Learning from experience: constructing critical case reviews for a leadership programme.

A previous paper described the development of a leadership programme for critical care and highlighted that one of the strengths of the programme was the critical case review. This paper sets out in some depth the major theoretical influences in the construction of the case review. Case reviews have been used in education for some time but often have predetermined outcomes. The education approach favoured here was based on action learning, which in itself belongs to the broad church of reflective practice. While reflective practice has been advocated in nursing since 1986 together with the introduction of clinical supervision neither have met with unqualified success in their own right. This paper concludes that while the concept and construction of the critical case review may be new it is in essence no more than a jigsaw of already well-established practices of reflection, clinical supervision and action learning woven into the foundations of clinical risk management and whole systems working.