writing challenge and complexity over time so graduate
students build capacity for publishing articles or creating poster presentations as a culminating
scholarship activity. The publication potential between nursing faculty, students, and writing
specialists would likely increase with a WAC program that supports the promotion of
scholarship across the entire school community.
An important consideration in assessing student writing is potential bias based on race
and ethnicity. Scholars still uphold the expectation that all students use the “standard” English of
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middle and upper class Whites (Bean, 2011; Rosa, 2016). This intervention does show evidence
of improving the writing capacity of students from diverse language backgrounds in becoming
more effective scholarly writers. However, the voices of raciolinguistically diverse students
deserve to be heard with the richness of their culture intact (Mitchell, 2017; Rosa, 2016; Ryan et
al., 2013). Scholarly writing within nursing has not yet embraced other non-standard forms of
English (Mitchell, 2018; Ryan et al., 2013). One way to facilitate nursing schools moving toward
this goal would be to adopt multidimensional assessment methods, like an e-portfolio, that would
allow for other modes of scholarly expression beyond one, potentially exclusionary form.
An e-portfolio assessment, combined with WAC, offers the ability to observe students’
writing and thinking development over time and in various contexts. An e-portfolio is a “student-
curated collection of learning artifacts and reflections” with the goal of making “learning visible
to the student and to others” (Eynon & Gambino, 2017, p. 10). There are different approaches to
portfolio assessment but the use of signature assignments, where all students reflect upon the
same learning activities at set points throughout the program, can be an opportune method of
viewing students’ writing and thinking development over time. With signature assignments from
writing-intensive courses, students can be given the opportunity to revise previous work for
wider dissemination. Students also have the choice to include other self-selected artifacts to
reflect upon or share during the review process, to assess learning beyond the classroom (e.g.,
service learning projects, volunteerism, community-based research projects, or clinical work).
E-portfolios are beneficial to faculty because it allows a more holistic, multimodal
evaluation of student learning and it benefits schools by documenting student learning across the
curriculum (Eynon & Gambino, 2017). In fact, the American Association of Collegiate
Registrars and Admissions Officers (n.d.) is embracing the use of a Comprehensive Learner
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Record (CLR) as a standardized repository for all students’ higher education experiences for
national use. Guided by program learning outcomes, competencies, and student goals, the e-
portfolio and CLR allows students to tell the story of their learning and guides reflection to
stimulate metacognition (Bowman et al., 2016), self-directed learning, and the development of
professional identity (Eynon & Gambino, 2017).
In summary, the four recommendations presented in this study can be meaningfully
integrated by instituting WAC programs in nursing schools and using an e-portfolio to assess
student learning. A WAC initiative presupposes ongoing faculty development in writing
pedagogy. Using writing specialists to embed scaffolded support for students, and faculty, in
writing-intensive courses is salient for the current needs of nursing professors. Likewise, this
cross-discipline faculty collaboration can serve as motivation to learn from one another and work
together on scholarly publications and research. Signature assignments create milestones where
students can periodically reflect on their learning progress towards meeting program
competencies, outcomes, and personal goals. An e-portfolio can guide students’ learning,
provide more robust student assessment for faculty, and generate data for program evaluation. A
school- or institution-wide design for WAC would amplify the instructional success exemplified
in this study, create more intellectually generous communities of scholarly writers, and empower
students to develop their identity, and their voice, within the healthcare profession.
Limitations and Delimitations
This study included several limitations and delimitations. Limitations are important to
acknowledge so future research can be advanced (Creswell & Creswell, 2018). The first
limitation was a lack of a sufficient control group because the Writing Workshop is typically the
first class that master’s students take. A large, convenient control group did not exist within the
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school. Without a control, it may be possible that students’ improvements were due to factors
other than the intervention (e.g., taking other courses, maturity, returning to school after a long
absence). The second limitation is due to the study’s methodology. Because specific components
of the intervention were not individually measured, the intervention should be viewed as a
combination of effective practices. Additionally, there may be other writing practices that were
not included in this study that may also be effective. Third, the study took place in the midst of a
global pandemic and nursing shortage that impacted the attrition rate of students enrolled in the
course, which may have undermined validity. Fourth, the lead instructor for the writing
intervention was a literacy teacher with over 30 years of teaching experience. This may impact
attempts to replicate the intervention results with less-experienced faculty, or those with less
expertise in writing pedagogy. Fifth, the studied writing class was a less racially diverse sample
than usual for this institution, perhaps because of similar factors that influenced the student
attrition rate, and may affect the generalizability of the study to other populations. Sixth, there
was a time limitation. Ideally, graduate students’ writing development would be studied over the
course of their entire graduate degree program. Although this study could serve as a baseline for
a longitudinal study in the future, student development was only examined over the course of one
semester. Lastly, the study is limited by factors such as the honesty of participants when
responding to the survey and interview questions, or life circumstances that may have precluded
a student’s full attention to, and experience of, the writing intervention.
There were several intentional boundaries, also known as delimitations, set for this study.
The first delimitation was that the study did not include survey or interview questions about
students who may have a first language other than English, culture of origin, or at what age
students learned English. Although research exists about writing development of domestic and
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non-domestic students that do not speak English as a primary language, this population was not
the focus of the study because English proficiency is a requirement for the master’s program.
The assumption was there would be few students in this category. Likewise, previous writing
research has also explored the writing development of students with learning disabilities. Again,
there are so few students with documented learning disabilities in the school that this research
was not included in the literature review and that population was not a focus of this study. The
third delimitation was the survey did not include questions about how long students had been
away from college studies, how many semesters of graduate work they had completed, or how
many other writing courses they had taken before. These questions may be areas for future
investigation regarding the effect of prior knowledge and writing experience on students’ writing
development. Lastly, the collected data were from one discipline-specific writing class in a
master’s program in one nursing school and may not reflect writing instruction in other contexts
or institutions.
Recommendations for Future Research
This study explored the student experiences of master’s nursing students. As a result of
analyzing these data, several recommendations for future research emerged. First, the study did
not include a control group to determine if outcomes were solely attributable to the intervention.
A future replication of this study could include a control group to address possible confounding
variables. Second, longitudinal studies are needed to evaluate whether gains in students’ writing
and self-efficacy are retained, particularly upon completion of the master’s program. Third,
future studies could explore the influence of various factors on students’ self-efficacy and
writing capacity. Demographic factors to analyze might include students with a primary
language other than English, first generation college students, students from underrepresented
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groups, or students who are neurodivergent. Lastly, in reviewing the qualitative results, students
highlighted elements of the course that corresponded with a cognitive apprenticeship model of
instruction. Future studies could examine the effects of a writing intervention using the cognitive
apprenticeship model as a theoretical framework.
Implications for Equity
The profession of nursing has the potential to launch people from underrepresented
groups or low socioeconomic status into a lucrative career with opportunities for advancement.
Indeed, many nurses begin as licensed practical nurses (LPNs) or in associate degree programs to
become registered nurses (RNs). As RNs, they can pursue avenues of advanced practice nursing,
leadership roles, teaching jobs, and doctoral study. The flexibility of career pathways makes
nursing, more than any other profession, a thoroughfare for social mobility. For example, people
in the Philippines are able to become nurses, emigrate to the U.S. and enter the middle class.
In order for students from underrepresented groups, cultures, and raciolinguistic
backgrounds to become nurses, higher education faculty and administrators must prioritize
instruction that has strong outcomes across all demographics. Supporting the development of
nursing students’ writing and thinking capacity has the potential to empower students from
underrepresented and low socioeconomic groups to not only enter the profession but to enable
their ongoing success in graduate school and as future leaders, scholars, faculty, and researchers.
Research-based writing pedagogy in nursing is a key component to bridging the current racial
concordance gap in the profession by providing scaffolded instruction that clearly guides
students in the process of thinking, communicating, and taking action as effective nurses. In
other words, faculty cannot place blame on students for failing if the faculty have not carefully
considered how to meet these demonstrated student needs: how to make a safe environment for
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student learning, how to provide scaffolded instruction to maximize students’ zones of proximal
development, how to foster self-directed learning, and how to enthusiastically mentor students
into the discipline and nurture their journey into scholarship. A sociocultural approach to
instruction is crucial for students who are first-generation college students, from low
socioeconomic status, or from other underrepresented groups. These are the students who tend to
lack the social capital, language skills, and mentorship opportunities that White, upper and
middle class students, and faculty, often take for granted, thereby reinforcing educational and
economic disparities. Continued research and use of evidence-based pedagogy can help eradicate
these inequities.
Conclusion
Nursing faculty have struggled with finding recommendations for writing instruction that
have been evaluated for their potency. This study demonstrates that a discipline-specific writing
course can have a significant effect on improving graduate nursing students’ writing capacity and
development. In 1984, Benjamin Bloom challenged educational researchers to explore group
interventions that parallel the outcomes of high-quality tutoring. One-on-one tutoring has been
shown to create a maximum effect on student learning when compared to other instructional
methods, with an effect size of two. The instructional methods used in the Writing Workshop
show great promise in meeting Bloom’s challenge. Although a control group was not used, the
quasi-experimental study did show significant growth in students’ writing performance with an
effect size of two, matching the sought-after effects of tutoring. These results provide evidence
that a writing intervention, with its roots in sociocultural pedagogy, can have a compelling
impact on students’ writing performance and self-efficacy in only one semester. The richness of
the qualitative data underscore the importance of the social elements and scaffolds necessary to
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become an effective writer within the context of a specific discipline. The intentional use of
scaffolding and reflection is critical to improve the writing capacity of novices. Moreover,
scholarly writing is a social act. Instructional design that leverages the impact of faculty and the
sociocultural environment is critical in developing the unique voices of master’s students as well
as providing students with an inclusive, hearty welcome into an esteemed community of
scholarship.

