Patient narratives in the investigation and development of nursing practice expertise: a potential for transformation

Abstract

This paper is a review of the experiences gained whilst working with the 'expertise in practice project'. The project was concerned with understanding the complex phenomenon of practitioners investigating and evaluating their own practice. The research intention was focused on making a difference to how those nurses practised, through introducing systematic practice-based inquiry processes that could enable nurses to think more critically about their work and how their practice affects others. Particular attention is paid to the process of engaging people who use healthcare services, as research participants in the evaluation of nursing practice expertise. We outline how the project incorporated practitioners' concerns about asking people who use health care services opinions on nursing practice expertise and how a process of discovery emerged that enabled transformation of practice and consideration of the patient-participants' role as a sophisticated evaluator of health-care. As a result, we present a case for transformational qualitative research. Such research is values-driven and uses inclusive, collaborative and facilitative processes. It contributes to human flourishing, not only through its 'ends' (i.e. research products) but also, intentionally, through its 'means' (e.g. research processes and stakeholder involvement). Thus, transformational research is complex and requires that researchers engage in reflexivity (deep self-reflection) to examine and critique their personal values.

Nursing expertise: a course of ambiguity and evolution in a concept

“…Expertise was also defined in terms of performance and as a ‘hybrid of practical and theoretical knowledge’ (McHugh and Lake , 276). No studies reviewed employed specific tools to measure expertise and a number of studies did not define expertise (Conway ; Hardy, Titchen and Manley ). The majority explored expertise at the level of the individual nurse.…”

FIRE (facilitating implementation of research evidence): a study protocol

“…Enabling facilitation is concerned with change and innovation, individual and team effectiveness, leadership and evidence use and development. Recent evidence suggests that practice development achieved through enabling facilitation methods requires a minimum of two years of sustained enabling facilitation [42]. Arm three, therefore, is a two-year, two-staged intervention.…”

Refining nursing practice through workplace learning: A grounded theory

“…The Ottawa Hospital model, and the implementation of the Clinical Nurse Expert role, is another similar, effective strategy for facilitating new graduate transitions and informal workplace learning through mentor‐guides (Jewell, ). The Expert Practice Project, employed in the UK, also focuses on the value of “skilled companionship” (Hardy, Titchen, & Manley, , p. 85) for mentoring other nurses. Changing organisational culture and shifting values regarding these potential mentors is not simple or easy; however, based on this grounded theory, it may facilitate significant learning for many nurses across the continuum of their careers.…”