Managing Professional Development Using Action Learning: Case

Managing Professional Development Using ActionLearning: Case Study, Nursing in the UK

Sheila Stark

The Manchester Metropolitan UniversityUnited Kingdom

A Primary Care Group in the North West of England commis-sioned the facilitation of action learning sets from a local Uni-versity. The aim of the sets was to support primary and commu-nity nurse practitioners who were in different disciplines (e. g. dis-trict nursing, health visiting, general practice nursing, commu-nity psychiatric nursing etc.) to work more collaboratively withcolleagues on projects in either staff development, or service im-provement.

This paper discusses the work of two action learning sets. Oneset introduced clinical benchmarking, which is a governmentsponsored initiative aimed at improving the quality of care andservices provided. This group undertook the benchmarking pro-cess in relation to record keeping. The second group examined thecurrent status of clinical supervision amongst primary and com-munity care nurses and developed a strategy to take this aspect ofprofessional development forward in a more effective way. Thispaper examines the development of both of these action learningsets. In addition, it will examine some of the issues and benefitsthat arose with taking an action learning approach to nursing de-velopment, and the usefulness of this approach for other healthcare practitioners.

In the United Kingdom (), the National Health Service () hasundergone continuous structural changes in its organisation and ori-entation (Warne ). Current policy guidance locates primary care atthe frontiers of health care modernisation (o ; a). PrimaryCare Trusts (s), comprising of previous Primary Care Groups (s)(which were formed by General Practitioner practices being brought to-gether) are set to become the driving force for change across the ,having much of the responsibility for commissioning and providing

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health care. Given this turbulent health care context (Stark et al. ),primary health care professionals and organisations have to explore newways of working and thinking (o ; a; b). The role ofnurses in primary and community care has steadily increased in impor-tance (Koperski et al. ; Kernick ; Bond et al. ). Promotingnurse leadership, in order to manage the changes and challenges of the modernisation process, is currently on the government’s agenda(o ; a; b). With this in mind, managers of a in theNorth West region of England, who had responsibility for nursing devel-opment, decided to use action learning sets as a means to organisationalchange. They held the philosophy that practitioner led approaches tolearning were ideal methods for health care professionals in which toengage (Rolfe ; Meyer ).

The sets comprised primary and community care nurses who wereleaders in their discipline (e. g. district nursing, health visiting, generalpractice nursing, community psychiatric nursing, specialist nursing).Four action learning sets were developed from this group of nurses;however, this paper specifically concentrates on the experiences of twosets. The actual changes in the organisation as a result of the two projectsundertaken will be outlined. The projects were in the areas of clinicalsupervision and clinical practice benchmarking. Further, the paper willfocus on the process of action learning and the suitability of this ap-proach for health care professionals given current health care contexts.

Action learning initially was a phenomenon (Mumford ), foun-ded by Reg Revans () but it is now used across the world. It was pri-marily use in industry, however, it is currently popular in higher educa-tion (including nurse education (Haddock )), as evidenced by sev-eral courses claiming to use an action learning approach on Web sitesboth in the and abroad.

The model rests on the premise that the learner develops ‘questioninginsights’, based on experiences at work, to find solutions to work relatedproblems/issues. While traditional learning relies on providing knowl-edge in the form of solutions that are already known by the teacher, thesolutions in action learning are actively sought via a cycle of identifyingand implementing courses of action, monitoring the results, refining theaction, testing again and so on. Thus, it is an emergent process, whereby

Managing Professional Development Using Action Learning

Professionaldevelopment

via actionlearning

. Share and refine knowledge,experiences, practice; embedand revisit over time

. Engage in the actionlearning set; focus learningby identifying work basedproblem/issue

. Share with set membersproblem/issue to be improvedvia action and develop‘questioning insights’

. Implement a course of action,based upon new learning

. Critically review/monitorsituation as a result of theaction taken

Development ofaction learning sets

Figure : The action learning cycle

the learner learns new ideas, skills and attitudes by being steeped in theactive involvement of the learning process.

