Introducing the Learning Practice - III. Leadership, empowerment, protected time and reflective practice as core contextual conditions

Rosemary Kathleen Rushmer, D Kelly, M Lough, JE Wilkinson, Huw Talfryn Oakley Davies

    Research output: Contribution to journalArticlepeer-review

    40 Citations (Scopus)


    Rationale, aims and objectives This paper is the third of three related papers exploring the ways in which the principles of Learning Organizations (LOs) could be applied in Primary Care settings at the point of service delivery. Methods Here we provide a systematic literature review of contextual factors that either play a key role in providing a facilitative context for a Learning Practice or manifest themselves as barriers to any Practice's attempts to develop a learning culture. Results and conclusion Core contextual conditions are identified as, first, the requirement for strong and visionary leadership. Leaders who support and develop others, ask challenging questions, are willing to be learners themselves, see possibilities and make things happen, facilitate learning environments. The second core condition is the involvement and empowerment of staff where changes grow from the willing participation of all concerned. The third prerequisite is the setting-aside of times and places for learning and reflection. This paper contributes to the wider quality improvement debate in three main ways. First, by highlighting the local contextual issues that are most likely to impact on the success or failure of a Practice's attempts to work towards a learning culture. Second, by demonstrating that the very same factors can either help or hinder depending on how they are manifest and played out in context. Third, it adds to the evidence available to support the case for LOs in health care settings.

    Original languageEnglish
    Pages (from-to)399-405
    Number of pages7
    JournalJournal of Evaluation in Clinical Practice
    Issue number3
    Publication statusPublished - Aug 2004


    • innovation
    • learning cultures
    • learning organizations
    • organizational learning
    • primary care
    • the learning practice
    • HEALTH
    • NURSE
    • CARE


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