Action Learning in Healthcare

A Practical Handbook

John Edmonstone

• Publisher: CRC Press
• Year: 2017
• eBook ISBN: 9781315346182
• Edition: 1
• Topic: Medicine
• Subtopic: Medical Theory, Practice & Reference

Action learning was developed in the UK in the 1960s and is now one of the most widely used development methods in healthcare. This practical manual embodies the dual focus of action learning as both philosophy and technique - exploring the underlying concepts derived from adult education and organisation development, addressing challenges and providing invaluable support material. Specifically targeting the healthcare sector, this book is divided into three parts: an exploration of core ideas and underlying assumptions including techniques and methods; practice-preparation, projects, sets, facilitation and evaluation; and a compendium of resources. Action Learning in Healthcare is vital reading for senior managers and professionals considering using action learning for leadership, management and organisation development purposes. It is also highly recommended for organisation development practitioners (with responsibility for project managing the use of action learning in local and national programmes). Action learning facilitators, too, will find much to absorb, modify and use in their own practice, as will action learning set members wishing to enhance their knowledge.

Part 1: Principles

CHAPTER 1

What is action learning and what is it for?

‘It is impossible for a man to learn what he thinks he already knows.’

Epitectus

There is no shortage of helpful definitions of action learning but at the heart of them all, is the idea that action learning is:

‘a method of both individual and organisational development based upon small groups of colleagues meeting over time to tackle real problems or issues in order to get things done – reflecting and learning with and from their experience and from each other as they attempt to change things.’¹

At first sight this may seem incredibly simple, yet this definition encompasses ideas about both adult learning and organisational change which are both complex and central to what action learning is about.

Adult Learning

Learning is now properly understood as an organismic or natural ‘living’ process, rather than an ego-driven process.² This means that it is not something that ‘I’ do, but it happens of itself, often in spite of ‘I’ and not because of it. Learning is also not something confined to formal and structured settings such as primary, secondary and tertiary, education and training events and programmes, but can also be informal in nature − that is, predominantly experiential and non-institutional − and may also be incidental − that is, unintentional and a by-product of other activity.³

Derived from the world of adult learning we now know that:

Learning starts from not knowing. It is only when people admit that they do not know how to proceed that they become open to learning. There can be no experts in those situations in which there are no ‘right’ answers and no obvious ways forward. Where there are no such right answers people then must act in order to learn. In that sense action learning involves sharing and exploring our ignorance.

Learning involves the whole person. People usually do not, in practice, separate their emotions (or hearts) from their intellect (or minds). The recent popularity of the concept of Emotional Intelligence or EI⁴ is a clear recognition of the critical role that emotion plays in both living and learning.

People learn only when they want to do so, and not when others want them to do so. Effective learning is therefore self-directed, voluntary, intentional and purposeful. It is an active and learner-driven process rather than a passive and teacher- or trainer-driven one.

A great amount of learning is episodic in nature, rather than continuous. Learning seems to take place in short bursts of relatively intense activity which absorb the learner’s attention and is embodied in the phrase ‘I’m on a steep learning curve right now!’ It typically comes to an end when the immediate purpose of learning has been achieved. People then resort back to a much slower pace of learning before the next such intensive episode takes place, again stimulated by a problem, situation or issue which demands resolution.

We feel the urge to learn when we are faced with difficulties that we would like to overcome. These real-world work and life problems provide us with the motivation to learn. We learn best when applying new information or materials to current, real-life challenges and when exchanging feedback with others around these applications. Therefore, people who take responsibility in a situation have the best chance of taking actions that will make a difference. We learn most (and best) when what and how we learn is experienced as relevant.

Learning is not only about the assimilation of knowledge, but also about the recognition of what is already known. Learning is inevitably based upon, and builds on, previous experience. It involves both what is taught or read and also our questioning insight. Learning can not only be the acquisition of yesterday’s ideas but must also include trying-out new and unfamiliar ideas. It involves asking useful questions in conditions of uncertainty and also involves risk – taking actions that may or may not work.

A powerful block to learning can be a predisposing way of seeing the world or ‘mindset’ which has been formed by previous experience. These mindsets are made up of our fears, hopes, dreams, speculations, queries, hunches, intuitions, habits, identifications, unconscious projections, half-baked notions, prior training, social conditioning and internalised cultural expectations. They are typically not shared, explicit or even logical when viewed by others, but contribute to the patterns (of beliefs, traditions, fears, conflicts, etc.) that make some things possible and others impossible for each of us. It is our perceptions, values and feelings that tend to get us ‘stuck’ rather than specific procedures. Everyone, therefore, needs to recognise when their mindset may be no longer be valid, be less useful and in need of review and revision. People learn best when they are able to question the fundamental assumptions on which their actions are based. Thus, review and re-assessment of all experience – our knowledge and skills, but also our self-image and personal feelings – is necessary.

Such recognition and revision requires that people have support from others with similar problems and that some of those people come from different settings in order to help stimulate the review process. Most people are open to learning when receiving helpful and accurate feedback from colleagues who are respected, valued and trusted. Mutual trust and respect provides strong motivation for learning.

Learning, and the resulting revision of mindsets, is made easier in a safe and secure atmosphere – what has been described as a ‘holding framework’ which can contain people’s anxieties with regard to the impact of change and can create the space for them to work on new ways to tackle such issues. Security can be developed by skilful preparation and understanding by a facilitator and from the support of fellow learners.

Learning only becomes possible when someone recognises the need for change and sees the impact of their actions in working on a real problem or issue. We learn best with and from other people when addressing together pressing difficulties to which no-one knows the solution. Learning is always for a purpose – clarifying an issue, resolving a problem or living in a more satisfying way. We are motivated to learn when what we learn can immediately be tried out in practice. In action learning, the ‘syllabus’ is work – the issue, question or problem – and the ‘trainer’ is replaced by the set members and the facilitator.

Learning is increased when we are asked questions and reflect on what we did; when we are given time and space to address pro...

Table of contents

• Cover Page
• Half Title
• Title Page
• Copyright Page
• Contents
• Foreword
• Who should read this book?
• About the author
• Acknowledgements
• Introduction
• Part 1 Principles
• Part 2 Practice
• Part 3 Resources
• Index