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Appendix A: Course Schedule for the Writing Workshop Fall 2021
Learning Objectives
1. Define a current problem in healthcare or healthcare organizations.
2. Develop a clear thesis and outline that synthesizes relevant policies, evidence, and research on the identified problem.
3. Effectively revise your writing based on feedback and the rhetorical context (audience, format, and purpose).
4. Write a concise, evidence-based argument to support reasonable recommendations and refute at least one main
counterargument.
5. Demonstrate correct use of current APA style (principles of academic honesty, bias-free language, grammar, sentence
mechanics, and a formal academic writing tone).
6. Reflect upon your development as a scholarly writer, including your educational and professional goals.

Date Topics Readings/Resources Assignments and Activities
Intro
Module
8/25 –
8/31
Course overview
Intros
The Writing
Process, Topic
Selection

Please review Sexual harassment policy, Intro
Video and:
Course syllabus, Course schedule, Learning
Modules (LM) and assignment, APA Manual,
Review Blackboard (Bb) Tutorial as needed.
Video lecture on the Writing Process, read about
psychological safety.
1. Read and sign the Professional and
Academic Honesty
2. Complete the Writing Assessment and Self-
Efficacy Survey in the Intro Module
3. Complete the Intro Quiz in Bb
4. Introduce yourself via the Discussion Board
5. Select a topic, complete problem statement
worksheet
9/1 – 9/7
LM #1
Critical Reading and
Note-Taking
Videos on Critical Reading and Analytic Summary
Read Chapter 1, attending to pages 3-11, in APA
manual
1. Complete quiz on readings
2. Complete analytic summary for one
research study

9/8 –
9/14
LM #2
Framing the
Problem, Crediting
Sources
1. Read chapter 8, page 21, and pages 75-78 on
Introductions in APA manual.
2. Watch video on Systemic Racism
1. Write a problem statement
2. APA Quiz
196

9/15 –
9/21
LM #3
Literature Synthesis View Andrew Wolf’s Panopto video on literature
synthesis
1. Literature matrix on 3 research studies (no
literature reviews, please)
9/22 –
9/28
LM #4
Thesis Development View video on thesis statements and read thesis
worksheet
Skim APA chapter 7
1. Literature matrix on 6 research articles and
one thesis statement.
9/29 –
10/5
LM #5
Outlines 1. Watch Outline video
2. Read example outline
1. Sentence Outline 1
Webinar on the Basic Paragraph Model
10/6 –
10/12
LM #6

Oppositions and
Refutations
Review lecture materials
Read chapter 2 in APA manual
Lecture on Oppositions and Refutations
1. Complete Outline 2: Recommendations,
Opposition, and Refutation; Revise Outline 1
based on faculty feedback
2. APA quiz
10/13 –
10/19
LM #7
Rhetorical Forms,
Body Paragraphs
and Transitions
Review lecture materials
Refer to chapters 9 and 10 as needed to complete
title page and references
1. FIRST DRAFT DUE IN BB AND TO
PEER REVIEW PARTNER
2. Faculty will review ONLY the title and
references page of first draft

10/20 –
10/26
LM #8

Peer Review Process
and Hierarchy of
Concerns
1. Hierarchy of Concerns lecture
2. Read peer review process
3. Read chapter 5 in APA manual
1. Peer review due in Bb and returned to peer
review partner
10/27 –
11/2
LM #9

Logical Fallacies
and the Revision
Process
Review information on logical fallacies

1. SECOND DRAFT due in Bb. (Review Safe
Assign report for plagiarism detection.)
2. Quiz on logical fallacies
11/3 –
11/9
LM #10
Grammar Review,
Writing a
Conclusion
1. Review Conclusions info.
2. Read chapter 4 in APA manual
1. Grammar quiz due
2. Check-in with your assigned faculty about
second draft.
197

11/10 –
11/16
LM #11
Line Editing and
Proofreading
1. Line editing webinar
2. Proofreading strategies and 19 Errors worksheet
3. Skim chapter 6 in APA manual
1. THIRD DRAFT due in Bb, with Letter of
Response.
Line editing webinar on Friday, November
15
th

11/17 –
11/23
Revision in Action Watch an example of how faculty revise their
written work!
Self-Efficacy Survey will be sent out via email.

Writing conferences, as needed.
If you are waiting for faculty feedback, you
can complete the Writing Assessment and
Self-Efficacy Survey in LM 13 now.

11/29 –
12/3
LM #12
Final Draft Schedule a writing conference with your assigned
faculty if needed
FINAL DRAFT DUE by 11:59 pm on Friday
12/4

12/4 –
12/8
LM #13
Final Reflection Review information on the importance of reflection
Reflect on what you have learned and
accomplished!
Course Evaluations and Teacher Evaluations
Complete the Writing Assessment and Self-
Efficacy Survey (needed to complete Final
Reflection)
Final Reflection due
198
201

Appendix B: Hierarchy of Writing Concerns
THE HIERARCHY OF WRITING CONCERNS

1) Thesis/Focus: the topic is narrow enough for the constraints of the assignment; a thesis
statement presents the author’s position including what they would like to persuade the audience
to think, feel, or do after reading the paper; the urgent problem, context, and background is
thoroughly presented by building upon existing scholarly conversation; and, the target audience
is identified or easily inferred.

2) Development of Ideas: the main ideas of the paper are clearly stated, the author provides
sufficient support for the thesis using a chain of logical reasoning, statistics, a summary of
relevant research, examples, definitions, details, analysis, sufficient explanation of the evidence
provided, and how it connects to and supports the author’s position.

3) Organization or Rhetorical Format: the paper is organized using a specific rhetorical format
(problem/solution, cause/effect, classical argument, compare/contrast, narrative, etc.), the main
ideas are presented in a way that logically flows (least to most important, chronological, general
to specific, use of logical syllogisms, etc.), attending to the format preferred by the profession
(APA style, literature review, policy paper, ethical decision making, SOAP note, etc.).

