Appreciative Inquiry Interviews Research Articles

Navigating the troubled waters of higher education – a phenomenological study on the needs and challenges of first‐year clinical associate students in South Africa

Background. Clinical associates (ClinAs) are educated in decentralised learning platforms where they gain skills and a concrete understanding of the fundamental challenges of healthcare in remote and poverty-stricken districts of South Africa. Due to the decentralised nature of the programme, these students seldom have access to ‘on-campus’ academic and psychosocial support. A peer mentorship programme has proved useful in this regard in other settings. Objective. To explore the unique academic and psychosocial challenges and needs of first-year clinical associate (ClinA) students and describe the views of the research participants on the perceived enablers and constraints of a ClinA peer mentorship programme. Methods. A phenomenological research design was used. The population included ClinA students and academic members of staff. Five appreciative inquiry interviews and two focus group discussions were conducted. Results. Four themes were identified: (i) flailing like a fish out of water (challenges experienced by ClinA students); (ii) floating devices (benefits of peer support programmes); (iii) the life saver (perceived enablers of peer support programmes); and (iv) rip currents (perceived constraints of peer support programmes). Conclusion. Unique challenges identified were: (i) the teaching and learning strategy implemented by the facilitator of the programme; (ii) the decentralised learning platforms; and (iii) the absence of institutional support at clinical learning centres. All participants agreed that peer mentor support is beneficial and essential for ClinA students, but that the peer mentor programme needs to be bespoke to address the limited access to academic and psychosocial on-campus support and the profile of the students, who are of rural origin and first-generation students.

What factors in the workplace enable success in antimicrobial stewardship in paediatric intensive care? An exploration of antimicrobial stewardship excellence through thematic analysis of appreciative inquiry interviews with healthcare staff

ObjectivesAntimicrobial resistance (AMR) is a major global health problem. Efforts to mitigate AMR prioritise antimicrobial stewardship (AMS) interventions. These interventions typically focus on deficiencies in practice and providing negative or...

Leadership in Canadian and French high security prisons expectations and perceptions

The literature has yet to study the ideal type of prison leadership in the eyes of frontline staff. Methodologically, most studies draw upon written questionnaires distributed to governors, not to their staff and analyse their data without using management or human needs theories. This study contrasts with the extant literature inasmuch as it is comparative (France/Canada) and draws upon Appreciative Inquiry interviews. It also draws upon three strands of literature and their variables: the general theory of management, self-determination theory and legitimacy of justice-procedural justice theories. The study finds that French and Canadian prison officers have needs in areas uncovered in this literature: competence, relatedness, autonomy, general fairness, respect/dignity and care. Our samples have mixed feelings about their local hierarchy; they are very critical regarding their national hierarchies. Prison officers describe their managers as being essentially either laissez-faire or as transactional. Limitations and institutional policy implications are explored.

Conducting a good ward round: How do leaders do it?

Rationale, Aims and ObjectivesWard rounds (WRs) are complex social processes. Done well, WR discussions and decisions contribute to timely, safe, effective progression of care. However, literature highlights medical dominance; marginalisation or absence of other perspectives, safety risks and suboptimal resource use. This study examined leadership behaviours and what supported good interprofessional WRs, defined as enabling interprofessional collaboration and decision making which progresses patient care in a safe and timely manner. Deepening appreciation of this art should support learning and improvements.MethodMixed‐method appreciative inquiry (AI) into how WRs go well and could go well more often. Context: daily interprofessional consultant‐led WRs in a large adult critical care unit. Data: ethnographic and structured observations (73 h, 348 patient reviews); AI conversations and interviews (71 participants). Inductive iterative analysis shaped by Activity Theory. Participants: 256 qualified healthcare professionals working in the unit.ResultsLeadership of good WRs supported (and minimized contradictions to): making good use of expertise and time, and effective communication. These three key activities required careful and skilled orchestration of contributions to each patient review, which was achieved through four distinct phases (a broadly predictable script), ensuring opportunity to contribute while maintaining focus and a productive pace. This expertise is largely tacit knowledge, learnt informally, which is difficult to analyse and articulate oneself, or explain to others. To make this easier, and thus support learning, we developed the metaphor of a conductor leading musicians.ConclusionsWhilst everyone contributes to the joint effort of delivering a good WR, WR leadership is key. It ensures effective use of time and diverse expertise, and coordinates contributions rather like a conductor working with musicians. Although WR needs and approaches vary across contexts, the key leadership activities we identified are likely to transfer to other settings.

