Lifelong learning is necessary for nurses and caregivers to provide good, person-centred care. To facilitate such learning and embed it into regular working processes, learning communities of practice are considered promising. However, there is little insight into how learning networks contribute to learning exactly and what factors of success can be found. The study is part of a ZonMw-funded research project ‘LeerSaam Noord’ in the Netherlands, which aims to strengthen the professionalization of the nursing workforce and promote person-centred care. We describe what learning in learning communities looks like in four different healthcare contexts during the start-up phase of the research project. A thematic analysis of eleven patient case-discussions in these learning communities took place. In addition, quantitative measurements on learning climate, reciprocity behavior, and perceptions of professional attitude and autonomy, were used to underpin findings. Reflective questioning and discussing professional dilemma's i.e. patient cases in which conflicting interests between the patient and the professional emerge, are of importance for successful learning.
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To elucidate how authoritative knowledge is established for better dealing with unstructured urban problems, this article describes how collaborations between researchers and officials become an instrument for conceptualizing and addressing policy problems. A case study is used to describe a research consortium evaluating the controversial practice of ‘Lifestyle’ based housing allocation in the Dutch domain of social-housing. Analyzing this case in key episodes, we see researchers and policymakers selectively draw on established institutional practices—their so called ‘home practices’—to jointly (re-)structure problems. In addition, we find that restructuring problems is not only intertwined with, but also deliberately aimed at (re-)structuring the relations within and between the governmental practices, the actors are embedded in. It is by selectively tinkering with knowledges, values, norms, and criteria that the actors can deliberately enable and constrain the ways a real-world problem is addressed.
This study explores the evaluation of research pathways of self-management health innovations from discovery to implementation in the context of practice-based research. The aim is to understand how a new process model for evaluating practice-based research provides insights into the implementation success of innovations. Data were collected from nine research projects in the Netherlands. Through document analysis and semi-structured interviews, we analysed how the projects start, evolve, and contribute to the healthcare practice. Building on previous research evaluation approaches to monitor knowledge utilization, we developed a Research Pathway Model. The model’s process character enables us to include and evaluate the incremental work required throughout the lifespan of an innovation project and it helps to foreground that innovation continues during implementation in real-life settings. We found that in each research project, pathways are followed that include activities to explore a new solution, deliver a prototype and contribute to theory. Only three projects explored the solution in real life and included activities to create the necessary changes for the solutions to be adopted. These three projects were associated with successful implementation. The exploration of the solution in a real-life environment in which users test a prototype in their own context seems to be a necessary research activity for the successful implementation of self-management health innovations.
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