The learning process takes place within an action learning set. The setis facilitated by an action learning advisor, whose role is important par-ticularly at the beginning of the process to increase cohesiveness, confi-dence and commitment (Spencer ). The set comprises typically of – individuals, perhaps of differing functional backgrounds, but who areof roughly equal status (Dixon ). The members meet approximatelyonce a month to present their problems. The other members of the sethelp the learner to develop questioning insights by using their ‘localknowledge’ to probe the problem/issue being raised (Beaty et al. ).Other set members may be working on the same or different projects(Froiland ), but all learn with and from each other.

The organisation in which set members are located must be conduc-tive to individuals trying things out (taking risks), reflecting upon theresults and sharing experiences with others in a non-threatening envi-ronment (Peters and Waterman ).

Since action learning is used when there is a need to find a solution toreal problems, as opposed to a simulation, and it is used when learning isvoluntary and learner driven, it appeared to be an ideal approach for the

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nurses described here. Twelve primary and community care nurses, ofroughly the same grade, representing several nursing disciplines formedan action learning group and began to meet approximately once ev-ery two months. These practitioners had recently completed leadershiptraining and were eager to put these new skills to use.

The author was commissioned to act as a facilitator (advisor) to thesepractitioners for months. It was felt that a person external to the or-ganisation may be more objective to the issues that were raised withinthe sets. Being free of organisational ‘baggage’ was seen as an importantfactor that may help to disrupt/challenge dominant and ritualistic waysof being and thinking. The facilitator also had experience working withnurses on action learning and action research projects in the past (Stark). The facilitator’s role was to ensure progress was maintained; to en-courage, model and reinforce reflective analysis and questioning insights;to nurture a supportive, yet challenging and respectful environment forlearning.

At the start of the process the practitioners were asked to identify a nurs-ing development issue/problem/area that they wanted to change/impro-ve/influence using action learning. The practitioners were asked to bearin mind the following criteria (based on an action learning philosophy ascited in the literature – McGill and Beaty ; Pedler ; Dixon ):

• The change would be directed towards practice, organisation orworking methods.

• The practitioner sincerely believed the change would directly or in-directly improve the services for patients.

• The change would present opportunities for personal and organi-sational learning.

• The change would contribute, directly or indirectly to integration,flexibility or new ways of working for nursing teams.

• The practitioner was committed to and had an interest in bringingabout the change.

• The practitioners held a management responsibility for the project.

Several individuals selected the same area and more than one area.Due to these overlapping interests it was decided the group would sub-divide into four action learning sets, each person in the set working onthe same topic. Some practitioners opted to work in more than one set.


The division of the action learning group, into four action learningsets, created an effective ‘layering’ of the action learning process. Eachset met regularly; meetings varied from once a week to once a month de-pending on the nature of the activities within the action learning cycles.As previously stated, the action learning group met approximately onceevery two months. The action learning process occurred both in the setsand in the group. Thus, the practitioners not only had the learning pro-cess reinforced, but they learned about other project areas that were alsohighly relevant to their professional practice. As previously stated thispaper centres on the work of two projects, these are outlined below. Theother projects focused on (i) nurses and the public health agenda and (ii)nursing empowerment.

Project – Clinical Supervision

Set members were concerned with the seemingly haphazard way inwhich clinical supervision was offered and received by primary and com-munity care nurses. They wanted to take a lead and suggest a way for-ward for more effective clinical supervision for nurses within the newlydeveloping framework. The project involved assessing the views andexperiences of nurses in relation to their current clinical supervision andpotential way/s forward. This took the form of a survey being adminis-tered to all primary and community care nurses in two regional healthlocalities (n = , response rate = (%)). The survey producedmuch data on the current state of clinical supervision for these nurses.For example several different models of clinical supervision were beingused. Some nurses had regular supervision, about once a month, whileothers claimed they never have clinical supervision. Most individuals didnot want their clinical supervisor to also be their manager. Most nurseswanted to select their own clinical supervisor. And so on. These findingswere written up in the form of a consultation document for the

Developmental Board/s. The document recommended a more effectiveapproach to clinical supervision for nurses, given the evidence collectedby the set members.

