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 facilitators’ 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 (𝙞𝙣𝙨𝙞𝙙𝙚 𝙮𝙤𝙪𝙧 𝙤𝙬𝙣 𝙝𝙚𝙖𝙙), the way they interact with groups, finding the right balance in facilitation to enable people to transform practice and to flourish (𝙬𝙖𝙡𝙠𝙞𝙣𝙜 𝙖 𝙛𝙞𝙣𝙚 𝙡𝙞𝙣𝙚) and how they react to situations and manage their own reactions (𝙗𝙚𝙞𝙣𝙜 𝙢𝙚). Cluster 2: External to the facilitator related to facilitators’ development. This cluster incorporated the significant learning that was gained from interactions with other facilitators (𝙖 𝙡𝙚𝙣𝙨 𝙤𝙣 𝙛𝙖𝙘𝙞𝙡𝙞𝙩𝙖𝙩𝙞𝙤𝙣) and getting to grips with and using theories to underpin facilitation practice (𝙢𝙖𝙠𝙞𝙣𝙜 𝙨𝙚𝙣𝙨𝙚 𝙤𝙛 𝙩𝙝𝙚𝙤𝙧𝙮). Cluster 3: Enacting transformational facilitation conveyed how facilitators assimilated their learning and experiences to enable them to work effectively with people in diverse settings (𝙪𝙣𝙙𝙚𝙧𝙨𝙩𝙖𝙣𝙙𝙞𝙣𝙜 𝙥𝙚𝙤𝙥𝙡𝙚 𝙞𝙣 𝙘𝙤𝙣𝙩𝙚𝙭𝙩) and become flexible in their practice (𝙗𝙚𝙞𝙣𝙜 𝙛𝙡𝙪𝙞𝙙). 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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