'ursing Praxis in New Zealand

A TRIPARTITE LEARNING PARTNERSHIP IN HEALTH PROMOTION

Susan Scott, RN, RM, MA, Senior Lecturer, School of Health and Social Sciences,
Massey University, Wellington Campus

Abstract

The shift in health care towards primary health services and health promotion requires nursing education to ensure
students learn to practice in partnership with communities. In primary health care settings opportunities for students
to learn the participatory communication skills required for collaborative practice have been found to be constrained
by a range of factors. An innovative approach increasingly being reported is for nurse educators and students to work
with groups in the community, for example with teenage mothers. In mental health this approach is common, with
consumers willingly working with nurse educators and students to complement the experience students gain working
alongside health care professionals. This paper describes a partnership between a New Zealand nursing programme and
a community trust whereby nursing students together with youth enrolled at a local high school promoted health. The
nursing students reported that the experience encouraged them to view their practice from the perspective of the young
people with whom they were working, and to see their efforts in the school setting as part of the wider community's health.
It is argued that this strategy successfully contributed to the students' acquisition of the collaborative skills required to
develop nursing partnerships within communities.

Key Words: Health promotion, clinical learning, partnership, primary health care, nursing students.

Introduction contemporary healthcare context (Carpenter, 1971).

In recent years the number of nurses working in
community based practice that has a population
health perspective is increasing, while the number
of nurses working in hospitals is decreasing (Benner,
Sutphen, Leonard, & Day, 2010; McMurray & Clendon,
2010; Nursing Council of New Zealand [NCNZ], 2010a).
Nursing education is striving to ensure that this shift
towards more emphasis on primary health care services
is reflected in clinical learning (Carryer, 2008; Chappie
& Aston, 2004; Association of Community Health Nurse
Educators [ACHNE], 2010; NCNZ, 2010b).
Undergraduate nursing students in New Zealand (NZ)
have been required for many years, following Dr Helen
Carpenter's benchmark report on nursing education
in 1971, to have clinical experience in a variety of
clinical settings to ensure their learning reflects the
Despite this requirement the need for a greater focus
on primary health care has recently been identified in
a review of educational standards for entry to practice
(NCNZ, 2010b). Challenges for nursing education
in this area are reported internationally (ACHNE,
2010; Holt & Warne, 2007; Kenyon & Peckover, 2008;
Swearingen, 2009). Nurses and educators working in
community based health report that they have struggled
to incorporate nursing students' clinical experience
into practice (Kenyon & Peckover). Students also
report issues to do with integrating health promotion
theory with practice (Holt & Warne). A recent report
by ACHNE's Education Committee suggests that it is
time to focus on practice where there is a community
level population focus and where support is available
to develop competencies identified as essential in
Scott, S. (2011). A Tripartite learning partnership in health
promotion. Nursing Praxis in New Zealand, 27(2), 16-23.