The learning about learning in this set was immense and sometimespainful, as they confronted attitudes and behaviours in themselves thatthey criticised in others. For example, some individuals criticized thepoor attendance at meetings that they set up (hence, hindering progresswith initiatives), but were often absent themselves at the action learn-ing group meetings. Since the set members were clinical supervisors theysometimes had to face harsh criticism from the survey respondents in

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relation to their experiences of current clinical supervision i. e. manage-rial in focus and occasionally disempowering rather than empowering.These findings added significantly to the paucity of data on the effective-ness of clinical supervision practices, particularly in nursing. To this end,set members are also writing papers for publication.

Project – Clinical Practice Benchmarking

The Essence of Care document (o a) outlines a clinical practicebenchmarking process that helps to improve the quality of essential as-pects of care. Benchmarking offers nurses a toolkit that will allow themto compare and share best practices in order to improve continuouslythe care offered to patients. The practitioners in this action learning set,however, were unsure of how to implement the benchmarking processand since the process was new in health care, there were no previous ex-periences in this context from which they could learn. The action learn-ing set provided a useful opportunity for these nurses to maximise thelearning process and learn with and from each other.

The set undertook to benchmark clinical practice in relation to onefactor within one aspect of care (record keeping) as outlined in theEssence of Care document, in a range of primary care and communitynursing groups. Members were successful in developing a mutually sup-portive forum for practitioners. Further, they successfully improved thestructures and processes for record keeping within the practice areas inwhich they worked. Set members are now supporting colleagues under-taking similar work. They have also shared their learning process withothers nationally via a conference and a publication in a national nurs-ing journal (Stark et al. ).

Much learning took place for all the practitioners, not only in rela-tion to the subject areas selected for their projects (i. e. benchmarking,clinical supervision etc.), but also in relation to leadership and organisa-tional change. The group’s learning cycles, for example, began to identifygeneric themes concerned with barriers to change, resource issues andpractice issues vis-a-vis nurse development. These are discussed here.

Both action learning sets achieved and, in some cases, exceeded their ob-jectives. The objectives were written in terms of realistic outcomes in re-lation to the topic they selected. Achieving these objectives resulted in


several aspects of learning taking place in relation to both the personaland professional development of nurses. These included:

• Fostering supportive, open and respectful working alliances, whichalso increased the practitioners’ motivation to improve in the areaof nursing development. A team effort gave the practitioners a sensethat they could bring about change.

• Developing their leadership qualities. For example, a small butquick ‘hit’ in relation to success with the benchmarking processmade the practitioners feel that they could make a difference.

• Raising confidence. For example, being invited to speak at a na-tional conference and having an article accepted for publicationgave the practitioners a sense that they were undertaking valuablework in nursing development.

• Increasing their knowledge and learning. For example practitionersexpanding their knowledge in relation to the range of clinical su-pervision models currently being used in primary and communitycare nursing.

• Developing a deeper level of reflection (Bunning ) – by ques-tioning their action and the action of others, also question their val-ues, beliefs and traditions. Practitioners began to question whether,for example, their model of clinical supervision was empowering ordisempowering for their supervisees.

• Developing diagnostic and listening skills and self-awareness. Forexample practitioners learned that their standards in relation torecord keeping were not meeting their patients’ needs.

• Learning the importance of monitoring and evaluation exercises.The learning cycles required the practitioners to evaluate courses ofaction at each stage. These discussions expanded their understand-ing of the situation and lead to a much more informed and struc-tured approach to learning and development.

• Developing research awareness and skills. For example the practi-tioners in the clinical supervision set learned how to construct, ad-minister, analyse and present the findings of a survey.

• Learning about the process of writing for publication as well as thejournal review process for a national nursing journal. The bench-marking set undertook this process and then ‘taught’ the membersof other sets the process via the action learning group meetings.

