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Occupational therapists are encouraged to use research evidence to guide therapeutic interventions that holistically address the consequences of dementia. Recent efforts to use research evidence in practice have emphasized the challenges of doing so in ways aligned to person-centred and professional principles. Using research evidence is a complex process influenced by multiple contextual factors and layers. The influence of context in occupational therapy for dementia is currently unclear. To explore the contextual complexities of using research evidence in practice with people with dementia, and to develop knowledge to improve the approach to using evidence in person-centred, occupation-focused practice. A case study methodology was used, in which the contextual conditions of practice were clarified through the facilitation of critical and creative reflection using the following methods – Think Aloud, practice observation, creative expression and reflective dialogue. Cultural beliefs that affected evidence use included technically-orientated understandings of evidence-based practice. These were underpinned by apprehensions about losing professional identity and taking risks when processes derived from research evidence were adjusted to incorporate a persons' occupations. These cultural factors were perpetuated at the organizational layers of context, where systemic priorities and other team members' needs disproportionately influenced occupational therapists' decisions. Occupational therapists' potential to make reflexive and responsive decisions by adjusting evidence-based processes can be affected by their perceived freedom to address organizational tensions. Raising consciousness of the influence of the organizational context on decision-making about evidence use could adjust occupational therapists' perceptions of their freedom and ability to be person-centred. Intentionality in reflective processes in practice are required to foster reflexivity. [ABSTRACT FROM AUTHOR]

Critical creativity is a paradigmatic synthesis linking critical social science with creative and ancient traditions. Our haiku summarises the essence of this three part paper. "Heavy feet of stone" describes the rationale for our creation of critical creativity. "Seeking transformation" sets out the background and methodology for our inductive, methodological development. "Dancing rocks and flows" unfolds a new methodological framework for action-oriented, transformational practice development and research that is concerned with human flourishing for those who engage in such work, as well as those for whom the work is intended. Through interplay of story, metaphor, poetry and critical dialogue, we present our methodological development approach for critical creativity and the evolving methodological framework. Within the framework, we focus on conditions and principles that enable our worldview of critical creativity to be used in action research and practice development. (Contains 5 notes and 7 figures.)

Action learning is being increasingly utilised as a strategy to underpin practitioner focused development and research projects in healthcare generally and nursing in particular. Whilst facilitators of and participants in action learning have a variety of resource materials to guide their practice and participation, there continue to be few systematic and/or evaluative accounts of the experience of participating in action learning for potential action learning participants to draw upon. This paper attempts to address this agenda. The paper presents an interpretive evaluation of the experience of nurses participating in action learning as the learning strategy underpinning a 3-year emancipatory practice development/practitioner research programme. In particular, the paper focuses on the experience of "joining a learning set". This focus has been adopted as the theory of action learning emphasises the principle of "voluntariness", but yet action learning is increasingly being pre-prescribed as a component of development and research programmes. Such was the case with the programme reported on in this paper. The paper describes an approach used to evaluate learning that was adopted in this programme and in particular the initial evaluation stage that focuses on participants' feelings about joining an action learning set. The data collection and analysis processes are described and the key themes arising from the analysis ("self-preservation" versus "development of self") discussed. It is concluded that working with principles of enlightenment is essential to successful action learning and the transformation of workplace cultures. (Contains 2 figures and 1 table.)

Action Learning is now a well established strategy for reflective inquiry in healthcare. Whilst a great deal is know about action learning there has been inadequate research on the process of learning that takes place, and the impact that this holds for individuals, groups or organisations. This article reports on the findings of 15-month action learning program based in a special care nursery. A realistic evaluation of the program uncovered individual and group journeys and provide evidence that action learning is an effective strategy in practice development. (Contains 2 tables and 1 figure.)

This article examines the case for the use of the creative arts in the process of designing, conducting, analyzing, and disseminating evaluations. The authors argue that using the creative arts in the process of evaluation evokes different ways of knowing and understanding the values of a program. The insights gained offer a unique addition to evaluation methodology. This not only broadens the perspective of what counts as evaluation knowledge but also creates opportunities for participants to engage in the process of valuing. The article also explores the challenges this perspective presents demonstrating--for example, how artistic knowing may be represented, claims to validity established, and methodological rigor ensured in integrating creative approaches in evaluation designs. The authors illustrate the case for the use of the arts in the evaluation process with examples from their own professional practice contexts in education, nursing, and health.

In this article, the authors expose, for critical review and public scrutiny, their challenge to the critical paradigm as an adequate location for the transformational practice development and research approaches that they are developing in healthcare. Whilst they accept the fundamental assumptions of the critical paradigm, in their view it does not recognise the creativity required in their approaches. Neither does it explicitly acknowledge that creativity often requires moral and sacred dimensions as people push out the boundaries of the known within their own practices. In particular, the authors expose these gaps within Fay's eight critical theories for practice. Over the last decade, the authors have addressed these gaps by combining the assumptions of the critical paradigm with their experiences of using creative imagination and expression in their practice development (PD) and action research work. Then through a critical review of their work, they have created a new paradigmatic synthesis to add to the critical paradigm. They call this synthesis "critical creativity". In this article, the authors set out their reflexive journey that has led to the articulation of "critical creativity" as a paradigmatic synthesis for action-oriented development and research. (Contains 3 notes, 3 tables, and 4 figures.)