Page 16 Vol. 27 No. 2 201 1 - Nursing Praxis in New Zealand

Nursing Praxis in New Zealand
health nursing practice (ACHNE; Swearingen). These
essential competencies include partnership skills which
are highly valued in the NZ context where the principles
of Te Tiriti o Waitangi underpin health care policy
(Ministry of Health [MOH], 2001).
One educational approach which addresses the
concerns outlined is well established in mental health
nursing both in NZ and internationally, and is popular in
other areas of nursing internationally including primary
health care. This requires nurse academics to have a
direct relationship with consumers of health services
(Bennett & Baikie, 2003; Hayward & Weber, 2003;
Repper & Breeze, 2007; Schneebeli, O'Brien, Lampshire,
& Hamer, 2010; Whittaker & Taylor, 2004). Repper
and Breeze in their literature review of educators who
involve users in the preparation of health professionals,
found that when educators work with consumers
students were supported to develop the skills that
consumers prioritise. This finding is especially useful
in primary health care and health promotion where
notions of partnership and empowerment underlie
policy goals in population based community health.
Repper and Breeze caution that there is a need to track
relationships between consumers, health professional
educators and students. Therefore, this paper describes
a service-based learning partnership in New Zealand
where a nurse educator worked with a community trust
to enable undergraduate nursing students to develop
their health promotion skills with local high school
students.
New Zealand Context
When practising in the area of primary health care,
nurses in New Zealand are required, as are nurses
internationally, to provide care which reflects the
principles of social justice (Department of Health, (DOH)
2003; MOH, 2001, 2003a, 2010; Piper, 2008). This goal
requires nurses to relinquish the role of expert and
become partners with their populations of practice
Vol. 27 No. 2 201 1 - Nursing Praxis in New Zealand
(ACHNE, 2010). In New Zealand the imperative to ensure
self-determination by honouring the special relationship
with Maori in accordance with the relationship between
the Crown and the Te Tiriti o Waitangi drives partnership
goals (MOH, 2001).
Nursing in NZ has been identified as being "crucial
to the implementation" (MOH, 2001, p. 23) of the
Primary Health Care Strategy which is designed to
address the health needs of the NZ population. A
range of approaches has been implemented in recent
years to upskill student nurses and graduates working
in this sector (Finlayson, Sheridan, & Cumming, 2009;
Haggarty, McEldowney, Wilson, & Holloway, 2009; MOH,
2003a, 2005, 2008). Given the blurring of boundaries
between community-based care which can include
nursing activities in secondary care, disease prevention
and community health promotion (ACHNE, 2010;
McMurray & Clendon, 2010) defining the particular
skills needed for primary health care nursing practice
has been acknowledged as complex. In NZ the largest
group of nurses working in the primary health care
area is practice nurses whose role includes both health
maintenance and health promotion (Hefford et al.,
2010). This paper uses the terms primary health care
and community based health care interchangeably. Both
incorporate the notion of health promotion.
There are clear changes in the employment settings
of the nursing workforce in NZ reflecting the move in
direction of health care service delivery both in NZ and
internationally. In North America 68.1% of nurses in
1984 worked in hospitals, by 2006 this number had
dropped to 56.2% (Benner et al., 2010). The pattern is
the same in NZ and, although actual figures are hard to
obtain, Cook (2009) claims 50% of nurses are working
in primary health care. The Nursing Council of New
Zealand, however, report that 20-22% are working in this
area, with another 4-7% working in community health,
Maori and Pacific services and 48% of nurses working
in acute hospital settings (NCNZ, 2010a).
Page 1 7

