Nurse Researcher
Participation in action research Shirley Jones and Leslie Gelling analyse how the challenges in engaging participants in projects of this type can be overcome Cite this article as: Jones S, Gelling L (2013) Participation in action research. Nurse Researcher. 21, 2, 6-7. Date of submission: October 15 2013. Date of acceptance: October 15 2013. Correspondence to [email protected] Shirley Jones, senior lecturer, Faculty of Health, Social Care and Education, Anglia Ruskin University, Cambridge Leslie Gelling PhD MA BSc(Hons) RN FRSA, reader in research ethics, Faculty of Health, Social Care and Education, Anglia Ruskin University, Cambridge Author guidelines http://nr.rcnpublishing.com
6
ACTION RESEARCH has become increasingly popular with researchers and practitioners in health and social care because of the focus on changing practice and on engaging practitioners and users in the change process. Action research projects seek to take a practical approach to improving the lives and experiences of those receiving or delivering care. One of the greatest challenges for those adopting such an approach is how they can most effectively engage stakeholders in their project. Without engagement, action research will invariably fail to achieve the desired outcomes. This issue of Nurse Researcher includes two papers on action research, each taking a distinctly different approach to participant engagement. In the first paper researchers in Australia describe a project undertaken to explore different models of emergency care provision (Sullivan et al 2013). A struggle was taking place in rural Victoria to maintain a 24-hour emergency care service at the same time as the medical workforce was diminishing. The Victorian state government funded a collaborative project to engage healthcare professionals from four rural health services and one bush nursing centre in exploring possible models of emergency care provision. An action research approach was adopted in an attempt to engage healthcare professionals with government officers in redesigning emergency care services and informing legislative change. Early in the paper, the authors acknowledge that engaging the practitioners would be the key to the success of the project and to finding a model for care delivery that might be implemented in practice. The authors then report a thorough approach to participant engagement throughout all stages of the project. The participant group included all those with a direct interest in the delivery of emergency care and with something to contribute to finding a solution to the focus of the project, comprising health service executives, managers, doctors, nurses and pharmacists.
November 2013 | Volume 21 | Number 2
06-07 NR NOV 2013.indd 6
Once recruited, the success of this project lay in meaningfully engaging participants in the conduct of the research: ■■ All participants were invited to a two-day planning forum and three one-day action learning sets. ■■ After each meeting they completed an evaluation about how it had achieved its aims. ■■ Participants generated the agenda for each of the learning sets. ■■ Participants determined what data would be collected, were involved in designing tools and were engaged in interpreting the data. ■■ Participants were also given the opportunity to share their individual views about their roles and their perspective on the focus of the project.
Owning the project Not only were the participants able to supply their own data, they also contributed to planning and conducting the research at all stages. This gave them considerable ownership of the project. The authors of this paper state that this project achieved its initial aims because they ensured collaboration permeated the endeavour. There might be nothing particularly novel about how these authors engaged participants, but what they have demonstrated is how participant engagement needs to be well planned and last for the duration of the project. Too often action researchers claim a participatory approach when engagement is limited to some elements of the project and not in a long-term manner. These authors have shown how a diverse group of participants in a complex healthcare situation can collaborate in a meaningful way to bring about change. In the second themed paper, Bevan (2013) explores the need for a communicative space to facilitate participant engagement in an action research project. Participating in action research can be uncomfortable and challenging for researchers; this often results from a perceived loss of control as participants are © RCN PUBLISHING / NURSE RESEARCHER
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
24/10/2013 14:12
Commentary encouraged to guide the research and to determine the future direction of the project. But this is what makes action research unique and is why it can be so effective as an approach to changing and improving practice. Bevan (2013) describes how they established a ‘communicative space’ for participants. This was a challenge because such a space did not previously exist and many of those invited to engage in this project did not know each other. The participants were mothers of pre-school children, so establishing an effective physical and conceptual communicative space was central to the success of this project.
