The Implementation of a Model of Person-Centred Practice In Older ...

The implementation of a model of person-centred practice in older person settings
Technical and emancipatory practice development
The technical approach is regarded as a top-down approach and is based on the
assumption that once practitioners have evidence, often policy based, they will find it
compelling and their practice will change (Manley and McCormack 2004; Sanders
2004). It also usually focuses on one aspect of practice, often a clinical concern
(such as pain assessment, catheter care, end of life care) and addresses it in
isolation from other aspects of practice and what is going on in the context.
Therefore, significant development of staff, if it occurs, is a consequence of practice
development rather than a deliberate and intentional purpose of the technical change
(Manley and McCormack 2004). This approach tends also to emphasis a stop-start
mentality to improving practice. The mind set tends to support the notion that once
the evidence has been put into practice then best practice has been achieved and
there is then no further need to attend to that aspect of care or practice.
It is vital that practice development activities contribute to professional and personal
development of practitioners and managers for longer term sustainability. Every
short term initiative should add to and enhance broader contextual and cultural
transformation. Manley and McCormack explain that emancipatory practice
development, on the other hand, has an explicit focus on the empowerment of the
practitioners. The practice development literature demonstrates that this is closely
related to the creation of a specific culture, termed a ‘transformational culture’.
Emancipatory practice development believes in learning and transformation in its
broadest sense. However, it also recognises the demands from organisations who
want value for money and visible outcomes in regard to service delivery and quality.
Emancipatory practice development explores concerns around oppression and
empowerment. These purposes are consistent with and reflect the influences of key
theoretical principles within critical social science. A critical social science
perspective suggests that social phenomena cannot be understood unless other than
through the history and structure within which they are founded (Fay 1987).
Therefore, central to emancipatory practice development is enabling practitioners to
understand their context and culture and to positively influence it rather than it
controlling them.
Practice development and associated research based on critical social theory
requires researchers to take an inherently critical stance and ask ‘how’ questions
(McNiff and Whitehead 2006). This implies not only a theoretical position but also a
28