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Practice Development with individuals: A Realistic Evaluation with Occupational Therapists

Melton, J. (2010). Practice Development with individuals: A Realistic Evaluation with Occupational Therapists. (Unpublished Doctoral thesis, City University London)


Significant investment has been made to develop the practice of health care professionals in order that service users are offered evidence-based care. This investigation is a ‘Realistic Evaluation’ (Pawson and Tilley 1997) undertaken to form an illuminative case study of a particular change initiative for a specific professional group (occupational therapists) in one organisational structure. A practice development programme was available to all members of this group and sought to enable participants to use contemporary theory and standardised assessments routinely in their work.

The aim of this research was to gain an in-depth conceptualisation of the mechanisms which when activated within particular environmental contexts supported individual practitioners to embed their learning into their daily practice. The latter was considered the desired outcome. Mixed methods of data collection were used to gain understanding of how engagement in a practice development programme concluded for different individuals who were employed within the same NHS Trust.

The results suggested that mechanisms supporting practice development can be identified and when activated act as catalysts for practice change. It was also evident that the immediate environmental context and the person’s attributes had an influence upon an individual’s capacity to activate mechanisms. Furthermore, the level of engagement in the same baseline practice development opportunity varied for different individual practitioners. The conclusion of this thesis is that differentiated PD needs to occur in order to maximise practice change across people and places. The Individual Practice Development Theory (IPD) presented in this thesis represents an original contribution to knowledge. Using the IPD theory in practice could enable best use of learning opportunities, ensure the judicious use of resources and raise the quality of service for service users.

Publication Type: Thesis (Doctoral)
Subjects: B Philosophy. Psychology. Religion > BF Psychology
H Social Sciences > HD Industries. Land use. Labor > HD28 Management. Industrial Management
Departments: Doctoral Theses
School of Health & Psychological Sciences
School of Health & Psychological Sciences > School of Health & Psychological Sciences Doctoral Theses
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