Using reflective practice as a management development tool in a Victorian Health Service

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  • This article was downloaded by: [University of Reading]On: 22 December 2014, At: 09:35Publisher: RoutledgeInforma Ltd Registered in England and Wales Registered Number: 1072954 Registeredoffice: Mortimer House, 37-41 Mortimer Street, London W1T 3JH, UK

    Reflective Practice: International andMultidisciplinary PerspectivesPublication details, including instructions for authors andsubscription information:http://www.tandfonline.com/loi/crep20

    Using reflective practice as amanagement development tool in aVictorian Health ServiceCarlene Boucher aa RMIT University , AustraliaPublished online: 04 May 2007.

    To cite this article: Carlene Boucher (2007) Using reflective practice as a managementdevelopment tool in a Victorian Health Service, Reflective Practice: International andMultidisciplinary Perspectives, 8:2, 227-240, DOI: 10.1080/14623940701289246

    To link to this article: http://dx.doi.org/10.1080/14623940701289246

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  • Reflective PracticeVol. 8, No. 2, May 2007, pp. 227240

    ISSN 1462-3943 (print)/ISSN 1470-1103 (online)/07/02022714 2007 Taylor & FrancisDOI: 10.1080/14623940701289246

    Using reflective practice as a management development tool in a Victorian Health ServiceCarlene Boucher*RMIT University, AustraliaTaylor and FrancisCREP_A_228828.sgm10.1080/14623940701289246Reflective Practice1462-3943 (print)/1470-1103 (online)Original Article2007Taylor & Francis82000000May 2007CarleneBouchercarlene.boucher@rmit.edu.au

    This paper reports on a research project undertaken at Northern Health Service in Melbourne,Australia to explore how reflective practice groups could be used to help managers developimproved management skills. Reflective practice is an approach to management and organizationdevelopment that integrates, or links, thought and action with reflection. The six reflective prac-tice groups met regularly for six months and were assisted by an external facilitator. An evalua-tion of the impact of the meetings was undertaken via a series of focus groups and interviews.The findings of this evaluation suggest that there is a place for reflective practice groups as a wayof developing managers in health service organizations (particularly their people managementskills) and that those in organizations responsible for management development should considerincluding reflective practice activities as part of a strategic and systematic management develop-ment strategy.

    Introduction

    This is an account of a research project that took place at Northern Health Servicein Melbourne, Australia for seven months in 2003 2004. Established in July 2000,Northern Health Service provides a wide range of quality health care services to theexpanding communities in Melbournes northern suburbs. The Health Service iscurrently located on four sites and provides a unique mix of services includingmedical, surgical, emergency, intensive and coronary care, pediatrics, womens andmaternal health, mental health, aged care, palliative care, and rehabilitationprograms. These are provided through inpatient, ambulatory and community-basedprograms. It serves an economically and ethnically diverse population including

    *School of Management, RMIT University, Level 16, 239 Bourke St, Melbourne 3001 VIC,Australia. Email: carlene.boucher@rmit.edu.au

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  • 228 C. Boucher

    many people who, in the past, have had limited access to appropriate healthcareservices.

    The project was undertaken by six staff from RMIT University in conjunction withtwo members of the Human Resource Management Department at Northern HealthService.

    The purpose of the research project was twofold. First, it aimed to make acontribution to the skill development of a group of managers at Northern HealthService. Second, it aimed to produce data that could be used to develop a modelfor using reflective practice approaches in the health industry. This paperdescribes how the groups were conducted and the sorts of matters that werediscussed by participants. It also reports the findings of an evaluation of theproject.

    The project came about as the result of previous collaboration between staff fromRMIT University and Northern Health Service. This previous work had also involvedthe use of reflective practice groups as a means of helping staff to develop their skills.We believed that this approach was useful and so wanted to engage in a more formalresearch project to examine the effectiveness of reflective practice as a managementdevelopment tool. For Northern Health Service an added benefit was the expectationthat the managers taking part in the project would develop improved managementskills.

    The nature of reflective practice

    The concept of reflective practice has its origins in the belief that in the context ofprofessional practice, problems and other complex issues are best dealt with by peoplewho can flexibly and intuitively draw on their knowledge of practice (or their informaltheory), rather than apply rules drawn from formal theory (Foley, 2000, p. 51).

    For the purposes of this project, reflective practice has been defined as a processof disengaging from or stepping back from an experience and taking time to deliber-ately and carefully review it, think about it and construct meaning from it (Doyle &Young, 2000, p. 18). Reflective practice can be used as a management and organiza-tion development tool to integrate or link thought and action with reflection. It is alearning technique that has been used in the health field for a number of years withclinicians (Johns, 1998; Duggan, 2005) and more recently with managers (Gardner& Boucher, 2000; Greenall, 2004).

    When used to develop the capacities of managers, it involves helping people tothink about and critically analyse their actions with the goal of improving theirmanagement practices. Vince (2002) suggests that reflective practice in organizationsshould contribute to the questioning of the assumptions that underpin how the orga-nization works. Engaging in reflective practice requires an individual to assume theperspective of an external observer in order to identify the assumptions and feelingsunderlying their practice, identify how these assumptions and feelings impact upontheir practice and determine if they need to change in some way to become moreeffective as a manager (Cherry, 2000).

