Practitioner research to promote practice development: the continued development by means of practitioner research of a multidisciplinary learning environment within neurorehabilitation care for older persons

摘要

Background : Continuous innovation is required to help clinical practice adapt to healthcare demand and there is a pressing need for sufficient numbers of professionals trained to work in this ever-changing context. New environments for learning are needed to enhance the development of these skills for existing and future care professionals. This article gives an account of how practitioner research was used to further develop a multidisciplinary learning environment for students of the Institute of Health Studies and the Institute of Nursing Studies of HAN University of Applied Sciences in a department specialising in neurorehabilitation for older persons from ZZG Herstelhotel, a public hospital offering long-term residential care in the Netherlands. Aim : The aim of the study was to pursue the development of the learning environment by exploring stakeholders’ visions of their ideal multidisciplinary learning environment. Method : Practitioner research was chosen as a methodology as it deliberately seeks to generate local knowledge and theories through exploring different perspectives, and to encourage learning and reflection. A research group was formed consisting of the first author and three practice supervisors. A mixed-methods approach was used by the research group. First, a selection of relevant publications was reviewed by the group. This was followed by learning sessions in which students, supervisors and managers were invited to dream and design on the basis of their own experiences, thereby linking up with the constructionist-based change approach of Appreciative Inquiry. Results : A collective view of the characteristics of a workbased learning environment was developed by students, supervisors and managers. These characteristics were placed in one of four ideal perspectives: the core professional competencies to be acquired; the resources available; the learning culture; and the supervision. Not all students valued multidisciplinary learning, preferring monodisciplinary approaches. Conclusion : The study has resulted in a group of stakeholders being able to set out a number of characteristics of their ideal learning environment from the four perspectives. In doing so, an important condition for organisational learning was created: making the tacit knowledge of professionals explicit. Implications for practice : We recommend the development and explication of a shared vision regarding the ideal knowledge and skills when introducing new approaches to learning in practice Educational perspectives (individual learning and curriculum development) and organisational perspectives (professional development and organisational learning) should be brought together to develop new learning models and methods in a practice context Practitioner research can contribute to practice development by making tacit knowledge explicit In practitioner research, participation is the defining principle throughout the process. This sometimes necessitates pragmatic choices in dialogue with stakeholders to maximise their participation at all stages of the research process Patient-centred healthcare is important, so patients should be involved as stakeholders in the development of new learning approaches in a practice context