Making rhetoric a reality: inclusion in practice as “transformative learning”
| DOI | https://doi.org/10.1108/MHSI-01-2016-0004 |
| Pages | 110-118 |
| Date | 09 May 2016 |
| Published date | 09 May 2016 |
| Author | Dave Mercer,Heidi Kenworthy,Ian Pierce-Hayes |
| Subject Matter | Health & social care,Mental health,Social inclusion |
Making rhetoric a reality: inclusion in
practice as “transformative learning”
Dave Mercer, Heidi Kenworthy and Ian Pierce-Hayes
Dave Mercer is based at the
Directorate of Nursing,
University of Liverpool,
Liverpool, UK.
Heidi Kenworthy is based at
Moving on With Life and
Learning (MOWLL),
Liverpool, UK.
Ian Pierce-Hayes is based at
the Directorate of Nursing,
University of Liverpool,
Liverpool, UK.
Abstract
Purpose –“Inclusivity”and “empowerment”are central concepts in the philosophy of nursing practice and
education. Recent professional concern has focused on the need to embed compassion in healthcare
cultures where practice contributes to learning. The purpose of this paper is to explore an innovative
partnership approach to undergraduate placement provision for adult-general nursing students in the context
of learning disability and mental health.
Design/methodology/approach –Critical discussion focuses on evaluation of a non-clinical placement
centred on the health and social care of individuals with a learning disability or mental health needs. Two
projects from practice around healthy living and hate crime illustrated the value of transformative learning as a
pedagogic philosophy.
Findings –Student feedback offered insight into social and cultural processes that impact on practice-
based learning, and factors promoting inclusive engagement. Such included the context of identity formation,
narrative as an evidence-base for caring, and personal/emotional growth through critical reflection.
Practical implications –Evaluation provided a platform to re-think model(s) of clinical practice learning
in healthcare education derived from a non-clinical placement. There are tangible benefits for sustaining
value-led practice at a time of political change in the way health services are configured and delivered.
Social implications –When engagement with the principles of inclusivity and empowerment become part
of the lived-experience of the nursing student, longer-term recognition and retention of caring, and enabling
values are more likely to endure.
Originality/value –The emotional development and skills acquired by nursing students transfer to all
branches of the profession by revitalising core conditions of compassion, respect, dignity, and humanity.
Keywords Inclusion, Mental health, Learning disability, Nurse education, Peer-advocacy,
Transformative learning
Paper type Case study
Introduction and aims
Following the findings of recent high-profile reports into instances of poor, or unacceptable,
standards of care (e.g. Department of Health, 2013a,b; Care Quality Commission, 2011) the
nursing profession has had to radically rethink how compassion can be better embedded in
education andpractice (Fotaki, 2015; Flynnand Mercer, 2013; Departmentof Health/NHS, 2012).
National and international evidence suggests a “hidden curriculum”operates in clinical settings
which undermines core conditions that define and construct dignified/empathic approaches
(Johnston et al., 2011; Wear and Zarconi, 2008). Many of these problems can be attributed to
systemic factors, best understood through inquiry into clinical cultures or ward ethnographies
(Jacobson, 2009; Walsh and Kowenko, 2002).
Routinely, nursing practice includes some of the most vulnerable social groups such as the
elderly, mentally ill, learning disabled, homeless, and asylum seekers; individuals who exist on the
periphery of society, experiencing the stigma and discrimination of “otherness”. In this context,
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MENTALHEALTH AND SOCIAL INCLUSION
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VOL. 20 NO. 2 2016, pp. 110-118, © Emerald Group Publishing Limited, ISSN 2042-8308 DOI 10.1108/MHSI-01-2016-0004
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