Strengthening practical wisdom

Abstract

Background:

Practical wisdom, understood as knowing how to be or act in any present situation with clients, is believed to be an essential part of the knowledge needed to be a professional mental health worker. Exploring processes of adapting, extending knowledge and refining tacit knowledge grounded in mental health workers’ experiences with being in practice may bring awareness of how mental health workers reflect, learn and practice professional ‘artistry’.

Research question:

The aim of the article was to explore mental health workers’ processes of development and learning as they appeared in focus groups intended to develop practical wisdom. The main research question was ‘How might the processes of development and learning contribute to developing practical wisdom in the individual as well as in the practice culture?’

Research design:

The design was multi-stage focus groups, and the same participants met four times. A phenomenological hermeneutical method for researching lived experience guided the analysis.

Participants and context:

Eight experienced mental health workers representing four Norwegian municipalities participated. The research context was community-based mental health services.

Ethical considerations:

The study was reported to Norwegian Social Data Services, and procedures for informed consent were followed.

Findings:

Two examples of processes of re-evaluation of experience (Association, Integration, Validation, Appropriation and Outcomes and action) were explored. The health workers had developed knowledge in previous encounters with clients. In sharing practice experiences, this knowledge was expressed and developed, and also tested and validated against the aims of practice. Discussions led to adapted and extended knowledge, and as tacit knowledge was expressed it could be used actively.

Discussion:

Learning to reflect, being ready to be provoked and learning to endure indecisiveness may be foundational in developing practical wisdom. Openness is demanding, and changing habits of mind is difficult.

Conclusion:

Reflection on, and confrontation with, set practices are essential to building practice cultures in line with the aims of mental health services.

Keywords

Mental health services multi-stage focus groups practical wisdom professional development recognition

Get full access to this article

View all access options for this article.

References

Eriksen

KÅ

Arman

Davidson

.‘We are all fellow human beings’: mental health workers’ perspectives of being in relationships with clients in community based mental health services. Issues Ment Health Nurs 2013; 34: 883–891.

Eikeland

The ways of Aristotle: Aristotelian Phrónêsis, Aristotelian philosophy of dialogue, and action research. Bern: Peter Lang Pub. Inc., 2008.

Gates

Higgs

Realizing wise practitioners. In: Higgs

Sheehan

Currens

. (eds) Realizing exemplary practice-based education. Rotterdam: Sense Publishers, 2013, pp. 43–56.

Fish

. Appreciating practice in the caring professions: refocusing professional development and practitioner research. Oxford: Butterworth-Heinemann, 1998.

Dewey

How we think. Mineola, NY: Dover Publications, 1910.

Higgs

Richardson

Dahlgren

. Developing practice knowledge for health professionals. London: Butterworth-Heinemann, 2004.

Schon

. The crisis of professional knowledge and the pursuit of an epistemology of practice. In: Raven

Stephenson

(eds) Competence in the learning society. New York: Peter Lang Pub. Inc., 2001, pp. 185–207.

Eriksen

KÅ

Arman

Davidson

. Challenges in relating to mental health professionals: perspectives of persons with severe mental illness. Int J Ment Health Nurs 2013. DOI: 10.1111/inm.12024

Borg

Karlsson

Kim

. Double helix of research and practice – developing a practice model for crisis resolution and home treatment through participatory action research. Int J Qual Stud Health Well-Being 2010; 5(1): 1–8.

10.

Skår

. Knowledge use in nursing practice: the importance of practical understanding and personal involvement. Nurse Educ Today 2010; 30(2): 132–136.

11.

Holm

Severinsson

. A hermeneutic approach to the characteristics of mental health nursing practice. J Psychiatr Ment Health Nurs 2011; 18(10): 843–850.

12.

Dahl

Alvsvåg

. Å fremme studenters evne til refleksjon – en pedagogisk utfordring [To promote students' reflection – a pedagogical challenge]. Uniped 2013; 36(3):22724.

13.

Walker

Cooke

Henderson

.Using a critical reflection process to create an effective learning community in the workplace. Nurse Educ Today 2013; 33: 504–511.

14.

Vatne

Bjornerem

Hoem

. Development of professional knowledge in action: experiences from an action science design focusing on acknowledging communication in mental health. Scand J Caring Sci 2009; 23(1): 84–92.

15.

Bogo

Paterson

Tufford

. Supporting front-line practitioners’ professional development and job satisfaction in mental health and addiction. J Interprof Care 2011; 25(3): 209–214.

16.

Cleary

Horsfall

O’Hara-Aarons

. The views of mental health nurses on continuing professional development. J Clin Nurs 2011; 20 (23–24): 3561–3566.

17.

Black

Jensen

Mostrom

. The first year of practice: an investigation of the professional learning and development of promising novice physical therapists. Phys Ther 2010; 90(12): 1758–1773.

18.

Hayward

Black

Mostrom

. The first two years of practice: a longitudinal perspective on the learning and professional development of promising novice physical therapists. Phys Ther 2013; 93(3): 369–383.

19.

Boud

Walker

Keogh

. Reflection: turning experience into learning. London: Kogan Page, 1985.

20.

Hummelvoll

. The multistage focus group interview: a relevant and fruitful method in action research based on a cooperative inquiry perspective. Nor Tidsskr Sykepl 2008; 1: 3–15.

21.

Lindseth

Norberg

. A phenomenological hermeneutical method for researching lived experience. Scand J Caring Sci 2004; 18(2): 145–153.

22.

Eriksen

KÅ

Sundfør

Karlsson

. Recognition as a valued human being: perspectives of mental health service users. Nurs Ethics 2012; 19(3): 357–368.

23.

Billett

. Learning throughout working life: a relational interdependence between personal and social agency. Brit J Educ Stud 2008; 56(1): 39–58.

24.

Alvsvåg

Førland

Engasjement og læring: Fagkritiske perspektiver på sykepleie [Engagement and learning: critical perspectives on nursing]. Oslo: Akribe, 2007.

25.

Thorkildsen

Råholm

. The essence of professional competence experienced by Norwegian nurse students: a phenomenological study. Nurse Educ Pract 2010; 10(4): 183–188.

26.

Mezirow

. Transformative learning: theory to practice. New Dir Adult Cont Educ 1997: (74): 5–12.

27.

Van Horn

Freed

. Journaling and dialogue pairs to promote reflection in clinical nursing education. Nurs Educ Perspect 2008; 29(4): 220–225.

28.

Secomb

. A systematic review of peer teaching and learning in clinical education. J Clin Nurs 2008; 17(6): 703–716.

29.

Rolfe

Freshwater

Jasper

. Critical reflection for nursing and the helping professions: a user’s guide. Basingstoke: Palgrave, 2001.

30.

Bergdahl

Benzein

Ternestedt

. Development of nurses’ abilities to reflect on how to create good caring relationships with patients in palliative care: an action research approach. Nurs Inq 2011; 18(2): 111–122.

31.

Chirema

. The use of reflective journals in the promotion of reflection and learning in post-registration nursing students. Nurse Educ Today 2007; 27(3): 192–202.

32.

Dahlqvist

Söderberg

Norberg

. Facing inadequacy and being good enough: psychiatric care providers’ narratives about experiencing and coping with troubled conscience. J Psychiatr Ment Health Nurs 2009; 16(3): 242–247.