Browsing by Person "Dickson, Caroline"

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Achieving congruence in ‘being and doing’ community nursing
(Mark Allen Group, 2022-06-02) Dickson, Caroline
Conceptual and theoretical frameworks for person-centred community nursing practices have not yet been fully developed. There is a need to explore this further in order to guide future district nursing, which forms part of the community nursing discipline in the UK. The contemporary district nursing role is undergoing change, although there appears to be little consensus about the district nurse's (DN) vision across the UK, and little indication of the theoretical position underpinning this change. Meeting strategic requirements ( National Health Service (NHS), 2019 ; Scottish Government (SG), 2017a & b ), DNs have advancing clinical expertise and are recognised for their technical skills. However, one may contend that this emphasis on ‘doing’ in practice contributes to practice decisions made exclusively on task performance by strategic decision-makers, and DNs continually viewing themselves as invisible ( National Assembly for Wales,, 2019 ; Queens Nursing Institute (QNI), 2006 ; Dickson 2018 ; 2020 ). District nursing education may contribute to this lack of clarity as curricula are based on borrowed theory from other disciplines that continue to focus on ‘how to do’, with little emphasis on ‘how to be’ a DN, and the continued decrease in DN numbers across the UK may be a consequence. In this paper, I explore current evidence that underpins district nursing practice, education and research in the UK, and advocate the use of the Person-centred Practice Framework (PCPF) ( McCormack and McCance, 2017 ) as a means of unifying and guiding ‘being a person-centred DN.’ This will enable practitioners who can draw on multiple forms of evidence to inform their advancing practice. This article offers philosophical and pedagogical principles to underpin person-centred education going forward. I argue this will promote congruence between ‘doing’ and ‘being’ a DN, giving a voice to DNs, and direction to their specialism.
Arabic-speaking students' primary care experiences in Scotland
(2010-02) Ahmed, Amel Ibrahim; Cameron, Shona; Dickson, Caroline; Mountain, Kristina
Internationalisation of the higher education sector has resulted in greater ethnic and cultural diversity within the student population throughout the UK and European Union. There is limited knowledge about the burden of poor health and health care utilisation among minority ethnic groups in higher education. Scottish health policy is directed toward proactive care delivered within primary care settings. The community of one university in Scotland was chosen to explore the perceptions of accessibility and acceptability of primary care among one minority group, namely Arabic speakers. The research methodology was of an exploratory descriptive design, with a convenience sample of Arabic speakers studying at one university. Quantitative and qualitative data were provided by 20 respondents. A questionnaire elicited demographic data and information about any primary care services used, while semi-structured interviews gathered more in-depth data. Participants were generally satisfied with primary health services. The majority were satisfied with the availability of a healthcare professional of their preferred gender, and their communication with and attitudes of healthcare professionals, as well as the health information provided. Recommendations include greater availability of written information in Arabic, and further research concerning cultural competence for healthcare professionals.
Becoming a person-centred facilitator of learning in a hospital setting: Findings from a participatory action-oriented study with hospital-based educators
(Elsevier, 2024-12-13) Robinson, Betty Ann; McCormack, Brendan; Dickson, Caroline
Aim Investigate the experience of hospital-based educators becoming person-centred facilitators of learning. Background Hospital-based educators working with staff are not well-prepared for their role. No person-centred pedagogical approaches exist specifically for use in hospital settings. Educators are positioned to advance person-centredness in clinical practice. To do so they need knowledge and skills in person-centred approaches. Little is known about how educators transform from teacher-centred approaches to person-centred facilitation. This study investigated how educators learn about and use person-centred principles to acquire educational theory and become person-centred facilitators. Design Participatory, action-oriented research Methods Guided by four person-centred principles blending relational inquiry and practice development, 10 educators participated in group and individual sessions over 18 months. Data were analyzed using relational inquiry and critical creative hermeneutics. Results Becoming person-centred facilitators was enabled through three principles: starting with self, developing community and belonging and bumping against culture and inviting transformation. Participants became person-centred facilitators through intrapersonal, interpersonal and contextual transformations during moments of discovery, reconciliation and action. Competence developed by experiencing and using four methodological principles of taking a relational stance; using active learning to learn in and from practice; being collaborative, inclusive and participatory; and linking creativity with cognition. This model resulted in improved trust, strengthened relationships and more meaningful and robust learning outcomes. Conclusions Hospital-based educators can be enabled to become person-centred facilitators by providing them with person-centred learning opportunities. The four methodological principles, as a model for person-centred education, provided an effective preparation and orientation to educational and person-centred theory.
