McCormack B, Manley K, Garbett R, editors. Practice development in nursing. Oxford: Blackwell Publishing Ltd, 2004. ISBN 1405110384
- Margaret B Harrison, PhD, RN
Practice development is a nebulous concept. It can mean anything—or everything—related to professional practice. Practice development in nursing brings a thoughtful academic and research perspective to the field. The collection is edited by Brendan McCormack, Kim Manley, and Rob Garbett who, combined, have an impressive amount of experience in practice development in the UK. The book is particularly relevant for a UK readership. For North American and other readers, a word of caution: practice developer, a role referred to throughout the book, seems to be common in UK settings but may not be a familiar title in other countries. Garbett and McCormack (chapter 1) note 71 activities of practice developers that are organised into 6 categories: promoting and facilitating change, translation and communication, responding to external influences, education, facilitating the implementation of research into practice, and audit and quality functions. The skills described fit various professional practice and development positions. These include advanced practice roles, nurse educators, clinical nurse specialists, and even nurse managers in some settings. It is noteworthy that professional development is typically viewed more broadly than education (continuing) in Canada and the US.
Practice development in nursing has 2 parts: part 1 (chapters 1–7) focuses on theoretical and methodological perspectives, and part 2 comprises a series of chapters recounting actual experiences with practice development.
Part 1 includes an introductory chapter and a collection of previously published work, including a concept analysis of practice development; a framework for thinking about practice development in terms of technical, practical, and emancipatory issues; and a description of an implementation framework and initiative developed by the Royal College of Nurses. The role and use of evidence in practice development is embedded in the chapters of part 1. The substantive challenges of appreciating, knowing, and implementing evidence useful to nursing practice are somewhat superficially addressed. The complexity of integrating either formally synthesised knowledge, such as quality practice guidelines, or knowledge that does not have a synthesised tool (eg, process of care or experiences of illness) could be further elaborated. This would help practice developers and practising nurses to operationalise and use the authors’ conceptualisation of practice development. The authors of the papers in part 1 highlight the paradoxes/perplexities that exist between practice and professional development, as well as between theory/frameworks and actual experiences of practice development. Although the intent was not to “academicise” (p33) practice development, this section is at times dense, and front line nurses and practice development professionals may find it challenging to distil the key points for use.
Part 2 includes 6 chapters recounting various experiences with practice development. The chapters are accounts of practice development initiatives in UK settings and Trusts (regional health authorities). They are characterised by their reflective nature, with comment on personal aspects as well as organisational and policy contexts. The authors are frank about what went well and what did not. Chapters 8−10 are about changes in particular areas of care within a Trust: older persons with dementia, acute mental health care, home visitors’ use of a family assessment, and a Royal College of Nursing initiative on child health nursing. Two large scale, Trust wide efforts are described in chapters 11 and 12. Each of these chapters is accompanied by a commentary, where observations link the case study with the theoretical concepts described in part 1 or provide further elicitation of relevant practice and policy issues. The final chapter of part 2 is a reflection and summary by the editors. Some readers may find it useful to read this chapter before reading the first part of the book in order to better appreciate the perspective of the editors on the frameworks and methods.
As someone who has been actively engaged in both practice and professional development for more than a decade, I would agree that the authors have met their goal of challenging current thinking on practice development.
Methods/quality of information: ★★★★☆
Clinical usefulness: ★★★☆☆