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In addition to these personal and professional development issues re-sulting from working in the action learning sets, further positive aspectsat an organisational level were evident. For example:

• The action learning sets increased the level of genuine collaborationbetween colleagues in line with government’s agenda (o a).The sets had community and primary care nurses, from differentdisciplines, working together on projects for the benefit of the localcommunity that they serve.

• Two geographical localities worked in partnership and shared re-sources to capitalise on work done separately for the benefit of thewhole. Such working is laying excellent foundations for ensuringco-ordination of planning and integration of service delivery (ob).

• While the practitioners did feel they were more empowered to im-plement change they also realised change was slow, and required asustained collaborative effort to encourage colleagues to not onlywelcome change, but also take an active part in the learning processto bring about any change. All practitioners agreed that much oftheir empowerment was learning the politics of what could/couldnot be done/challenged within their organisation.

• The work has resulted in nursing leadership and development beingon the agenda for Developmental Boards in change of restruc-turing primary and community care in the region.

Clearly, the two action learning sets resulted in several positive devel-opments for the nurses involved. Further, the sets did achieve their ob-jectives. However, at times, the actual learning process was difficult andpractitioners struggled with several issues that had an adverse affect onthis process. Some of these tensions are outlined here.

• The nurse leaders involved in the action learning knew each otherfor several years – having interactions during the course of theireveryday work, undertaking professional development courses to-gether, attending the same meetings etc. These relationships helpedthem to be ‘comrades of adversity’ (Revans ) – a crucial element


in action learning and is concerned with the ways in which individ-uals help one another to resolve problems. On the other hand, how-ever, some found this historical legacy and unspoken ‘politics’ and‘pecking orders’ anxiety laden at times (Atkins et al. ). Strongcharacters were prone to dominate the programme of work and theprocess of learning. This lead to defensive behaviour and rhetoric– ‘I’ve tried that and it doesn’t work’ – and an impaired learningprocess for either themselves or other set members.

• Practitioners were sometimes reticent to criticise others both in theaction learning group and set, perhaps in fear of offending/embar-rassing, or creating a situation where others may feel they can crit-icise them. Thus, there was a tendency to retreat into discussion(Morris ) as opposed to the more difficult (and more risky) taskof critical reflection and questioning. However, there may have beenan element of not knowing what questions to ask (see next point).

• Some practitioners were unaware of, or unwilling to acknowledgegaps in their knowledge and expertise. The facilitator found it ex-tremely difficult to push deeper their critical reflection of self. Herquestioning was deflected. It appeared to be too painful, uncom-fortable and difficult for the nurses to turn the mirror on them-selves and take a deep and critical look at their own behaviour andattitudes. It was much easier to blame others or the organisation ingeneral, for the current situation. They were less willing, for exam-ple, to explore the possibility that their behaviour may be reinforc-ing the conditions that they were criticising, or that their attitudescould be disempowering as opposed to empowering other nurses,and so on.

• At times there appeared to be an innate complacency with some ofthe nurses and they often found it difficult to resist the tug to con-form to familiar and ‘programmed’ ways of working and thinking,despite the contrary belief which they articulated and an apparententhusiasm for change.

• Attendance at the set and group meetings was erratic. This madecontinuity of the projects difficult. We had to spend much of themeeting getting those who had not attended the last sessions/s up-to-date. Two key reasons were given for this lack of attendance:

. Other pressures of work were a big issue. This was especiallythe case for practice nurses and some clinical supervisors.

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. Movement within their job – several practitioners experiencedrole disruptions. This seems to be a negative phenomenonparticularly evident in the (o b). Disruptions in-volved; practitioners leaving the area for a new job; being sec-onded to a new role; acting in a new role; obtaining a newrole; undertaking professional development courses (over anextended period of time) and so on.

• Some practitioners were members of another learning set. Withhindsight, since time was restricted for meeting, it was perhaps un-wise for individuals to be part of more than one action learning set.At the time, set membership was voluntary and the commissionersof the study did not wanted to discourage practitioner enthusiasm.