Being conductor of the orchestra: An exploration of district nursing leadership
(Mark Allen, 2020-05-07) Dickson, Caroline; McVittie, Chris; Smith, Margaret Coulter
The purpose of the present study was to gain insight into how district nurses understand their leadership role. Data were generated through interviews and audio-journals and analysed using interpretive phenomenological analysis. Findings suggested that district nurses managing teams and caseloads experienced a burden of responsibility. Being creative problem solvers, they adopted facilitative ways of engaging with patients but directive approaches to team management. District nurses sharing leadership with multidisciplinary colleagues did not appear to experience this burden. Their leadership drew on their facilitative approaches to care-giving. If nurses enabled, rather than directed teams, they could create a context for developing autonomy and growth, easing the burden of responsibility.
Being person‐centred in community and ambulatory services
(Wiley-Blackwell, 2021-02) Dickson, Caroline; Peelo‐Kilroe, Lorna; McCormack, Brendan; McCance, Tanya; Bulley, Catherine; Brown, Donna; McMillan, Ailsa; Martin, Suzanne
Building an Inclusive Research Culture
(Springer, 2020-12-23) Baldie, Debbie; Dickson, Caroline; Sixsmith, Judith; Sixsmith, Andrew; Sixsmith, Judith; Mihailidis, Alex; Fang, Mei Lan
Clinical leadership and quality care
(Hodder Arnold, 2012-04-27) Dickson, Caroline; Bain, H.; Chilton, S.; Clarridge, A.; Melling, K.
Community placements: A pocket guide for student nurses
(Lantern Publishing, 2018-11-30) McKinlay, Lesley; Tsigkas, Georgios; Dickson, Caroline; Stuart, Fiona
Community placements are part of every student nurse's learning pathway - but they can be intimidating to the unprepared. This pocket guide is designed to make placements more enjoyable and less stressful, to help student nurses get the most out of their time in the community.
Creative reflections on Enhancing Practice 16: New explorations, insights and inspirations for practice developers
(Foundation of Nurisng Studies, 2016-11-11) Baldie, Deborah; Brown, Angela; Dewing, Jan; Dickson, Caroline; none
It began two years ago, then Arriving in Edinburgh the enthusiasm abounds. The first day arrives - oozing anticipation. Great to gather old friends, new friends; Clans and clever creativity, having fun Energy in the room, creating, innovating, Creative ways transforming minds, creating impact. The International Practice Development Collaborative (IPDC) is loose network of practice developers, academics and researchers who are committed to working together to develop healthcare practice. The IPDC believes that the aim of practice development is to work with people to develop person-centred cultures that are dignified, compassionate and safer for all. One of its four pillars of work is a biennial Enhancing Practice conference. Moving round the world, the IPDC members take it in turns to host the conference; in early September 2016 it was the turn of Queen Margaret University (QMU) in Edinburgh. This article has been created collaboratively by a number of the people who attended this three-day conference. The IPDJ team invited participants to offer 'the line of a poem' that captured or reflected their experience and/or learning. These were then collected and shared, and together we created a series of poems and a collection of haiku (a three-line Japanese poem with 17 syllables, 5-7-5). Other participants have subsequently offered reflections, which we would also like to share with you here. We offer this article to you, as a celebration of our time together; our learning, connections and creating, in the hope that there might be some learning in here for you and that you may consider joining us at our next conference in Basel, Switzerland in 2018.
