Action Learning in Health, Social and Community Care Action Learning in Health, Social and Community Care Principles, Practices and Resources John Edmonstone CRC Press Taylor & Francis Group 6000 Broken Sound Parkway NW, Suite 300 Boca Raton, FL 33487-2742 © 2018 by Taylor & Francis Group, LLC CRC Press is an imprint of Taylor & Francis Group, an Informa business No claim to original U.S. Government works Printed on acid-free paper International Standard Book Number-13: 978-1-138-03559-1 (Paperback) This book contains information obtained from authentic and highly regarded sources. While all reasonable efforts have been made to publish reliable data and information, neither the author[s] nor the publisher can accept any legal respon- sibility or liability for any errors or omissions that may be made. 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Description: Boca Raton, FL : CRC Press, Taylor & Francis Group, [2018] | Includes bibliographical references and index. Identifiers: LCCN 2017016740| ISBN 9781138035591 (paperback : alk. paper) | ISBN 9781138099579 (hardback : alk. paper) | ISBN 9781315266701 (ebook : alk. paper) Subjects: LCSH: Health services administration. | Learning. Classification: LCC RA971 .E328 2018 | DDC 362.1--dc23 LC record available at https://lccn.loc.gov/2017016740 Visit the Taylor & Francis Web site at http://www.taylorandfrancis.com and the CRC Press Web site at http://www.crcpress.com Contents Foreword vii Who should read this book? xi Acknowledgements xiii Author xv Introduction xvii PArt 1 PrINCIPLES 1 1 What is action learning and what is it for? 3 2 How does action learning differ from other development approaches? 17 3 Action learning as ethos and method 23 4 The benefits of action learning 41 PArt 2 PrACtICE 53 5 Preparing for action learning 55 6 Action learning sets 71 7 The energy investment model and action learning 85 8 The key skills 91 9 Supporting, recording, ending 101 10 Dealing with anxiety in action learning 107 11 Facilitating action learning sets 113 12 Systemic learning: Action learning organisation-wide 121 13 Evaluating action learning 129 14 Postscript: Action learning as reflective activism 139 PArt 3 rESOUrCES 143 15 What resource tools are available to help me in working in action learning? 145 Index 191 v Foreword I am delighted to be invited to write a foreword for this new book by John Edmonstone. A copy of John’s earlier book, Action Learning in Healthcare: A Practical Handbook (2011) sits proudly on the shelves of both my home and work offices, ready for me to return to when- ever I need inspiration, information and/or resources. My personal involvement with action learning spans being a set member, a facilitator, and an evaluator, and as one of the founding members of the Revans Academy of Action Learning at Alliance Manchester Business School, I have had the opportunity to examine action learning PhDs and to organise a range of semi- nars and workshops on the subject. More than 13 years after my first encounter with action learning, as a tool for individual and organisational learning within the NHS, the subject still excites, intrigues and reassures me and I have found in John Edmonstone’s work the support, challenge and reassurance that I need in my task of seeking to inspire, and support, students, facilitators and sceptics of action learning. The title of John’s new work Action Learning in Health, Social and Community Care: Principles, Practices and Resources aptly encapsulates how and why this text has evolved. Its expansion to include social and community care reflects the changing context of health care today and the new emphasis upon working across organisational and professional boundaries, with a call for new innovations in commissioning to support the integration of services and the introduction of new models of care, such as Vanguard sites, devolution and multi-speciality care providers, in order to enhance quality and to manage costs. This need for health, social and community care to work together brings with it new challenges, new anxieties and new uncertainties. Yet a context such as this also provides opportunities. The very nature of action learning allows it to foster connection across organisational and personal boundaries and to facilitate the space to think, to reflect, to question and thereby to learn. This book provides an opportune resource which can enable us to develop the knowledge, skills and capability to seize these opportunities. It will therefore provide an essential resource for educators, com- missioners, managers, OD practitioners, action learning facilitators, set members and anyone with the desire to learn. Part 1 of this book provides a thorough explanation and discussion of the underlying prin- ciples of action learning. This section begins with a useful exposition of action learning prin- ciples, deftly weaving both its theoretical underpinnings and its practice to provide a secure grounding in the subject for those new to action learning, those wishing to deepen their understanding or those who, like me, are constantly seeking new insights. While there are many excellent introductions to the subject of action learning, where this text differs is in its consideration of the type of learning required for the current and specific challenges of health, social and community care and in its exploration of how action learning might support both vii viii Foreword individuals and organisations in confronting these. Following on from this in-depth introduc- tion, the author takes us on a journey to explore how action learning differs from other devel- opment approaches, providing some excellent insights into the nature of learning itself. There is both a complexity and simplicity to these insights, enabling them to simultaneously support and intrigue those seeking to learn and/or to facilitate the learning of others. With the context now set, the book moves on to consider action learning as an ethos and a method, providing a pertinent explanation of its values and ways in which action learning has evolved to keep up with the changing context. This includes a very informative description of two increasingly popular forms of action learning – critical and virtual action learning, what they mean and how