The concept of “Reflective Practice” – time built into the work week for people to get together to reflect in a structured format about the work – is a component of the Learning Community I attended this past week with Fulfilling Lives staff. The meeting was facilitated by a research professor at Newcastle University Business School and the structure was co-developed with the Fulfilling Lives staff during an initial meeting. (Please note that what follows is a brief outline of what I observed during the Learning Community I attended and is by no means meant to be a complete representation of the process. For more information and research about Learning Communities, there is contact information at the end.)
At the beginning of the meeting, everyone was reminded by the facilitator that the purpose of the Learning Community was to “talk authentically about challenges in the practice.” Two themes or topics are chosen by the group for each meeting; themes can range from challenges with service users to programmatic struggles. For example, one theme might be managing referrals while another could be about perceived service user manipulation. The facilitator manages the time allotted for the discussion of each theme as well as the flow of speakers. One of the rules of the meeting is that you can’t interrupt or talk over anyone so if you want to speak, you have two options — raise your hand with an open palm if you want to contribute on the current point or raise your hand with a closed fist if you want to make a new point on the same theme. The facilitator keeps a list of speakers and prompts them in order when it is their turn to speak. There is relatively strict adherence to the speaker list, although when I observed it was done with a sense of humor and the acknowledgement that it can be difficult to wait your turn and not just jump in when you have something to contribute. Other group rules agreed upon at an initial meeting include: confidentiality, challenging ideas not people, being open and honest, providing positive feedback, and respecting views and difference.
During the discussion the facilitator keeps track of ideas for action or change that have been introduced. At the end of the discussion around the chosen theme, the facilitator asks the group if there is any collective action that should be pursued. For example, a suggestion might be made about additional training or a question about changing practice that needs to be raised with leadership. The group decides what action steps to pursue and individuals volunteer to take them up. At the end, there is a vote on themes for the next meeting and then there is also a round where everyone is asked to share something about their experience of the group and/or to highlight something that was said that had particular relevance for them.
Fulfilling Lives was funded to learn about best practices for people with multiple, complex needs. One of the things that is refreshing about a culture of learning that is built into a project and has everyone’s buy-in, is the understanding that ideas will be introduced and tried out and not everything will be instantly successful or go exactly as planned. Along with that, is the expectation of flexibility and tolerance for change. This was reflected in the Learning Community where it seemed that the goal of the conversation wasn’t about coming up with definitive solutions to problems, although people did make suggestions for change, but rather about reflecting on practice, sharing points of view, listening, being heard, and learning from each other. Across the board, the staff at the Learning Community meeting I attended said it is one of the most valuable aspects of their job; as a regular practice, front line staff said it was more valuable than clinical supervision. One of the staff members said that her trust and comfort level has increased over the course of the meetings which indicates that this kind of practice has the potential to strengthen group cohesiveness and trust over time and build a better working group — one whose member can truly challenge each other’s practice so that individual professional growth occurs, the program itself is strengthened, and work performance is improved.
Creating an intentional, structured space for a work team to reflect and learn together is appealing to me because the work we do with vulnerable people is emotionally intense and can take its toll on practitioners resulting in daily stress, increasingly poor health over time and ultimately, burn-out. Additionally, the research on integrated health care settings, which require people from a variety of disciplines to work together and solve system problems in real time, shows the importance of creating a cohesive working team with a high level of trust and flexibility; the Learning Community is one idea for how this can be done.
For more information on Learning Communities and Performance Measurement please contact Dr. Toby Lowe at Newcastle University: toby.lowe@ncl.ac.uk or visit https://blogs.ncl.ac.uk/tobylowe/.