• An important role for the facilitator was to reduce anxiety and de-velop an acceptance amongst set members that ambiguity and ‘notyet knowing the answers’ was a healthy and natural state for actionlearning. Further to nurture the meta-skill of questioning insight inorder to examine critically what is and see opportunities for whatcould be or what should be. This takes time and a sustained effortto build up trust within the set and group. The lunchtime meetingswere usually interrupted and characterised by practitioners arriv-ing late, leaving early or not being able to attend the meeting at all.Therefore, this quantity and quality of time, to become emerged inthe action learning process, was limited.

• On occasions the facilitator failed to break the dependence othershad on her and shift in the responsibility for the learning to thepractitioners (Vince and Martin ). The sets required ‘work’ tobe done between meetings (collecting and reading literature, writ-ing questions for the survey, liaising with other ‘experts’ and so on).The facilitator feared that if the practitioners were given too muchto do then their voluntary participation in the set might be threat-ened.

Another important interpretation was that the facilitator was unwill-ing to relinquish her control in the sets. This subject is widely writtenabout in the action learning literature (Kozubska ; Bennett ;Casey ; Donaghue ). The facilitator was conscious that her timewas being commissioned to work with practitioners. Thus, she felt thatthe commissioners needed to see some outcomes for their money. Withhindsight, there was perhaps a misplaced assumption to be concerned


with achieving tangible outcomes in the form of reports, benchmarks,papers and presentations, rather than focusing on the learning processas an outcome in itself.

This paper has discussed the process of using action learning for nurs-ing development with primary and community care nurses. While theprocess had elements of success with the clinical supervision and bench-marking projects outlined in this paper, there were several inhibiting fac-tors identified when using this approach to learning. This then leads tothe following questions being raised:

• Is the process of action learning appropriate for use in health carecontexts?

• And, to what extent can it make an impact on practitioners andtheir organisations?

The author believes action learning does have a valuable contributionto make in nurse development, the practitioners themselves and theirorganisations:

• Action learning begins with real projects ‘on the ground’.

• It engages practitioners in a sustained learning process, learningwith and from each other.

• It has the benefit of achieving both personal and organisational ob-jectives.

• It may help to bridge the gap between theory and practice.

• It can provide a useful antidote to the isolation often experienceby primary and community care nurses – nurses learning together,with practitioners who are experiencing similar things.

• It can provide an opportunity to develop analytical and questioningskills.

• It encourages leadership.

• It focuses on learning how to learn – how a person functions. Nursesneed to become skilled at recognising and managing this process,since it is the process that determines the quality of the content(what they achieve). Without this, nurse leadership and develop-ment may be slow to change.

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It is easy, however, to list the benefits of action learning, but in orderto be successful the process needs a receptive environment in which toflourish. The current health care context tends to be imbued with prac-tical and political realities that may hinder the effective use of this ap-proach to development and change for both the organisation and itsemployees. The culture is traditional and hierarchical and oper-ates using clear ‘top-down’ policy and procedural manuals and guide-lines (Stronach et al. ). This organisational approach runs contraryto the ‘bottom up’ philosophy underpinning action learning. So, whilethe practitioners may embrace action learning, if the organisation is lesswilling to change, then progress will be minimal, and worse, a demoti-vated and resentful workforce may result.

Success with action learning requires a commitment to the learningprocess, sharp analytical questioning and also creativity in conceptualthought in order to gain insights (Bunning ). This requires time ina supportive and stimulating group environment. Health care workers,in particular nurses, are seldom given the luxury of protected time awayfrom their practice setting to work on problems (o b). This timeis unlikely to be a priority when the is short of some , regis-tered nurses ( ), with an average vacancy rate of % (Robertsand Fielding ). Further, as highlighted at the beginning of this paper,the is in a constant state of flux with new structures, demands andtargets being imposed on health care professionals relentlessly. The ex-periences of the sets highlighted that this led to sustained role disruptionfor practitioners, involving movement of either themselves or their col-leagues or both. Such an organisational climate is not conducive to thetime and continuity necessary for effective action learning.

