Being Permeable

Permeable practitioners expect and recognise uncertainties in practice. This is because they are self-aware, aware of and for others, awareness-sharing, feedback-seeking, open to alternatives, critically aware and willing to change.

These behaviours and characteristics not only support the permeable practitioner to expect and recognise uncertainties in day-to-day practice but also facilitate the practitioner to resolve practice uncertainties. I’ve long been influenced by the work of the personal construct psychologist George Kelly. Kelly applied the notion of permeability to constructs but I am using permeability to describe this cluster of helpful behaviours and characteristics.

Discovering permeable practitioners

The permeable practitioner is the main idea which developed from my PhD research conversations with allied health professionals (specifically occupational therapists, physiotherapists and speech and language therapists). I noticed from these conversations that it is the combination of behaviours and characteristics which is important. Awareness alone might help the practitioner to spot and recognise uncertainty but unless the practitioner is willing to share this awareness and seek feedback, the uncertainty is likely to persist. Of course, it is possible to get unexpected or unwelcome feedback, at odds with current or preferred approaches to practice but to resolve an uncertainty it is necessary to be open to alternatives and to critically appraise whether the alternatives offer a possible solution; not to reject alternatives out of hand. Ultimately, where an alternative approach offers the potential to resolve an uncertainty, the practitioner needs to have a learning disposition and be willing to change.

diagram - practitioner permeability

Checking, assuring and adjusting practice (if required)

Although a willingness to change is a crucial aspect of practitioner permeability, I’m not suggesting that resolving an uncertainty always requires us to change in some way through for example, the acquisition of more knowledge, skills, experience or different ways of being in practice. There may be uncertainties where awareness sharing is enough; when we just need someone to know what we are uncertain about or how busy we are. There will also be times when we conclude from our appraisal of feedback and alternatives that an uncertainty can be tolerated or is unfounded. In essence, permeable behaviours and characteristics support practitioners to check how they are doing and to seek assurances about practice, only making adjustments when necessary; a sort of practice recalibration through which the practitioner works out when and if to make changes.

A spectrum of permeability

Through my conversations with practitioners, I notice a spectrum of permeability. There are times when we, or our colleagues are more or less permeable; times when we feel the need to stick to familiar and established ways of doing things, others when we need more reassurance or support and others when we are prepared to try new or alternative approaches in practice. For each of us, to successfully navigate our day-to-day practice, there will be a position of optimum permeability; not necessarily right in the middle of the spectrum and an optimum which will shift according to the demands and uncertainties we encounter. However, getting stuck at one or other end of the spectrum can make resolving uncertainties more difficult. If we are too permeable, we may be highly dependent, constantly seeking feedback, more training and so on. On the other hand, being impermeable may result in us failing to recognise our uncertainties and their impact on our practice or choosing not to share them and avoiding feedback. Being stuck at one or other end of the spectrum can leave us feeling fragile and struggling with the inevitable uncertainties we encounter in everyday practice.

permeability spectrum diagram


Making use of the permeable practitioner idea in practice

As I’ve been sharing my PhD work over the last couple of years, I’ve found health professionals have welcomed this concept of being permeable. I’ve had lots of conversations about how we might cultivate permeable behaviours and characteristics and about how being permeable serves us in navigating and resolving our uncertainties. If often seems like a lightbulb moment when practitioners recognise the potential to think about uncertainties as important prompts to learn and that by continuing to recognise these prompts for learning, we have a better chance of minimising risk and error.

Permeable practitioners and supervision

I will write about the relationship between permeability and supervision in later blogs but for now want to highlight that being permeable serves to maximise the potential of supervision for both supervisee and supervisor. Permeable supervisees are willing to share concerns and seek to resolve them though don’t necessarily expect the supervisor to have all the answers; they recognise their own part in resolving their uncertainties. Permeable supervisors recognise there may be multiple ways to practice safely and to resolves concerns and are also willing to acknowledge that they are not always the best person to support the supervisee to resolve their concerns, signposting to others when necessary.

Further reading and resources

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