4) Internal Paragraph Organization and Transitions: Each paragraph contains only one idea,
generally stated in the topic sentence, the main idea is supported with evidence and reasoning,
the sentences are organized in service of the topic sentence, and transitions between paragraphs
are used to move the argument forward.

5) Sentence Mechanics and Style: the writing is free of grammatical and spelling errors, the
writing uses the appropriate citation style (APA, etc.), line editing has been used to improve
clarity, concision, active voice, and style.

Teaching with the Hierarchy of Concerns

Hierarchy refers to the chronological order in which each of these elements should be addressed
when helping writers revise, not the weight or degree of importance of each element.

To respond to the author, select one or two of these concerns, and respond to them in the order
in which they are presented here, as the essay requires. For example, if the essay presents a (1)
solid thesis or focus, then respond to (2) development and/or (3) organization; however, if the
essay does not present a (1) a solid thesis or focus, then address this concern first.

This approach keeps your feedback focused without overwhelming the author. It helps the author
understand where they are in the writing process and how much revision work remains ahead. It
is efficient for the reader and the author because neither is spending time on lower level
concerns, such as line editing, before the main ideas are fully developed, organized, and revised.

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Appendix C: Final Rubric for The Writing Workshop
Dimensions of Writing
Expectations
Demonstrates
Mastery
Meets
Majority of
Expectations
Does Not
Consistently
Meet >50%
Expectations
Meets Few
to None of
Expectations
Focus: Statement of Problem,
Identified Focus, and Relevant Context
- Clearly and succinctly identifies an
important problem.
- Presents necessary evidence, context,
history, definitions, policies, and
background information.
- Builds upon recent, relevant literature,
identifies gaps, and appropriately
addresses a target audience.
- States a clear thesis, focus, topic, or
question to explore.
19.5-20 16-19.4 12-15.9 0-11.9
Argument Development: Critical
Thinking, Logic, Findings
- Main ideas are sufficiently developed
with reasoning, statistics, study results,
and relevant information.
- Main ideas progress to form a logical
chain of reasoning that offers strong
support for the final recommendation or
conclusion.
- Multiple perspectives and potential
objections or critiques of
recommendation are addressed.
- Paper concludes with a clear summary
of argument, recommendations, and
relevance to practice.
19.5-20 16-19.4 12-15.9 0-11.9
Use of Evidence: Source Quantity,
Quality, Application, and Synthesis
- Sources are sufficient in number and
quality, as specified in assignment
guidance.
- Evidence/research results are fairly
represented and summarized.
- Paraphrasing is an accurate
representation of the primary source;
direct quotes are used sparingly.
- Evidence represents different
perspectives to sufficiently explore the
stated problem or issue.
- The evidence from the literature is
synthesized into patterns or themes that
are adequately discussed in relation to the
problem or focus.
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Organization: Document and
Paragraph Structure
- Follows document organization in
assignment guidance.
- Thoughtful use of title and headings.
19.5-20 16-19.4 12-15.9 0-11.9
203

- Each paragraph contains one idea stated
in the topic sentence and maintained
throughout the paragraph.
- Transitions are used to move the
argument forward.
- Paper flows, without redundancy, at all
levels.
Scholarly Conventions and Mechanics
- Sentences are readable and
grammatically correct.
- Writing is proofread and free of
spelling errors, grammar/spell checker
was used.
- Writing is clear, concise, formal,
interesting, in the active voice, objective,
and free from bias and
anthropomorphisms.
- Writing is appropriately leveled to
intended audience.
- All ideas, words, and research
belonging to others are properly
attributed in-text and in the references
section.
- Conventions for document format are
followed, as stated in the current APA
manual.
19.5-20 16-19.4 12-15.9 0-11.9
Score:
Formative Faculty Feedback on Drafts
1. What student did well:
2. Recommendations for improvement:
3. Revision strategies based on hierarchy of concerns:
4. Summary:

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Appendix D: Survey Questions
Instructions: As you respond to the items in this survey, please visualize any past writing
experiences you’ve had while writing at the post-secondary (university or college) level.
Experiences you had prior to university or college may contribute to how you self-assess your
writing abilities in the areas described in the instrument.

Rate what you think is your ability to successfully achieve each task presented in the question
with a score of 0 meaning you are “completely sure you cannot” successfully perform that item
and 10 meaning you are “completely sure you can” successfully perform the item.

Writing Essentials
1. Even when the writing is hard, I can find ways to overcome my writing difficulties.
2. I can successfully use scholarly, academic words and phrases when writing in my
courses.
3. I can combine or synthesize multiple sources I’ve read to create an original product or
text.
4. I am confident that I can successfully complete scholarly writing assignments in master’s
level nursing courses.

Relational Reflective Writing
5. When I write, I can think about my audience and write so they clearly understand my
meaning.
6. When I receive feedback on my writing, no matter how it makes me feel, I can use that
feedback to improve my writing in the future.
7. When I reflect on what I am writing, I can make my writing better.
8. When I read articles about my topic, the connections I feel with the ideas of other authors
can inspire me to express my own ideas in writing.
9. When I look at the overall picture I’ve presented in my writing, I can assess how all the
pieces tell the complete story of my topic or argument.

Creative Identity
10. I can use creativity when writing a scholarly paper.
11. I feel I can give my writing a creative spark and still sound professional.
12. I feel I can develop my own writing voice (ways of speaking in my writing that are
uniquely me).
13. Even with very specific assignment guidelines, I can find ways of writing my assignment
to make it original or unique.

Task Value
Rate your answers to the following statements with 0 meaning “not at all” and 10 meaning
“extremely.”
205

14. I think I will be able to use what I learn about scholarly writing in The Writing Workshop
in other courses in my graduate program.
15. It is important for me to learn how to write like a nursing scholar.
16. I am very interested in the content of The Writing Workshop
17. I think the course material in The Writing Workshop is useful for me to learn as a
professional in healthcare.
18. I like learning how to become a better writer.
19. Understanding the scholarly writing process is very important to me.

Note: These survey questions, except for the task value items, are from the “Situated Academic
Writing Self-Efficacy Scale” by Mitchell, K. M., McMillan, D. E., Lobchuk, M. M., & Nickel,
N. (2021). Development and validation of the Situated Academic Writing Self-Efficacy Scale
(SAWSES). Assessing Writing, 48(2), 100524. https://doi.org/10.1016/j.asw.2021.100524

The task value items are adapted from “A manual for the use of the motivated strategies for
learning questionnaire” by Pintrich, P. R., Smith, D. A. F., Garcia, T., & McKeachie, W. J.
(1991). A manual for the use of the motivated strategies for learning questionnaire. Technical
report no. 91-B-004. The Regents of The University of Michigan.
206

Appendix E: Summary of Survey Psychometric Properties
Psychometric Properties from the “Situated Academic Writing Self-Efficacy Scale”
Exploratory Factor Analysis in 255 Nursing Students:
● Three factor scale explained 61% of scale variance
● RMSEA (90% CI) = .068(.052-.081); TLI = .95; CFI = .97; RMSR = .03
Multigroup Confirmatory Factor Analysis (543 Interdisciplinary undergraduate students; 264
Interdisciplinary graduate students)
Table E1
Multigroup CFA Tests of Goodness of Fit and Measurement Invariance on SAWSES

Parallel form reliability – electronic version verses a paper version of the questionnaire
using a 0-100 mm visual analog scale for each item (56 Nursing students)

Total scale: r = .91
Writing essentials: r = .85
Relational reflective: r = .88 Creative identity: r = .88

Cronbach’s alpha (255 Nursing students; 543 Interdisciplinary undergraduate students;
264 Interdisciplinary graduate students) line
Total scale: a = .94-.95
Writing essentials: a = .79-.81
Relational reflective: a = .88-.91
Creative identity: a = .88-.91