Physical and conceptual When planning a physical space, the researchers’ main concerns were comfort and ease of access. They sought a neutral space with easy car and bus access. The venue was known to the participants but it was not someone else’s territory. Childcare, which was of particular relevance to the project, was made available to the participants if they chose to use it. Bevan (2013) describes how some mothers opted to keep their children with them in the group meetings and how this might have contributed to the dynamics of the group. In many ways, establishing a physical communicative space was more straightforward than understanding the complexities of the conceptual communicative space, which is described as having three phases. In the first phase, the inclusion phase, participants start to find their places in the group; they determine the purpose of the group and what is expected of them. Once through the inclusion phase, participants enter the control phase, during which they grow in confidence and begin to feel able to challenge each other or to argue or discuss important issues. In the final phase, the intimacy phase, the group members begin to become dependent on each other. Group members encourage each other and can become sympathetic to each other’s opinions and experiences. Bevan (2013) emphasises the importance of an appropriate physical communicative space but also highlights the need to understand how the conceptual communicative space will develop as the project progresses. Having one space without the other would not enable the participants to contribute to the group or to engage in the project. Most, if not all, action researchers will be familiar with the need to create a physical space conducive to debate, discussion and argument. Too many action researchers, however, fail to give sufficient consideration to the conceptual space. This is most obvious when they rush data collection and do not allow group dynamics to develop or for the conceptual space to mature. When this happens the data collected might not be as useful or valuable as it might be if the researchers had allowed more time. © RCN PUBLISHING / NURSE RESEARCHER
06-07 NR NOV 2013.indd 7
These two papers have offered a practical insight into how action researchers have endeavored to engage participants in their research. In both projects it was clear that their success depended on the researchers’ ability to create a truly participative environment. What neither author has made clear was how they managed and negotiated the ethical requirements for their projects. One of the main challenges for both researchers and research ethics committees when action research is being planned is in obtaining appropriate ethical approval (Gelling and Munn-Giddings 2011). Researchers are required to offer a clear description of how the entire project will be conducted. The difficulty is that the participatory nature of the research means they have not yet determined what data will be collected, how it will be collected or how it will be analysed. For example, Sullivan et al (2013) highlighted how the participants determined what data would be collected during the planning forum or action learning sets. It would have been interesting to gain some insight into how the participatory nature of the research impacted on the practical management of both projects. Action research is about engaging people in change and empowering them to shape the resulting change. The two papers published in this issue have offered a practical insight into some of the issues that action researchers must consider. References Bevan A (2013) Creating communicative spaces in an action research study. Nurse Researcher. 21, 2, 14-17. Gelling L, Munn-Giddings C (2011) Ethical review of action research: the challenges for researchers and research ethics committees. Research Ethics. 7, 3, 100-106. Sullivan E, Hegney DG, Francis K (2013) An action research approach to practice, service and legislative change. Nurse Researcher. 21, 2, 8-13.
November 2013 | Volume 21 | Number 2
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
7
24/10/2013 14:12
Participation in action research Shirley Jones and Leslie Gelling analyse how the challenges in engaging participants in projects of this type can be overcome Cite this article as: Jones S, Gelling L (2013) Participation in action research. Nurse Researcher. 21, 2, 6-7. Date of submission: October 15 2013. Date of acceptance: October 15 2013. Correspondence to [email protected] Shirley Jones, senior lecturer, Faculty of Health, Social Care and Education, Anglia Ruskin University, Cambridge Leslie Gelling PhD MA BSc(Hons) RN FRSA, reader in research ethics, Faculty of Health, Social Care and Education, Anglia Ruskin University, Cambridge Author guidelines http://nr.rcnpublishing.com
6
ACTION RESEARCH has become increasingly popular with researchers and practitioners in health and social care because of the focus on changing practice and on engaging practitioners and users in the change process. Action research projects seek to take a practical approach to improving the lives and experiences of those receiving or delivering care. One of the greatest challenges for those adopting such an approach is how they can most effectively engage stakeholders in their project. Without engagement, action research will invariably fail to achieve the desired outcomes. This issue of Nurse Researcher includes two papers on action research, each taking a distinctly different approach to participant engagement. In the first paper researchers in Australia describe a project undertaken to explore different models of emergency care provision (Sullivan et al 2013). A struggle was taking place in rural Victoria to maintain a 24-hour emergency care service at the same time as the medical workforce was diminishing. The Victorian state government funded a collaborative project to engage healthcare professionals from four rural health services and one bush nursing centre in exploring possible models of emergency care provision. An action research approach was adopted in an attempt to engage healthcare professionals with government officers in redesigning emergency care services and informing legislative change. Early in the paper, the authors acknowledge that engaging the practitioners would be the key to the success of the project and to finding a model for care delivery that might be implemented in practice. The authors then report a thorough approach to participant engagement throughout all stages of the project. The participant group included all those with a direct interest in the delivery of emergency care and with something to contribute to finding a solution to the focus of the project, comprising health service executives, managers, doctors, nurses and pharmacists.
November 2013 | Volume 21 | Number 2
06-07 NR NOV 2013.indd 6
Once recruited, the success of this project lay in meaningfully engaging participants in the conduct of the research: ■■ All participants were invited to a two-day planning forum and three one-day action learning sets. ■■ After each meeting they completed an evaluation about how it had achieved its aims. ■■ Participants generated the agenda for each of the learning sets. ■■ Participants determined what data would be collected, were involved in designing tools and were engaged in interpreting the data. ■■ Participants were also given the opportunity to share their individual views about their roles and their perspective on the focus of the project.