Developing philosophical and pedagogical principles for a pan-European person-centred curriculum framework
(Foundation of Nursing Studies, 2020-09-30) Dickson, Caroline; van Lieshout, Famke; Kmetec, Sergej; McCormack, Brendan; Skovdahl, Kirsti; Phelan, Amanda; Cook, Neal F.; Cardiff, Shaun; Brown, Donna; Lorber, Mateja; Magowan, Ruth; McCance, Tanya; Dewing, Jan; Štiglic, Gregor
Background: In the associated article in this special issue of the International Practice Development Journal, Phelan et al. (2020) offer an analysis of the global positioning of person-centredness from a strategic policy perspective. This second article, an international person-centred education curriculum development initiative, builds on that foundational work. It outlines the systematic, rigorous processes adopted by academics from five European countries to analyse stakeholder data, theoretically frame the data, and thereby identify philosophical and pedagogical principles to inform the development of person-centred curriculum frameworks.
Embedding storytelling in practice through CAKE – a recipe for team wellbeing and effectiveness
(Foundation of Nursing Studies (FONS), 2023-05-24) Dickson, Caroline; MacDonald, Kath
Background: CAKE, an interactive resource to promote individual and team wellbeing and effectiveness through storytelling was co-designed with community nurses in 2020. In Phase 1 of this project, CAKE comprised seven slices that guided teams through a process of connecting, storytelling, reflecting and action planning to promote wellbeing. It was developed in response to an increasing awareness of psychological harm experienced by nurses and other healthcare professionals. Levels of stress in the workplace are currently contributing to problems with recruitment and retention, and a lack of resources have impacted on practitioners’ wellbeing, and their ability to be compassionate caregivers and to contribute to healthful teams. Aim: Phase 2 of the project sought to: 1) develop facilitators of CAKE; 2) pilot test the prototype CAKE resource in a range of contexts; and 3) create a digital version of CAKE. Methods: An evaluation approach to pilot testing, using multiple methods of data collection, involved 130 health and social care practitioners at 17 sites across the UK. Eight facilitator support sessions, underpinned by the Critical Ally model were offered and data were analysed using thematic analysis. Findings: The findings revealed two overarching themes: facilitating CAKE and experiencing CAKE. In the former, three themes emerged: preparing for CAKE, trying CAKE and embedding CAKE. The latter had two themes: giving it a go and culture change. Following the study, the number of CAKE slices was increased from seven to eight by separating reflection and action planning, and minor amendments were made around spelling and grammar. Conclusion: We propose CAKE as a novel resource to promote individual and team wellbeing and effectiveness in health and social care teams. CAKE users acknowledge the challenges in creating space to use the resource, but when it is implemented teams embed practices that create healthful teams. As facilitators use CAKE, they develop their facilitation skills but they require preparation and support.
Enhancing undergraduate community placements: a critical review of current literature
(2015-04) Dickson, Caroline; Morris, Gillian; Gable, Clare
In the face of the UK-wide policy shift to increased home care, inspiring and enabling the next generation of community nurses is more urgent than ever. The quality of the pre-registration practice learning experience is highly influential on career choices at the point of qualification. Given that 50% of learning by pre-registration students takes place in practice, mentors have a crucial role to play in preparing the next generation of nurses to work in the community. This article discusses the findings of a systematic and critical literature review of pre-registration placements that was funded by the Queen's Nursing Institute Scotland. The review found that students' experiences of learning in community settings are variable, and perceptions of students and mentors are misaligned in terms of what a quality placement should look like. Although there is no clear definition of what constitutes a community placement and there is some underuse of learning environments in areas such as general practice nursing, there are also a number of examples of new and imaginative placements. While these innovations provide 'whole experience' placements, they are currently lacking robust evaluation, despite their potential usefulness on a larger scale. Mentors have the opportunity to provide students with a range of learning opportunities that increase preparedness for working in the community, allowing final year students in particular greater influence over their learning experience. Students undertaking community practice learning, where they have a managed level of autonomy, are more likely to feel confident to take on community nursing roles.