Developing and conducting appreciative inquiry interviews.

The appreciative inquiry (AI) interview follows a specific format and needs to be planned and developed before implementation. AI questions are designed to draw on the interviewee's experiences, commencing with general questioning and progressing to more focused questioning. To explain how to plan and undertake AI interviews, and to discuss issues that nurse researchers might encounter. This article is based on the first author's experience of undertaking an AI doctoral study. The primary method of collecting data for the study was AI interviews. The more focused questioning related to participants' experiences of positive actions or behaviours. Although questioning was positive in nature and participant-centric, conducting the interviews was more problematic than the first author anticipated. Some participants struggled to recall positive memories to share. The unexpected response to the interview questions required the first author to examine her practices, as well as beliefs and judgements relating to AI. This reflexivity assisted in implementing changes to the study's process, resulting in a more positive experience for her and the participants. Researchers using the AI interview require the capacity to be self-critical and change the process if necessary to enrich the outcome.

Leadership Development Model: A Case of International College of Thai Private-Higher Education Institutions

This research is a research and development study, aiming at examining the gaps between current & expected situations, exploring common insights on Leadership development, and proposing a Leadership development model. The research site is in Thailand, involving six private-higher education institutions/universities. The participants in this study consisted of full-time faculty members and staff, totaling 101 people, and full-time Deans, totaling 25 people. Research instruments included a needs assessment questionnaire and an appreciative inquiry interview. Data treatments and validity included descriptive statistics; priority needs index, contents analysis, and field experts' reviews. The quantitative findings in term of the ranking indicated that human resource management was ranked the first-order need, followed by risk management which was ranked the second-order need, then brand management which was ranked the third-order need, then change management which was ranked the fourth-order need, and lastly, strategic management which was ranked the fifth-order need. The quantitative results implied that there was the gap in the experience of the fellows of the Deans who are faculty members and staff. The largest gap between the current and expected situation was in the area of human resource management and risk management. The overall quantitative results are congruent with the qualitative findings of the appreciative inquiry interviews with 25 Deans, revealing that three attributes that commonly contributed to the Leadership Development Model are: people development, organization culture management, and whole-systems management and development. These attributes are highly valued and commonly patterned as an integrative model of the practicing and enabling systems of the Leadership where each attribute interdependently bolsters one another.

Impact of Positive Feedback on Antimicrobial Stewardship in a Pediatric Intensive Care Unit: A Quality Improvement Project.

This project took place over 12 months (April 2017-March 2018) in a 31-bedded PICU. We identified and measured processes about AMS daily. Healthcare professionals, achieving success in these processes, received positive feedback via Learning from Excellence, during a 6 months intervention period. Selected reports were followed with appreciative inquiry interviews to reinforce positive feedback. We calculated antimicrobial consumption data from existing databases (antimicrobial doses dispensed divided by PICU bed-days). Health Care-Associated Infection (HCAI) rates were included as a balancing measure. Antimicrobial consumption was 6.5% lower during the intervention period compared with the matching period from the previous year. We reduced broad-spectrum antimicrobial (meropenem) consumption by 17.6%. Improvements in processes were mixed: a daily review of antimicrobials and documentation of antimicrobial prescription and administration significantly improved. Other processes failed to improve. HCAI rates did not change. Positive feedback can be used as a QI intervention to improve processes around AMS. This intervention may contribute to a reduction in antimicrobial consumption. Not all processes are impacted equally, and there may be a "dose-response" effect. Further evaluation would benefit from a trial study design in other settings.

Young families become mindful of their possibilities through the appreciation of their family life

Young families, as viewed through a multi-generational lens, provide the environment in which children can be nurtured and socialised. The purpose of the research is to explore and describe how the parents and grandparents of young families appreciate their family life. A qualitative, exploratory, descriptive and contextual multiple case study design was used to conduct the study. Purposive sampling methods were applied to select families according to the sampling criteria, each family representing an individual case study. Appreciative inquiry interviews were conducted with the young parents and available grandparents, during which the participants were asked four open-ended questions. Data collection was enriched by means of reflective letters to participants, collages created by the young parents, and the researcher's field notes and journal inscriptions. The data collected from each individual case study was analysed and then synthesised by means of a cross-case analysis. A cross-case validation report was compiled. The themes and categories that emerged from the data were discussed. The research study concluded that when young families embarked on a journey of discovering their strengths and potential in the larger family system, they creatively envision and discovered the possibilities to transform their destiny in a purposeful and constructive way.

