Authentic Professional Learning
From the holistic perspective taken in this research, the descriptions of APL throughout this chapter are imbued with nuances of the professional life-world, but because the focus is on the experience of learning, some life-world details are lightly sketched. To contextualise the phenomenological structure of APL, this chapter begins with a description of the professional life-world drawn from the complete data corpus, with respect to three aspects of the professional context: professional affiliations, employer organisations and local workplaces.
KeywordsProfessional Practice Professional Association Active Engagement Speech Pathologist Uncertain Situation
5.1 Professional Life-World
From the holistic perspective taken in this research, the descriptions of APL throughout this chapter are imbued with nuances of the professional life-world, but because the focus is on the experience of learning, some life-world details are lightly sketched. To contextualise the phenomenological structure of APL, this chapter begins with a description of the professional life-world drawn from the complete data corpus, with respect to three aspects of the professional context: professional affiliations, employer organisations and local workplaces.
5.1.1 Professional Affiliations
Most clearly identified themselves as an occupational therapist, a physiotherapist or a speech pathologist before thinking of themselves as an employee of an organisation. That is, their professional affiliation seemed stronger than their employer connections. Participants were aware of common expectations about a professional’s responsibility with respect to continuing learning. They repeated, almost word for word, their perceived professional responsibilities to keep up-to-date with new knowledge and practices, maintain a quality service, be accountable and use evidence-based practice.
These perceptions tally with documentation available from most professional associations. As only half of the participants were members of their association, this shared perception was presumably gained through interaction with the wider professional community. Professional association websites stressed continuing PD, with terminology such as “knowledge acquisition” and “updating knowledge” used rather than PL. Although learning is implied in many of the PD statements, the focus of these documents was, and still is, on public accountability through maintenance of professional standards, delivery of PD activities and supervision of practice.
In the current climate of accountability and litigation, there are moves towards mandatory and auditable PD as a requirement of yearly registration for all health (and many other) professionals. The professional associations award points for attendance at accredited courses as well as for other forms of individual PD, such as reading articles or presenting to colleagues, requiring written evidence of such activities. Many participants mentioned that public acknowledgement of their knowledge and skills, by their peers, offered professional credibility and was necessary for career progression.
I think that there is probably a role for a journal, or at least a section of one, which encourages clinician’s viewpoints without the expectation that papers are well researched, referenced and scientific in nature. The present state of our current national journal does little to encourage the masses to contribute to discussions. I repeat what I said before, the cutting edge is in clinical practice, not in the universities. (Dom)
Finally, all associations stressed the need for supervision of therapists and offered varying degrees of support through mentor programmes. The terms “supervision”, “mentoring” and “support” are often used interchangeably. Participants also used these words interchangeably in the interviews despite the different inferences of the terms. For example, statements such as I really need supervision to help me know what to do were made in situations where a need for support or mentoring was implied.
5.1.2 Employer Organisations
The two large government organisations, who employed 13 of the 16 participants, published clearly identifiable strategic directions and goals that included staff development, as do most public organisations. One also had a learning and development policy for employees involving individual learning plans aligned with workplace priorities. None of these 13 participants mentioned or seemed aware of these policies. Some did comment, however, that these two organisations valued the professionals’ ability to be accountable, develop measurable outcomes and meet goals in a timely manner.
One of my colleagues said that it’s like, it’s us and them but we’re never us, as therapists, we’re always them. I don’t feel that the organisation understands why they need to have therapists, the decision makers don’t know, don’t really have any contact with therapists about decisions. (Nerida)
A few participants expressed a strong feeling of frustration at what they saw as an abrogation of a social justice agenda, describing the organisation’s main focus as fiscal rather than client-centred, despite rhetoric to the contrary. Most participants were quite explicit in their feelings that neither they nor their contribution was valued. For some, this resulted in resignation. Sam noted, I’m leaving due to frustration, dissatisfaction and feeling totally undervalued. It has become very evident that I am just a position number. Others pragmatically stated they loved what they did in their work but that being appreciated would be the icing on the cake (Mary).
The two smaller non-government agencies had no published policies on PL, nor did the three participants from these organisations mention many of the workplace concerns commented on above by other participants. None of these three participants alluded to feeling that they or their work was unvalued.
All four organisations supported staff to attend some PD activities within budget constraints. Participants reported attending a variety of PD activities provided by the workplace, professional associations or private providers, both within and outside working hours. Sometimes the organisations funded activities but all professionals attended self-funded activities as well. Two participants mentioned they were not granted organisational approval for funds or leave to attend PD that had a specific therapy focus, as this focus did not align with organisational goals. The three workplace PD sessions I attended were enthusiastically received, according to my observations and to organisational satisfaction surveys. The focus was on clinical practice, with client examples, preceded by theoretical background. They were delivered to a seated audience in a traditional didactic manner, but interaction and interjection were encouraged and did occur.
Formal professional networks were supported to some degree by all organisations and participants agreed on the value of these networks for their PL. The networks were usually organised on the basis of location and profession, although some informal networking based on shared interests was reported. The network meetings I observed varied according to who facilitated the group. When a senior professional supervisor facilitated, the proceedings were reasonably formal. Participants tended to speak in turn, looked for the supervisor to lead and waited for her comments before proceeding. When the local network met without a supervisor the discussions were more informal with interaction between multiple participants. In particular, I observed more readiness of participants to admit failure or doubt in the latter situation. This was not observed when the supervisor was present.
5.1.3 Local Workplaces
From the workplace visits and interviews, it became obvious that the structure of the local workplace had particular impact on continuing PL experiences. Participants commented, in particular, on the impact of opportunities for interactions with other people and the value of flexibility in schedules and timetabling.
All the participants worked with other staff. Usually this includes other therapists as well as psychologists, teachers, nurses, residential care workers and administrative staff. Of the 16 participants, 10 worked in multi-disciplinary teams with regular interaction. The other six had minimal interaction with team members, because they worked on different days or because of staff shortages and unfilled vacancies. In addition to interaction with clients, who ranged from children to adults, most of the therapists interacted with the clients’ families. When I observed teams sharing space and time during the day, such as over lunch breaks, I noted significant interaction between them, described by them generally as catching up socially, sharing humour as a safety valve or brainstorming ideas about work.
The pace, intensity and busyness of the professionals’ work situations were commented on in a negative way by most participants, especially in the large organisations, if they had limited autonomy. Even when participants reported coping with the workload, they used phrases such as we’re just run off our feet or we just dig away at the mountain of work. Some participants reported working extended hours and having difficulty taking leave because of their perception of unmet client need and a high level of commitment to their clients. Many found that work intrudes on their personal lives. One younger professional commented: How does having a family fit in as well as maintaining our professional career? That worries me (Nola). The high workload of frontline staff has been commented on in public enquiries into similar government organisations.
Participants discussed a range of strategies for dealing with the intensity of work. A process of prioritisation of client service was in place in one organisation with varying degrees of success according to participants. In the other organisations prioritisation was decided locally. The working days of four participants were particularly tightly scheduled. After I finished an interview with one of these professionals to the sounds of the next client crying outside the door, the irony of a union notice about workload on the staffroom wall did not escape me. It stated in bold print: “Say no to work overload. Speak up when you have too much to handle”.
5.2 Situations Where Professionals Learn
Within the contexts described above, there were many different situations where professionals considered they had learnt. After describing their everyday work in the interviews, participants gave detailed descriptions of several learning situations. They described situations where, either at the time or in hindsight, they identified that something happened, resulting in learning. Using a term from one participant, I call these transition situations where the professional’s awareness of the situation changed. As expected, there were many types of transition situations. Some were relatively straightforward involving a chance encounter with a client or talking with a colleague. Others were complex, such as dealing with a client with multiple needs or resolving a difficult organisational dilemma. In all cases, the descriptions of one situation led to descriptions of others that were related in some way.
Most participants discussed learning through clinical problem solving with clients, especially when the client had complex or unusual problems. A transition in awareness, where the therapist understood what was happening or saw the situation in a different way, occurred through various means. Feedback from the client, the addition of new information or discussion with others was involved in this change. Sometimes the situation was clear-cut, such as learning to apply a new technique with a client. Many learning situations, however, involved multiple shifts in awareness and concerned broader issues with clients, where professionals described moving over time to a more holistic or long-term perspective about practice issues.
About half the participants began their descriptions of learning situations by discussing a PD course. Invariably it was one attended some years ago but remembered because it was a significant learning experience. This is in contrast with general comments that participants learnt little from many PD courses because they were either not relevant or forgotten if not incorporated into practice. When probed further about PD courses considered to be learning experiences, it became apparent that the course was only part of the learning experience, being always linked to other situations. For example, a transition in awareness sometimes occurred after a course when working with clients or talking with others. It is then that it all made sense, or the pieces fell into place. Only one professional described a transition in awareness during a course when she suddenly saw a whole new way of looking at my practice (Gina). Some described transitions in awareness through several situations before a course, noting how the course confirmed an emerging change in their understanding.