Evaluating The Student Experience of Inquiry-Based Learning: An Educational Initiative
(University of Glasgow, 2010-04) Dickson, Caroline
This paper outlines the development, implementation and evaluation of two honours level inquiry-based learning (IBL) modules, one in a pre-registration and one in a postregistration nursing programme within a modern university. Although IBL has been embraced by nursing curricula as a means of developing effective practitioners to meet the needs of a complex, changing healthcare environment, the evidence to support its adoption remains variable. The literature identifies effective curriculum design, facilitation, motivation and cooperation of learners as key in achieving effective IBL. Scenarios to stimulate IBL were developed from practice for these modules, with contributions from practitioners to ensure currency and relevancy. Student evaluation of the modules revealed that one scenario lacked focus leading to some uncertainty for students. Both student groups encountered some anxiety, particularly during the IBL process and workload was perceived by students as heavier than for traditional methods of teaching and learning. Both groups reported effective facilitation. Although no claims can be made concerning improvement in conceptual thinking within this study, pre-registration students' assessment results in this module were higher than their dissertation module. However, post-registration students' marks were lower when compared with a previous cohort. This small educational initiative raises questions about the importance of content, inquiry process, social interaction and overall effectiveness of IBL methods.
Expertise in action: Insights into the dynamic nature of expertise in community-based nursing
(Wiley, 2018-02-01) Dickson, Caroline; McVittie, Chris; Kapilashrami, Anuj
Aim To gain insight into community nurses' experiences and how they make sense of the expertise they offer in their role Background Globally, the spotlight is currently on community nursing expertise because of the movement of hospital-based to community- based care. Caring for people at home is no longer solely concerned with prevention, but delivering complex care to patients who are acutely unwell or at the end of their life. Little is known about the distinct expertise of community nurses, or their contribution to patient outcomes. There is a need to examine expertise in this group in order to inform current and future care provision within community settings. Design A hermeneutic, phenomenological study. Method Semi-structured interviews were conducted with eight community nurses in Scotland, UK, who hold an additional post-registration, professional qualification. Participants also kept audio-journals. Data were analysed using Interpretive Phenomenological Analysis. Findings Participants described their expertise in three themes; negotiating a 'way in' to care, managing complexity, and 'thinking on your feet'. They did not refer to themselves as specialist practitioners, nor did they perceive that they were viewed as specialist by colleagues or management. They appeared to dismiss their range of expertise which included forming trusting relationships, anticipating care needs and problem-solving, enabling them to undertake complex care management. Conclusions Expertise of community nurses in this study is dynamic, contextualised and action-oriented enabling them to be creative problem-solvers. It reflects engagement with patients and families and all aspects of the setting where care is provided, rather than being solely an identifiable set of specialist skills, Relevance to clinical practice It is vital to recognize community-based expertise internationally, especially if current WHO aims for community-based health care are to be achieved. Highlighting this expertise contributes to current discourse and may be considered in education and practice reviews. This article is protected by copyright. All rights reserved.
