Vikki Entwistle

When you think about ‘good’ health care, you might consider various things such as how effective and personally appropriate treatments are, how fairly services are allocated, and how respectfully and compassionately staff work with people.

As health professionals strive to provide services that are ‘good’ in several senses at once, and for people with diverse needs and concerns, they often face quite challenging judgement calls. They need ‘practical wisdom’ to discern and pursue good ways of acting in each situation.

Several developments in recent decades have perhaps made it harder for health professionals to develop and exercise practical wisdom. Many clinical practice guidelines and organisational policies, protocols and targets have been introduced to try to help ensure the effectiveness, efficiency and safety of health care. These have arguably obscured the value of practical wisdom – although they have certainly not removed the need for it, especially if we think good care should be person-centred or humanistic as well as effective, efficient and safe. At the same time there seem to be fewer opportunities for many health professionals to gain practical wisdom by learning from and with each other. Senior health professionals who recognise the value of practical wisdom often lament the decline of communal lunch breaks and regular team meetings in which health professionals could share their experiences and discuss the (perhaps ‘little’) concerns or questions that arise in the course of their practice. 

We are interested in investigating how practical wisdom can be characterised and supported in contemporary health care. In this specific project, we will review the current literature to gather information on recent practical initiatives that have deliberately introduced and evaluated discussion spaces for health professionals to reflect together on issues relating to healthcare quality and ethics. We will also hold preliminary discussions with interested health professionals, teams and relevant policy leaders to develop plans for future research.