they can be utilised. Part 1 concludes with a description of the benefits of action learning, supplemented with examples of its use within health, social and community care and a consid- eration of how it operates across a wide range of different contexts and cultures. With a firm grounding in the principles, types and benefits of action learning provided by Part 1, Part 2 goes on to provide a guide to the practice of action learning, taking the reader through a life-history of the action learning process, from initial preparation, right through to endings and evaluation. Action learning, as a process of questioning and challenge, can pose a threat to the status quo and anyone who faces some resultant trepidation at embarking on its use will find help- ful the section on assessing whether the organisation and its culture are prepared, can pro- vide reassurance and an antidote to possible learning casualties, thus enabling practitioners of action learning to ‘rock the boat’ without being thrown out of it! This section also includes a comprehensive guide to the roles and responsibilities of the various stakeholders in action learning and an essential practical guide to its components. A very practical useful part of this section is the provision of practical tips and resources, such as where to meet, how often and for how long, how to get the set started and how to manage the process of the set. A requisite skill in working within any set is the ability to work with a variety of unique individuals. A way of understanding the contribution of participants to the set’s working is provided in Part 2, through the introduction of the ‘energy investment model’, a model devised by the author to explain the contribution of participant’s personal energy and attitudes to the set’s working. This model provides an excellent resource for understanding both enablers, and potential disablers, within the set and will prove of immense value to set members and facilita- tors alike. The practical focus of Part 2 of the book continues with a comprehensive introduction to the key skills of action learning and includes, for example, skills of active listening, effective questioning, reflection and feedback. The important, yet often neglected, skills of supporting, recording and ending the action learning set are also included, along with a highly practical explanation of various appropriate diagnostics and support mechanisms and their pros and cons. A constant attendant in work in health, social and community care is anxiety. Despite being rarely discussed in texts relating to action learning, it is a frequent ‘participant’ and can have a profound impact upon the success of any learning endeavour. Its inclusion within this text is very welcome therefore, providing the reader with an explanation of the possible causes and manifestations of anxiety, as well as a guide which will enable the action learning practitioner to use anxiety as a tool for learning and to prevent it from becoming a learning saboteur. In addition to this useful guide to understanding and managing anxiety as part of the learn- ing process – a skill essential for any action learning facilitator – this book provides a compre- hensive guide to all of the skills and qualities required by facilitators. This guide, coupled with Foreword ix resources to support the facilitator’s development, and the means to avoid potential pitfalls, will be of immense practical value to any current or would-be facilitator. Another key component in Part 2 of the book is the guide to the challenging subject of enabling organisational learning. In his approach to this highly contested topic, John reviews aspects discussed earlier in the text, in addition to insights from some of the major writers in the field of action learning, thereby equipping the reader with the capacity to support organ- isational development and learning. One of the aspects of this part of the book, which makes it so very valuable to anyone interested in action learning, is the author’s commitment to subjects often avoided in con- siderations of action learning. Evaluation is one such elusive topic and so I was delighted to find a guide to this practice provided through a discussion of the challenges involved, and the presentation of useful questions to support the evaluation process. With this resource, readers will be able to provide the evidence for the value of action learning in practice. This practical part of the book concludes with a postscript which discusses action learning as ‘reflective activism’, a stance which entails reflection, active engagement in the workplace and the constant review of personal and contextual values, assumptions and practice. In this part, as in earlier ones, the discussion is of use not only to those interested in action learning but to anyone interested in the topic of learning per se. Following this section on the practice of action learning, Part 3 of the book provides an extended toolkit of resources, which together with the extensive bibliography and examples utilised throughout the text, are sufficient to provide anyone interested in action learning with the confidence to succeed in its implementation. What I love about John’s books is how the author’s drive to make a positive difference to individuals, organisations and society, jumps off the page, touching the reader and igniting their belief in their own power to do the same. I would like to conclude with a passage from the author’s postscript in which this is particularly potent: In the current times of increased inequality and insecurity in the larger society, there is a strong sense of powerlessness abroad – a belief that nothing can be done to change the situation which people find themselves in. Action learning is the antithesis of this belief….in that it helps people to take an active orienta- tion towards life in general and to overcome this dominant tendency to think, feel and be passive towards the pressures of life, … rather to embrace the opportunities and challenges of organisational and social change. Dr Elaine Clark Senior Lecturer in Action Learning and Healthcare Management Programme Director, BSc Management/BSc Management Specialisms Alliance Manchester Business School University of Manchester