Many significant transition situations were described where the focus of the shift in awareness was interaction with others. Every participant mentioned learning to work with others as part of their PL experience, described as learning interpersonal skills, communication skills or conflict resolution. The majority mentioned this as a crucial part of learning once a professional is in the workforce and one they generally felt unprepared for. Learning to work with others was ongoing, as even experienced therapists recounted significant learning experiences in this area. Learning through interaction with others also included learning from the experience of teaching others or presenting to peers and of being mentored and mentoring others.
The learning situations described by the two least experienced therapists, working for less than two years, were focused on learning what to do as a professional. They explained what had helped them to learn initially and what difficulties they faced. The transition situations they described included learning where to start in complex situations and learning how to put the theory they knew into practice.
Finally, some descriptions of learning were about moral or ethical dilemmas and what was learnt through their resolution. Almost half the participants recounted how they learnt about themselves through PL and two spoke of learning about learning. Thus descriptions of learning situations led to general comments about learning: what helps, what hinders, what is valued and which strategies are used. All participants expressed varying preferences for different ways of learning.
The type of learning situations described through the pilot study did not differ from those in the interviews. This indicates that the PL experiences of the 16 interviewees were similar to the larger group. Similarly, the types of learning situations from the second round of interviews a year later were similar to those mentioned already. Further clarification was gained from the second interviews about what supported the professionals to continue learning and what they, their profession and the workplace valued about learning. In two cases further contextual information about the local workplace was gained. In these cases, workplace dilemmas had worsened, resulting in frustration and anger on behalf of clients by one professional and disillusionment and stress leave for the other.
From this overview of learning situations, the diversity and complexity of the experience of PL can be glimpsed. The problem with research that remains with specific instances of learning, describing specific factors that may encourage learning, is that similar situations support learning for one person but not for another. In this research, the intention of asking participants to describe concrete situations where they had learnt as professionals was to draw out rich descriptions of the experience of PL. Viewing these descriptions from a phenomenological perspective allows constituents of an experience rather than elements of a specific situation to be seen. The value of a phenomenological approach to studying complex experiences is demonstrated in the following section.
5.3 Phenomenological Structure of APL
What is it about the various situations described above that make them identifiable to the participants, to other professionals and to myself as PL? From the phenomenological analysis, four constituents, understanding, engagement, interconnection and openness, were identified as essential to the experience of APL. All of these constituents were present in each participant’s description of their PL experiences. As mentioned in Chapter 4, the essential structure of a complex experience revealed through phenomenological analysis is holographic, with each constituent incorporating the experience as a whole. The constituents are interdependent, but are separated below for the purpose of description. Their interdependence is evident in the short vignette of participants’ experiences, following each constituent.
5.3.1 Overview of Authentic Professional Learning
Constituents and sub-constituents of the structure of APL
Constituent 1: Understanding
Change in professional understanding
• from prior understanding through learning transitions to changed understanding as a professional
Variation in the type of transition(s), involving:
• knowing what to do;
• thinking about what to do; and
• questioning what is done.
Constituent 2: Engagement
Engagement in professional practice
• actively engaged in some way;
• cared about aspects of professional practice;
• perceived aspects as uncertain; and
• aspects of professional practice perceived in a novel way.
Variation in engagement in different aspects of professional practice and ways in which uncertainty is perceived by the professional.
Constituent 3: Interconnection
Interconnection of experiences over time
• multiple experiences interconnected in a circuitous iterative web;
• imagination draws together past, present and future; and
• through dynamic interaction with others.
Variation in the type of interactions and the extent of shared experiences and understanding.
Constituent 4: Openness
Openness to possibilities that is circumscribed
• process of APL is open ended requiring openness of attitude;
• opportunities and constraints of professional context shapes APL; and
• resolution of tensions between openness and context.
Variation in ways of resolving tensions, providing a unique quality imbuing the shared structure of APL
In constituent 1, change in professional understanding involves more than cognitive knowing, encapsulating all that a professional embodies and expresses through being a professional in practice. In situations where professionals describe having learnt, the prior understanding they bring to the situation is insufficient for the requirements of that situation, but changes through learning transition(s). Variation in this constituent is related to different types of transitions involving knowing what to do, thinking about what to do or questioning what is done.
Constituent 2 describes how such change in understanding occurs, through the professional’s active engagement in aspects of professional practice that they care about and perceive as uncertain. Here professional practice pertains to a broad range of activities related to being a professional. Through learning, a feature of professional practice is perceived in a novel way as professional understanding changes. Variation in this constituent is related to engagement in different aspects of practice and ways in which uncertainty in practice is perceived by the professional.
Constituent 3 describes how multiple experiences of learning are interconnected over time in APL. Professionals learn through dynamic interaction with a range of other people in an ongoing, circuitous and iterative manner that creates a web of interconnected experiences. In this process, the professional’s imagination draws together recollections of past experiences, awareness of the present situation and anticipation of future possibilities. This constituent accounts for and integrates the complex social and temporal dimensions of APL. Variation in this constituent is related to the type of interactions that occur and the extent to which experience and understanding is shared.
Constituent 4 describes how APL is experienced as a process that is open to many possibilities because it occurs through engagement with others in the complexities of practice over time. APL is open ended with no clear beginning or predetermined outcome, requiring an openness or flexibility of attitude on the part of the professional to cope with the inherent uncertainty of the process. Yet this openness is not infinite, but is circumscribed and shaped by the opportunities and constraints of the professional’s working context. There are tensions between the possibilities inherent in APL and the circumscription of context. Variation in this constituent is related to the way in which different professionals resolve these tensions. This resolution shapes the professional’s experience of APL, so that the learning of each professional has a unique quality although the structure of that experience is common to all the professionals.
Change in professional understanding is the core constituent. Active engagement in professional practice and interconnection of experiences over time describe in a chiasmic manner how such change in understanding occurs. Circumscribed openness to possibilities describes the way that the overall experience of APL is shaped so that changes in understanding in APL are experienced and expressed by professionals in unique ways. All four constituents interact dynamically.
In every experience of APL there is the recognisable thread of all four constituents. As I describe each constituent in detail in the following four sections, I refer to other constituents as appropriate. Similarly the vignettes at the end of each section contain elements of all four constituents although one is highlighted. Throughout the descriptions I draw on participants’ words, shown in italics.
5.3.2 Learning as Change in Professional Understanding
Constituent 1, the keystone of the structure of APL, describes how learning is essentially about change in professional understanding. In the study, professionals were asked to describe particular situations where they learnt as a professional (occupational therapist, physiotherapist or speech pathologist). Through exploring such concrete situations, participants spoke about how their understanding as professionals changed through learning.
Change in Professional Understanding
In common use, understanding refers to perceiving the meaning of something and is often used with reference to knowing and learning. In this study understanding encapsulates more than this. The word itself was widely used in interviews in the study. It was referred to by participants in the sense of being aware that they had learnt. The most common phrase used to describe understanding was making sense.
There is a holistic rather than purely cognitive sense to their notion of understanding that involves all aspects of being a professional. Participants described understanding that included sensory perception, bodily awareness, humour, intuition, imagination and emotion, as well as cognition. Phrases used include I saw it differently, I have a gut feeling, I just know when movement’s wrong, I learn so much from being hands on. Thus professional understanding is described as cognitive, intuitive, bodily, practical and emotional.
Professional understanding refers to all the professional is and does as a particular professional, for example, an experienced speech pathologist working in a rural setting. Professional understanding includes this professional’s way of perceiving situations as well as way of practicing. These aspects are not separate, as the way a professional approaches situations determines what she does and vice versa. Professional understanding draws together all aspects of being a particular professional and is integral to practicing as a professional. That is, without a certain professional understanding it would not be possible to function in daily practice.
While change can take many forms in professional experience, such as instigation of workplace changes, change in professional understanding is the crux of all the experiences of APL described by the participants. Only when change in professional understanding occurs is APL experienced. Professionals described their professional understanding as second nature or commonsense. When a change in understanding occurred through learning one participant described this as having a new sense about it … rather than a common sense about it (Kim).
In the descriptions of learning, participants included who they are as a professional and how they change through learning. They commented that the way they saw themselves (or understood themselves) as a professional changed, using phrases such as I’m more realistic, I’m more confident, I’m more resilient. Many descriptions highlight the embodied nature of learning as a professional, that is as much about who the professional is, as it is about what she knows. Sometimes this description was explicit: My learning makes a change in my being, I become more aware of what I am (Charlie). At other times it was implicit: It really came home to me was how Mary describes her change in understanding about a work situation, where the word “home” implies self.