Exploring leadership in community nursing teams
(Blackwell, 2012-07) Cameron, Shona; Harbison, Jean; Lambert, Vicky; Dickson, Caroline
Aims.- This article is a report on a study investigating how leadership is perceived in community nursing teams and how these perceptions are translated into working practices of team leaders. Background.- The consensus in community nursing literature is that leadership is important, and especially so in a time of change. However, little empirical evidence exists on how leadership works in practice. Method.- The study adopted an exploratory descriptive design, utilising individual semi-structured interviews and focus groups in four case-studies, with a total of 54 participants. Two case-studies focussed on district nursing teams and two involved public health nursing teams, located in two geographical areas. Participants debated their understanding of the concept of leadership, its associated practices and behaviours in teams, if they saw themselves as leaders, and what preparation was required. The study was undertaken in 2009. Framework analysis techniques were employed to analyse the data. Findings.- A 'quasi-family' model of leadership emerged, with significant emphasis on the importance of personal relationships and support. Nursing grade had a greater impact on perceptions of leadership than geographical context or professional and clinical focus. Conclusion.- No clear fit with any existing theoretical framework was identified. However, nurses in the highest grade banding, in particular, demonstrated practices associated with transformational leadership. Nurses expressed the very clear need to be acknowledged, respected and valued, and that those who provided this support were regarded as good leaders.
From root to fruit – flourishing in change. Evaluation of a development programme for practice development facilitators in end-of-life care
(Foundation of Nursing Studies (FoNS), 2018-05-16) Dickson, Caroline; Legg, Melanie; Penman, Pam; Smith, Tracy; Marie Curie
Background: This paper outlines the structure, processes and outcomes of a 12-month development programme for nurses who were transitioning from a practice-based training role to a practice development role. The programme was part of organisational commitment to develop a person-centred culture. A new team of Practice Development Facilitators across the UK was formed at Marie Curie. Marie Curie, a UK-based charity supporting people with palliative and end of life care needs. Aims and Objectives: The overall aim of the programme was to enable PDFs to engage with the theory and practice of practice development to develop as enablers in the delivery of person-centred practice. Methods: A co-designed multi-method evaluation of the programme that adopted emancipatory practice development and active learning methodologies. Data collection included 4th Generation evaluation, reflective writing, participant stories and examples of practice change. Findings: The programme supported a change in focus of their role from technical to emancipatory. The team identified new ways of engaging together which enabled them to embody person-centredness. By experiencing active learning they came to understand themselves and their practice. Throughout the programme the team experienced a range of organisational challenges which impacted on their progress throughout the programme. Development of their facilitation skills and a strong community of practice will assure embeddedness and sustainability of their new role. Conclusions: Facilitators of Practice Development are a catalyst in developing person-centred cultures which are indicative of flourishing organisations but this needs to be included in organisational strategy. Experiencing flourishing creates a sense of well-being and renewed commitment to develop practice in ways that keep person-centred care at its heart. Key messages: • Making explicit values and beliefs at the beginning of a programme enable social learning and innovation in practice • Investment in PD can be a catalyst to developing person-centred cultures • Role-modelling person-centredness has an impact on staff well-being and person-centred practices • Embedding communities of practice will main momentum in new ways of working
Implementation of learning into person-centred practice: evidence of impact from community nursing preparation programmes
(Frontiers Media S.A., 2025-08-08) Tyagi, Vaibhav; Churchill, Julie; Dickson, Caroline
Introduction: There has been a global move towards personalising and “humanising” healthcare and promoting caring cultures. Education is addressing this agenda by incorporating person-centred principles into teaching and learning. The aim of this research was to explore the implementation of person-centred learning into healthcare practice. More specifically, this study aims to explore community nurses' implementation of learning about person-centredness in their practice and to demonstrate the impact of person-centred curriculum. Methods: A cross-sectional quantitative survey design was used with community nursing graduates and current students who engaged with person-centred curricula. Results: Significant improvements were found in three constructs of person-centred practice—clarity of beliefs and values, knowing self and developed interpersonal skills. Discussion: These findings provide support for the development of pre-requisites of person-centred practice, rather than person-centred processes in pre-registration curricula. With key pre-requisites for person-centred practice such as leadership attributes of knowing self and of advanced communication skills, learners and graduates will be able adopt healthful leadership practices which are vital in developing others and in creating person-centred cultures.