District Health Boards (DHBs) employ 62% of nurses
with most working in hospital areas with high acuity
(District Health Board NZ Future Workforce, 2009).
Most graduates practice within the DHB's (Haggarty
et al., 2009). These statistics are likely to explain why
acute care dominates undergraduate nursing education
(NCNZ, 2010b). However it is also likely that there may
be wider constraints on access for nursing students to
primary health care nursing settings (NCNZ, 2010b).
In the programme in which the students who took
part in the project to be described in this paper were
enrolled, the majority (88%) of undergraduate clinical
experience hours were accessed in environments other
than community health.
Background
An important issue arising from the dominance of
acute care for undergraduate clinical learning is that
hospital-based nurses have been found to focus on
health education rather than health promotion in its
broadest sense (Carlson & Warne, 2007; Dympna,
2007; Piper, 2008). Piper, in a qualitative study of 32
registered nurses working in an acute care hospital in the
UK, found that "for the most part the narrow meaning
given to health promotion ... was related to limited
forms of intervention and not activities associated with
the Ottawa Charter" ( p. 195). One participant referred
to population targets in relation to health promotion as
"government propaganda" (p. 193).
In contrast to the limited understanding of health
promotion by some nurses working in hospitals, recent
research with primary healthcare nurses working
in school communities reveals nursing practice that
incorporates the wider social determinants of health
and also partnership perspectives (Barnes, Courtney,
Pratt, & Walsh, 2004; Cleaver & Rich, 2005; Kool et
al., 2008; Murphy & Polivka, 2007; Northrup, Cottrell,
& Wittberg, 2008; Speroni, Earley, & Atherton, 2007;
Summers et al., 2003). Collaborative relationships
Page 1 8
Nursing Praxis in New Zealand
have been identified between nurses and groups in the
community with these being described as: embracing
patterns of partnership (Kool et al.); partnering across
sectors (Northrup et al); extending practice to include
afterschool programmes (Speroni et al.); advocating for
'latchkey' programme parental preferences (Murphy &
Povlika); negotiating to overcome gatekeeper barriers to
promote youth sexual health (Cleaver & Rich); working
alongside students, teachers and parents (Barnes et
al.); and finally, gathering survey data to shape practice
(Summers et al.). These practices meet the call for
nurses to "... no longer adopt the role of 'expert' but
work 'for' and 'with' rather than 'on' the people for
whom the change is intended" (Carlson & Warne, 2007,
p. 511; MOH, 2001).
Gaining access to practice where nurses use these
participatory skills which enable partnerships to be
established with consumers in the community has
been reported as difficult for nurse educators in the
UK. Holt and Warne (2007) found in a study of 100
second year pre-registration nursing programmes
that they experienced a "dichotomy" (p. 373) and
a need for "greater congruence" (p. 379) between
health promotion theory and practice. Kenyon and
Peckover (2008) studying the issue from the perspective
of the registered nurses and academics, found that
placing students in community and primary health
care settings was best described as a juggling act for
both clinicians and educators. In their UK qualitative
study with 28 staff in a Primary Care Trust (PCT) the
difficulties encountered during clinical placements of
nursing students included managing a 'different' kind
of relationship between clients and nurse. Organising
opportunities for students to engage with clients was
found to be hampered by the changing context in
which care is delivered in community settings, such as
in home visiting and other outreach services. As was
pointed out by Kenyon and Peckover this environment
contrasts with institutional settings where the close
working relationships found in these environments.
Vol. 27 No. 2 201 1 - Nursing Praxis in New Zealand
Nursing Praxis in New Zealand
such as hospitals, limited students independent and
self directed learning.
Working directly with communities offers another way
for nursing education to develop and complement
nursing students' clinical experiences (Hjalmhult,
2009; Lasater, Luce, Volpin, Terwilliger, & Wild, 2007;
Repper & Breeze, 2007; Whittaker & Taylor, 2004).
This could address the problems which have been
reported between primary and community health care
practitioners and nurse educators (Carlson & Warne,
2007; Dympna, 2007; Holt & Warne, 2007; Kenyon &
Peckover, 2008; NCNZ, 2010a; Piper, 2008; Whitehead,
2007). What this means is that the nurse educators
(the academics) work alongside the students as they
develop partnerships with consumers, thus offering the
opportunity to gain access to consumers where they live
and work in the community thereby extending clinical
experience beyond the recognised healthcare services.
For example, Bentley and Ellison (2005) found that
undergraduate students working cooperatively with
teen mothers as part of the Early Head Start initiative
in Alabama, developed their understanding of the teens
health care concerns and cultural difference, as well as
developing a sense of responsibility towards community
groups. Partnerships between nursing education and
communities indicate that they develop the students'
collaborative skills which are a pre-requisite for effective
promotion of primary health care in the community
(Hayward & Weber, 2003; Whittaker & Taylor, 2004).
The Project: Promoting Health in a New
Zealand Community Setting
A tripartite partnership between a Community Trust,
the University nursing programme and a local high
school in a NZ community enabled undergraduate
nursing students to work with youth to promote health
in the school classroom over a four year period from
2005-2008. The goals of the partners in this project
were complementary. The nursing programme was
Vol. 27 No. 2 201 1 - Nursing Praxis in New Zealand
promoting and delivering the Bachelor of Nursing (BN)
programme. The Community Trust, which is funded
jointly by a community and the Ministry of Social
Development, was assisting local youth to transition
into the workforce or tertiary education and the
school was developing the health component of their
curriculum. The Trust invited educators from the nursing
programme, as a regional education provider, to support
its goals and to work through them with the school.
The nursing programme recognised this invitation as an
opportunity to develop undergraduate nursing students'
skills and to concurrently promote youth health.
The curriculum topic chosen by the school was nutrition,
exercise and health reflecting the Health Promoting
Schools Organisation 'Healthy Eating Healthy Action'
(HEHA) (MOH, 2003b) campaign. This was described
as a strategic approach towards improving nutrition,
increasing physical activity and achieving healthy weight
where people live, work and play. The second year
baccalaureate nursing students who participated in the
project were enrolled in a course, the learning outcomes
of which emphasised health promoting practice in
primary healthcare settings. The project consisted of a
group of eight students working with the school teachers
and youth to develop an interactive classroom session
held in both semesters of each year over the four years
of the partnership with the school.
The nursing students worked directly with senior school
students (16) to plan and deliver an hour long workshop
session to junior students (>200) during a day designated
for delivery of components of the 'health' curriculum.
Planning consisted of these senior school students
and the nursing students meeting at the school three
times early in each semester and negotiating topics and
activities for the session. The nursing students then
went away and prepared the resources, and in this stage
of the project visited members of the local community
to gain support. This led to one supermarket supplying
food samples for demonstration purposes during the
Page 19
sessions and health centres providing pamphlets and
some equipment for visual aids during the session. The
nursing students worked alongside the senior school
students as they prepared to facilitate the small group
workshop activities with the junior school students (the
ratio was two nursing students to four senior school
students). On the 'health' day all the junior students
rotated through the hour long sessions being delivered
by the senior students, and during the day each small
group of nurses mentored the senior students during
the delivery of the sessions.
The nursing students were supervised by academic
staff throughout the planning and delivery of the
project. Pass/fail criteria were used to evaluate all the
learning outcomes being met during the project. The
assessments included a written evaluation of each
group's performance of the overall task, including
planning and delivery of the final health sessions to
junior students; a peer assessment by each member
of another group member's contribution to the group
process'. As well there was an individually written
reflection by each group member on their own learning
during the execution of the project. The Trust staff
carried out a written narrative evaluation which served
as a further reflective exercise for the nursing students.
Evaluation of the Project
Through participating in this project the nursing
students reported in their written evaluations that
they had enjoyed promoting health with youth and
engaging in health education on a topic in which the
school students had enthusiastically participated.
The Trust analysis of their written evaluations showed
that the school students' understanding of nutritional
requirements had improved and that the high school
reported the project had successfully contributed to
the schools' expansion of the health component of
the curriculum.
During their planning discussions with the school
Page 20
students the nursing students working on this project
reported their realisation of the depth of the school
students' prior knowledge about nutrition, exercise
and health. They then worked out that their role
was to build on this knowledge and explore any
issues the school students identified in managing
the relationship between food, activity and keeping
well. This realisation also applied to exploring the
best teaching strategies to be used in the classroom
to share their nursing knowledge and ensure it was
relevant and appropriate to youth. A major factor
which emerged from the nursing students' reflections
was an awareness of the level of respect the junior
students demonstrated for the senior students by their
engagement with the latter during the delivery of the
sessions. The younger students responded positively
and teachers also reported that they were pleasantly
surprised by the degree of interest shown by these
students. By discerning this esteem, the nursing
students recognised the ability of the mentoring process
to empower the school students. This aspect of the
project demonstrates the development of negotiation
skills and shared decision making, skills which underlie
the ability to build the partnerships necessary for the
implementation of primary health care policy (Carlson
& Warne, 2007; Whittaker & Taylor, 2004).
The nursing students also reported making links
between this project work and their clinical placements
with primary health care nurses, where some had
taken part in home visiting and screening clinics in the
same community in which the school was located. The
nursing students talked about understanding the school
students within their wider communities.
Discussion
During the conduct of this project the health needs of
the community were aligned with the learning needs of
nursing students. Working in a partnership relationship
required the nursing students to focus on the needs of
Vol. 27 No. 2 201 1 - Nursing Praxis in New Zealand
Nursing Praxis in New Zealand