The varied experiences of APL described by the participants changed the professionals’ understanding in some way. APL involves a change in the way of thinking about self and work (who they are as professionals), the way of practicing (what they do as professionals), what they felt they know or their way of working with others. Professional understanding encapsulates all that a professional does and is, so that change in understanding alters some aspect of being a professional. But a professional is not an aggregate of parts, existing rather as a whole. All these aspects of professional understanding presuppose a prior, implicit understanding of being a professional in a particular way.
The participants were articulate about their own particular way of being a professional, although such a specific question was not asked. When discussing APL, they made comments such as that’s just who I am, I’m by nature a reflective sort of person, I like to keep everyone happy at work or I like challenges. Although such observations could also refer to their way of being more generally, these comments were made as part of their descriptions of learning as a professional. Thus professional understanding encapsulates all that a professional embodies and expresses through being a professional in everyday practice. Through learning, there is some change in the professionals’ understanding of being a professional.
It is implicit in the nature of change that there is a transition from a previous condition to a different one. APL involves transitional situations where a professional’s understanding changes, often over an extended period of time. The participants were aware of learning taking place in those situations, either at the time, on subsequent reflection or years later. Sometimes this change is apparently small, as Nerida described in the beginning of this book: I saw him and his abilities in a different way after that. At other times the change seems far-reaching. For example, Kim said, referring to a change in her way of understanding her practice: It was wonderful. It was just like I’d opened a door and the situation was different then. Together these transitions in understanding constitute the experience of APL.
Although it occasionally appeared that there was a single transition point, an “ah ha” experience, further discussion always revealed a series of transition periods leading to a learning situation, as well as following it. Transition periods are part of the texture of the professional’s life-world, so that changes are understood in the context of the person’s current understanding of being a professional. In Nerida’s experience of learning mentioned above, her prior knowledge of the client and of what communication entails enabled her to learn from that brief exchange. Such interconnection of experiences is explained in detail in constituent 3.
A change in understanding implies a prior understanding. The professionals bring a prior understanding to professional situations based on their previous experiences and way of being a professional. For example, many therapists describe learning new techniques but they approach such learning situations with a sense of what the technique is and its potential relevance; otherwise they would not be able to make sense of their further investigations.
In the descriptions of APL this prior understanding was sufficient to engage interest, but insufficient for the requirements of the situation. All the participants spoke about uncertainty or not knowing what to do as part of learning, using phrases such as we didn’t have a clue or I felt unprepared. Prior understanding ranged from a feeling of not knowing to wanting to know more, for example: It was intriguing, I was curious. This prior understanding is not always experienced as a conscious awareness on the part of the professional. At times it is only through change that prior understanding can be identified. For example, I now know what to do implies I previously did not know. Change from an insufficient prior understanding to a new or different understanding is interpreted by participants as learning.
Varying Types of Transitions
As stated, there is considerable variation in the type of changes in understanding that occur in different learning transitions, yet all are interpreted as APL. Three types of transitions where professional understanding changed are described in the structure of APL: type 1 describes learning involving “knowing what to do,” type 2 describes learning through “thinking about what to do” and type 3 describes learning that involves “questioning what is done”. Each is described below.
I think people miscredit the experience of just being in there and doing it. They don’t realize how much you actually get from that. You develop a bit of a feel for things, after years you can short cut a bit because you know where things are heading or what things are more likely to work. (Gerri)
All the participants also described learning involving type 2 transitions (thinking about what to do) as a conscious awareness of thinking to make sense of situations. Thinking is described in terms of going inside my head, racking my brains, untying a few knots or being able to visualise what had happened. All the professionals spoke about thinking and doing in these experiences as separate though related. Many participants value time to think or talk about a situation when they are uncertain, to try to understand or work out what is happening or what is really going on, so they can proceed. Type 2 transitions occur when the professional is engaged in a situation that is challenging or when something unexpected happens, for example, if what they are doing doesn’t work out as planned and they try to work out why. This type of transition often, but not always, involves the use of problem-solving or clinical reasoning strategies.
Everyone said they thought about situations in this way, but they rarely used the term “reflection”. When they did use this term it was usually in the sense of thinking about what to do. The outcome of reflection, described as productive reflection, is valued. Nerida explained her perception of reflection: I don’t know that I [reflect] as productively as I could. I think I do sometimes tend to spend too much time thinking about stuff rather than actually trying it and putting it into practice. When asked for more details, she replied: You can theorize about whether or not something’s going to work but you can’t actually know until you try it.
Whereas all participants described instances of type 1 and 2 transitions, only six of them described type 3. It is included within this constituent, however, as a variant of change in understanding. Type 3 transitions involved not merely thinking about practical situations, but questioning assumptions underlying these situations. In other words, although in all cases of learning, professional understanding changes in some way, in type 3 transitions the professional consciously reflects on certain aspects of professional understanding. For example, Sam described learning that involved questioning her assumptions about being a professional, describing this as Standing back and thinking – am I imposing my values, my ethics, my morals onto the [client] and do I have the right to do that.
These six participants spoke about understanding of being a professional in a substantially altered way because of learning, as exemplified by Gina, below, describing a whole new way of looking at everything. All situations involved a challenge to the professional’s understanding of being professional. Olivia described how she saw a serious misunderstanding in professional communication as being due to our different assumptions, and how she learnt to re-evaluate my way of communicating [as a professional]. All the professionals who described type 3 transitions as part of their learning were experienced therapists, but not all experienced therapists described learning that involved such challenges. Others may of course have questioned in this way but not mentioned it in the interviews. This type of transition alters the framework through which the professionals interpret and derive meaning from their practice.
The fact that both level 2 and 3 transitions take time to think was seen as a problem for the many professionals who are in the busy work situations outlined earlier. Those who expressed a desire for more time to think sometimes found it difficult to make time as they always have higher priorities. Some saw thinking as such a high priority that they made time even if it was outside work hours. The varied impact of such constraints on learning is detailed in constituent 4, openness.
Vignette: A Whole New Way of Looking at Everything
It was like magic. Seeing the course leader work with a child we knew, how the child responded so quickly to her non intervention. We saw a better way to go. A whole new way of looking at everything, about how to get activity from a child. A real changeover in my thinking. It was immediate, it happened that day, it was huge. (Gina)
The course leader was direct. She told us the methods we were using were hopeless. Some people got defensive, some liked it. I was excited as the child was happy and I saw she was learning. I decided to try and use it almost immediately at work. She made sense, she was credible because we’d seen her work. I was challenged. I was trusting my gut instinct and what she said, but it was really flying across traditional therapy thinking. (Gina)
Gina has learnt more about this approach since then, exploring it through ongoing active engagement in practice (constituent 2): How did I get a grasp on what she was saying? From practical experience. I’m a very practical learner. She continues to learn through day-to-day situations with clients in an iterative manner: I did read what she wrote but I had to go over and over it, and then something would click with my practical observations. As Gina works, observing her clients’ reactions and making small changes to what she does, she describes interpreting what happens on the spot (type 1 transition): There are certain illuminating experiences. Not every day, but then a run of them. I tend to respond intuitively to what I see. In this way her experiences are interlinked (constituent 3).
Her learning also involves type 2 transitions, thinking about what is happening with clients through discussion with other staff and going back over books on the topic: We’ve had lots of discussion about how we would put it into practice. Every time I read the books something else comes out. Once I’ve seen a practical situation, it makes sense. I take home books and plan – a lot of time spent thinking, problem solving.
Over a number of years, Gina’s understanding of being a professional has changed considerably through these experiences of learning. As she explained, with reference to her current professional understanding: Now I have a clearer understanding, I have a more rounded holistic approach in general.
This example demonstrates several aspects of constituent 1, how Gina’s professional understanding changes through APL. Her understanding involves more than cognition, encompassing all she embodies through being a professional: her gut instinct, her way of looking at things. Through the experience of APL her prior understanding of her practice was demonstrated to be inadequate, and changed. This example also demonstrates all three types of transitions. Although she experienced a major transition, there are continuing illuminating experiences often interconnected as a run. Elements of constituents 2 and 3 can be seen as her understanding continues to evolve through ongoing engagement in practice and interconnection over time with others.
Thus understanding in this analysis is complex and multilayered. To reiterate, professional understanding is a broad, holistic concept referring to understanding of a specific professional situation at the same time as it refers to how someone understands themselves as a professional. All the different forms of professional understanding described in this constituent presuppose a certain understanding of being a professional. Change in professional understanding is the core constituent of the experience of learning as a professional, permeating the other three. These other constituents describe how professional understanding changes through APL.
5.3.3 Learning Through Engagement in Professional Practice
Constituent 2 describes how changes in professional understanding occur through engagement in practice. In all the learning experiences described by participants, including the example of Gina above, a change in understanding occurred whilst the professional was actively engaged in some aspect of professional practice. Specifically, learning occurs when they care about this aspect, perceive it as uncertain and a novel feature is revealed. There is wide variation within this constituent because of the diversity of learning situations and types of engagement described in the data. There is also variation in how uncertainty in professional practice is perceived.