Concurrent Validity: (234 Nursing Students)
Self-Efficacy Scale for Academic Writing (Mitchell et al., 2017) r = .59 – a process focused
instrument
Writing Self-Efficacy Instrument (Shell et al., 1989) r = .50 – a grammar and mechanics focused
instrument

207

Hypothesis Testing: (234 Nursing Students)
Writing Apprehension (Daly & Miller, 2013) b = .625
A single item assessing perceived classroom writing support b = .271

Note. From the “Situated Academic Writing Self-Efficacy Scale” by Mitchell, K. M., McMillan,
D. E., Lobchuk, M. M., & Nickel, N. (2021). Development and validation of the Situated
Academic Writing Self-Efficacy Scale (SAWSES). Assessing Writing, 48(2), 100524.
https://doi.org/10.1016/j.asw.2021.100524

208

Appendix F: Descriptive Statistics for Task Value Survey Items

Note. From “A manual for the use of the motivated strategies for learning questionnaire” by
Pintrich, P. R., Smith, D. A. F., Garcia, T., & McKeachie, W. J. (1991). A manual for the use of
the motivated strategies for learning questionnaire. Technical report no. 91-B-004. The Regents
of The University of Michigan.
209

Appendix G: Interview Protocol
Interview Questions Potential Probes

1. What is your intended major in the master’s
program?
Which classes have you taken at the
school of nursing before this one?

2. Tell me about your current job. What are your career goals for the future?

3. How would you define scholarly writing? What would you say the purpose of
scholarly writing is, within the field of
healthcare management and nursing?

4. Describe the process you used to write a paper
before taking this course.
Prompts: For example, where did you usually
write? When did you usually write? Who did you
ask for help or feedback on your writing, if
anyone?
How has your writing process changed as
a result of taking the Writing Workshop,
if at all? (Revisit prompts again, as
needed.)

5. How do you feel about the revision process
used in the writing workshop?
What was your usual approach to
revising your writing, before taking this
class?

6. Based on the Hierarchy of Writing Concerns
(focus, development, organization, paragraphs,
and sentence structure), which areas were your
biggest challenges and successes in this class?
What has helped you manage this
challenge, if anything? Were there any
specific strategies you learned in this
class that helped you address this
challenge, if any.

7. What changes did you notice in your writing
test scores from the beginning of the semester to
the end?
What changes did you notice in your
confidence scores from the self-efficacy
survey at the beginning of the semester to
the end? What was it like to see those
changes?

8. What connections do you see between the type
of work you did in this class and your current job,
if any?
In what ways has this course changed the
way you think or act at work, if at all?
How has this course prepared you for
your future career, if at all?

9. How did your interactions with peers contribute
to your experience in The Writing Workshop, if at
all?
What was the peer review process like for
you? Tell me about any interactions you
had with classmates outside of class, if
any.

10. What was it like working with the same
faculty member throughout the course?
In what ways did you communicate with
your assigned faculty member?
210

Interview Questions Potential Probes

11. Tell me about any meetings you had with your
assigned faculty.

Describe what happened in the meeting.
How did you feel about the meeting?
12. What feedback do you remember receiving
from your writing faculty? (Refer to feedback on
third draft if needed.)
What surprised you about the feedback
you received, if anything? How did the
faculty’s feedback impact your learning?

13. How did working with your assigned writing
faculty affect your confidence in your writing
ability?
How could the faculty have supported
your writing development more?

14. What things within and outside the class
affected your motivation to write in this class?
(e.g., family, work, co-workers, other classes, the
pandemic, etc.)
Is there anything else you’d like to share
about your experience with the faculty or
peers in this course?

15. Tell me about a time when you worked with a
writing coach or librarian this semester, if at all?
Could you tell me more about that?
What did you learn from your meeting?

16. Why did you decide to reach out to a writing
coach or librarian (or not)?
How did working with the coach or
librarian meet your needs, if at all? (Or:
Did you use any other school resources to
help you this semester?)

17. If the student worked with a writing coach:
How did you feel about the feedback the writing
coach gave you?
How would you feel about working with
a coach again?

18. What could the coach or librarian have done to
help you more, if anything?

19. What was the most important thing you
learned to do in this class?

20. Some people say that true learning is
transformative. How did this class transform you,
if at all?

How has this class changed the way you
think as a nurse (or manager) now, if at
all?
21. What might you say to a co-worker who was
thinking about taking this class?

22. How could your learning experience in the
writing course have been improved?
Is there anything else you’d like me to
know about your experience in the
writing course?

211

Appendix H: Students’ Interview Responses Regarding Transformations
Table H1: Students’ Reflections on Changes in Their Self-Efficacy Scores
Participant What changes did you notice in your self-efficacy survey responses at the
beginning of the class versus the end?
Cadence My confidence increased, definitely, just because in the beginning, I had
nothing. It really, it had been a long time since I had to write and I know, I'm
not a strong writer. But my competence now, you know, in my HR class, I
had a final paper that I had to research. And I followed a lot of the same
process. So developing my thesis, knowing my topic, finding the papers to
back it up, all of those things, I was using those strategies. So I know that it
definitely works. So that part, I felt, did boost my confidence, at least I knew
some of those steps to working with and using the online library, meeting
with the librarian, so they helped with that as well. So finding out how to
find those articles.
Noel So I went, it went up, the score, I didn't feel confident at all at the beginning.
And then at the end I feel confident that I can write an essay, and start
writing it, no problem. Like, I just know how to start it and kind of how to
organize those ideas. So depending on the topic, and use my resources, the
librarian. … And I told my husband, I was telling him how well I did on the
essay and, how proud I felt. He was like, “Yeah, I'm proud of you!” It felt
great. Just to see how much I progressed in the class. So, that was good.
Lyric I think I'm more confident now. I think the reason I become more confident is I
just enjoy writing. Just enjoy it, don't overthinking it. I think like sometimes,
the lack of confidence is, it's just because we're overthinking it. Just like, the
purpose of writing is like learning English. Like, I used to be very self-
conscious about my accent, this and that. And now I'm just like, as long as
people understand me, I think that's okay. That's the purpose of the language
is to deliver what you're trying to say. Maybe it takes longer for people to
get at what you are trying to say, but the purpose is to deliver the
information and as long as you can do that, and you can perfect that through
the practice. I think this is the biggest lesson I've learned for this class. Yeah,
deliver the message and then perfect that while you are doing it.
Eden Um, so I was definitely fours and fives for confidence. Everything, I was like,
below average, where I felt writing-wise, confident in writing. And then oh,
by the end I'm probably seven, eight or nine depending on the topic. So
100% now, I don't feel afraid submitting my writing. I'm 100% positive like,
I'll write a paper and be okay with it (laughter).
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Participant What changes did you notice in your self-efficacy survey responses at the
beginning of the class versus the end?
Melody I definitely felt like my confidence grew but I don't remember the exact
scoring, to be honest, on that one, but I definitely feel more confident...I
believe I rated myself [at the end of the course] I want to say maybe a nine?
… It was quite gratifying.
Justice I think overall, I started as an eight [in self-efficacy], I felt again, coming into
the course I felt fairly confident as a writer. . . so that stayed as an eight but
with … most of the other ones, I went up one digit, you know, so I can
successfully use scholarly and academic words and phrases, I started as an
eight, I went through. And same thing with combining and synthesizing
multiple sources, I went from an eight, and grew to a nine. And so for each
of the individual questions, I've improved by a score of one, but the overall
confidence stayed at an eight. I … feel confident, but definitely know that
there's probably still some room for growth.
Jubilee I would say my, I didn't notice a big change. But now that I'm actually like, my
attitude changed a lot from the beginning to the end, like I came in thinking I
was confident in my writing. And then, but now, when I took my post self-
efficacy survey, I noticed I was more confident, but in a different way of
thinking, like, I thought I was confident in how I used to write and, you
know, I was. My process was fine, the way I wrote things was fine. But now,
I'm more confident in the fact that I can write a well-structured paper, and I
can use plain language better. Um, I always had an issue with using a lot
more quotes from articles. Because I thought that if I did use plain language,
the person reading it might not, you know, understand it as well. So I just
wanted to use the quote, because I knew that that's how it was written. And I
was always worried about citing if, you know, it was like questionable
plagiarism, so I was like, just use the quote, that makes it better. But this
time, when I took my post survey, I was really confident in the fact I could
look at an article, use plain language, and it still sounded fine.
Trinity I mean, if I was in a quote unquote writing program where a program where
this was going to continue on. And I know it is, and it's going to help me
with all my other papers and my other classes and things like that. I didn't,
I'm still not as confident as I would like to be. Am I more confident? Did my
confidence increase? Yes, by far, because I know now what's expected of
me. And I think the, like I said, the one-to-ones, and the program layout and
stuff like that, really lays out the expectations of what a graduate paper
should look like, and what our expectations are as a critical thinker, critical
writer in a graduate program. But as for my confidence, it improved, but I'm
still a little anxious, like, when I go to write all those papers yet, it might get
better as the program goes on. But I'm still gonna have that anxiety of like, I
213

