Practice-based Learning, but Not as We Know It: Lessons from Improvising Advanced Practice Roles

Abstract

Practice-based learning is well established in the education of practitioners in health and social care. However, a singular description of practice-based learning is elusive, not least owing to global neo-liberal trends in the reform or modernisation of publicly funded services that challenge received approaches in diverse ways. This paper outlines some of these trends with reference to an example of a major workforce development intervention to modernise the healthcare workforce in northwest England, developing assistant and advanced practitioner roles through a work-based programme. In particular, it draws upon research that suggests that 'not knowing' calls forth improvisatory practices from practitioners and educators that offer promising possibilities for practice-based learning that is responsive to the challenges posed by forces of change and uncertainty