How is Brilliance Enacted in Professional Practices? Insights from the Theory of Practice Architectures

Nick Hopwood,Chris Elliot,Kady Moraby,Ann Dadich

doi:10.7577/pp.4022

Abstract

Brilliance has been overlooked in studies of professional work. This study aimed to understand how brilliant practices are made possible and enacted in a multidisciplinary paediatric feeding clinic, where professionals from different disciplines work together and with parents and carers of children. The existing literature has thematically described brilliance but not theorised how it is accomplished and enabled. Using video reflexive ethnographic methods, the study involved the video-recording of 17 appointments and two reflexive discussions with the participating professionals, who selected and reviewed five episodes exemplifying brilliant care. These were analysed through three themes: carer-friendly and carer-oriented practice; ways of working together; and problem-solving in actu (in the very act of doing). Using the theory of practice architectures, we explored brilliant practices as complexes of sayings, doings, and relatings, identifying the arrangements that enabled those practices and the forms of praxis involved.

Highlights

Research into brilliance can enable its spread in practice but has been overlooked in studies of professional work (Dadich et al, 2015)
We argue that the two approaches are non-competing, without claiming to resolve differences between them, or discounting the relevance of power and conflict in healthcare professional practices
The findings highlight aspects of brilliance that the professionals reflected on during the reflexive sessions. The discussion theorizes these findings through the theory of practice architectures

Summary

Introduction

Research into brilliance can enable its spread in practice but has been overlooked in studies of professional work (Dadich et al, 2015). Brilliance in professional practice has been thematically described, yet it remains inadequately theorized. The theory of practice architectures (Kemmis, 2019) recognizes the complex, emergent, and morally imbued nature of professional practices but has not been used to understand how brilliance is enacted or how “architectures” make such enactments possible. In foregrounding brilliance, we take seriously aspirations to excel in professional practices and provide a counter to approaches that highlight problems and shortcomings. Brilliance is not taken up in a competitive spirit or as a pre-defined category, but rather as a novel window into professional practices that highlights aspects of them that are often otherwise overlooked

Objectives

Results

Discussion

Conclusion