Participant What changes did you notice in your self-efficacy survey responses at the
beginning of the class versus the end?
have to write this paper! But I now know I have tools in my toolbox that are
going to help me improve and things like that. So I feel like it's kind of a
little unfair to say, it was only one class, how I've improved. I think I need
subsequent classes, like papers to write and things like that. We'll talk at the
end of the program, and we'll go from there (laughter).
Kairos So that's an interesting one because I did not change this [self-efficacy] score.
It was seven, just because of overall feeling of my struggles of being a non-
native speaker just because I feel like, with time, that will come in more
practice. But in class, the clear expectations, the outline, tools, and the
feedback that were given to us, it made it clear how it all kind of fits
together, it was very helpful. … I know that this class helped me a lot. And
I'm just more worried about, I'm just hoping it doesn't go away, because I
know that practice makes it better. … It was more confidence, kind of like,
okay, I can do this, but I'm still nervous about it, that, you know, it
demonstrated that it's something I can be successful with. But as far as
feeling competent in writing, that I am still feeling shaky, that I can do it by
myself, without the feedback, without those tools. I will keep applying it,
you know, the things that I learned. I'm just not sure I can kind of like, do it
by myself, and run with it.

214

Table H2: Student Reflections on Improvement in Writing Performance Assessment Scores

Participant What changes, if any, did you notice in your writing test score from the
beginning of the semester to the end?
Noel I'll give you an example. When I took the first assessment, I got a two as a
score. And I like kind of just froze for most of the time, like, where do I
start? Like, okay, what should this intro be like? And I started talking about,
answering the question, but the second time around, I was able to just say,
Okay, well, in my head, just to kind of create a little outline and how I was
going to approach that and I went from a two to a five. So I just started
working on my intro, and then I said, I'm going to talk about this in this
paragraph as to why this is a good idea. And as to what people may think
that's not a good idea. And it's kind of like the conclusion portion of it. So
yeah, it just felt a lot easier, like, more natural to start writing that essay.
Eden So I didn't really do well on that (laughter). Because I, again, like I didn't have
a template, so I was just like, Oh, you're gonna do this? Okay, so does that
mean I can write in like six sentences? So I only wrote, like, maybe 15
sentences? It was not organized at all, it was just a blurb of words, my
thoughts going into this thing. So, all of my scores were threes on that. And
then I got that result and I was like, what, three out of what? So I was
confused about what it was. And then I was glad that it mattered nothing to
your grade. Sounds like we're good, because I don't even know what I just
did.

So then, when I took it again, I was like, okay, having learned all these things, I
actually made paragraphs and it led into the next one. And it was this big,
long thing. And I was like, look at that! So then I submitted it. And now I
had sixes on everything. No, I think I had one five, and I don't remember for
what. So it was, it was threes for all of them. And then I went sixes and a
five. Yeah. So I was happy with that. And then, it told you that it was out of
7? No, six. I was like, well, that improved! … So after learning the skills, I
was like, “Hey, I could write a properly formatted essay now!”
Cadence That was the hard thing for me to know, my score increased by one. But I don't
know, again, you know, I got a three the first time and a four the second time
… so I feel okay about myself (laughter). I increased a little bit, which was, I
was hoping I would.
Jubilee It was a four and then when I did my post-test, it was a six. When I saw the
four I was like, Oh my goodness. I don't know what this is out of, Is that
bad? I was confused. I was like, is it like a four out of 20? Because if so, I
did awful. When I found out toward the end that it was out of six, I was like,
215

Participant What changes, if any, did you notice in your writing test score from the
beginning of the semester to the end?
oh, so I actually didn't do that bad. So my writing's not too bad. I was like, I
just need to work on some things... Yeah, when I saw that was out of six. I
was like, okay, so definitely I got better, but I wasn't as bad as I thought I
was at the beginning, you know.
Kairos So my first one was two and second one was four. To be honest, I think it
would have been helpful to know that it was out of six because we didn't
know that until the end. … Then when I got four, and I found out at the end,
then it was out of six. I was like, Oh, I guess you know, like, it's not that bad.
But for me, it was confidence of knowing that there is progress. And that it
wasn't intentional. You know what I mean? That the improvement just was
organic.
Lyric So we had a writing assessment tool, we use, I think the maximum score is six,
my initial one was two. And at the end of the class, I got four.
Melody I started out at a three and ended at a five. … I think it was really just the
organization piece of putting things together and sticking to how you meet
all the points that are expected in a writing piece, and then putting it together
and helping it to flow, so the reader best understands what you're trying to
get across.
Justice Yeah, I think that's the basic paragraph model, I think, is what, in looking at my
pre-course assessment and my post-course assessment, I think that was super
helpful. I think that alone may have been what changed my scores from
threes and fours, to fives and sixes, was just being able to stay focused. And
here's my topic, here's how I'm going to develop it with evidence, with some
explanation in there as well. And then let's transition to the next. … So it
was encouraging to see, you know, increase from threes and fours to fives
and sixes. Because I felt like, you know, in terms of my overall organization,
development and focus, that those were the areas that I improved most over
the course of the course. So, yeah, it was both telling and kind of, for me
like, Yep. That was kind of affirmation of, Yeah, you've grown and changed
as a writer. Where before, you have a lot to say, but it's, Can we just get it
focused and organized in a way that's succinct and not word salad all over
the place?
Trinity That's my one thing, I disliked that assessment, I thought it was … the least
impactful thing on me. Okay, because I was so stressed by the time
constraint of it that I did poorly on it. I did improve my next one by one
point. And I think it was only because I slowed it down and realized, okay, I
had a whole hour, but it was still anxiety-provoking in a way that I don't
216

Participant What changes, if any, did you notice in your writing test score from the
beginning of the semester to the end?
think it was my true self of how I write. I think it was just like, I gotta get
this in, I have 59 minutes, bang it out, just get it and I did horrible on both of
them... I just feel like it wasn't a great showcase of how I write or what I
learned in the class. I think the reflection paper and relating it to what I
learned in the class, my revisions, my drafts, all those things, and relating
them and how, at the end of the class, how I saw myself grow in the class
was better.

217

Table H3: Changes in Professional Communication and Critical Thinking

Participant Changes in professional communication and critical thinking
Kairos So, going back to work or what I do now, it helps me to put my messaging
together. It's not like I'm writing paper, but I think this class is also very
applicable when I talk about advocating, it's really just kind of in daily life, to
put that concise email together and get that message across. … The body of
my email or whatever piece of writing that I'm putting together, the logic
behind it, the examples, how I start my email, the proof that I put in, and how
I finish it. So I really think about not just kind of like, responding to the
email, or starting conversation, it's really in the messaging. And making sure
that I'm getting my point across. … So for me, it's the same kind of
expectations the sender has for me, not just responding to the email, but
really reading it, what are they looking for, taking time to understand what
the task, or ask is.
Melody I think, depending on how I'm communicating, via email to someone, I might
rethink how I word things. I just might think more about it now than in the
past.
Lyric I think having the desire to be a good nurse practitioner, that drives me to write.
And also, especially like after taking this class, I understand more, like, the
better you write, the better you communicate. And I like that, because as I
know, especially in the medical field, communicating is so important with
patients, with family members, with your providers, and, writing. The writing
was not just helping me to communicate, the communication part is also the
confidence to go there, just address what you're trying to say.