Not only is the nursing workforce experiencing an acute shortage, thenurses in the force work are under pressure to be ‘all things to all peo-ple’. The Briggs report () outlined a foundation for developing themodern nurse – reflective, critical thinking and one whose uses researchand evidence based practice in her increasingly autonomous role. Sincethe Briggs report there has been a major shift in nurse education andtraining in the from the apprentice model and into higher education.Educationalists and practitioners remain undecided as to the success ofthe higher education model in producing the type of nurse advocated byBriggs (). The recent Research Assessment Exercise in () clearly highlighted that nursing is still in its infancy in relationto research. Nursing has traditionally been a task orientated profession


(becoming proficient in technical skills), as opposed to being focussedon process (being interested in how a person functions). Unless nursesrecognise the value of the process, it is unlikely they will become skilledat recognising and managing this process. And, since it is the processthat determines the quality of the content (what they achieve) nursingleadership and development may be slow to change.

The health care culture appears to be steeped in often unspoken andsometimes unrecognised (being blind or turning a blind eye?) issues ofpower, status, authority and competition between disciplines and withinhierarchies. Unless these are made part of the learning processes then,again, change may be slow to occur. Unfortunately, nursing is often char-acterised by what nurses claim to already know and this knowledge oftenblocks them from new knowledge – ‘we always . . . ’, ‘we do . . . ’ ‘we’vetried that . . . ’. Concealment and subversion enables practitioners to feelmore comfortable about themselves, but it reinforces, rather than chal-lenges, the oppressive culture and, in turn, stifles learning and develop-ment.

Staff development in the is often in the form of short course, one-day workshops or academic courses in universities. This form of pro-fessional development often embodies the ‘expert’ in an organisationallanguage that emphasises a dependency relationship (Thorpe and Taylor) and, again, reflects a ‘top-down’ culture. Further, ‘experts’ tend tofollow a well-trodden path that draws on past experiences. ‘Leaders’, onthe other hand, chart new territory with commitment, dedication andthoughtful clarity of vision. Thus, if action learning is going to be suc-cessful in health care contexts the organisation needs to shift from the‘expert’ model to a ‘leadership’ model. As has been demonstrated in thispaper, this model begins with real projects ‘on the ground’ whereby prac-titioners are empowered (by the organisations) to engage in a sustainedlearning process. The author believed that this approach would stimulatethe motivation necessary for positive organisational change.

Primary and community health care within the is currently ex-periencing a turbulent oganisational culture characterised by constantchange. The government has indicated that nurses could and should takea lead in providing primary care within the new organisational structures(o a; b). This is a prime opportunity for nurses to forge a

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leadership role and create an organisational culture receptive to nurs-ing development and innovation. Current professional development fornurses, therefore, needs to equip them with new ways of thinking andworking. This will require them to resist responding to the urgency ofthe moment and respond to more long-term learning. Further, they willneed to resist entering into round-robin discussions involving blame, re-living past crisis, emotions and failures and instead ask what they learnedfrom these behaviour patterns and attitudes.

This paper outlines an approach to learning that could help them tocope more effectively with both individual and organisational leadershipand change. Action learning aims to solve ‘on the ground’ problems thatcannot be solved by training. However, the experiences of the practition-ers involved in two projects described in this paper, highlight that cur-rently aspects of the culture within primary and community care nurs-ing can impede action learning. For example, political (organisationalpower hierarchies) and psychological (emotional) components can hin-der or discourage learning. Unless the organisational culture becomesmore conducive to such approaches to learning and development, thennurse leadership and empowerment may remain a rhetoric that does notmatch with reality.

Atkins, H., K. Kellner, and J. Linklater. . Action learning: Employingthe workplace within. www.sba.oakland.edu/ispso/html/atkins.html.

Beaty, L., T. Bourner, and P. Frost. . Action learning: Reflection onbecoming a set member. Management Education and Development ().

Bennett, R. . Effective set advising in action leaning. Journal of Euro-pean Industrial Training ().

Bond, S., S. Beck, S. Derrick, J. Sargeant, W. F. Cunningham, B. Healy, G.Rawes, S. Holdsworth, and J. Lawson. . Training nurse prac-titioners for general practice. British Journal of General Practice:–.

