Sue Lillyman

Participatory and appreciative action and reflection (PAAR) – democratizing reflective practices

The paper introduces a new approach to reflecting and acting called participatory and appreciative action and reflection (PAAR). It explores its potential to enable individuals and groups to move forward, to improve their working practices and lives in particular communities and contexts. The paper situates PAAR in the historical context of participatory and action research and reflective learning. It suggests that using PAAR requires four strategic ‘turns’. By turn we mean a change in direction from one way of thinking and practising to another. The four turns are: (i) away from a preoccupation with changing behaviours in order to solve problems, with ‘fixing’ things and an engagement in deficit‐based discourses, towards the development of appreciative insight, understanding the root causes of success and sustaining strengths‐based discourses in order to amplify those things that will help build a better future from the positive present; (ii) away from self‐learning (individualism and isolation) and towards collective learning through interconnectedness, appreciative knowledge sharing and the use of new forms of communications technology which enable simultaneous action in dispersed geopolitical spaces; (iii) away from one way of knowing and one perspective on truth to an acceptance of more pluralistic view of ways of knowing, of understanding human experience and putting this knowing to good use; (iv) away from reflective cycles and spirals and towards the use of a reflective learning (r‐learning) framework comprising four mutually supportive processes. They are those of developing an appreciative ‘gaze’, of reframing lived experience, of building practical wisdom and of achieving and moving forward.

Providing a Positive Learning Experience for International Students Studying at UK Universities: A Literature Review.

Much of the current literature relating to international students at university level tends to highlight their experiences from a deficit perspective and in some cases even problematises the experience for the student and university. Other studies tend to focus on recruitment and motivation rather than the lived experiences of the student, thereby providing little assistance to guide the student, academic and host university in their preparation for, and working with, the international student. International students choose to study in the United Kingdom for a variety of positive reasons. However, these factors have the potential to become stressors as the student makes the transition to studying in a foreign country. Rather than viewing these stressors from a negative perspective, this literature review identifies how, with planning, support and understanding, universities can provide and develop a positive experience for all concerned.

Using a storyboarding technique in the classroom to address end of life experiences in practice and engage student nurses in deeper reflection

This paper evaluates the use of storyboarding within a classroom setting as a means of addressing end of life issues and engaging second year student nurses in creative, critical thinking and deeper reflection on practice. Storyboarding is a process that was developed to encourage learners to use the creative right brain and the critical left brain to formulate ideas in front of a group and then to look at those ideas critically (Lottier, 1986). The session was evaluated using a questionnaire and group discussion to elicit perceived learning from students. The activity was to create the storyboards in small groups, then review the content generated by discussion with the whole group. Main themes identified by the students included breaking bad news, dealing with cardiac arrest situation, coping with families following bereavement and the dying patient. Evaluation of the teaching session suggested that students found storyboarding helped to identify cultural aspects and feelings related to the dying patient. Students valued sharing with each other and the opportunity to have their experiences heard. It was noted that although this method provided as valuable learning experience for the student it is staff and time intensive and attention is required to establish a climate of trust and safety. The risk of exposing unexpected emotions within individual students appears no greater than with other approaches to teaching about loss, death and dying.

Using storyboarding to gain appreciative reflection in the classroom

This paper reviews the use and value of a storyboarding approach in a classroom setting for healthcare professionals. This approach is used with adult students from foundation to postgraduate level of study. It describes how the authors used a positive appreciative reflection approach to storyboarding in order to develop the narratives of the students’ lived experience. The authors identify how the storyboarding helped to develop one student’s narrative into a group activity. This approach provided the students with space and time to work together on creating the storyboard and gain ‘collective wisdom’ from their peers and facilitators in the process. The paper acknowledges some of the limitations and benefits of using this approach to storyboarding within the classroom setting.

Palliative care for people with dementia: a literature review

With growing numbers of people dying with, and from, dementia there is a need for professionals and health-care organisations to review the access to and provision of palliative care. This literature review has identified several key themes in relation to the person dying with dementia including: diagnosis of the dying phase, appropriate timing of referral to specialist palliative care services; ethical decisions in relation to medication and nutrition; the environment; undertreatment especially, for pain relief; over and burdensome treatment interventions; carer involvement; collaborative working and advance decision making.

Reducing Social Isolation in a Rural Community Through Participation in Creative Arts Projects

This article reports the initial findings from the evaluation of four creative arts projects involving groups of older people living in a rural community. The purpose of the projects was to reduce social isolation among participants through providing direct access to arts and social activities. The view was that these activities would improve life skills and independence, increase levels of activity and improve the health, wellbeing and quality of life of participants. Evaluation of these projects demonstrated increased levels of self-worth and self-esteem among participants. Many of the older people involved agreed that they had made new friends while having the opportunity to try out a new activity.

Communication skills for advance care planning at end-of-life

A total of 44 one day advance care planning (ACP) communications workshops were developed and delivered across two counties to health and social care practitioners Band 5 and above. This collaborative project between two Hospices and a University aimed to develop knowledge, skills and confidence in ACP discussions underpinned by national and local initiatives and policy and the evidence base. Satisfaction with the programme was excellent with 98% of participants very satisfied/satisfied that the programme was clinically relevant. There were post programme increases in confidence in exploring patient cues, structuring an ACP discussion and identifying patient & relatives concerns. The workshops also highlighted areas for further development in more general communication skills including identifying and following through cues and use of questions and silence. The structure of these workshops has since been used for the development of other local programmes addressing ACP and dementia. However recommendations from this evaluation would suggest that further communication skills training prior to the application to ACP discussions would facilitate conversations taking place particularly in getting conversations started.