Before I took this class, I was like, Why [do] I have to take a writing class?
Because I am an RN, a nurse. I'm not trying to be a writer. Taking this class,
it's so helpful for anyone who want to find a career in the medical field. It
helps you to be a better communicator, be a better provider, and better
educator, because we educate patients too and it polish[es] you. That's the
way to put it. Yeah, so definitely, I recommend this class to anyone.
Noel But as far as having the experience of improving my writing, I am part of a
committee now. And we have to submit this proposal to help at the patient
primary care center. So, obviously I know where my resources are, and I feel
confident about submitting ideas. So you know what that could look like and
feeling more confident about my writing. That's great. So I guess that will be
the connection there, just being able to go ahead and start typing and feel
good about, you know, it makes sense (laughter).
218

Participant Changes in professional communication and critical thinking
Cadence Actually, I had to put a grant proposal together last week, and I needed to have
some research. But I found with the grant proposal and doing some of that
research and citing it and putting the references in there appropriately,
because it was going to the university, was actually, you know, very helpful.
And I've actually gone back to some of my courses. I have three of my
courses … and I have to have my references listed. So now being able to go
back and understand how to actually have those cited, it has been really
helpful as well. So I can, you know, when the nursing educators need my
references, I can have everything ready for them. … Yeah, two years ago,
when I created the classes, I wouldn't have had any idea (laughter).
Justice For example, we just started a long-acting injectable program here at the clinic.
And it was, we had to gather research, we had to do a needs assessment. And
then it was, okay, here's the need. Is this something that we would be able to
take care of in the clinic? And in presenting these ideas to both my leadership
team and the clinical leadership team, you had to do those things, where you
had to, okay, here's the needs, this is what we can do. And I think this is how
it's going to help. You had to have, not necessarily hard evidence to support
what you're saying, but you had to have evidence for why this is something
we should do as a clinic. So it wasn't necessarily that I had to put it into a
formal document. But I had to present my ideas in a similar way to how
we've talked about things in the course. You know, here's the major
argument, and here's the evidence to support it. And this is why it's going to
be good. So those are things that, in discussing things, and presenting ideas to
my leadership team, goes very much through the same process, just not
necessarily in a formal writing way.
Trinity I think that's where I've kind of taken the most from this course, is, and
Professor X said it to me, you know. She said, “when you want something
done, you have to back it up with evidence. If you don't back it up, why you
need this done, you're not going to get that accomplished.” And I do it every
day. And now when I have a meeting, and I have an agenda, and even for this
one [interview], you know, I wrote stuff down that I thought we might be
talking about that I could just reflect on. But I write it out, as in like, okay,
these are the topics that I want, I have my broad topic, patient safety, per se.
And then we go into, like [patient] falls, right? I lay it out in the same way as
if I was going to write a paper. Whereas like, I have my heading, and I have,
this is my evidence to back this up. So in my day-to-day career in life, I just, I
try to put as much evidence as I can to support what I need to get
accomplished.
Eden In my day to day, I have to do a presentation to our staff for like, advance
directives, and handwashing techniques, and we have to do these annual
219

Participant Changes in professional communication and critical thinking
trainings for OMH, and the staff has to be a part of that every year to stay
compliant. So I'm actually working on my PowerPoint presentation now, and
I'm actually thinking like, “Oh, I should say this. And this should lead into
this.” And it's not a paper. But it's still something that I have to write before
presenting. And it's bizarre to me that now my brain will associate some of
those techniques into that, and nobody will ever read it. It's just me speaking.
But it's still, to me, it's now more well-organized, and it flows better. And I
think the point will get across faster than me just rambling. And I think in
that sense, my job for those [presentations] will be impacted.
Jubilee Yes, actually, because I'm grading a lot with my students... And I also see it in
my clinical trial job because, I mean, that's evidence-based practice. Like,
that's changing all the time anyway. So with both of my jobs, I'm like, oh,
you know, my reading articles and understanding scholarly writing and then
transitioning it to me reading it as somebody from the outside. So, yeah, I
would say so. I feel like I'm more conscious about using plainer language.
And I'm kind of more, it's because it's different now that I'm an instructor as
well, versus when I used to work on the floor. My students are trying to learn
from me. But I realized that they are new as well. And they don't understand
everything yet. So I have to use plainer language. So the fact I had to use it in
my paper helps me.

220

Table H4: Student Reflections on Overall Transformation

Participant How did the course transform you, if at all?
Melody So I know that I will have many more papers to come. And I feel much more
confident in knowing I can tackle those based on the results I've seen in my
own personal progression through the course.
Noel It honestly just boosted my confidence in me. My husband tells me all the time,
like, I'm capable of doing that. And I proved that I was capable of doing that.
But, once you actually do it, and then you have that realization, like, “Yes, I
did it, like, I'm able to do it.” So I will say it boosted my confidence in
writing a lot.
Trinity Um, like I said, with everything going on and stuff like that, it kind of made me
proud. Like, I got this, I did this, this was all me. … It took me this long in
my career, and in my life to realize, I did this. So, to me, it's the most
impactful. And this is the one class, I've taken writing classes before … but
this is the one where it just, something stuck. … But this one is the most
impactful of any paper I've ever written. And I have tools, I just know what
to do now. … I wish I would have done it 20 years ago when I was, you
know, first started.
Cadence I would say from September to now, it has transformed me, in a sense, just
because I think it's built my confidence that you know, when you're middle
age and going back to school in such a long time, that I was really thinking,
this is really stupid. And probably the first couple of weeks, I'm thinking,
“Why am I doing this? There's no reason to be doing this. Why am I beating
myself up? And stop it.” And now, I can't wait for the next class! So really
just boosting my confidence to say, “You know what, yes, you can!” And
knowing that this class is a prerequisite to almost everything else for a
reason. Like, it really makes sense to have this as a stepping stone. Because
without it, there's no way I would be able to survive any other classes
knowing there's going to be more papers.
Kairos Again, showing that that's something you never thought you could be good at.
That as long as you put in work. If you know it, it's kind of corny and silly,
but at the same time, like a lot of people say, “If I could do it, anyone else
can.” You know, with weight loss or whatever it might be. You know, just
coming from barely speaking English to being able to write paper that I'm
proud of. You know, it made me feel good about myself and my abilities.
Justice I think again, it was just being more succinct, and not you know, just because
you have a lot to say, it doesn't mean you need to say all of it. It's organizing
what you say so that it's focused and driven and to the point. Because if you
221

Participant How did the course transform you, if at all?
say things succinctly in in an organized way, people are going to listen a lot
more readily than if you just kind of spew and spew and spew and spew. So
just being organized, being focused, was what I took away.
Lyric And I even feel more confident when I'm doing a document for my nurse job.
… I was so self-conscious about oh, the doctor read this and he may or she
may not understand what I was trying to say. And now I just put whatever
you want to say there first, and then read three times. That's what I'm doing
now is read three times. I don't have to read aloud but I just read to myself
and then change there, or it's like rewriting for this class. So that helps. I
think. … documentation and even like communicating with patient and with
providers, I feel more confident now. Especially I think the biggest areas
that show in my work is documentation.
Jubilee I feel like it [the course] made me a better not only student, but it made me a
better nurse. I feel like I'm more confident now in communicating with, you
know, nurses that maybe are more knowledgeable in certain fields. I can go
look at things and study them and organize my thoughts looking at different
evidence and be able to interpret it better and communicate it to somebody
else. And then just the fact that I'm more confident in my writing. So that
transformed me a lot.
Eden It's increased my confidence in my writing and submitting of my writing. It
transformed my way of thinking on how to approach writing about a topic.
And then, it's made me more confident to pursue maybe more scholarly
writing, possibly my DNP, or maybe something from my master's program,
maybe try to publish or something like that. Like, I'm not so fearful of that
now, I feel like I could probably do that now. You know, that's definitely the
biggest of the transforming for me.