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  • Reflective practice as a management tool 229

    The reflective practice approach adopted for this study

    The term reflective practice is used in the literature to describe a range of group andindividual activities. In most cases these activities share a number of features:

    Description and examination of ones actions, assumptions and their conse-quences in a critical way (Foley, 2000).

    Theorizing about those actions and assumptions, thus creating explanations aboutwhy things happened in a particular way (theorizing) (Lashley, 1999).

    Making a judgement about the appropriateness of ones action and making adecision to try to behave the same/differentially next time or in similar situations inthe future (Barnett, 1995).

    Making broader links to learn about other aspects of ones assumptions andbehaviour (Horup, 2004).

    Reflective practice activities may also include practicing changed behaviour,resulting in a process similar to an action learning cycle (Yeo, 2006). In this project,participants were encouraged to close the loop by practicing new behaviours butopportunities to do this did not always eventuate.

    The literature suggests that learning that occurs during reflective practice activitiescan occur at the individual, group and organizational level (Horup, 2004). The mainfocus in this study was individual learning but the findings suggest that a significantamount of the learning that occurred was located at the group level. This learning wasnot about how the group operated, but rather collective learning that emerged fromthe interactions of group members.

    The literature also suggests that learning can be focused on learning about how todo managerial tasks or learning about oneself in the role of manager. The former ismore about developing skills and attributes whilst the latter is more focused on devel-oping self-awareness (Talbot, 1997). These two aspects of learning are not mutuallyexclusive and the aim of this project was to focus on both types of learning. This wasa considered decision made by the research team based on a view expressed by seniormanagers in the organization that this was the type of learning most lacking amongstthe project participants.

    Unlike action learning sets that often focus on specific organizational problemsand are conducted in a structured way (Fry et al., 2000), in this project eachreflective practice group developed its own way of operating within broad guide-lines. The task of each group was to collectively reflect on their managementpractice. They did this by sharing their individual and collective stories, focusingon issues of concern to them. Individuals were then expected to develop strate-gies for addressing these issues. They would then take action in the workplaceand report back at the next meeting. In many cases the participants were engag-ing in a series of cycles of action learning (Cherry, 2000). There was no require-ment to identify particular organizational issues to discuss and act on and norequirement to take up particular roles in the group (other than that of a learner)(Fry et al., 2000).

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  • 230 C. Boucher

    The choice to use this approach to reflective practice was based on the researchersmore than 20 years experience in working with such groups and previous experienceworking with similar participants. It was a model that had developed over time. Theemphasis was on reflection-on-action (Schn, 1983). The approach was similar towhat Vince (2002) calls peer consultancy groups but, in this case, with a facilitator,more participants and without the conversation structure adopted in that model. Itwas about making connections for the self: review and reflection underpinned byfriendship and mutuality (Vince, 2002, p. 70).

    Methodology

    Action research is:

    a family of research methodologies that pursue the dual outcomes of action andresearch action research profits from the use of a cyclical or spiral process in which theresearcher alternates action with critical reflection its cyclical/spiral process and pursuitof both action and research as defining characteristics of action research. (Dick, 2002, p.159)

    This project employed a conventional action research methodology in which therewere two cycles of action/reflection.

    At the micro level, the researchers met regularly to collectively reflect on theirinvolvement in the project, to learn from each other and to plan the next steps. At themacro level, the work reported in this paper was the first phase of a multi-phasedstudy that is ongoing. The evaluation of this phase was used to design the next phasewhich will be completed shortly.

    Methods

    The reflective practice groups

    An invitation to be involved was made to all managers at Northern Hospital andBroadmeadows Health Service (two of the campuses of Northern Health Service). Aseries of information sessions were conducted to provide staff with information aboutthe project. Once managers had indicated that they were interested in taking part theywere allocated to a group. Those who chose to be involved included nurse managers,allied health managers, managers of support services (non clinicians) and managersof programs who had a clinical background but no longer had a clinical role. Mostwere female. Ethics approval for the project was obtained from both RMIT Univer-sity and Northern Health Service and each manager was advised that they could takepart in the reflective practice groups but opt out of the research aspect of the projectif they chose to do so.

    In line with the agreed research protocol, the six reflective practice groups met fort-nightly at their workplaces for one and a half hours from September 2003 until March2004 (12 meetings each). The groups consisted of between fourseven staff each thatdid not report to each other. A total of 34 people took part in the groups. There were

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  • Reflective practice as a management tool 231

    four groups at Northern Hospital and two groups at Broadmeadows Health Service.An RMIT University staff member facilitated each group. Each of the facilitators hadexperience working with these types of groups.

    The group members were not given ground rules for behaviour but all groupsdiscussed their ground rules in the first few meetings. Matters such as confidential-ity, trust and a commitment to the group (by attending physically and emotionally)were the main issues discussed. The group members were encouraged by the facili-tators to realize that it would take time for them to trust one another at the levelrequired for this type of reflective work. Trust actually appeared to develop quitequickly (two to three meetings) but the issue of regular attendance remained prob-lematic in most groups and this will be taken up later. Different approaches toreflective practice were used by the groups. Participants in some of the groups wereencouraged to keep learning journals in which to record events in...

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