Practice Development: My personal vision for the future

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Practice Development My personal vision for the
future

• Rob McSherry Principal Lecturer Practice
  Development Postgraduate Institute School of
  Health Social Care, University of Teesside,
  Middlesbrough, UK
• Chair of the Developing Practice Network,
  Foundation of Nursing Studies, London UK.

Transformational Practice Practice and
Professional Development Nurses Forum
(PPDNF) Walton Conference Centre, Southern
General NHS Trust, Glasgow Scotland 14th June
2006.
Promoting Evidence-Based Practice
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Aim

• To share my personal vision for the future by
• outlining where we are now
• where we want to be
• and by
• highlighting whats potentially on the horizon

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Where Practice Development is Now!
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• Practice Development (PD) originated in the the
  United Kingdom (UK).
• associated with supporting modernisation,
  organisational, service and quality improvements
  but more importantly in promoting patient
  centeredness.
• Its perceived value is in its facilitative
  approach to innovation and change

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Highlight where practice development could be!
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The dichotomy

• There appears to be limited evidence
  substantiating the existence of a knowledge base
  within the field of PD
• Need to consolidate our position and move forward
• How?

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Applying the Method of Concept evaluation
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• What are concepts?
• Concepts are the building blocks of theory
  (Chinn Jacobs 1983)
• Concepts may be linked together to form a
  framework of the body of the theory, and they are
  the link between abstraction and data.
• Concepts form the theoretical realm of a
  discipline, and they are the means by which,
  through rigorous developing, testing and
  modifying,a discipline advances
  (Morse et al. 1996)

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Defining concept evaluation

• Concepts do not just exist or not exist they
  emerge and are introduced to the scientific
  community and mature with time (Wallace 1983)
• A mature concept is well-developed having
  consensus and consistency amongst the theorists,
  researchers and practitioners (Morse et al. 1996)

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Evaluation criteria
(Morse et al. 1996)
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Literature Review
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• Extensive literature review on CINAHL undertaken
  at the end of 2004, using the key words practice
  development revealed 416.
• Limited to 130, which made direct reference to
  practice development in the title.
• From these articles, 23 are research focused and
  107 associated with informing the practice
  development debate
• Critically reviewed and categorized literature
  into themes

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Literature Review Emergent themes/debates
aligned to practice development
Grounded in Critical social theory
Obstacles
Definitions
Practice Development
Attributions/ esteem factors
Fundamental principles
Roles and responsibilities
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Grounded in Critical Social Theory
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• Habermas (1972) three kinds of knowledge
• interwoven with Human Interest
• Technical
• Gaining technical knowledge to enable greater
• skill in the delivery of practice.
• Practical
• Understanding and clarifying how others see
• the world
• Emancipatory
• How self-reflection and self understanding is
• influenced by social conditions
• (McCormack et al. 2004, p37-39)

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World views on practice development
Technical practice development
Assumptions Values Beliefs
Transformational culture
Practical practice development
Emancipatory practice development
Methodologies
Critical social theory
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Definitions
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• - Kitson (1994) Research focused
• - Mallett et al. (1997) Distinction between
  practice development and professional development
• - McSherry Basset (2002) Team working and
  collaboration
• - Page Hammer (2002) Quality improvement
• McCormack et al. (1999 2004, Pg. 258).
• continuous process of improvement towards
  increased effectiveness in person-centered care,
  through the enabling of nurses and health care
  teams to transform the culture and context of
  care. It is enabled and supported by
  facilitators committed to a systematic, rigorous
  and continuous process of emancipatory change

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• Clarity and consensus of what PD is and is not
• PD is linked to change and continuous quality
  improvement
• PD provides frameworks for facilitating and
  supporting change
• PD supports the E approach to advancing and
  evaluating practice

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Practice development in action taking the E
approach to advancing and evaluating practice!
Evolving

Engaging
Practice development in action
Enabling
Enlightening
Encouraging
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Fundamental principles
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• Purpose
• Quality patient-focused care
• Using knowledge, skills and values to enhance
  personal development
• Means through
• Developing knowledge and skills
• Enabling individual, teams and organisations to
  change
• Skilled facilitation
• Systematic, rigorous and continuous process of
  emancipatory change
• (Booth et al. 2004,Garbett McCormack
  2001,Unsworth 2000)

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Role and responsibilities (boundaries)
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Practice development Facilitates and compliments
the governance agenda
(McSherry Driscoll 2004, McSherry, 1999)
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Attribution/esteem factors (outcomes)
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Supports modernisation
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Dissemination
Evaluation
Collaboration
Practice Development and Modernisation
Partnerships
Best Evidence
Teamwork
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Promotes multi-disciplinary working
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Universal
Crosses all professional boundaries
Unifying
Practice development
Practical
Essential
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Identify whats on the horizon!
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Practice (Quality) Encourage and
engage Protect and support Articulate and
differentiate Focus on impact
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Educational Innovative and creative educational
programmes Stakeholder/partnerships and
collaborative working Provide easier access to
tools and techniques
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Research and development Support and
facilitate Focus on evaluation Enterprise and
consultancy
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Communication Developing new and creative ways
of information retrieval and giving Provide
easier and quicker access information Widen
participation Share and disseminate (Internationa
l Conference 2006)
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Practice development patients/public employers pro
fessional Centeredness
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Practice (Quality)
Educational
Practice development patients/public employers pro
fessional Centeredness
Research and Development

• Communication

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Summary
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• The concept evaluation criteria was a useful
  approach to identify the maturity of a new
  discipline/field of practice.
• Practice development is an emerging and maturing
  discipline in its own right.
• Empirical evidence exists clarifying what PD is
  and what practice developers do.
• Essential skills, attributes and characteristics
  of practice development have been identified.

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• The primary principle of practice development is
  patient-centeredness.
• The role of individuals is vital particularly in
  leadership and facilitation.
• The future challenge is in delineating the role
  and responsibilities of PD.
• Developing appropriate methods of evaluation.

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• Protect and support the position and each other
  in light of future change.

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Concept maturity of PD against the evaluation
criteria
(Morse et al. 1996)
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Final thought

• It should be recognised that many conditions will
  influence PD within the context of the service
  provision. Practice development by its nature is
  not a linear process and can be messy. It can
  also be difficult to order into structure without
  dedicated roles as every organisational culture
  and working conditions are different making it
  difficult to generalise.
• (McSherry Warr 2006)

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Acknowledgement
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Information about joining The Developing
Practice Network (DPN)http//www.dpnetwork.org.u
k/
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For further information about this presentation
please contact Rob McSherry Principal
Lecturer Practice Development Postgraduate
Institute School of Health and Social Care
University of Teesside MIDDLESBROUGH ENGLAND TS1
3BA Tel [phone] Fax 01642
384143 E-mailRobert.McSherry_at_tees.ac.uk
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Thank you for your attention

• Any Questions Please?