Browsing by Person "Freeth, D."

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A practice development programme to promote the use of the Model of Human Occupation: contexts, influential mechanisms and levels of engagement amongst occupational therapists
(College of Occupational Therapists, 2010-11) Melton, J.; Forsyth, Kirsty; Freeth, D.
This study evaluated a multifaceted, organisation-wide practice development (PD) programme in one National Health Service mental health and learning disabilities trust. Method: Individual differences in integrating the Model of Human Occupation in occupational therapists' daily practice were examined through in-depth qualitative, multimethod realistic evaluation. A stratified sample of all occupational therapists (n = 74) was achieved using a self-report survey. Semi-structured interviews at three time points, practice observation and documentation audit continued until saturation appeared highly likely and categories were well elaborated (n = 10). Findings: The findings indicated that environmental contexts, particularly the support of the immediate team, and the therapist's personal circumstances influenced MOHO use. The mechanisms that acted as catalysts for practice change were Building Confidence, Finding Flow, Accumulating Reward, Conferring with Others, Constructing Know-how and Channelling Time. Four stages of MOHO integration, characterised as In the Hangar, On the Runway, Take-off and In the Air, were identified. Conclusion: Most studies of the uptake of PD treat people as relatively homogeneous, but they are not. Greater attention to individual differences, the mechanisms underpinning successful engagement and influencing contexts may result in better outcomes from PD investments. A degree of tailoring PD approaches to individual circumstances would be beneficial.
The Individual Practice Development Theory: An individually focused practice development theory that helps target practice development resources
(Wiley, 2012-06) Melton, J.; Forsyth, Kirsty; Freeth, D.
Background Research indicates that multifaceted practice development (PD) interventions are more effective than single strategies. However, models of education in health care need to consider cost-effectiveness. Objectives This paper presents a research-based, PD theory called the Individual Practice Development Theory. It argues that programmes that use the Individual Practice Development Theory to tailor PD support to the learning needs of practitioners will result in more engagement in PD and will target PD resources efficiently. Methods The in-depth qualitative, multi-method realistic evaluation was of a multifaceted, organization-wide PD programme in one National Health Service Mental Health and Learning Disabilities Trust. Semi-structured interviews, practice observation and documentation audit were used to gather data from occupational therapists. Findings Results indicated that environmental contexts, particularly the support of the immediate team, and the participant's personal circumstances affected PD behaviour change. Six mechanisms acted as catalysts. These were: Building Confidence, Finding Flow, Accumulating Reward, Conferring with Others, Constructing Knowledge Know-how and Channelling Time. Four stages of PD characterized as: 'In the Hangar', 'On the Runway', 'Take-off' and 'In the Air' were identified. The research also illustrated the interconnectivity between outcome levels, contextual circumstances and activating mechanisms. Discussion The findings suggested that PD interventions need to be more individually tailored to achieve optimum learning outcomes. The identification of four discernable stages permits rapid understanding of PD support needs in order to focus PD support. Conclusion With a systematic and individualized approach to PD in health care, more target PD supports can be put in place. 2011 Blackwell Publishing Ltd.
Using theory in practice
(Elsevier, 2008) Melton, J.; Forsyth, Kirsty; Freeth, D.; Duncan, Edward