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使用两种工作场所促进模式为以人为本的文化发展创造条件:一项参与式行动研究。

Using two models of workplace facilitation to create conditions for development of a person-centred culture: A participatory action research study.

机构信息

Division of Nursing, Queen Margaret University, Edinburgh, UK.

Galway Clinic, Galway, Ireland.

出版信息

J Clin Nurs. 2019 Aug;28(15-16):2769-2781. doi: 10.1111/jocn.14897. Epub 2019 May 15.

Abstract

AIMS AND OBJECTIVES

To examine facilitation in workplace learning where nurses are focused on creating person-centred cultures; to provide a framework for novice and proficient facilitators/practitioners to learn in and from their own workplaces and practices; and to provide the conditions where practitioners can gain an understanding of the culture and context within their own workplace.

BACKGROUND

Evidence suggests that person-centred cultures depend on purposeful, facilitated practice-based learning activities. For person-centredness to become more meaningful to nursing leaders in their daily work, focus must be placed on their acquisition and use of facilitation skills. The facilitation framework "Critical Companionship" remains an exemplar in the development of expert facilitation skills. Two sequential facilitation models were developed as "steps" towards Critical Companionship, as a framework for novice and proficient facilitators and practitioners to learn in and from their own workplaces and practices.

DESIGN AND METHODS

This research, situated in a critical social science paradigm, drew on participatory action research to devise, explore and refine two facilitation models: Critical Allies and Critical Friends. The researcher adopted an insider approach to work with five nursing leaders, which was subsequently reported using the EQUATOR guidelines on best practice in reporting of participatory action research.

RESULTS

The results show the complexity of enabling facilitation within the workplace. Four themes and twelve subthemes emerged from the data that describe the attributes needed to facilitate workplace learning and reveal that managers can have an active role in enabling person-centred culture development.

CONCLUSIONS

This research adds to the body of knowledge on developing person-centred culture. It offers practical stepping stones for novice and proficient facilitators to enable embodiment of the skills necessary to facilitate learning in person-centred cultures. The models offer a workplace-friendly pathway with practical methods and further contribute to our understanding of how we create person-centred cultures.

RELEVANCE TO CLINICAL PRACTICE

Facilitation of practice development and workplace learning remains the most effective methods to develop person-centred cultures. This research introduces a pathway for clinical leaders/managers to become facilitators with their own teams, maximising the impact on the culture where care is delivered.

摘要

目的和目标

研究护士专注于创建以患者为中心的文化时的促进作用;为新手和熟练的促进者/从业者提供一个在自己的工作场所和实践中学习和从中学习的框架;并为从业者提供在自己的工作场所中了解文化和背景的条件。

背景

有证据表明,以患者为中心的文化依赖于有目的、促进的基于实践的学习活动。为了使以患者为中心的理念对护理领导者在日常工作中更有意义,必须关注他们获取和使用促进技能。促进框架“关键伙伴关系”仍然是发展专家促进技能的典范。为了成为“关键伙伴关系”的“步骤”,开发了两个连续的促进模型,作为新手和熟练的促进者和从业者在自己的工作场所和实践中学习和从中学习的框架。

设计和方法

这项研究基于批判社会科学范式,利用参与式行动研究来设计、探索和完善两种促进模式:关键盟友和关键朋友。研究人员采用内部人士的方法与五名护理领导者合作,随后根据在参与式行动研究报告方面的最佳实践报告准则,使用 EQUATOR 指南进行了报告。

结果

结果表明,在工作场所中促进促进的复杂性。从数据中出现了四个主题和十二个子主题,描述了促进工作场所学习所需的属性,并揭示了管理者可以在促进以患者为中心的文化发展方面发挥积极作用。

结论

这项研究增加了关于发展以患者为中心的文化的知识体系。它为新手和熟练的促进者提供了实用的垫脚石,使他们能够体现在以患者为中心的文化中促进学习所需的技能。这些模型提供了一条友好的工作场所途径,具有实用的方法,并进一步有助于我们了解如何创建以患者为中心的文化。

临床实践相关性

促进实践发展和工作场所学习仍然是发展以患者为中心的文化的最有效方法。这项研究为临床领导者/经理提供了一条与自己的团队一起成为促进者的途径,最大限度地提高了护理提供文化的影响力。

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