222

Appendix I: Student Definitions of Scholarly Writing

Table I1

Participant Students’ definitions of scholarly writing
Cadence I would think of scholarly writing as, you know, based on research and being able
to report findings based on other research or research that you've done in order
to, you know, I don't want to say that make an impression, but you know, either
just provide information or provide an argument of some sort, to, you know, to
sway somebody one way or the other to make a decision on something.

I was going to say, considering how much research there is in any part of the
medical field. Depending on if it's a systematic review, or you know, whatever
you're doing, being able to compile the data into one document to make it easier
for somebody to be able to get some of that information, or you're pulling from a
lot of different resources and kind of putting it into your own findings,
depending on what your agenda is, and what your research is on. Instead of me
having to find 20 different articles. I can read yours that you've already read
those 20.
Eden So when you can, when you can write a document that's not personal, where you're
having just your opinions in it, and that you can back it up with evidence. That
to me is scholarly writing, and grammar, correct. It's well thought of, and it's not
chaotic. It's a well thought out plan, that's scholarly writing to me (laughter).

[The purpose of scholarly writing in nursing is] to appropriately get across
evidence based practices. So, for instance, if there's research out there, pulling
data together to make it a, a common thought that can be put in place. So for
nurses, we have to look at all kinds of articles to make sure that we're doing the
most recent evidence based practice for instance, like, we know now, you
should wash your hands all the time. Because it makes sense. But there's that
writing, there was a document that was put out that research stated, okay, these
are how we're going to do it and the article was able to verbalize that for us.
Jubilee I would say scholarly writing is being able to take research, or even if you're not
doing something research-related, taking articles or information from a textbook
and using it in your own words, and being able to understand it, and use plain
language to explain it to other people.

Evidence based practice, because the field of nursing and medicine in general is
changing daily. And the scholarly writing is used to change the way we do
things, the way things are treated, the way we do procedures.
223

Participant Students’ definitions of scholarly writing
Justice To me, that's scholarly writing is presenting an argument and presenting facts and
research and data to support that argument. [In nursing] I think that depends. It
can be, you know, hey, here's a new idea. I think this is something that I think
might work, it could be to support a policy or practice that's been used for
decades. So I think it's all over the board, whether it be you're presenting a new
way to handle a certain patient’s situation, it could be presenting a new, you
know, process or policy on how to how to manage certain situations or certain
illnesses. It can be, you know, it's, there's a wide, wide area of things that you
can cover in in nursing when it comes to scholarly writing.
Kairos I would say, now, as you asked that question that it [scholarly writing] would be
well-written, organized. So the reader can follow you, follow kind of like your
train of thought and it would be logical, but yet concise explanation of things
because communication is very important in healthcare. So you have to be very
specific and methodological in the delivery of your message.

Yeah, everything just new. Like, if it is old, just something that, you know, like
looking at best practices, or advocating for patients, relaying that, you know,
like, where new research. It's really think about advocating and there are various
applications of how it could be actually applied. Because when I think of health
care, it's really all the way advocating for patients. And it could be clinical, it
could be administrative. Any encounter that you have in healthcare, it's really
related to patient care.
Lyric I think the scholarly writing helps me in the nursing field, this goes two ways. One
is like evidence based study, I feel like as a reader to read those articles. By
taking this class, helps me better to understand the articles as a reader. Like
those, like evidence based practice, like, you know, especially like, in the
medical field it's an ever-changing, the medicines, the technology, and that
helps. And also, sometimes we're doing the presentation, we're trying to
communicate with the providers, and also do the patient education. And
scholarly writing, helps me delivery the messages, and also helps me to finding
the most valuable information for my patient, if I don't agree with my
providers, . . . so this is like a tool for me. To find the information that's
valuable. And, and also deliver it. I think this class it helps me to deliver. So the
evidence base class I was taking with this class, it helps me to finding the
evidence and this class helps me to deliver.
Melody To me, it [scholarly writing] would mean abiding by APA format, presenting
information in a way that is professional and ... scholarly (laughter).

[In nursing] to create something that is well received and respected by fellow
healthcare workers.
224

Participant Students’ definitions of scholarly writing
Noel Okay, um, scholarly writing, I think it's just kind of being able to use research
articles and, and being able to find the information to prove your point and
convey the idea. And just being able to write a persuasive paper or like what we
did in class, we were able to write this research paper where we were able to
convey the idea as to why this is necessary, but also see the other side of it and
do a refutation and say, you know, why not? And have your information to back
up that information. . . . So it'd probably be a good thing to do if you're trying to
get like an approval for an equipment or, you know, maybe a new procedure, a
different way to do something with the patient that will have a better outcome,
that you can you can use that sort of scholarly writing to prove your point and
have information to back up that point.
Trinity Scholarly, it's in the title, what you're asking, night and day from what you expect
from undergraduate level to the graduate level. Really using those peer reviewed
articles, evidence based practice journals, it was a lot of researching for me.
Before I was like, I would just gather my information, and then go through my
journals, and then find out what I would use. These ones I really had to be
particular in what I was using as evidence in my paper. Somehow, every article
when I would do my undergraduate, every article I could kind of tweak to fit
into my paper. With these, with this graduate level work, I really had to focus on
what the evidence they were providing and how it was going to relate to my
topic. I couldn't just put fluff pieces in, you know, and I also had to, there was
areas where it's like, I needed more support, where I needed more articles. So, it
was a higher level of learning. Definitely. I could feel it right off the bat, you
know, just the difference.

225

Appendix J: Student Reflections on the Peer Review Process

Table J1

Participant Peer Review Process
Eden And it was hard for me to submit my work to a peer. Because I thought I was
going to be judged, like, this girl doesn't know what she's talking about. She
doesn't know how to write or you know. It was just, it was hard for me
(laughter). So, but she was gentle. And I tried to be gentle to her writing. But
she did get some good points and she had brought up something, she was
like, Oh, this paragraph is about this. And I'm like, I didn't think it was about
that. So I actually had to change my paragraph because she was right. So I
was trying to write something different and she actually took it a different
way. And I was like, Alright, we gotta change this. This is not where I'm
going with this. So it was helpful. But yeah, the process was a little scary.
I think it's beneficial, and it should be done all the time. Because it was helpful
to know that she wasn't grading my paper. That was a good thing. She's just
going to give me feedback. So, I feel like the more feedback you can get
from other people, other than the teacher who's grading, it's beneficial. But I
didn't see it like that until after we did it. And I got over my fear of it. So
knowing now leading up to that, it'll be a good experience if other classes
have us do that. But until I went through it and had the experience of it,
because my Bachelor's program never did that. There was no peer review.
Justice I'm big on always having somebody else revise your writing, you know, having
somebody else read it, whether it be a coworker, my wife who's in the field
of education, I always have her take a look at things, just so you can get a
new set of eyes on it. Because as the person that's been researching and
writing, you've seen it 1000 times. So for you to try and catch changes and
catch things that need to be, it's difficult. But when you can get a fresh set of
eyes, it is helpful.