Active Engagement in Professional Practice
All the participants strongly expressed, in different ways, that being actively engaged is essential to the experience of learning as a professional. This is the most readily apparent constituent of the structure of APL. Although all the descriptions of learning involved work situations, active engagement in professional practice did not necessarily mean being located at work. Professional practice encompasses a broad range of activities related to being a professional. While at work, they may be working with clients or talking with colleagues. In some cases they describe being at PD workshops or weekend social events with people from work. Sometimes they are at home at night thinking about work, a commonly reported occurrence.
All the descriptions of learning involved the professional being actively involved in professional practice in some way, by thinking, talking, watching, writing or taking action, usually in combination over a period of time. Taking action varies from working with a client to going to a library to get information.
Situations where learning takes place are commonly related to an issue at work involving a client. It may be working out why a specific client has problems, or more broadly related to service delivery, such as learning to work with other staff in implementing a programme. Many comment that it is only through active engagement in practice, when they do something for themselves or see something work for themselves, that they feel they learn.
For example, Lisa had read about a therapeutic strategy but didn’t understand it until she used it following a workshop. She said: I flicked through the book a couple of times but it just didn’t quite gel with me. It didn’t really make much sense, I suppose because I hadn’t seen anyone use it. I like to see it for myself. Wim also described a workshop where she and experienced peers worked with clients together, noting the doing was enough: because I had a bit of a background, it wasn’t as important to discuss the whys, it’s really seeing it in practice that’s what we needed.
It doesn’t matter if I don’t know everything to start with, as you can just try and learn as you go. Next time I had a client as soon as we worked out a focus, I made the resources and started support instead of dilly dallying for ages. It’s good if you can take everything into consideration, but if you can’t, then you can still give things a go, and if it doesn’t work then you modify it instead of thinking you have to have it perfect to start with. (Nerida)
Caring About Practice
The second important aspect of all the situations where professionals learnt is that they cared about the situation. There are a variety of ways that the participants describe how certain aspects of professional practice in which they are engaged concern them or matter to them. They all expressed a deep concern about their clients’ well-being and valued their role in making a difference through helping or assisting them. Dom stated: I really feel there are not too many jobs where you feel as though you have the opportunity to have an effect on the way that somebody else lives their life. Nerida related what many professionals expressed: what’s the point of learning unless you can make a difference to clients?
But caring about the situation extends beyond caring about the clients. As a few professionals noted: We have to make therapy interesting to engage clients and likewise we only learn if we’re interested (Gina). Professionals described themselves while learning as excited, curious or stimulated. They say they enjoy learning. They sometimes expressed a passion for finding a better way through learning and describe learning as active exploration. Carl maintained that APL is about finding creative new ways to practise, a fresh approach to stop [the client] getting bored as well as us, to spice things up for ourselves and them.
We had to video ourselves working with [a client] as a case presentation to our professional peers. It was all very confronting, exposing myself, that was very terrifying, but it was very helpful. And I’ve tended to find that the things that are the most confronting or the most difficult tend to be the ones that you learn the most. (Gerri)
This notion of caring about aspects of practice reinforces the essential nature of this sub-constituent in that it is not possible to make a professional learn, because APL involves active engagement in a situation that the professional cares about. The participants were explicit about the fact that they don’t learn when they are not interested or they saw situations as irrelevant to them. Gina as well as many others described how she only learns from PD courses that are directly relevant to her practice: I always forget the others, about half are useless. Carl demonstrated the need to care about professional practice in APL. He described how he thinks it time he left the profession, as he has disengaged from his professional practice, and worried that he no longer fulfils his professional responsibility in continuing to learn.
Uncertainty in Learning
Another important feature of the experience of APL is that something was uncertain or unsatisfactory about situations where professionals learnt. Expressions were used such as his movement was unusual or his behaviour didn’t fit any pattern I knew. Sometimes there was a perception that something about the situation needed to change. In situations involving miscommunication, for example, comments were made such as we got to a point where we had to act or I just hit a brick wall. These perceptions triggered the transition where learning is experienced.
The uncertain and ambiguous nature of everyday professional practice with multiple factors to be considered was seen as a problematic feature for many, but not all, of the participants. There was significant variation in the degree of comfort with uncertainty amongst professionals. Less-experienced therapists say they felt unprepared for this: Practice isn’t clear cut like at Uni. Regardless of the professional’s feelings about uncertainty in practice, uncertainty is an important feature of learning.
I guess with most of the [clients] here, they have lots of different issues so it’s trying to pick apart and decide where to start. So there’s been some where we’ve just had no idea. As a team, we’ve had to do an observational assessment and through trial and error – just work it out. (Nola)
Uncertainty about situations is related to not knowing. Admitting to not knowing enables professionals to learn from what doesn’t work and from others’ experiences. Sam noted that professionals have to be willing to admit they’ve made mistakes and be open to learn from them. Being able to express not knowing and accept that it is impossible to know everything is dependent not only on the professional’s self-confidence but also on the workplace culture in which she works, as is discussed in constituent 4. Not knowing is an important precursor to learning.
Regardless of the type of learning experience described, uncertainty is a feature of situations where learning takes place. Something was different or unusual, unclear or confusing or needed changing in situations where professionals learnt. Being engaged in and caring about these situations leads to learning. Through learning, a situation, as part of the experience of being a professional engaged in practice, is understood in a novel or different way.
Revealing the Novel
When participants learnt, they described something new being revealed or added as part of learning. In many cases participants described new information, in the form of something they read, heard or saw that they could draw on to help make sense of an uncertain situation. Participants usually expressed preferred ways of seeking information such as I like to watch others and then try something, I get a lot from reading, talking to others helps me make sense and I learn so much from client feedback. Thus the experiences of professionals are interconnected (constituent 3) through interaction with others whilst being engaged in learning.
Sometimes information is actively sought and brought back to a complex situation, whilst at other times it is remembered from a past situation. Information is never seen as all being available at one time, but is accumulated over time. Often information is described as clues about a situation that give the professional ideas about what to do. A number of participants described learning as finding new ways of doing something, to keep themselves stimulated and their clients interested: I really like to look for things that are new, so I get quite excited when I find something (Kathy). New ideas or information on their own are not sufficient for learning however. It is only when these relate to a situation that the professional cares about, is engaged in and sees as uncertain or unsatisfactory, that they lead to learning.
On occasion, the new occurrence is a shift in the professionals’ understanding because of what a client or co-worker says or does that enlightens them or illuminates the experience. Sometimes a prior understanding about the situation is confirmed so that what changes is the professional’s confidence about her own perspective, such as when Gerri presented to her peers. Sam commented that what she learnt from a workshop served to reconfirm what she had been thinking: That it wasn’t just me thinking this is really important, that I was on what I perceived philosophically to be the right track. Indeed one therapist described learning as becoming aware of something that I was previously unaware of (Nerida).
In whatever way a novel feature is revealed, it precipitates a change in the professional’s prior understanding of that aspect of professional practice. This change varied widely amongst the participants depending on the learning situation they described. It can range from a specific change in understanding how to use a technique (I know how to do that now) to a broad change in understanding practice (I’m more holistic, I see the big picture when I treat). It can range from an altered way of understanding a client (I saw him in a different way) to a new personal insight into who they are as a professional (I really had to look at my assumptions about how I communicate as a professional). No matter how diverse these changes are, they have in common that when professionals learn, their understanding of being a professional alters so that they understand and approach their practice differently.
Vignette: Putting the Pieces Together
Usually when you find a situation that doesn’t quite fit the picture you try to expand. Okay, so it’s not just the normal quality of movement there are other factors going on here. And you consider the many different conditions and the many different combinations that can occur, and there can still be ones like this [client] where they still don’t quite fit with all of those pictures that you’ve built up in your mind. (Mary)
You thought you had an idea of what the course leader was actually talking about at the time, so you go back through, and then it’s like revising, it’s almost like going back over it again and going yes, now I do really understand what she was talking about. I have seen that now in what I have actually found lately. And suddenly that penny drops. I really have taken that knowledge on board, and I know that bit now. So, you’re continually finding that the pieces are all fitting in and are falling into place. (Mary)
Mary described being actively engaged in learning in situations where she feels uncertain as putting the pieces together, through multiple interconnected experiences over time. Moreover, she cares about being able to really work out what is happening in such uncertain situations as she values this way of being a professional. Mary described how through such experiences her professional understanding changes. She describes herself as a professional who is becoming less rigid in my thinking, more open to new ideas with a more holistic and long term focus with clients.
