Nursing
Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/24
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Item Developing person-centred care in hospices through the voice and leadership of nursing: lessons from the United Kingdom(Frontiers Media, 2025-10-15) Haraldsdottir, Erna; McCormack, BrendanIntroduction: Nursing leadership and the voice of nurses are crucial for developing person-centred care in hospices. Concerns have been raised that, as palliative care has evolved from its original vision and become more integrated into the mainstream healthcare system, it has increasingly become medicalised. This paper presents an emancipatory practice development programme aimed at enhancing the visibility and voice of nursing and nurse leadership to improve person-centred care in hospices across the United Kingdom. Methods: The project was a 10-month collaborative education programme for nursing practice leaders in hospices throughout the United Kingdom, running from September 2023 to July 2024. A total of 24 clinical and practice development leaders from eight different hospices participated. The Kirkpatrick model for evaluating learning programmes was adapted to create a framework for assessing the programme's outcomes and impact. The evaluation process utilised Collaborative Critical Creative Inquiry. Results: The key findings from the evaluation indicate that the programme created conditions for the participants to gain transformative insights and understanding that positively impacted their practice through emancipatory practice development. Discussion: The programme enabled leaders of person-centred care in hospices to rekindle their vision for palliative care practice. The participants became more aware of how care was constructed within their organisations and recognised the assumptions that were often taken for granted—assumptions that influenced daily care practices that sometimes leaned towards a traditional medical model. They acquired new skills and knowledge that empowered them to engage more intentionally in making changes to enhance person-centred care. Conclusion and implications for practice: Humanising healthcare is a global agenda, and within hospice care, nurses are at the heart of transforming care to be more person-centred. They are well-positioned to reclaim the core principles of palliative care, as developed by Cicely Saunders, and push back against the medical model that has overshadowed the development and integration of palliative care into current healthcare systems. Nurses are expert practitioners and leaders who hold positions of authority within their organisations. Yet, for many, their change-making potential is not realised. Innovative learning and development programmes are an essential part of humanising healthcare, and emancipatory practice development programmes can unlock nurses' potential to lead this transformation.Item 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, CarolineAim 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.Item Reaching for the rainbow: Person-centred practice in palliative care(Foundation of Nursing Studies, 2020-05-13) Haraldsdottir, Erna; Donaldson, Kim; Lloyd, Anna; Barclay, Irene; McCormack, BrendanBackground: Person-centred practice is inherently integrated in palliative care. However, it cannot be assumed that its underpinning values are lived out in day-to-day practice in a hospice. At St Columba’s Hospice, Edinburgh, the five-year strategy demonstrated commitment to person-centredness and this prompted an 18-month project focusing on the evaluation and development of a person-centred culture, taking a practice development approach.Item A person-centred observational tool: Devising the Workplace Culture Critical Analysis Tool®(Foundation of Nursing Studies, 2020-02-12) Wilson, Val; Dewing, Jan; Cardiff, Shaun; Mekki, Tone Elin; Øye, Christine; McCance, TanyaThe Workplace Cultural Critical Assessment Tool (WCCAT) is a participant observational tool developed a decade ago to capture evidence about workplace culture that can then be used to support practice development initiatives. The WCCAT has been applied extensively across the world in a range of healthcare settings. Since its inception, practice development has progressed and it is now explicitly linked to advancing person-centred cultures. With this in mind, it seemed timely to revise the WCCAT to reflect the progress made within practice development, and strategically link the tool to person-centred practice and achieving person-centred outcomes. This revision (WCCAT®) has been undertaken by members of the International Community of Practice (the authors of this article), whose focus is person-centred practice research. This article outlines the process undertaken for the revision and for the alignment of the revised tool with the Person-centred Practice Framework. Guidance is provided on when, why and how to use the tool to capture participant observational data that highlights evidence of person-centred practice. Detailed information and cues to support the observer in collecting and analysing data are provided, along with suggestions for facilitating feedback of data and subsequent action planning to support changes in practice. The benefits and limitations of using the WCCAT® are outlined.Item Using two models of workplace facilitation to create conditions for development of a person-centred culture: A participatory action research study(Wiley, 2019-04-24) Hardiman, Michele; Dewing, JanAims 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; 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 for Best Practice in the reporting of Participatory Action Research. Results: Show the complexity of enabling facilitation within the workplace. Four themes and twelve sub-themes emerged from the data that describe the attributes needed to facilitate workplace learning and reveal that mangers 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-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.Item 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 CurieBackground: 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 workingItem Third-generation professional doctorates in nursing: the move to clarity in learning product differentiation(Foundation of Nursing Studies (FoNS), 2017-11-15) Cashin, Andrew; Casey, Mary; Fairbrother, Greg; Graham, Iain; Irvine, Lindesay; McCormack, Brendan; Thoms, DebraContext: Professional doctorates have been a part of the academic landscape for many years. Over this time, their focus, structure and mode of delivery have changed significantly as the terrain of professional practice has developed. In this paper we articulate this development over time through discussion of the evolution of first- and second-generation professional doctorates, and argue that there is a need for a third-generation doctorate with greater clarity regarding focus, structure and mode of delivery, in the context of advanced professional practice. Aims: A scoping review was undertaken of the development of professional doctorates in the discipline of nursing to inform thinking with regard to future design work for a post-masters (nurse practitioner endorsement) professional doctorate. Conclusion: In the context of the absence of any identified published outcome-based evidence of the value of first- or second-generation professional doctorates in general, and specifically in nursing, a third-generation evolution is proposed. This is based on the conclusion that the lack of identified outcomes is based not only on the axiomatic absence of research, but also that this may be symptomatic of a prevailing lack of clarity in programme design. A third-generation professional doctorate for nursing offers an opportunity to focus on congruence and internal consistency between the aims of the programme, learning outcomes, learning content and design, and the assessment. Implications for practice development: - The third-generation professional doctorate would no longer need to be distinguished from other degrees via an expression of what it is not, but rather would set out what it is - The educational product, with clear processes and content that are congruent with the course aims, could be clearly described as a self-contained entity more capable of producing measurable outcomes - Practice development is an integral part of the learning product through being a prescribed method in the research component of the courseItem Medical students volunteering in hospital: a novel method of exploring and recording the patient experience(2017-05-17) Hytiris, Monica Lorraina; Prentice, Fraser; Baldie, DeborahBackground: Patient experience is increasingly recognised as an important feature of healthcare quality improvement. However, many of the methods implemented for its collection have significant limitations and reliability issues. This article describes how a UK healthcare organisation worked with medical student volunteers to build capacity for the collection of patient feedback in evidence-informed ways, and summarises student reflections on this process. Aims: To improve the quantity and quality of inpatient feedback, and in doing so provide new learning opportunities for medical students. Conclusions: Patient feedback gathered by volunteers is beneficial to the service and to medical student volunteers. As the feedback gathered is ward-specific, opportunities are created for practice improvements to be identified and acted on. It is feasible for medical students to be trained effectively as volunteers in gathering patient care experiences with adequate support mechanisms in place. Implications for practice: - Healthcare services should consider the use of personnel independent of the care team for thecollection of patient feedback - Patient feedback needs to be shared with practitioners in a timely manner - Medical schools should consider this type of volunteering as a unique opportunity for medicalstudents to improve understanding of patients' experiences of healthcare, and of how care canbe person-centred