I think it's a fantastic idea, just in practice I wish that we had had, and I don't
know if this is due to COVID or just the fact that it's an online course. But
having the opportunity to sit down and discuss with that other person. You
know, what your revisions are, what your thoughts are, because I feel like
it's the same way with text messages and emails. Sometimes your feelings
and intuitions aren't necessarily conveyed and communicated appropriately
just through a document. So I didn't like in my peer review with my partner.
I didn't want to be too critical because I was like, man, I hope she doesn't
think that I'm just beating up this piece of writing because it's pretty good.
But there's definitely some areas that need, you know, some changing or,
you know, further development, but I don't want her to think that I'm just
226

Participant Peer Review Process
crushing her paper. And I think that, you know, person-to-person, in
conversation would help with that conveying of meaning and purpose.
Lyric And it helped me when I was reading her papers. Because when I was reading
her papers, it kind of helped me to understand because I read her paper first.
… And so after reading my peer’s paper, when I come back to read the
comment, the feedback Professor X gave to me, it make more sense. So I
was able to see the big picture. I need to, I guess it's like the structure, the
style, and I was kind of losing sight on that. But when I was reading, after I
finished reading my peer’s paper. So that become more clear to me.
Cadence I really liked the peer review because it made me clue in, when I was reading
somebody else's paper, to things that I needed to change on my own, before I
even got my peer review information back. So I could already go in and start
making the changes because I could identify it from the list of
recommendations that the professor had provided to us for the hierarchy of
concerns and going through that, and it made a huge difference. So the peer
review I absolutely loved and being able to write up some feedback for that
person.
Kairos It's funny because the person that reviewed my paper thought that I had too
much proof in my paper, that I had to take it out. And I felt like she didn't
really have enough proof. So I suggested to her, Okay, show me why?
There's a lot of, I felt like, there's a lot of opinion. And the proof was
lacking, just kind of like, Okay, but why is this good? You know, it was
funny, because the one thing that she thought that I needed to improve, you
know, she was kind of like, lacking that. And it was just interesting to read
something else, because you get tired of your paper or your topic, it was a
nice break.
Trinity So when we were able to see somebody who was on the same level as us, this
is their first writing class. It was nice, because you can see, all right, I'm not
that bad. Like, she had the same issues. … so I enjoyed the revision process,
with the peer review side, the peer review process.

When I did my reflection paper about the peer review and stuff like that, when
we saw it come up on Blackboard, I was like, Oh my gosh, I'm working 60
something hours a week, we're in the middle of a pandemic, I'm trying not to
get sick. … but when we did that peer reflection, to find somebody who was
dealing with the same thing I was dealing with, and that knowing that it's not
just me, was very impactful. And knowing that, okay, every time you get a
sample of somebody's work where you can say, Okay, this is what they
227

Participant Peer Review Process
need. This is what they mean by that, you know, what they expect or what
their expectations were, was great. Like, it helped out a lot.

228

Appendix K: Assignment Guidance for Final Reflection Paper
From The Writing Workshop
Rebecca Red Wolf

Length: At least 1.5 typed pages, double-spaced (no title page needed)
Total Points Possible: 40 DUE: last day of class

WHY: Through guided reflection and self-assessment, you can learn more about who you are as
a practitioner, leader, and scholar. Thinking through your writing journey this semester can
improve your ability to revise your own work and develop your own inner writing coach. The
reflection process also provides your faculty with valuable insight into how you learn so that
they can improve their teaching practice.
WHAT: As we bring the semester to a close, your final assignment is to consider the writing you
have done in this course. You will need to look closely at your own work and think about your
answers to the questions below.

HOW: Consider the classical argument paper you just wrote. Your letter should answer the
following prompts for each section of your reflection:
1) In your first paragraph, reflect upon the course content (lectures, assignments, learning
activities, assigned readings, worksheets, videos, writing conferences, webinars, etc.) and any
impact these have had on your development as a critical reader and writer. Was there a
specific lecture, webinar, or assignment that helped you better understand the scholarly
writing process?
2) In the next section, tell the “story” of how you wrote your paper. Consider the following areas:
a) The process you used to write this classical argument;
b) Which areas you struggled with;
c) What revision strategies you used that worked well for you;
d) How your essay improved with each successive draft; and,
e) How you feel about the final paper you produced?
3) In the third section, describe your experience with the peer review process.
a) What did you learn from writing a letter of analysis?
b) What did you learn from receiving feedback from your peers and/or professor?
c) How has the peer review affected your approach to revision?
d) Is there anyone you might ask to review your drafts in the future? (Note: the school’s
writing coaches are available to help you at any stage in the writing process.)
4) Please share the writing goal(s) you set for yourself at the beginning of the semester.
a) How successful were you at reaching your goal(s)? What did you learn from receiving
feedback from your peers and/or professor?
229

b) Describe any changes in your end-of-course writing assessment score when compared to
your score from the beginning of the semester? What was it like to see these changes, if
there were any?
c) How has your confide changed in your abilities to think critically, synthesize research,
and present evidence in a scholarly writing format? (Please review your responses to the
pre- and post-self-efficacy surveys to inform your reflection.)
d) Explain which scholarly skills you would like to keep developing throughout your
master’s program. How can you use these skills in your current job?
5) Think about the “defining moment” you shared at the beginning of the semester. What was
one transformational moment you experienced in this course? Perhaps somewhere you
noticed a change in your thinking, confidence, or behavior (if at all)?
Please note: The grade you receive is based on your completion of all aspects of the assigned
work. If your letter includes all of the tasks mentioned above, you will receive full credit,
regardless of the faculty’s opinion of the content of your work. This assignment is meant for
your benefit and individual growth; it is not our place to judge or evaluate the honest reflection
of your own work, only to create a space for that internal reflection to happen.

Abstract (if available)

Abstract The purpose of this mixed-methods study was to determine how a 14-week intervention affected students’ self-efficacy, task value, and writing performance. Bronfenbrenner’s ecological systems theory was used to explore sociocultural influences on students’ writing development and student perceptions of the intervention experience. The participants were master’s nursing students enrolled in an existing one-semester writing course for health professionals. A quasi-experimental mixed methods design was used to measure the difference between students’ pre- and post-intervention scores on an IntelliMetric® writing assessment, and the SAWSES self-efficacy survey. Qualitative data were gathered from semi-structured interviews with nine student volunteers, then coded for thematic analysis. The quantitative results showed statistically significant gains in self-efficacy and writing performance with large effect sizes. In the qualitative interviews, students explained the perceived benefits they received from the scaffolded instructional design of the course, balanced formative feedback from faculty, and the practical writing strategies they were taught. The interviewed students discussed transformations in their scholarly writing, critical thinking, professional communication skills, and confidence after participating in the course. Students also shared the positive and negative effects of various ecological environments on their learning. This study addresses the gap in nursing education regarding the assessment of research-based writing interventions on students’ scholarly writing capacity. Recommendations include implementing a required scholarly writing course in all graduate-level nursing programs, promoting self-directed reflective learning with e-portfolio assessment, using a sociocultural approach to instruction across the curriculum, providing formative feedback in a supportive environment, and differentiating instruction with a flexible scale of help to scaffold students’ cognitive and professional development.

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Asset Metadata

Creator Wolf, Rebecca Red (author)

Core Title Exploring the scholarly writing development of master’s nursing students

Contributor Electronically uploaded by the author (provenance)

School Rossier School of Education

Degree Doctor of Education

Degree Program Organizational Change and Leadership (On Line)

Degree Conferral Date 2022-05

Publication Date 05/04/2023

Defense Date 04/18/2022

Publisher University of Southern California (original), University of Southern California. Libraries (digital)

Tag academic writing,critical thinking,formative feedback,metacognition,nursing education,OAI-PMH Harvest,portfolio assessment,reflection,scholarly writing,self-efficacy,writing across the curriculum,writing capacity,writing in the disciplines,writing instruction,writing intervention,writing scaffold

Format application/pdf (imt)

Language English

Advisor Seli, Helena (committee chair), Janke, Dawn (committee member), Stowe, Kathy (committee member)

Creator Email rebeccawolf@gmail.com,rredwolf@yahoo.com

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC111259366

Unique identifier UC111259366

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Format application/pdf (imt)

Rights Wolf, Rebecca Red

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