CHAPTER 7

CONCLUSION AND SUMMARY

The first question addressed the types of nurses using the list. Subscribers are predominantly female, from North America, and use educational e-mail addresses. Most ontributors are nurses working in educational settings, mainly as teachers but with some students, or in some aspect of management. Few qualified nurses working primarily in direct clinical care currently contribute to the list. Males, particularly from North America, form a higher proportion of contributors than they are subscribers, and tend to contribute more frequently.

My experience of interviewing participants via e-mail (the second research question) indicates that it is a viable means of gathering research data. Evidence from a number of the interviews indicates that other nurses have also used this method successfully. While the absolute time scale in obtaining responses may be prolonged compared with FTF interviews, the fact that both interviewer and interviewee have the opportunity to save and peruse the complete exchange has implications for the structure of the interview, and its later analysis. Either participant can review at their leisure the progress to date before making their next response. This provides opportunity for the interview being a highly reflexive process, something that is more difficult in FTF interviews or paper-based questionnaires. A highly significant aspect is that the complete record of the interview is available for easy transcription, with no loss of non-verbal aspects.

I believe that this study has demonstrated the utility of Fairclough's method for analysing discourse of this type, conducted through this particular medium (question three). The discursive practice analysis indicated that several genres exist within the list, i.e. information presentation, posing and answering of questions, and discussion of nursing issues. Extensive intertextuality is evident, particularly the manifest intertextuality of cut-and-pasting sections of previous messages to indicate the particular discussion or question to which the contributor refers. In view of the existence of multiple simultaneous discussion threads, this is essential for maintaining coherence in the discourse.

Textual analysis indicated that nurses generally make extensive use of politeness and repair strategies, usually to minimise misunderstandings. The concurrent use of modality in many contributors' messages, though, indicates that many nurses lack a sense of their own power. This may be internalised from the types of communicative strategies nurses use in FTF conversations with other health professionals. The problematic issue of turn-taking, with the inability for a contributor to select who will have the next turn may ironically be one of the greatest strengths of this communication medium, and contribute to equalisation of contributions among subscribers.

Analysis of the social practice indicated that nurses on the list feel safe and confident in being able to present themselves to others, often exposing aspects of themselves that in FTF situations they may be less willing to do. A sense of community is evident from the list, but the gender issues around influencing the content and direction of the list are more problematic and would merit further study.

Fairclough's method is not easy to use, particularly within a small study, due to the need to integrate elements from three dimensions to provide an overall analysis of the discourse. It has, however, distinct advantages in compelling the researcher to explicitly recognise the need for incorporation of wider contextual features into the analysis of the text. Derrida (1976) seems to say that there is nothing outside the text; in one sense, when considering disembodied words on a computer screen, this is true. However, knowing that the text comes from a nurse, in a particular country, of particular gender, and who may have particular qualifications, in themselves provide a plethora of potential extra-textual information to consider in one's analysis of the words on the screen.

The DA has been necessarily selective, as I have indicated throughout in an attempt to provide grounds for judging its reliability. A researcher using a different discourse analytic method, or different aspects of Fairclough's method, may reach different interpretations of the corpus. I believe, however, that if they were operating within the same philosophical frame of reference, their findings would be congruent with those presented here, rather than contradictory.
 

Future directions

Among the additional questions that have been posed, and would merit further investigation are:

1. what factors influence the size of turns that an individual makes within a discussion? Are these factors primarily technological or cost-related?

2. is the view expressed by interviewees of CMC being personal and personalised shared by users of other lists, or is it particular to nurses and nursing lists? Are there differences between how males and females view this issue, or between different countries or cultures?

3. does the amount and nature of manifest intertextuality used by a subscriber relate to their level of technical expertise in using CMC?

4. are the politeness and repair strategies exhibited by subscribers to this list common to other nursing lists, and to non-nursing lists?

5. is the degree of modality displayed particular to nursing CMC? Do nurses use more or less modality in on-line discussions, compared with FTF discussions, or different forms of modality?

6. does the gender of the originator of a discussion thread have any influence on the life of the thread?

7. what uses are made of sig files? Are they related to users' gender, age, technical expertise, or other factors? Are they a mechanism of exerting influence within discussions?

8. what impact and influence does CMC have on the off-line practice of nursing?

This case study has examined a particular corpus, produced at a particular moment in time and within a particular context. Its interpretation must take these points into consideration, especially when considering possible generalisation from the findings. The constantly changing nature of CMC, within nursing as well as the wider global community, necessitate the temporal aspect of the corpus' production being uppermost in the reader's mind (Stake 1994). It would have been impossible to produce this corpus two years before, as the Nursenet list did not then exist. Two years hence, the nature of the discourse on Nursenet may be totally different, due to factors including contributions from more subscribers in total, and more subscribers from different parts of the world. In the 4 months between the creation of the corpus and the final writing of this report, the number of subscribers to Nursenet has increased by 22% world-wide, and by 117% in GB (Norris 1995;28 Feb.). More nurses are seeing the benefits of and are able to participate in on-line communication with their colleagues around the world. Nursing can only benefit from this increase in sharing of knowledge, information and ideas.

NOTES

1. Connection to the wider Internet is not a prerequisite for CMC. It can occur within closed, local networks, even within single buildings, requiring at minimum only two computer terminals to be connected. However, the case discussed here does use the Internet to achieve connectivity between individuals.

2. It is not possible to cite specific pages for electronically-stored materials, as they are often not broken down into pages, and the page derived from downloading may be purely a feature of the reader's word-processing package.

3. I use the term participant in preference to Leininger's (1985) term, "informant".

4. Subscribers who use commercial organisations with headquarters in the USA appear on that part of the subscriber list, irrespective of their country of residence. As illustration, at the time of the corpus, my Nursenet subscription was by mail through CompuServe, so I was counted in the US subscribers. However, in this instance, other information available within the corpus confirms the country of origin of most messages.

Chapter 6

Contents

References

Copyright: Peter J. Murray 1996, 1997, 2000

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