goals of the Community Trust as well. This requirement Conclusion

meant that they were given the chance to develop their
collaborative skills, an acknowledged pre-requisite for
promoting community health (ACHNE, 2010; Carlson &
Warne, 2007; Hayward & Weber, 2003; Holt & Warne,
2007; MOH, 2001; Swearingen, 2009; Whitehead, 2007;
Whittaker & Taylor, 2004). This also meant that the
nursing students could see the project through what
Holt and Warne describe as a "wider lens" (p. 375) rather
than the single dimension of health services. Viewing
individuals in this way has been described by Hjalmhult
(2009) as an essential part of the "new paradigm"
(p. 3139) of public health nursing practice where the
community itself is recognised as the client. This project
therefore made it possible for these nursing students
to see their efforts within the school environment as
an example of what Lasater et al. (2007) describe as
community focused practice.
Because the project located the nursing students within
the school itself, they were able to see the students in an
environment where the impact of social determinants
on health could be recognised. They could also practise
their health promoting communication skills in the real
world of the community without creating any of the
unease between nursing education and nursing practice
which has been reported in the UK (Holt & Warne, 2007;
Kenyon & Peckover, 2008).
The tripartite relationship underlying the project
described in this report provided a structured
opportunity in a NZ school setting for nursing students
to collaborate across the health, education and social
development sectors. Working directly with the
youth in this school enabled the nursing students to
develop the communication and collaboration skills
necessary for working in partnership, skills which,
particularly in the NZ context, are necessary to promote
self-determination. These transferable skills were
encouraged in the students in a context where there was
no strain on nursing resources. However, more research
on the relationship between nursing education and
community partnerships is necessary to ensure that on
graduation New Zealand undergraduate nurses are well
prepared to meet the challenges facing nursing as health
care shifts into the community - where communities
themselves will be identifying their health needs.
Acknowledgement
The author would like to acknowledge Sandi Savage,
School Partnership Facilitator, Partners Porirua and
Brad Williamson, Year 10 Dean, Head of Health, Aotea
College, Porirua.

