A Platform for Practice

A platform for practice refers to a synthesis of our knowledge, skills, experiences in and out of work, personal qualities and preferences. In combination, these elements underpin and support us to prepare, engage in and deliver our everyday practice.

The platform for practice is an idea which I developed from my PhD research with allied health professionals (specifically occupational therapists, physios and speech and language therapists). It’s an idea I have thought about and developed further during 2019 and 2020, through projects with a much wider range of health professions who are working or developing in multi-professional advanced clinical practice. In this blog, I set out what a platform for practice is and some thoughts about why this idea may be useful in practice.

Relating the platform for practice to what others have said

I agree with others, like Dall’Alba who wrote in a 2009 paper that professional practice entails combining knowledge and know-how with knowing how to be. Hence, I suggest that a platform for practice is not just the sum of our professional knowledge, skills and experiences (the formative and empirical stuff we front load in professional education and training) but includes influences from our lives outside of work and also personal factors or characteristics; ideas you could read more about in the ‘lifeworlds’ literature such as Galvin and Todres’ 2013 book or Hörberg, Ozolins and Ekebergh’s 2011 paper. It also follows that because we all have different experiences and personal qualities, that in any cluster of similar professionals (shared professional background, similar time qualified, etc) their platforms for practice would have lots in common but each practitioner would also have individual, idiosyncratic differences too. We can probably think of colleagues who click with some patients and not others, have some aspects of practice they feel more at home with than others and so on.

The platform for practice and practitioner uncertainty

I developed this idea of a platform for practice through listening to practitioners talking about their practice uncertainties. I noticed that practice uncertainties could be about knowledge and/or knowing what to do in familiar and unfamiliar practice situations, perceptions of self or concern about the perceptions of others. Unsurprisingly, some uncertainties arise simply because there is too much to do and not enough time to do it. I suggest that we draw on the dimensions of our platform for practice in different combinations depending on the practice demands of any given practice encounter; we anticipate what we will need to know or do based on things like a referral or a handover conversation or a previous encounter with the same patient or indeed colleague. Practice encounters play out in expected and unexpected ways and this is what can lead to practice uncertainties. Sometimes we anticipate an encounter will be straightforward and it turns out to be more complex. Other times we think we might be struggling in an unfamiliar encounter and our suspicions are confirmed, while in other encounters we are pleasantly surprised that things proceed more smoothly than expected, and so on.

The personal dimensions of a platform for practice

Like those who adopt a lifeworld perspective, I suggest professional practice it is not just about applying professional knowledge and skills but extends to deciding how to be in each practice encounter and that involves us as a whole ‘in work and out of work’ human. The idea of a platform for practice recognises that we do not leave our personal self and life at the door when we arrive at work. Imagine if I am the go-to physiotherapist in my hospital with specialist cancer knowledge and skills but right now, someone close to me is navigating their own cancer diagnosis and treatment. My specialist cancer knowledge and skills are not changed but I will now be adding some new personal insights and associated feelings to my platform for practice. From now on, insights arising from these new, personal experiences will combine with and influence how I draw on the existing elements of my platform for practice and perhaps create unanticipated uncertainties for me as I challenge some of the taken-for-granted aspects of my existing platform for practice.

In reality, a practitioner’s uncertainties are not neatly packaged and matched to discrete dimensions of a platform for practice. Instead, uncertainties are interwoven, messy and ill-defined.

How can a platform for practice be useful?

I’m finding a number of ways in which the concept of a platform for practice can be useful for health and care professions:

  • As a tool in supervision to identify which dimensions might need some attention to help to resolve, reduce or tolerate a practice uncertainty
  • As an adjunct to a person specification in identifying the optimum platform for practice for new and emerging roles
  • To support appraisal or learning needs analysis

Further reading and resources

To find the possible further reading mentioned in this blog and activities for exploring the idea of a platform for practice go to Ideas and Resources