Facilitation on the Run: Enabling Work-Based Facilitation in the Midst of Practice
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The vision of person-centred cultures is core to all policy and standards in healthcare in Ireland (Health Information and Quality Authority, 2012) and globally (World Health Organisation, 2016) implementing these strategies and standards require focused development of staff who deliver care in our health services (Department of Health and Children, 2010). In the acute hospital setting in Ireland this staff development has largely been technical in its approach to date. Evidence suggests that for person centred cultures to emerge, purposeful Practice Development (PD) needs to be facilitated within the workplace (McCormack et al, 2010). The role of clinical nursing leaders is pivotal in developing and sustaining of the person-centred cultures and is therefore a key element of all PD activity (McCormack et al, 2010). If PD is to become more meaningful to nursing leaders as part of their daily work, more focus must be placed on making the development and ‘doing’ of facilitation easier. Although complex facilitation frameworks such as Critical Companionship (Titchen, 2002) remain an exemplar in the development of expert facilitation skills, use of this particular framework has been minimal due largely to its complexity (Gribben and Cochrane, 2006; Dewing and Wright, 2004).
Two sequential facilitation models Critical Allies and Critical Friends emerge as first steps in the development of work based facilitation skills for novice and proficient facilitators. Thereby enabling nurses to work with colleagues’ to help them to learn in and from work, grow their expertise and contribute to developing person-centredness in the workplace.
During the process, Facilitation on the Run (FoR) cards were used to focus conversations and quickly create reflective spaces within the work place. The 28 pack of cards, depict the breakdown of the critical allies and Critical Friends Frameworks unpicking the elements into three sections in each framework (1) prerequisite for facilitative relationships to begin (2) strategies (3) Expected Outcomes. The cards subsequently served as an everyday tool to remind novice and proficient facilitators of the steps that they should be working through to facilitate the learning of colleagues. The FoR cards became an invaluable resource as part of the associated doctoral research study which used insider researcher approaches to work with clinical nursing leaders within their own workplace.
It also makes a contribution to the methods for achieving communicative spaces and discourse in busy workplaces and proposes that facilitation is not stationary space.