This example clarifies what makes a situation in professional practice one where a professional learns through engagement. It is not just working actively with a client that leads to learning, it is not just the gaining of new information from books or courses that leads to learning and it is not just caring about work that leads to learning. These are drawn together, changing a professional’s understanding, through engagement in practice. Mary’s descriptions also highlight that her learning involved interconnected experiences over time, as described in constituent 3.
5.3.4 Learning Through Interconnection Over Time
Constituent 3 describes how APL involves the interconnection of multiple experiences in a complex web of understanding. As stated, this constituent accounts for and integrates the social and temporal dimensions of APL. No participants described learning that was isolated to a single transition situation. In other words, the experience of APL is broader than specific learning situations and more than the mere accumulation of them. Professionals learnt with others over time in a dynamic, circuitous and iterative process creating a web of interconnected understanding.
Participants were clear that APL is ongoing and continuous, with many using the term lifelong. Those with extensive experiences spoke of continuing learning after retirement: Learning is my way of operating. It’s just something that I’ve probably done continuously over the last 20 years. It’s a normal part of my life (Mary). Another aspect of the continuing nature of PL is that there is always more to know, you can never know it all. Inexperienced professionals found this aspect overwhelming, whereas some others felt stimulated by the never-ending nature of APL and said that continuing to learn stopped them from feeling bored or stagnant in their work.
Circuitous and Iterative Web
I think what I tend to do for professional development, I tend not to follow up things to the letter, I tend not to go back over my notes and it’ll be little islands of information that I happen to retain and I think, well I can apply that in some way, but I cannot just do things as prescribed. (Carl)
I read more about it just for fun, like a search for meaning through work as well as thinking well this is actually worth it. It was not until I began to study it I saw I could apply this everywhere – and it’s like having a new religion, you know a thing that you saw the whole world through, a way of understanding the world. (Charlie)
Professionals described APL as iterative as well as circuitous, saying: I often revisit situations, I keep going back until it makes sense. It is also described as circular. Gerri explains, I’ve got to sort of loop right the way round and there actually is an end point if I can remember where I started. In the vignettes above that summarise constituents 1 and 2, Mary and Gina described going backwards and forwards, from observing and working with clients to reading and discussing with colleagues, until they understood a situation.
Although circuitous and unstructured in many ways, continuity and perseverance over time were noted as important in APL to see what worked and learn from that. This is only possible where professionals care enough about the situation. Wim described how she learnt by working through a difficult situation she wanted to resolve: I think it’s the fact that I didn’t run away the first time it all went wrong. But said, let’s try this a different way. As she stated: learning is about perseverance and sticking to your guns and continuity in seeing what happens in the end. It is often in hindsight, when learning is viewed as an entire process, that various parts of it made sense. The vignette of Olivia at the end of this constituent highlights this feature.
In these examples, the professional’s understanding changed through a circuitous learning process that shifts backwards and forwards, as well as round and round, creating complex web-like interconnections of significance as understanding changes. Through this process the professional’s understanding of specific situations as well as overall understanding of being a professional can change over time.
Imagination Draws Together
In this study, the professionals described using their imagination to draw on past experiences, integrate them with the present situation and anticipate and plan for future possibilities. Imagination is described here as a dialectic entwining of the past, present and future in professional practice. For example, Carl talked about a workshop where he learnt about a new therapeutic strategy he was interested in. He described his (present) perception at the workshop, saying: this is something I imagine could work (in the future), referring to clients with whom he’d had little success with (in the past).
Those who did not use the word imagination expressed this notion in other ways involving imagery. The concept of images was widely used by participants in their descriptions of learning. Many described bringing up visual memories of past experiences. Visual imagery was used to describe changing awareness during present situations: it was illuminating, I could see it work. Imagination was also used to anticipate creative ways to work with clients in the future. Thus the professional’s imagination provided a link between engagement in situations referred to in constituent 2 and openness to possibilities in constituent 4.
Imagination includes planning what to do next with a client or work situation and thinking of creative ways in which to do it, drawing on memory and visualisation. For example, Gerri described how she and another professional tried to work out creative ways to obtain a particular response from a child: You’re continually using your imagination and problem solving. You know what you want to happen, but how are you going to get it to happen? Together, they worked from past experience with the client, using their imagination to think up creative possibilities to try. She described how, because they can anticipate possible future results, they know when something works in the present, and thereby learn new ways to approach similar problems in the future.
Anticipation of possibilities is reliant on past experiences, although not limited to those of the individual professional, as experiences are shared through interaction. For example, Nola, a relatively new graduate, described how, despite her theoretical knowledge, she found it difficult to know what to actually do as a therapist. In particular, being creative and doing new things with [clients] was where I struggled. She drew on other professionals’ past experience, by observing them in present situations and asking them for creative ideas to try in the future. Thus imagination allows sharing of experiences with others over time, linking the social and temporal components of this constituent. In other words, through interaction with others’ experiences over time, understanding can be shared.
Dynamic Interaction with Others
In this study, participants stressed the social nature of APL, involving interaction with a wide range of peers, clients and their families. These interactions were highly valued and dynamic, incorporating multiple changing interplays between people over time. Even in solitary activities, such as reading, the professionals described relating what they read to professional practice, which is by nature a social activity. The importance of dialogue between people was stressed, not only spoken but also written, virtual (in cyberspace) and imaginary (remembered or anticipated).
Learning involved both learning with others and learning about others through a range of shared experiences. The nature of these interactions and the PL involved varied with the degree of understanding between people. Thus PL can result from situations such as collaborative team problem solving where understanding is shared as well as from situations involving misunderstanding and confrontational, interpersonal conflict. In describing the widely varying nature of interaction in APL, I focus first on the people involved, second on the nature of interactions where people learn and finally on the degree to which understanding is shared.
All participants stressed that they learn from others. Although experienced professionals can be helpful mentors in APL, participants also learnt from less-experienced professionals as well as from clients and their families. Client feedback was sometimes immediate, in that professionals gained a response to intervention and integrated that into their next action intuitively. Professionals also gain long-term feedback from clients as part of their learning about what works. In fact it was often from people (professionals or clients) who had a different perspective that participants learnt the most: They just know different things and you learn from them and you see their perspective and that is really helpful (Wim).
Networks or teams acted as valuable learning resources for most of the professionals, offering the opportunity to talk, question and share ideas. Many commented that they learn most at PD days from talking to others. Where supportive networks were not available, a few proactive professionals described establishing their own online.
Professionals learnt by sharing experiences with their peers through watching or talking with them. Nola described: I would remember by looking and then I’d kind of visualize the situation again. Wim had learnt the importance of making better use of the ideas of other people, whereas I had felt a kind of pressure that all the solutions had to come from me. Many participants expressed an opinion that whilst learning from others’ work was acceptable initially, they shouldn’t continue doing so as it exposed the embarrassing fact that they didn’t know.
Two key issues about the nature of the interactions described are the degree of trust and the ability to question. These issues are related. Learning between peers usually involved giving and receiving of feedback. A number of participants clearly articulated the importance of a sense of trust between colleagues before candid feedback could be shared. Olivia mentioned the value of people being comfortable with one another, knowing that you haven’t got to present an image. She later explained such trust in more detail: It’s really about learning to feel comfortable expressing what you don’t know.
The texture of such learning interactions became clearer after I visited workplaces and network meetings. Questioning played an important role, as described in the observation of work in Chapter 1. I observed that it was in more relaxed environments where interactive questioning occurred. Most of the questioning between professionals involved questions such as Why do you think that happened? or What will I do now? There was little questioning of underlying assumptions described in peer learning. Many participants seemed uncomfortable with such challenges.
The people on the team are not very defensive professionally. I know it takes a little while whenever you’re starting your job to sort of wriggle your way in and work out what your boundaries are with the other professionals, so that you are not treading on toes and offending each other, and yet still feeling that you’re able to practise the way that is appropriate. (Gerri)
Learning from those of a different profession, as described above, is possible when professional boundaries are flexible. Like others, Gerri noted how her understanding of being a professional changed through such interactions: My value systems and my concepts of what’s possible and appropriate have evolved massively over these last few years, because of the influences of the range of people on the team. She added how through such learning experiences, she has grown as a person.
A crucial aspect of such interactive PL was learning about other people’s perspectives. This was usually described as: understanding others, learning to work with others or interpersonal skills. It was described as not only one of the most important aspects of learning to be a professional, but one of the most valuable ways to learn as a professional. Many participants commented that their professional education did not adequately prepare them for understanding the perspectives of others.
Sometimes different perspectives can be confronting but for the few professionals who felt comfortable being challenged, these are seen as valuable learning opportunities. Sam described an interaction with another professional who had very different opinions on issues. This other professional was very forthright in her opinions, but Sam respects her credibility to challenge and actually seeks out such challenges because they help her to question her assumptions about her practice. Charlie agreed with this approach, noting that other peoples’ perspectives show up things that have become rituals and habits of what we do.