References
Association of Community Health Nurse Educators. (2010). Essentials of baccalaureate nursing education for entry-level community
public health nursing. Public Health Nursing, 27, 371-382. doi:10.1111/j.l525-1446.2010.00867.x

Barnes, M., Courtney, M. D., Pratt, J., & Walsh, A. M., (2004). School-based youth health nurses: Roles, responsibilities, challenges and
rewards. Public Health Nursing, 21, 316-322. doi:10.111/j.0737-1209.2004.21404.x

Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A cali for radical transformation. San Francisco: Jossey-Bass.

Bennett, L., & Baikie, K. (2003). The client as educator: Learning about mental illness through the eyes of the expert. Nurse Education
Today, 23(2], 104-111. doi:10.1016/50260-6917(02)00193-4

Bentley, R., & Ellison, K. J. (2005). impact of a service-learning project on nursing students. Nursing Education Perspectives, 26, 287-290.

Carlson, G. D., & Warne, T. (2007). Do healthier nurses make better health promoters? A review of the literature. Nurse Education
Today, 27, 506-513. doi:10.1016/j.nedt.2006.08.012

Vol. 27 No. 2 201 1 - Nursing Praxis in New Zealand Page 21

 Nursing Praxis in New Zealand

Organisation Regionai Office for the Western Pacific Short Term Consuitant. Wellington, New Zealand: Department of Health.

Carryer, J. (2008). Editorial. Nursing Praxis in New Zeaiand, 24(3), 2-4.

Chappie, M., & Aston, E. S. (2004). Practice learning teams: A partnership approach to supporting students' clinical learning. Nurse
Education in Practice, 4, 143-149.

Cleaver, K., & Rich, A. (2005). Sexual health promotion: The barriers school nurses face. Community Practice, 78, 429-432.

Cook, L. (2009). A nurse education and training board for New Zeaiand: Report to the Minister of l-ieaith: An evaluation of the need
for a nurse education and training board for the oversight of nursing education and training in New Zeaiand. Wellington, New
Zealand: Committee on Strategic Oversight for Nursing Education.

Department of Health. (2003). Liberating the talents: Helping primary care trust nurses deliver the NHS Pian. London: HMSO.

District Health Boards New Zealand (DHBNZ) Future Workforce. (2009). Current status of the nationai reguiated nursing workforce
2009. Wellington, New Zealand: DHBNZ.

Dympna, C. (2007). Nurses perceptions, understanding and experiences of health promotion. Journai of Clinical Nursing, 16, 1039-
1049. doi:10.111/j.l365-2702.2007.01640.x

Finlayson, M., Sheridan, N., & Cumming, J. (2009). Nursing deveiopments in primary health care. Wellington, New Zealand: Health
Services Research Centre.

Haggarty, C, McEldowney, R., Wilson, D., & Holloway, K. (2009). Growing our own: An evaiuation of the nurse entry to practice
programmes in New Zeaiand 2006-2009. Wellington, New Zealand: Ministry of Health.

Hayward, K. S., & Weber, L. M. (2003). A community partnership to prepare nursing students to respond to domestic violence. Nursing
Forum, 38(3), 5-10.

Hefford, M., Cumming, J., Finlayson, M., Raymont, A., Love, I , & van Essen, E. (2010). Practice nurse cost benefit analysis: Report to
the Ministry ofi-iealth. Wellington, New Zealand: LECG

Hjalmhult, E. (2009). Learning strategies of public health nursing students: Conquering operational space. Journal of Clinical Nursing,
18, 3136-3145. doi:10.1111/j.l365-2702.2008.02691.x

Holt, M., & Warne, T. (2007). The educational and practice tensions in preparing pre-registration nurses to become future health
promoters: A small scale explorative study. Nurse Education in Practice, 7, 373-380. doi:10.1016/].nepr.2006.11.009

