An exploration of developing skilled facilitation within transformational practice development in healthcare

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Facilitation is key to engaging people in transformational change and facilitators require considerable skill. However, a thorough understanding of the nature of facilitation and how people develop as facilitators remains elusive. This research investigated the experiences of practice development (PD) facilitators regarding their understanding of transformational facilitation and becoming skilled. The research was situated within the Constructivist paradigm and used Naturalistic Inquiry as the guiding methodology. The study was a two-stage in-depth exploration of the topic. The first stage incorporated 15 interviews with PD facilitators in Australia/New Zealand to gain their understanding of transformational facilitation and their practice as a facilitator. The second stage allowed for deeper understanding, and elaboration, of the themes identified in stage 1. This stage explored transformational facilitation internationally through interviews with seven leading PD facilitators from four European countries. Seven overlapping and interacting themes were identified that formed three distinct clusters. Within each theme there was evidence of a continuum of development. Inexperienced facilitators were at one end of the continuum with those who were highly skilled at the other end. The continuum reflected the increasing sophistication of facilitatorsโ€™ thinking and management of situations as they gained expertise. Cluster 1: Internal to the facilitator identified elements that related to the way a facilitator thinks (๐™ž๐™ฃ๐™จ๐™ž๐™™๐™š ๐™ฎ๐™ค๐™ช๐™ง ๐™ค๐™ฌ๐™ฃ ๐™๐™š๐™–๐™™), the way they interact with groups, finding the right balance in facilitation to enable people to transform practice and to flourish (๐™ฌ๐™–๐™ก๐™ ๐™ž๐™ฃ๐™œ ๐™– ๐™›๐™ž๐™ฃ๐™š ๐™ก๐™ž๐™ฃ๐™š) and how they react to situations and manage their own reactions (๐™—๐™š๐™ž๐™ฃ๐™œ ๐™ข๐™š). Cluster 2: External to the facilitator related to facilitatorsโ€™ development. This cluster incorporated the significant learning that was gained from interactions with other facilitators (๐™– ๐™ก๐™š๐™ฃ๐™จ ๐™ค๐™ฃ ๐™›๐™–๐™˜๐™ž๐™ก๐™ž๐™ฉ๐™–๐™ฉ๐™ž๐™ค๐™ฃ) and getting to grips with and using theories to underpin facilitation practice (๐™ข๐™–๐™ ๐™ž๐™ฃ๐™œ ๐™จ๐™š๐™ฃ๐™จ๐™š ๐™ค๐™› ๐™ฉ๐™๐™š๐™ค๐™ง๐™ฎ). Cluster 3: Enacting transformational facilitation conveyed how facilitators assimilated their learning and experiences to enable them to work effectively with people in diverse settings (๐™ช๐™ฃ๐™™๐™š๐™ง๐™จ๐™ฉ๐™–๐™ฃ๐™™๐™ž๐™ฃ๐™œ ๐™ฅ๐™š๐™ค๐™ฅ๐™ก๐™š ๐™ž๐™ฃ ๐™˜๐™ค๐™ฃ๐™ฉ๐™š๐™ญ๐™ฉ) and become flexible in their practice (๐™—๐™š๐™ž๐™ฃ๐™œ ๐™›๐™ก๐™ช๐™ž๐™™). This doctoral study provides new insights regarding the nature of skilled facilitation and ways in which facilitators practice and develop themselves. The findings contribute new knowledge about the inner dialogue of facilitators and how they draw together all aspects of their practice to enable transformation in individuals, teams and healthcare cultures. These findings have implications for all facilitators, as well as facilitation practice and ways to support facilitator development.
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