Learning can occur through misunderstandings, even when these are problematic. For example, much of the therapeutic intervention planned by therapists is implemented by others. Often there is a difference in the way that intervention is understood or valued by different people. Participants commented that people wouldn’t follow through with therapy programmes. Many participants described situations where they were frustrated by miscommunication. Despite feelings of exasperation, some commented that problematic workplace situations such as these can lead to profound PL experiences. Such learning stems invariably through clarifying a mismatch in expectations, when people work from different assumptions (Olivia). The professionals described a number of ways that their understanding of themselves and their practice changed through learning to work with others. Often such learning lead to more effective practice: so it actually works and makes a difference.
Vignette: How Will I Do It Differently Next Time?
The sub-constituents of learning through interconnection are drawn together in the description of Olivia’s experience of APL. By describing how she learnt through interaction with others over time, Olivia explains the interconnection of social and temporal aspects of APL in this constituent. She described drawing on her imagination to link what she and others experience in finding creative solutions to problems. In particular, in working with others with different perspectives, she examined and reframed her own assumptions about how she understands herself as a professional (constituent 1).
Olivia described learning through a situation involving miscommunication. She explained: We’re working with clients but also their carers and there can be a big difference between what could be done versus what the carers can actually do. Because of conflict over this issue, Olivia re-examined her understanding about how she communicated as a professional. She changed by focusing on building an alliance with the carers through reflecting a lot and trying to understand and see what are the different lives for these people. She tried to see the perspectives of others in situations: The carers have many other factors that they’re coping with. Through doing so, Olivia described reframing her expectations and the focus of her therapy to suit the circumstances: Moving away from textbook approaches or big goals that could actuate if everyone was on board, instead taking it back down to tiny simple meaningful things that the carers can achieve.
Olivia also spoke about other learning situations where as a team she and colleagues have worked through conflict, developing shared trust. She explains that: There were people wanting to leave work and yet we’ve managed to come together. It’s been their learning experience as well as mine. She has learnt through these shared experiences with the team to deal with difficult organisational issues involving unstated expectations and miscommunication. Olivia explained how learning as a professional extends beyond learning about therapeutic interventions with clients: It relates to any professional. It’s not just the discipline specific stuff – that other interpersonal area of learning has been really big for me.
I’ve learnt that there is perhaps more of a process to communication, and working through that whole debriefing process and making sure that you’re wrapping it up is important. Because where I have made mistakes is where I have not completed that process properly. My learning is about how am I going to deal with it, how am I going to do it differently next time? (Olivia)
The bottom line is we’re all people and sometimes you’re facing really tough issues whether its colleagues, managers, or day to day carers. So learning is not just to do with your core profession, although it’s related to it, but such a large part is also just learning as a person (Olivia)
Like a number of other professionals, however, Olivia was worried that through a focus on people instead of techniques she has moved away from being a real therapist. Through continuing to learn as a professional, Olivia described a change in her understanding of being a professional to one who is more open to different possibilities: That’s what learning is for me. Understanding that there’s not just that one way but it’s a big broad area with many branches. The way in which the experience of APL can be described as open is described below.
5.3.5 Learning as Circumscribed Openness to Possibilities
Constituent 4, openness, describes how APL is a process that is open to possibilities due to the very nature of the other three constituents. Thus the professional’s active engagement in the complexities of practice, through an interconnected web of experiences with others over time, opens a broad range of possibilities that shape changes in understanding.
This sense of openness in the learning experiences described by participants makes APL different from most undergraduate learning in which participants described processes, situations and outcomes as contained. Yet this openness is not infinite but is experienced by participants as circumscribed by boundaries, some more explicit and overt than others. These boundaries shape the experience of learning, sometimes constraining it, at other times offering opportunities. Tensions exist between the possibilities of openness and the circumscription of many contexts that are resolved by the professionals in different ways. Because this tension reflects a multifaceted interplay between each professional and her working context, its resolution is complex and varied.
Openness to Possibilities
Openness to possibilities in APL is a sub-constituent with two interrelated features. As alluded to in constituent 3, APL involves an open-ended process with no clear beginning or predetermined outcome. Because of this, professionals described the need to develop an open attitude to cope with the inherent uncertainty of learning. I describe first the open process, followed by the way professionals deal with this openness.
Being web-like and open ended, APL is not structured in any well-defined or step-by-step way. Neither was learning described as neat and self-contained, but often messy and always interconnected. It was often difficult to identify a starting point. Some professionals commented that they didn’t set out to learn about a particular area and that the process of learning is sometimes serendipitous once the professional is engaged in it. An initial spark that engages the professional can often be identified in hindsight, as Dom described: I get a really interesting child or I have an idea of an approach that might work and follow that lead. It’s amazing how your interest in a particular area appears to attract clients with those sorts of issues. Dom explained how as an interest develops, the professional notices or is more attuned to similar issues.
The open-ended nature of APL raises the question of how the professionals know they have learnt. Many professionals described being unaware of learning something, until they thought about the situation at a later time. In many cases this awareness arose through comparison with others’ experiences. For example, Lisa described how working with a student helped her realise how so much that you do becomes second nature and how much you learn without realizing it. In most cases no real endpoint is identified in learning, with APL described as never-ending by many. When I first graduated I thought I’ll learn a bit more and then I’ll be on top of things and I realize now you never are (Kathy). That there is always more to know was described as frustrating by some and stimulating by others.
Although the experience of APL is generally unstructured, logical stepwise processes were followed by many professionals as part of their learning. Clinical reasoning guidelines were described as useful for providing some structure for problem solving, especially for new graduates. However, even when following these processes learning does not always proceed as planned. Many possibilities are encountered, often involving unintended outcomes and learning through trial and error.
I think you do come out from university as a therapist, a little bit rigid in your thinking. But time and working with many different people, does allow you to realise that there are many different ways of solving the same problem. You have to be open to new ideas and other people’s perspectives. (Mary)
All the professionals concurred about the need to develop an open attitude, regardless of the extent of their experience. There was significant variation in how comfortable they felt about this openness. Through APL, many professionals learn there are different ways to approach situations and they develop an eclectic perspective that is adaptable to the client and circumstances. Yet for some professionals, coping with uncertainty in their practice and in learning was challenging. Being in uncertain situations where they don’t know or cannot control the outcome was described by some as unnerving and led to them feeling inadequate as professionals. Thus there is a tension for some between accepting the need to be more flexible and open, yet feeling uncomfortable about it.
You come in as a therapist with education and ideals and ideas of therapy and maybe undeserved confidence. It’s sometimes easier to be a competent therapist than being led by the family. It unnerves you a little bit. You’re not sure where your place is. (Kim)
This attitude of openness is also what allows professionals to access their imagination and creativity in learning situations as mentioned in constituent 3. It allows professionals to see links between ideas and approaches that may be useful in very different situations: You see a new perspective and that lightens up previous difficult or complex situations and opens up new vistas. So you stick your head out a bit further (Charlie).
Opportunities and Constraints of Professional Context
The possibilities of APL, or how far a professional could stick their head out, are not limitless but are contained within the boundaries of the professional’s working context. These include features of the local work environment, the structure of the employing organisation and expectations of the wider professional community. Some of these features were discussed earlier in the professional life-world section. These features circumscribe the openness inherent in APL. Although all participants described ways in which their learning experiences were shaped by these boundaries, the same feature can act to enhance learning opportunities for one professional yet constrain learning for another. Participants described four features of the professional context that have a particular impact on learning: staffing, workload, organisational culture and professional expectations. Although they are interrelated, I deal with them one at a time.
As noted in constituent 3, the participants learnt from a range of different people. In most instances, the local staffing situation offers many opportunities for APL through such interactions, depending on the nature of these interactions. Some professionals described their local peer group as open and sharing, not just caring about their own profession (Wim). Other groups were different. Kathy described working in one situation where nobody discussed clinical issues openly. She described how difficult it was to learn in that situation as no one felt comfortable asking for help about uncertain situations.
Many professionals referred to the sometimes intangible atmosphere within a work group that affects interactions and hence learning. Referring to the situation in the previous vignette, Olivia said: It’s the unsaid, it’s the feel, things that aren’t spoken, the environment affects you. She discussed how the working atmosphere, described by her as the energy at work, changed as team issues were resolved, allowing more open communication.
With respect to workload, all the professionals lived busy working lives yet not everyone saw this as a problem with respect to learning. The perception varies with the degree of autonomy professionals have in structuring their days. Where time was a constraint on learning, it was a lack of time to think that was the issue. For example, Mary described herself as feeling very stressed with an increasingly high workload, leaving little time to think. She felt that work was very demanding of my mental capacity. You can have so much happening that you can completely drain yourself and your capacity to plan or think.