Kenyon, L., & Peckover, S. (2008). 'A juggling act': An analysis of the impact of providing clinical placements for pre-registration
studentsontheorganisationof community nursing and health visiting work. Nurse Education Today, 28, 202-209. doi:10.1016/j.
nedt.2007.03.014

Kool, B., Thomas, D., Moore, D., Anderson, A., Bennetts, P., & Earp, K. (2008). innovation and effectiveness: Changing the scope of
school nurses in New Zealand secondary schools. Australian & New Zeaiand Journal of Public i-leaith, 32(2), 177-180. Retrieved
from http://www.cinahl.com/cgi-bin/refsvc?jid=1491&accno=2009908168

Lasater, K., Luce, L, Volpin, M., Terwilliger, A., & Wild, J. (2007). When it works: Learning community health nursing concepts from
clinical experience. Nursing Education Perspectives, 28, 88-92.

McMurray, A., & Clendon, J. (2010). Community heaith and Wellness: Primary heaith care in practice. Sydney, Australia: Elsevier.
Ministry of Heaith. (2001). Primary Health Care Strategy. Weilington, New Zealand: Author.

Ministry of Health. (2003a). investing in heaith: Whakatohutia te orange tangata: A framework for activating primary heaith care
nursing in New Zeaiand (4th ed). Wellington, New Zealand: Author.

Ministry of Health (2003b). The heaith promoting schoois process. Wellington, New Zealand: Author.

Ministry of Health. (2005). Evolving models of primary health care nursing practice. Wellington, New Zealand: Author.

Ministry of Health. (2008). Clinicai Training Agency purchase intentions 2008/2009. Wellington, New Zealand: Author.

Ministry of Health. (2010). Health targets. Wellington, New Zealand: Author.

Murphy, M., & Polivka, B. (2007). Parental perceptionsof the schools' role in addressing childhood obesity. 7oürno/o/Sc/7oo/A/urs/ng,
23(1), 40-46.

Northrup, K. L., Cottrell, L. A., & Wittberg, R. A. (2008). L.i.F.E.: A school-based heart-health screening and intervention program.
Journal of School Nursing, 2 (1), 28-35.

Page 22 Vol. 27 No. 2 201 1 - Nursing Praxis in New Zealand

Nursing Praxis in New Zealand

Nursing Council of New Zealand. (2010a). The New Zealand nursing workforce. Wellington, New Zealand: Author.

Nursing Council of New Zealand. (2010b). Report on the review of education programme standards for the registered nurse scope of
practice. Wellington, New Zealand: Author.

Piper, S. (2008). A qualitative study exploring the relationship between nursing and health promotion language, theory and practice.
Nurse Education Today, 28,186-193. doi:10.1016/j.nedt.2007.03.010

Repper, J., & Breeze, J. (2007). User and carer involvement in the training and education of health professionals. A review of the
literature. International Journal of Nursing Studies, 44, 511-519. doi:10.1016/j.ijnurstu.2006.05.013

Schneebeli, C, O'Brien, A., Lampshire, D, & Hamer, H.P. (2010). Service user involvement in undergraduate mental health nursing in
New Zea\aná. International journal of Mentoli-iealth Nursing, 19(1), 30-35. doi:10.1111/j.l447-0349.2009.00642.x

Speroni, K. G., Earley, C, & Atherton, M. (2007). Evaluating the effectiveness of the KID LIVING FIT program: A comparative study.
Journal of School Nursing, 23, 329-336.

Summers, L. C, Williams, J., Borges, W., Ortiz, M., Schaefer, S., & Liehr, P. (2003). School-based health centre viability: Application of
the COPC model community oriented primary care, issues in Comprehensive Pédiatrie Nursing, 26(4), 231-51.

Swearingen, C. D. (2009). Using nursing perspectives to inform public health nursing workforce development. Pubiic Health Nursing,
26{1), 79-87. doi: 10.1111/j.1525-1446.2008.00756.x

Whitehead, D (2007). Reviewing health promotion in nursing education. Nurse Education Today, 27, 225-237. doi:org.ezproxy.massey.
ac.nz/10.1016/J.nedt.2006.05.003

Whittaker, K. A., & Taylor, J. (2004). Learning from the experience of working with consumers in educational developments. Nurse
Education Today, 24, 530-537. doi:10.1016/j.nedt.2004.06.005

Vol. 27 No. 2 201 1 - Nursing Praxis in New Zealand Page 23

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