Briggs, A. . Report of the committee on nursing. London: The Station-ary Office.

Bunning, C. . Turning experiences into learning. Journal of IndustrialTraining ().


Casey, D. . The shell of your understanding. In Action learning inpractice, nd ed., ed. M. Pedler. Gower: Aldershot.

Department of Health. . The new : Modern and dependable. Lon-don: The Stationary Office.

Department of Health. . Saving lives: Our healthier nation. London:The Stationary Office.

Department of Health. a. The plan. London: The StationaryOffice.

Department of Health. b. Making a difference. London: The Station-ary Office.

Department of Health. a. Essence of care. London: The StationaryOffice.

Department of Health. b. From vision to reality. London: The Sta-tionary Office.

Dixon, R. L. . Action learning: More that just a task force. Perfor-mance Improvement Quarterly (): –.

Donaghue, C. . Towards a model set effectiveness. Journal of Euro-pean Industrial training ().

Froiland, P. . Action Learning. Training (): –.. . research assessment exercise: The outcome. Bristol: The

Highter Education Funding Council for England.Haddock, J. . Reflection in groups: Contextual and theoretical con-

siderations within nurse education and practice. Nurse EducationToday :–.

Kernick, D. P. . Nurses and doctors in primary care: Decisions shouldbe based on maximising the cost effectiveness of a system of primarycare and not the dictates of historical precedent. British Journal ofGeneral Practice :–.

Koperski, M., S. Rogers, and V. Drennan. . Nurse practitioners ingeneral practice – an inevitable progression? British Journal of Gen-eral Practice :–.

Kozubska, J. . Role of the set adviser. Action learning resource,

University Press.McGill, I., and L. Beaty . Action learning. nd ed. London: Kogan

Page.Meyer, J. . Using qualitative methods in health related action re-

search. , no. :–.Morris, J. . Action learning: The long haul. In Gower handbook of

training and development, ed. J. Prior. Aldershot: Gower.

Sheila Stark

Mumford, A. . A review of action learning literature. www.cchs.usyd.edu.au/arow/mo/Mumford().htm

Pedler, M. . Action learning in practice. rd ed. Brookfield, : Gower.Peters, T., and R. Waterman. . In search of excellence. London: Harper

and Row.. . Nursing pay: Facts and figures. Briefing, London.Revans, R. . Developing effective managers: A new approach to business

education. London: Longman.Revans, R. W. . The origins and growth of action learning. Bromley:

Chartwell-Brat.Roberts, G., and P. Fielding. . No vacancies. Nursing Standard ():

.Rolfe, G. . Expanding nursing knowledge: Understanding and re-

searching your own practice. Oxford: Butterworth Heineman.Spencer, J. . Action learning for individuals and organisational de-

velopment. Http://ericacve.org/docs/pab.htm.Stark, S. . A nurse tutor’s experience of personal and professional

growth through action research. Journal of Advanced Nursing :–.

Stark, S., I. Stronach, T. Warne, D. Skidmore, A. Cotton, and M. Mont-gomery. . Teamworking in mental health: Zones of comfort andchallenge. Research Report Series. London: .

Stark, S., A. McHale, E. Lennon, and L. Shaw. . Benchmarking: Keepit simple, keep it real, have a go. Nursing Standard (): –.

Stronach, I., B. Corbin, O. McNamara, S. Stark, and T. Warne. . To-wards an uncertain politics of professionalism: Teacher and nurseidentities in flux. Journal of Education Policy ().

Throp, R., and M. Taylor. . Action learning in an academic context.In Action Learning in Practice, nd ed., ed. M. Pedler. Aldershot:Gower.

Vince, R., and L. Martin. . Inside action learning: An exploration ofthe psychology and politics of the action learning model. Manage-ment Education and Development ().

Warne, T. . Customs and contracts in the FundholdingScheme. h diss., The Manchester Metropolitan University.

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Managing Professional Development Using Action Learning: Case