I’d like to be able to stay... and just have my time, sitting at my desk, going inside my head where I get all my ideas. Where I’ve always wanted to be, quiet by myself and I don’t get that time. [At work] there’s people around and I don’t learn enough in the busy environment. I can’t switch off and I need it. I take my notes home and I sit at the desk at home and I go inside my head and just think about it. (Sally)
There are barriers to everything if you want to consider them as barriers. I mean you find ways around them if you’re motivated. You can hide behind those things and say there’s not enough time, or I’ve got too much paper work to do. It’s partly in the way that you prioritise things, whether you prioritise your own professional development highly enough, but it’s something that’s very important to me. (Dom)
Only professionals from the two large government organisations noted that the organisational culture impacted on the possibilities for PL. A culture of regulation and control was highlighted by those participants but the impact on individual professional’s learning varied. Organisational culture was not mentioned by the three professionals from smaller agencies, but small numbers make it impossible to draw conclusions from this.
One aspect of organisational regulation is the time required for administrative paperwork that participants complained leaves limited time available for other professional pursuits including learning. Part of this complaint was about the requirement to use organisational jargon relating to strategic outcomes in reports: We’ve got to relate everything to them and coming from a therapy background and training, that’s not the way you think. It’s just a word game trying to justify what we’re doing. But really, I live with it (Sally). Like Sally, most professionals found pragmatic and sometimes imaginative strategies to cope with this constraint.
Some were more strident about the lack of autonomy that organisational control allowed. Paula argued that too much structure imposed from above resulted in a lack of space to be creative, limiting her learning: You need to have all of those things that creativity needs which is space and confidence and support to take risks. We’re not given the space to be creative. It was only those professionals who spoke about questioning assumptions who mentioned the link between autonomy and creativity.
An organisational issue of greater concern for the participants was alignment between organisational values and the values of the professionals. Many professionals from the large organisations described discord between the focus of the organisation and their own focus on making a difference to the lives of their clients. With respect to learning, they described feeling unsupported by the organisational culture, but mostly learnt to deal with this by being pragmatic, realistic and adaptable with respect to what is and is not feasible: I try not to let the environment get me down too much. I’m able to see where I can make a difference and where I can’t (Nerida).
Finally, as mentioned earlier there are widely shared and clearly articulated professional expectations with respect to continuing learning. All participants said they accepted these expectations. As Sally explained: It’s an obligation, we’re expected to keep up-to-date and I think that’s part of what you take on when you take on being a professional person. Being a professional person implies being part of a professional community. Many professionals’ descriptions of learning invoked comparison against the yardsticks of professional expectations, leading to feelings of inclusion or exclusion.
When professional networks worked well, a sense of shared understanding was expressed as being a valuable support for APL: Your own profession understands where you’re coming from. We share the same language (Nerida). It helps professionals confirm that what they are doing fits in with what others are doing and is supported by them: Knowing that everybody else is doing it gives me confidence (Paula). But comparison with professional expectations led some therapists to conclude that they were not a real therapist because they did not fit the norm. For example, some professionals felt excluded by the very language that others shared. Gina has tried for years to use everyday language in her work with children and families and now finds the use of professional jargon intimidating, commenting that: other therapists come out with all the proper words.
All the professionals spoke about the value of what they called everyday learning through their engagement in practice with others, as described in the previous constituents. Many expressed a concern, however, that this learning was not valued or supported by their professional associations, universities and workplaces. Gerri described the development of intuition that she and many of the other professionals stated was an important part of everyday PL: You develop that intuitive aspect, getting a feel for things. I’ve got that innate knowing what to do, but I know that they’d gnash their teeth at the university if I said this.
Although she feels her intuitive knowing is important, Gerri doesn’t feel her profession values it, focusing instead on analytical evaluation of evidence on which to base practice: Generally as a profession I feel that innate knowing has been devalued which has probably made me feel or wonder how well I perform as professional. Kim described an increasing focus on more formal PD courses: I felt maybe earlier on that the learning was much more exciting. It was much more an adventure, whereas now it is much more an expectation and it’s much harder to do and it’s much more expensive.
Many issues about the context for learning raised in this section are not widely or openly discussed within the professional community, unless professionals work in supportive environments with colleagues who they trust enough to be open with. These issues, such as admitting to not knowing or using intuition and imagination in making judgements, are a feature of APL as described by the participants but are often hidden in the public rhetoric about PD. Thus there is a dissonance between what the professionals valued in APL and what they perceived to be valued by sectors of the workplace and professional community.
Resolution of Tensions
While the professional context offers opportunities for APL, there are a number of tensions between the openness of APL and constraints of context outlined in the previous section. Professionals described the need to develop a sensitive grasp of the nuances of their working context, its possibilities and constraints, as part of learning to be a professional. The way each professional resolves these tensions shapes her learning. Thus, although all the APL experiences described share the same structure that has been detailed throughout this section, each professional’s learning has a unique quality.
Tensions vary around two aspects of APL: the professional’s attitude towards the inherent openness and uncertainty of APL, and the mix of opportunities and constraints afforded by the varying contexts in which the professionals worked. Although all participants described ways in which their learning was shaped by these tensions, they used different approaches and strategies to resolve them. Thus the experience of APL is a continual interplay between the professional (including her experience, attitudes and professional understanding) and the various situations in which she practices (with the uncertainty and challenges, opportunities and constraints, social settings and organisational structures therein). The constituent of openness surrounds and infuses the entire experience of learning as a professional. Thus resolution of tensions, as a sub-constituent, also refers to tensions in this overall experience, although they are particularly apparent in this fourth constituent.
With therapy there’s always that thing about excellence. We always aim for excellence. I think the profession expects it, and personally as I get older I’ve learned to live with the fact that it’s okay if I’m not the best therapist in the world, so long as I do a thorough and fair job with people that I see. (Gerri)
Some professionals spoke about putting on a professional persona when they are not comfortable with this balance: If you’re feeling there are barriers to being open, in a way you still put that professional cloak on. You don’t want to seem dumb or an idiot or you’re not doing it well enough (Olivia).
One of the professionals who questions assumptions as part of her learning, and whose professional understanding changed significantly as a consequence, reinforces this notion of needing to feel comfortable in order to be open. Sam felt some of her colleagues hid behind professional personas and were unwilling to be open about changing their perspective. She explained: they don’t feel comfortable enough to be challenged so they put up all the barriers so they don’t encourage people to question.
Lisa described putting up such barriers in order to appear confident: You have to come across in a way that fools people into thinking you really know what you’re talking about. She described her professional persona as a big act a lot of the time. You might be feeling really doubtful about what you’re suggesting but you’ve got nothing else so you just make that suggestion and do it confidently.
Vignette: The Theoretical Framework Doesn’t Match Reality
The following example from Sam draws together the sub-constituents of openness. It illustrates one way of resolving tensions between the way she views the possibilities of openness in APL and the way she deals with the varying opportunities and constraints of her working context. It describes her way of learning.
Sam is an experienced and well-respected professional who described herself as: proactive in my own learning. For her, APL is about: constantly challenging myself and seeking out information. I’m really willing to learn from others. She viewed challenge as a productive way of learning and seeks to question the status quo when she feels there could be a better way of working.
She sometimes had difficulty finding others who were as comfortable as she is with challenge and whom she respects as being credible. Being proactive, she has developed an international online network to find such people. Sam describes learning as being reciprocal and open: We challenge each other. It’s not a closed book approach. It’s okay well I can see your point but I don’t do that because …. Her online community enabled a much more productive discussion on issues than just taking a textbook off the shelf.
They were really trying to do an impossible job with no training and lack of respect for therapists who they sort of saw as glorified Queens (laugh) who would strut in and always be late and often create more havoc than actually anything constructive. (Sam)
There is no concept of the family dynamics and the other priorities that might be more important at that point in time, and maybe not a lot of insight into the stress levels and anxiety of parenting and also the difference between graduates and the socio-economic status of many of the parents. (Sam)
Although Sam is confident and experienced, and often supported others in their learning, she stated that she consciously avoided using the expert mode. She felt learning was always mutual. I guess I’ve always been willing to learn from others and be able to say I don’t know, and underlying that I basically respect other team members.
Professional associations are out of touch. A lot of what they are doing is irrelevant. I find university is fairly unrealistic, distant from what it’s actually like at the coal face. At work issues out in the field are not understood. The theoretical framework of how it should be and what you should do doesn’t match the reality and therapists feel unsupported as a result. (Sam)
There is little awareness in the organisation of what I do and that’s pretty unrewarding. There is also no acknowledgement through the system for going the extra yard or the personal compromises that you make to do that.
Thus Sam describes a tension between being open to learn, constantly questioning her professional understanding though engagement and interconnection in practice, and what she sees as the lack of support for this openness from her professional context. She deals with this tension in the proactive way described. She chose to move to another organisation where she felt the environment was more supportive of open and inquiring learning.
