Use this URL to cite or link to this record in EThOS:
Title: Learning to listen, learning to act listening to the learning Using action learning to shift the balance of power within the NHS
Author: Clark, Elaine
ISNI:       0000 0004 2676 720X
Awarding Body: The University of Manchester
Current Institution: University of Manchester
Date of Award: 2007
Availability of Full Text:
Access from EThOS:
My PhD thesis arose as an attempt to develop "the science of praxiology" (Revans. 1982:493) through a study and development. of my practice. as manager.of the Patient Advice and Liaison Service. This practice was located within a context of crisis within the NHS, articulated within the NHS Plan and Kennedy Report (DOH 2000. 2001) as the need for a change of culture to a culture of partnership in which patients/carers and professionals could learn with and from each other. The Patient Advice and Liaison Service (PALS) was a new service introduced in 2001 to operationalise this change within the NHS. My questions revolved around how to act to facilitate partnership between patients/carers and professionals. In particular. how could I enable a group of patients who were traditionally excluded from having input within their own care. patients with learning disabilities, to 'teach' professionals and to have influence on a personal, inter-relational and organisational dimension? My chosen approach is Action Learning, supplemented by the use of story as a mode of enquiry and of change management. I have suggested within the course of my thesis that action learning. through its core features of enabling learning through doing. partnership between programmed knowledge and questioning insight and an empowerment of the learner provides a metaphorical analogy for the aims and values of my practice. Within this PhD. I have developed Revans' learning equation (1982) through exploring in practice. how to amplify the questioning insight of patients with learning disabilities. so that learning might occur on individual, inter-relational and organizational, dimensions. I have suggested that action learning provides "a sociology of freedom" able to transcend methodological and epistemological paradigms. facilit<;lting synthesis and partnership between expert/everyday knowledge. learnerl'learned' and levels of hierarchy. I thereby propose an expansion of the learning equation to include pragmatic. subjective and programmed knowledge in partnership and critiqued through questioning insight. Key to the development of questioning insight becomes the creation of a culture for dialogue, which enables stories to be heard and utilized for learning. This requires a model of communication as a continuum facilitative of reflective learning and a minimization of negative influences upon learning. and the use of story as a lever for change and empowerment. Throughout the course of my PhD I have been guided by the aim to create a culture for partnership. seeking to facilitate a shared discourse as a pre-requisite for partnership working. This discourse was created within practice through the development of an integrated care pathway. developed between patients. carers and staff. My major contribution to practice has been in enabling the voices of a seldom heard group to be amplified sufficiently to facilitate learning within an organization not used to hearing.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available