Alan Bleakley, Richard Farrow, David Gould and Robert Marshall
Initial results are presented from an ongoing, work‐based collaborative inquiry between three medical consultants (a pathologist, a radiologist and a dermatologist) and three…
Abstract
Initial results are presented from an ongoing, work‐based collaborative inquiry between three medical consultants (a pathologist, a radiologist and a dermatologist) and three experienced visual artists into processes of clinical and aesthetic judgements in the visual domain. The doctors’ habitual conventions are challenged through the interventions of the artists, leading to a re‐education of the senses through a revitalised clinical imagination. Outcomes include self‐assessed improvement of clinical acumen through systematic review of the clinical reasoning process looking specifically at the aesthetic dimension. A central research interest is how forms and styles of judgement construct identities of the expert practitioner in work settings. The papers describes a change in practice from “looking” to “seeing” as the development of a “connoisseurship” of informational images informed by tolerance of ambiguity, creating a practice identity against the grain of the normative technical‐rational discourse of clinical reasoning.
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The paper seeks to show that narrative close call reporting is one strand of an ongoing collaborative inquiry project with 300 staff aiming to improve teamwork in operating…
Abstract
Purpose
The paper seeks to show that narrative close call reporting is one strand of an ongoing collaborative inquiry project with 300 staff aiming to improve teamwork in operating theatres in a large UK hospital. How teams deal with close calls (“accidents waiting to happen”) reveals resourcefulness but exposes flaws, including resistance to basic safety practices such as briefing and debriefing.
Design/methodology/approach
In this paper over 400 issues from close call reports over two years have been thematically analysed to map a variety of (mis)communications. This paper goes beyond this descriptive level of data analysis to a deeper level, where close calls are read textually. The most common rhetorical strategies are reported, shown in around a quarter of all reports.
Findings
The paper finds that accounts are neither transparent nor objective, but offer a medium for the exercise of rhetorical strategy, a main function of which is construction and management of identity. Practitioners maintain traditional boundaries between professions by stereotyping the “other” professional in the team, serving to stabilise identity. Work is typically presented as on the edge, close to collapse, serving to shape an identity of “heroic survivors” for team members.
Practical implications
In the paper habitual practices that impede teamwork are challenged, such as stereotyping. Reporting can encourage “fearless speech” – regardless of position on the traditional hierarchy – that is an empowering form of “plain speaking” underpinned by moral courage.
Originality/value
The paper shows that close calls are typically treated instrumentally. A deeper, aesthetic and ethical reading is offered. Education in “fearless speech” in close call reports may offer a reflexive stance and new context for identity construction.
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Alan Bleakley, Adrian Hobbs, James Boyden and Linda Walsh
Work in progress is reported for a research project aiming to improve multiprofessional teamworking in operating theatres through iterative educational intervention. Experimental…
Abstract
Work in progress is reported for a research project aiming to improve multiprofessional teamworking in operating theatres through iterative educational intervention. Experimental design is combined with collaborative inquiry. The hypothesis is: will planned, complex educational intervention focused upon improving communication in teamwork lead to better patient safety? The project is embedded in a wider educational agenda promoting democratic working practices, and this is reflected in the participative inquiry aspect of the research where operating theatre staff take ownership of the project through establishing common meanings for “good practice”. The cohort involves 300 personnel (surgeons, anaesthetists, nurses and support staff) spread across two theatre complexes (11 theatres in total) in a large UK hospital. The focus of this paper is necessarily upon design and methodology, as the first data set is being gathered and analysed at the time of writing. Future papers will focus upon results and offer conclusions and recommendations.
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Sian May and Kevin House
This chapter argues we should not regard school-to-school collaboration as simply a mechanism for outcome-driven improvement but rather consider the establishment of teacher…
Abstract
This chapter argues we should not regard school-to-school collaboration as simply a mechanism for outcome-driven improvement but rather consider the establishment of teacher relationships as the necessary priority when building highly effective collaborative networks. By revisiting the research of Sandra Kruse, Amanda Datnow and Andy Hargreaves, we develop an additional tool to Hood’s matrix of regulation and cohesion in an effort to position collaborative networks in the context of international private fee-paying schools. The tool visualizes the collaborative network development as a relationship continuum in which time is the necessary driver of a network’s success. The 12 Asian private international schools in the case study were given collaborative framework guidance drawn from multiple sources. Subsequently, the enablers and hindrances reported by the collaboration leads highlight the need for trust and teacher agency development to be prioritized by leadership. Finally, on sharing some lessons learned from the case study, we close by arguing the value of collaboration lies in opening the door to allow for agenetic cultures that build reflexive practitioners.