Sam prided herself on the congruence between her beliefs and her actions as a professional, that is, she acts on her beliefs in an authentic manner: I like to think my credibility is that I do what I say I do. Her way of learning is congruent with her understanding of herself as a professional who is authentic. Moreover, her way of learning is an expression of who she is as a professional.
5.3.6 Summary of the Structure of APL
Throughout this section the four constituents of APL, understanding, engagement, interconnection and openness, have been described using concrete examples of participants’ lived experiences. The vignettes illustrate the way in which the constituents are intertwined and the varied and complex manner in which they are expressed through each professional’s experiences.
As one example of this interdependence, I reiterate the nature of uncertainty in APL. The open-ended nature of APL (constituent 4) means that uncertainty is a feature of the overall experience of continuing to learn as a professional. It is also a feature of specific situations where professionals learn, where uncertainty is related to not knowing (constituent 2). In constituent 3, uncertainty is related to the complexity of the interconnected web of experiences that is APL. As noted in constituent 3, feeling comfortable about uncertainty or saying you don’t know requires an atmosphere of trust in a supportive workplace. Feeling comfortable with uncertainty enables assumptions to be questioned in learning (constituent 1). This example of uncertainty as a quality woven through the constituents highlights the holographic nature of a phenomenological structure. Each constituent describes a slightly different perspective on the whole experience of APL.
Finally, for the purposes of clarification, it is useful to reflect on what APL is not, calling upon the phenomenological construct of imaginative variation, referred to in Chapter 4. Thus, no participant described learning without a change in understanding about some aspect of being a professional, whether the change was simple or far-reaching. Neither did any participant describe learning when she was disengaged from practice nor did not care about the situation in which she was involved. Instead, participants described many cases where they did not learn because of disinterest or disengagement.
No participant described an experience of APL taking place in isolation as a single unconnected situation. Past experiences and future possibilities were always brought into play. No participant described learning without reference to interaction with other people, whether supportive or problematic. Similarly no APL experiences were described as a controlled process with predetermined outcomes, separate from the constraints of the working context. Finally, all APL experiences included the constituents and sub-constituents described in this section, interwoven into a whole. These four constituents are essential to the experience of APL for these participants.
5.4 Learning as Part of Being a Professional
So far in Chapter 5, the life-world of the health professionals in this study has been sketched, with an overview of situations where the professionals learnt. The phenomenological analysis of APL described a common structure that also illustrated the unique quality of each professional’s learning. The data corpus is evaluated in this section from a broad perspective that considers what part APL plays in the experience of being a professional.
The interviews revealed more than the experience of APL. They also allowed glimpses into professional experience in general. In addition, personal issues or overall philosophy of life were disclosed, although not directly sought. The data revealed that APL is indeed part of the experience of being a professional, through rich descriptions of various aspects of professional being. Throughout the phenomenological analysis, APL experiences are foregrounded whilst the more general aspects of professional experience are maintained as background. In this section, I draw on evidence from these background features in interviews, observations and documents to provide a more comprehensive understanding of the variation in APL in relation to the wider scope of professional experience.
Sources of variation in participants’ experiences of APL
Variation in understanding oneself as a professional:
• The degree of self-awareness and insight the professional has about herself as a professional and as a learner.
• The differing conceptions of learning held by the professional.
• The ability to question one’s own and other’s assumptions about learning, professional practice and the world.
• The degree of comfort the professional feels in dealing with uncertainty in learning and professional practice.
• The ability to be proactive in finding learning opportunities that suit the professional’s way of learning.
Variation in understanding in interaction with colleagues:
• The perception of trust between colleagues at work.
• The ability to learn from others and be open to another’s perspective.
• The way the professional compares herself to other professionals.
• The perceived degree of support from others at work.
• The degree of comfort the professional feels in being questioned by others.
Variation in understanding the professional context of practice:
• The perception of autonomy available in organisation of the professional’s work and learning.
• The perception of time pressures and the value placed on time for thinking.
• The degree of adaptability to the nuances of the environment and how pragmatic the professional is about what can and can’t be changed at work.
• The degree to which the professional questions her working milieu.
• The feeling of dissonance between what the professional values in APL and what is perceived to be valued by the workplace and profession.
• The degree of comfort the professional feels in speaking out about her experience and what she values about work.
These sources of variation relate to the tensions described in the experience of APL, for example, to varying degrees of comfort with uncertainty, openness to being challenged or questioning of contextual issues. The way in which tensions in APL are resolved shapes the professional’s way of learning, as noted in the vignette about Sam’s experience. Way of learning does not refer to what is commonly expressed as learning styles or ways of gaining information. Although each professional expressed preferences for ways of accessing information, these varied with circumstances with different strategies used in different contexts. Way of learning refers to the idiosyncratic quality that permeates each professional’s experience of APL. Examining this idiosyncratic quality highlights how APL is shaped by different ways of being a professional.
Whilst it was not the aim of this research to identify qualitatively different ways of being a professional, stark differences were apparent from the data. Only cautious statements are made, but some account of how these differences shape learning experiences is necessary in understanding APL. Participants drew themselves and who they were as professionals into the interview. They expressed their understanding of themselves as professionals in many ways. Paula makes the point, for example, that there are aspects of being a professional that are core features of who she is, not just her way of acting out a professional persona: I’ve always loved children and I take that into my job. I mean I can leave work behind, but that love of children is just me; that’s not me just doing my job, that is actually just me. Loving children is integral to Paula’s way of being a health professional.
Moreover, the way a professional experiences APL is an expression of who she is as a professional. The four vignettes in the previous section illustrate the variation in ways of being a professional that shapes each participant’s learning. In these vignettes, the focus was on the shared nature of the experience of APL. In the following descriptions, the focus is on the idiosyncratic quality of each of these professionals’ learning as an expression of her way of being a professional.
Gina described how a learning experience significantly changed her way of being a professional. As the vignette (Section 22.214.171.124) describes, she was willing to rethink her assumptions about her practice when she saw a whole new way of looking at my practice. Gina’s description highlights her flexibility as a professional, noting that as a professional you have to be open to hear different opinions and not get locked into one mode. She is open to making changes in her practice if she sees it makes sense and makes a difference for her clients. She trusts her intuition in learning about new areas although she wonders if she is no longer a real therapist because of her flexibility. She values that learning involves: moving on, that there’s something else new to try. Gina’s way of learning as a professional has a focus on flexibility by being open to new ideas as part of an interesting journey.
Mary described herself throughout the interview as a professional who is a competent problem solver. She likes to see the big picture, stepping back to evaluate situations. Her learning reflects this. As the vignette (Section 126.96.36.199) describes, she highlights the holistic viewing of a situation in her experience of learning. She actively seeks to collect all relevant information and reflect on problems. Mary places a high value on clinical reasoning processes to understand problems, so she knows what to do and can develop practical strategies to resolve them: I value developing the skills to be able to assess – being able to really work out what’s going on. Mary describes this ability as the essence of what I do as a professional. Mary’s way of learning as a professional highlights the value she places on logical problem solving.
Olivia described herself as a professional who seeks to find meaning from her work. She highlights her search for meaning in life, both personal and professional. As described in Section 188.8.131.52, relationships at work, communication and shared understanding are a vital part of her way of being a professional: To me it comes back to the style of person you are and I’m a person that likes to keep harmony and balance. For Olivia, the key thing about my professional learning has been learning about myself and the way I communicate with others. As she explains, first and foremost I’m not really a therapist I’m a person. She describes how she has developed her self-awareness through critical reflection on her own and others’ assumptions. Olivia’s way of learning as a professional highlights personal growth.
Sam described herself as a professional who has a strong sense of social justice, is proactive and happy to challenge the status quo if she believes something can be improved for her clients: I certainly don’t just accept situations. When she has sought to make changes in the past she has sometimes had to stand my ground. She explains: I’ve always been a fairly individual person who values creativity and lateral thinking. As the vignette in Section 184.108.40.206 describes, Sam values acting on her beliefs in an authentic way and is happy to challenge the assumptions underlying those beliefs. Being authentic is the basis of her experience of APL. She finds being challenged an important part of her learning as it makes me rethink about my practice. She proactively seeks situations and other people who she can learn from in this way. Sam’s way of learning as a professional invariably involves standing up for what she believes, yet inviting challenge about those beliefs.
As these examples demonstrate, the way participants describe learning reveals some of their assumptions about themselves, knowledge, professional practice and the world. The varying ways of being a professional expressed in these descriptions flavour the experiences of learning. In this study, each professional’s experience of APL has an idiosyncratic quality that is an expression of who she is as a professional. Because APL involves change in professional understanding, learning also shapes each professional’s way of being. Thus APL has an important ontological dimension: APL is as much about who a professional is as it is about what a professional knows.
I use the generic term therapist rather than occupational therapist, physiotherapist or speech pathologist and alter some details of practice to maintain anonymity.