Review: Blending practice development methods with social science research: an example of pushing new practice research boundaries

摘要

Breaking new ground in using research methodologies and methods is fraught with methodological and other problems, particularly within the context of funding and time constraints. It is unsurprising, therefore, that many researchers prefer to use established or 'off-the-peg' approaches that have been exposed previously to the blow torch of rigour. The authors illustrate the use of a hybrid research methodology, combining a key element of collaborative action research (CAR) with practice development methods, in an exemplar about unlocking the phenomenon of why inappropriate admissions of elderly people occur in emergency departments and exploring more suitable care pathways. They integrate several key principles of practice development (e.g., engagement, clinical puzzling, values clarification, person centred approaches) in a three-phase process to enhance engagement in the reconnaissance stage of CAR: (i) a focused approach, comprising individual interviews with 12 emergency department staff and the collection of some general data, to gather information about and map the phenomenon, and to develop a provisional framework; (ii) a broader perspective to explore and extend the map and refine the framework, in this instance, by incorporating the views of a wider range of stakeholders (including some from the focused approach) to consider the phenomenon and to propose ways to deal with the issue; and (iii) after a period of reflection, re-engaging the same group of stakeholders and adopting solution-focused ways of working to refine the proposed framework to address the phenomenon.