Practice Development is defined as:

"a continuous process of developing person-centred cultures. It is enabled by facilitators who authentically engage with individuals and teams to blend personal qualities and creative imagination with practice skills and practice wisdom. The learning that occurs brings about transformations of individuals and team practices. This is sustained by embedding both processes and outcomes in corporate strategy". (Manley, K., McCormack, B. and Wilson, V. 2008)

The principles used in this approach include:

• Being person-centred: Respecting and valuing individuals and engaging with them in a way that promotes their dignity, sense of worth and independence.
• Working with values: Engaging individuals and teams to clarify and explore their values and beliefs about themselves and their practice; then reflecting on these values to identify aspects of the work environment that prevent individuals and teams from realising their espoused values, and what they can do to change this.
• Enabling self and others through skilled facilitation: Development of mutually respectful, helping relationships and use of enablement as a means to making sense of the context in which care is delivered.
  Skilled facilitation is a process and an outcome aimed at enabling individuals and teams through critical reflection, high challenge in supportive environments, active learning and transformation of individuals and their practice. Enablement is most effective when it occurs as near to the clinical interface as possible.
• Being critical and active: Working with individuals and teams who have a genuine interest in changing, to engage in critical reflection to learn in and from practice, to challenge assumptions and taken for granted norms, and to take action towards individual, team and organisational effectiveness.
• Evaluating all PD work using collaboration, inclusiveness and participation: PD evaluation activity is underpinned by the use of collaboration with all stakeholders to reach shared decisions and goals, being inclusive of all those affected by this work without purposely excluding anyone, and providing opportunities for individuals and teams to actively participate towards common goals, in a way and at a time that suits them and the team.
• Developing and using evidence and knowledge: Use and blending of different types of knowledge and evidence in ways that are appropriate to the context, as well as systematic development of evidence from practice and the cultures that sustain these, to improve clinical and operational decision-making.
• Striving for emancipation and human flourishing: Developing person-centred care environments and workplace cultures that enable individuals to thrive, grow and be the best they can be.

The use of transformational Practice Development methodologies allows the identification of values and exploration of current practice at ward/ unit level. This provides a basis to examine practice and workplace cultures, challenge rituals and assumptions, enabling new ways of working that are values and evidence based.

This leads to sustainable practice change while providing an ongoing framework for evaluation.

Carr, A. (2000) Critical theory and the management of change in organizations. Journal of Organzational Change Management. (13)3: 208-20.

Koch, T. (1994) Beyond measurement: fourth-generation evaluation in nursing. Journal of Advanced Nursing. (20): 1148-55.

McCormack, B., Dewar, B., Wright, J., Garbett, R., Harvey, G., and Ballantine, K. (2006) A realist synthesis of evidence relating to practice development. Final report to NHS Education for Scotland and NHS Quality Improvement Scotland.

McCormack, B. & McCance, T. (2006) Development of a framework for person-centred nursing. Journal of Advanced Nursing, 56(5): 472-9.

McCormack, B., Henderson, E., Wilson, V. & Wright J. (2009) Making practice visible: The workplace  Culture Critical Analysis Tool (WCCAT). Practice development in Healthcare 8(1): 28-43.

Manley, Kim., McCormack, Brendan., and Wilson, Val. (Eds) (2008), Practice Development in International Nursing and Healthcare. Blackwell Publishing, Oxford UK.

Manley, K., and McCormack, B. (2003) Practice Development: purpose, methodology, facilitation and evaluation. Nursing in Critical Care. (8)1: 22-9.

NSW Health Nursing and Midwifery Office (2009) Essentials of Care Resource Guide for Facilitators.

Senge, P. (2006) Chapter 11. Shared Vision in The Fifth Discipline: The art and practice of the learning organization. Doubleday/Currency.

Wilson, V. (2005) Improving the effectiveness of patient care: an emancipatory practice development approach. Neonatal, Paediatric and Child Health Nursing. (8)3: 4-11.

Wilson, V., McCormack, B., and Ives, G. (2004) Understanding the workplace culture of a special care nursery. Issues and Innovations in Nursing Practice (50)1: 27-38.

Wright J. & McCormack B. (2001) Practice Development: Individualised care. Nursing Standard 15(36: 37-42. RCN Publishing Company.