The rules of the game in graduate entry nursing: A longitudinal case study.

Background: Graduate Entry Nursing programmes are pre-registration nursing curricula designed for candidates who already have a health related degree. The programmes aim to attract highly motivated individuals who have a commitment to nursing and hold the cognitive abilities associated with studying in higher education including critical thinking styles and capability to study independently. These attributes are termed within the literature as "graduateness". They are viewed by some as advantages to nursing. In contrast, however, there remains widespread scepticism amongst the public and some professionals towards those who are academically educated entering nursing.

Objectives: To explore how GEN students anticipate, experience, explain and respond to attitudes which imply resistance to those who are academically educated.

Design: Longitudinal case study informed by the conventions advocated by Yin (2014).

Settings: School of Health Sciences in a British University.

Participants: Eight GEN students participated over the two year duration of their programme. Twelve clinical assessors with a minimum of four months' experience of supporting GEN students in practice.

Methods: Students took part in individual interviews at six monthly periods which were informed by the content of diaries maintained throughout their clinical placements. Clinical assessors took part in focus group discussions. Practice documentation was accessed to identify the progression of clinical competency along with written feedback received by students from clinical assessors.

Results: Results demonstrate the ways in which GEN students position themselves performatively in order to pre-empt or challenge negative stereotypes relating to their competence, compassion and commitment.

Conclusions: Students employ a number of strategies to navigate the challenges of learning within an environment in which they are viewed with suspicion and distrust.