Applying Legitimation Code Theory to teach breastfeeding in nurse education : A case study

Journal article

Bowdler, Suzanne, Nielsen, Wendy, Meedya, Shahla and Salamonson, Yenna. (2023). Applying Legitimation Code Theory to teach breastfeeding in nurse education : A case study. Nurse Education in Practice. 72(3), p. Article 103780. https://doi.org/10.1016/j.nepr.2023.103780
AuthorsBowdler, Suzanne, Nielsen, Wendy, Meedya, Shahla and Salamonson, Yenna
Abstract

Aim
To use Legitimation Code Theory as a framework to inform the design of nursing education and gain insights into student perspectives of this design.

Background
Internationally, the World Health Organization’s breastfeeding recommendations are not being met. One contributing factor is that healthcare providers including registered nurses lack the knowledge to support breastfeeding women on an ongoing basis and rely on their personal experiences to inform the care they provide. Undergraduate nursing students should receive education to assist breastfeeding women in practice.

Design
The study is underpinned by case-study methodology. The Legitimation Code Theory (LCT) dimension of Semantics and the concepts of semantic gravity and semantic density were used to theoretically frame and develop an intervention module to teach undergraduate nurses about breastfeeding.

Methods
This module was part of an elective seven-week paediatric nursing course. University Human Research Ethics Committee (HREC201/203) reviewed the study. Participants (n = 9) completed semi-structured interviews and thematic analysis helped us to understand their experiences of the module. The Template for Intervention and Description and Replication (TIDeR) framework was used to report the intervention.

Results
The breastfeeding module was positively received by participants who noted the module’s structure differed from previous courses. Three main themes were identified in the student experience. These are: a) threads and links; b) engaging structure; and c) seedlings.

Conclusion
Legitimation Code Theory is an effective course development framework to harness the learners’ prior informal knowledge and weave learning activities between theory and contextual practice to develop cumulative knowledge.

Impact
With an increased understanding of how undergraduate nursing students develop knowledge, the LCT dimension of Semantics can be ussed to structure content knowledge in instructional design. This approach builds explicit bridges between knowledge development in the nursing curriculum and learners' informal knowledge and contextual practice in clinical settings.

KeywordsLegitimation Code Theory; knowledge development; undergraduate nursing students; undergraduate midwifery students; education; breastfeeding
Year2023
JournalNurse Education in Practice
Journal citation72 (3), p. Article 103780
PublisherElsevier Ltd
ISSN1471-5953
Digital Object Identifier (DOI)https://doi.org/10.1016/j.nepr.2023.103780
PubMed ID37738786
Scopus EID2-s2.0-85171976043
Open accessPublished as ‘gold’ (paid) open access
Page range1-8
Publisher's version
License
File Access Level
Open
Output statusPublished
Publication dates
Online20 Sep 2023
Publication process dates
Accepted11 Sep 2023
Deposited16 Apr 2025
Additional information

© 2023 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).

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Brett, Lindsey, Traynor, Victoria, Stapley, Paul and Meedya, Shahla. (2018). Exercise and dementia in nursing homes : Views of staff and family carers. Journal of Aging and Physical Activity. 26(1), pp. 89-96. https://doi.org/10.1123/japa.2016-0368
Sufficient exercise for Australians living with dementia in residential aged care facilities is lacking : An exploration of policy incoherence [Commentary]
Brett, Lindsey, Stapley, Paul, Meedya, Shahla and Traynor, Victoria. (2018). Sufficient exercise for Australians living with dementia in residential aged care facilities is lacking : An exploration of policy incoherence [Commentary] John Wiley & Sons, Inc.. https://doi.org/10.1111/1753-6405.12800
Association between maternal sense of competence and self-efficacy in primiparouswomen during postpartum period
Bagherinia, Marzieh, Meedya, Shahla and Mirghafourvand, Mojgan. (2018). Association between maternal sense of competence and self-efficacy in primiparouswomen during postpartum period. Shiraz E-Medical Journal. 19(3), p. Article e59286. https://doi.org/10.5812/semj.59286
Effect of educational and support interventions on long-term breastfeeding rates in primiparous women : A systematic review and meta-analysis
Meedya, Shahla, Fernandez, Ritin and Fahy, Kathleen. (2017). Effect of educational and support interventions on long-term breastfeeding rates in primiparous women : A systematic review and meta-analysis. JBI Evidence Synthesis. 15(9), pp. 2307-2332. https://doi.org/10.11124/JBISRIR-2016-002955
Effect of educational and support interventions to increase long-term breastfeeding rates in primiparous women : A systematic review protocol
Meedya, Shahla, Fernandez, Ritin and Fahy, Kathleen. (2017). Effect of educational and support interventions to increase long-term breastfeeding rates in primiparous women : A systematic review protocol. JBI Evidence Synthesis. 15(3), pp. 594-602. https://doi.org/10.11124/JBISRIR-2016-003132
Effects and feasibility of an exercise intervention for individuals living with dementia in nursing homes : Study protocol
Brett, Lindsey, Traynor, Victoria, Stapley, Paul and Meedya, Shahla. (2017). Effects and feasibility of an exercise intervention for individuals living with dementia in nursing homes : Study protocol. International Psychogeriatrics. 29(9), pp. 1565-1577. https://doi.org/10.1017/S1041610217000138
The health and health preparation of long-term Australian travellers
Halcomb, Elizabeth, Stephens, Moira, Smyth, Elizabeth, Meedya, Shahla and Tillott, Sarah. (2017). The health and health preparation of long-term Australian travellers. Australian Journal of Primary Health. 23(4), pp. 386-390. https://doi.org/10.1071/PY16138
The Milky Way educational and support programme : Structure, content and strategies
Meedya, Shahla, Fahy, Kathleen and Parratt, Jenny A.. (2016). The Milky Way educational and support programme : Structure, content and strategies. Women and Birth. 29(4), pp. 388-393. https://doi.org/10.1016/j.wombi.2016.01.006