Implementing person‐centred key performance indicators to strengthen leadership in community nursing: A feasibility study
(Wiley, 2020-08-13) McCance, Tanya; Dickson, Caroline; Daly, Laura; Boomer, Christine; Brown, Donna; Lynch, Brighide; MacArthur, Juliet; Mountain, Kristina; McCormack, Brendan
Aims To explore the utility and feasibility of implementing eight person‐centred nursing key performance indicators in supporting community nurses to lead the development of person‐centred practice.
Inspiring undergraduates towards a career in community nursing
(RCNi, 2015-09) Cable, Clare; Dickson, Caroline; Morris, Gillian
This article is based on the findings of a literature review commissioned by the Queen's Nursing Institute Scotland as part of its commitment to promote an evidence-based educational policy. An analysis of the literature suggests that there is potential to expand the provision of community placements beyond traditional clinical areas and these placements should be identified and overseen in collaboration with managers, mentors and higher education institutions to ensure a consistent approach and a positive learning experience. This may inspire undergraduate nurses to pursue a career in community nursing. Currently, there is little evidence to support models. High-quality evaluation research is required to ensure that new models are developed using a sound evidence base. Read More: http://journals.rcni.com/doi/abs/10.7748/nm.22.6.18.e1382
‘It’s a nice place, a nice place to be’. The story of a practice development programme to further develop person-centred cultures in palliative and end-of-life care
(Foundation of Nursing Studies (FoNS), 2018-05-16) Dickson, Caroline; Smith, Tracy; Ford, Hilary; Ludwig, Steffi; Moyes, Rhona; Lee, Laura; Adam, Elaine; Paton, Tracy; Lydon, Brigid; Spiller, Juliet; McCormack, Brendan
Background Palliative and end of life care services need to be person-centred. However, it cannot be assumed that such services are ‘naturally’ person-centred as in reality they face the same pressures and challenges as any other service. This is the case in the practice development research reported in this paper. Whilst the service had good patient and family feedback/satisfaction, the context of care provision for staff did not reflect these same levels of satisfaction. This contrast poses challenges for organisations in the context of staff well-being and the sustainability of person-centred care. The work undertaken in this project aimed to address this issue. Aim To implement a programme of practice development to further the development of a culture of person-centred practice in the Marie Curie Care (MCC) Edinburgh Hospice. Methods The programme was theoretically informed by The Person Centred Practice Framework of McCormack and McCance (2017) and operationalised through the methodology of Transformational Practice Development. Thirteen multidisciplinary team members formed a project group and participated in 10 x 4 hour workshops of learning and development, spread over a 12-month period. Practice development activities were planned in-between the workshops to be undertaken by the group members. Evaluation data were collected prior to the practice development work commencing, as a continuous process throughout the 12-months and at the end of the project period. Data collected included patient and staff stories, practice observations, creative expressions and routinely collected data. These data were analysed through a participatory approach with the group members and theorised through the lens of human flourishing. Findings The findings are located within a framework for exploring the conditions for human flourishing. They illustrate the tension between person-centred care and person-centred cultures. Key findings demonstrate the need for all persons to be ‘known’ in order for effective person-centred relationships to exist, the significance of shared values, the importance of addressing ‘small’ practice changes as well as the need to ensure the hearing of different voices. Findings fromn routine collected data further demonstrate the relationship between the development of a person-centred culture with patient and staff outcomes. Conclusions and Implications for Practice This project is one of the first to explicitly use a framework for human flourishing to analyse the relationship between person-centred culture and care provision. The programme demonstrates the importance of person-centred cultures for sustainable person-centred care. Implications for practice include: 1. Practice settings need to be clear about the difference between patient and person-centredness. 2. The engagement of a multidisciplinary team in interdiscioplinary systematic transformational practice development has the potential to transform the culture and context of care and produce sustaiunable outcomes. 3. Human flourishing is an appropriate focus to adopt in exploring how practice settings embrace the principles of person-vcentredness for all persons.