Owning the project Not only were the participants able to supply their own data, they also contributed to planning and conducting the research at all stages. This gave them considerable ownership of the project. The authors of this paper state that this project achieved its initial aims because they ensured collaboration permeated the endeavour. There might be nothing particularly novel about how these authors engaged participants, but what they have demonstrated is how participant engagement needs to be well planned and last for the duration of the project. Too often action researchers claim a participatory approach when engagement is limited to some elements of the project and not in a long-term manner. These authors have shown how a diverse group of participants in a complex healthcare situation can collaborate in a meaningful way to bring about change. In the second themed paper, Bevan (2013) explores the need for a communicative space to facilitate participant engagement in an action research project. Participating in action research can be uncomfortable and challenging for researchers; this often results from a perceived loss of control as participants are © RCN PUBLISHING / NURSE RESEARCHER
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
24/10/2013 14:12
Commentary encouraged to guide the research and to determine the future direction of the project. But this is what makes action research unique and is why it can be so effective as an approach to changing and improving practice. Bevan (2013) describes how they established a ‘communicative space’ for participants. This was a challenge because such a space did not previously exist and many of those invited to engage in this project did not know each other. The participants were mothers of pre-school children, so establishing an effective physical and conceptual communicative space was central to the success of this project.
Physical and conceptual When planning a physical space, the researchers’ main concerns were comfort and ease of access. They sought a neutral space with easy car and bus access. The venue was known to the participants but it was not someone else’s territory. Childcare, which was of particular relevance to the project, was made available to the participants if they chose to use it. Bevan (2013) describes how some mothers opted to keep their children with them in the group meetings and how this might have contributed to the dynamics of the group. In many ways, establishing a physical communicative space was more straightforward than understanding the complexities of the conceptual communicative space, which is described as having three phases. In the first phase, the inclusion phase, participants start to find their places in the group; they determine the purpose of the group and what is expected of them. Once through the inclusion phase, participants enter the control phase, during which they grow in confidence and begin to feel able to challenge each other or to argue or discuss important issues. In the final phase, the intimacy phase, the group members begin to become dependent on each other. Group members encourage each other and can become sympathetic to each other’s opinions and experiences. Bevan (2013) emphasises the importance of an appropriate physical communicative space but also highlights the need to understand how the conceptual communicative space will develop as the project progresses. Having one space without the other would not enable the participants to contribute to the group or to engage in the project. Most, if not all, action researchers will be familiar with the need to create a physical space conducive to debate, discussion and argument. Too many action researchers, however, fail to give sufficient consideration to the conceptual space. This is most obvious when they rush data collection and do not allow group dynamics to develop or for the conceptual space to mature. When this happens the data collected might not be as useful or valuable as it might be if the researchers had allowed more time. © RCN PUBLISHING / NURSE RESEARCHER
06-07 NR NOV 2013.indd 7
These two papers have offered a practical insight into how action researchers have endeavored to engage participants in their research. In both projects it was clear that their success depended on the researchers’ ability to create a truly participative environment. What neither author has made clear was how they managed and negotiated the ethical requirements for their projects. One of the main challenges for both researchers and research ethics committees when action research is being planned is in obtaining appropriate ethical approval (Gelling and Munn-Giddings 2011). Researchers are required to offer a clear description of how the entire project will be conducted. The difficulty is that the participatory nature of the research means they have not yet determined what data will be collected, how it will be collected or how it will be analysed. For example, Sullivan et al (2013) highlighted how the participants determined what data would be collected during the planning forum or action learning sets. It would have been interesting to gain some insight into how the participatory nature of the research impacted on the practical management of both projects. Action research is about engaging people in change and empowering them to shape the resulting change. The two papers published in this issue have offered a practical insight into some of the issues that action researchers must consider. References Bevan A (2013) Creating communicative spaces in an action research study. Nurse Researcher. 21, 2, 14-17. Gelling L, Munn-Giddings C (2011) Ethical review of action research: the challenges for researchers and research ethics committees. Research Ethics. 7, 3, 100-106. Sullivan E, Hegney DG, Francis K (2013) An action research approach to practice, service and legislative change. Nurse Researcher. 21, 2, 8-13.
November 2013 | Volume 21 | Number 2
Downloaded from RCNi.com by ${individualUser.displayName} on Nov 27, 2015. For personal use only. No other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
7
24/10/2013 14:12