Slovene Management Education In The Changed World Through Appreciative Inquiry

<p class="AbstractText">Paper presents the study of appreciative inquiry (AI) methodology in the context of management education. Current perception of managers in Slovenia about economic situation is negative which may have a significant impact on investment and positive outlook of future business. Therefore, we propose that AI which focuses on positive aspects of doing business needs to be investigated and implemented into management education of future managers and we provide empirical evidence of thinking patterns of three generations of students at the Faculty of Economics University of Ljubljana. AI means researching what gives success to human systems when they function at their best. It represents discovery process of optimum identity and a way to the best possible future. Positive core of existing situation is chosen as the focus of AI process. AI is researching into stories that give energy for further action. Purpose of this paper is to offer an alternative approach to tackling challenges, based on analyzing the causes of previous successes. Further, we aim to offer the scientific community a new methodology that solves real business, relational or individual challenges. In the Winter semester during study years 2012/13, 2013/14 and 2014/15 we invited our students to be in a state of inquiry about themselves, their life and their work. We asked them: What is the best future you can imagine? In a longitudinal study we have gathered 171 AI pair interviews documentations. Students’ AI data was analyzed in three thematic segments: 1) favorite quotes; 2) preservation of past and present into the future and 3) vision of the future. Analysis of all three generations’ AI interviews revealed emphasis in their favorite quotes on the “people” component and the need of the students to understand life and make sense of gained knowledge and experiences. They also stress the need to think about contemporary issues and gain practical experiences. Students would most like to preserve in the future their work ethics, dedication to hard work, creativity, family members around them, experiences and knowledge gained. Their visions are focused on balancing successful international careers and family lives. New ways of communication represent an important consideration for the students. They expressed their wish to be driven by intrinsic motivation and being respected in their profession. Theoretical advantages of our paper are in elaborating on AI in management education. Practical implications are in helping students to clarify their strategic goals and visions through introspection and qualitative methodology. Professors can implement and adjust the AI questionnaire based on their own developmental objectives and also based on the needs of their students. Contribution of our paper is in the field of management education and AI field.</p>

Young families become mindful of their possibilities through the appreciation of their family life

Young families, as viewed through a multi-generational lens, provide the environment in which children can be nurtured and socialised. The purpose of the research is to explore and describe how the parents and grandparents of young families appreciate their family life. A qualitative, exploratory, descriptive and contextual multiple case study design was used to conduct the study. Purposive sampling methods were applied to select families according to the sampling criteria, each family representing an individual case study. Appreciative inquiry interviews were conducted with the young parents and available grandparents, during which the participants were asked four open-ended questions. Data collection was enriched by means of reflective letters to participants, collages created by the young parents, and the researcher's field notes and journal inscriptions. The data collected from each individual case study was analysed and then synthesised by means of a cross-case analysis. A cross-case validation report was compiled. The themes and categories that emerged from the data were discussed. The research study concluded that when young families embarked on a journey of discovering their strengths and potential in the larger family system, they creatively envision and discovered the possibilities to transform their destiny in a purposeful and constructive way.

The value of the pre-hospital learning environment as part of the emergency nursing programme

Background: Professional nurses enrolled in a post-basic emergency nursing programme presented at a tertiary nursing education institution in South Africa are placed in different clinical learning environments to reach the set clinical outcomes and gain appropriate clinical experience. These students are placed in the hospital environment (emergency department and critical care unit) and pre-hospital environment (road ambulance services) to ensure they gain the necessary clinical exposure in order to learn the relevant and necessary skills and knowledge which in turn will help them become safe and independent emergency nurse practitioners. Controversy about the value of placing emergency nursing students in the pre-hospital environment has raised questions from specifically the private healthcare sector. During the pre-hospital placement, emergency nursing students are absent from the hospital environment which is costly and, according to the healthcare services, unnecessary.Objective: The study explored the views of the emergency nurse students regarding the value of rotating through the pre-hospital learning environment during an emergency nursing programme.Methods: A qualitative, explorative, descriptive and contextual research design using an Appreciative Inquiry approach was used to collect the data. Through purposive sampling a total of 45 emergency nursing students participated. Data was collected by means of selfreported Appreciative Inquiry interview guides and individual Appreciative Inquiry interviews.The data was analysed using content analysis.Results: Four major themes were identified: an unpredictable environment, role players in emergency medical services, team work, and competencies.Conclusion: The research findings support the value and continuation of utilising the prehospital clinical learning environment for placing post-basic emergency nursing students when enrolled in the emergency nursing programme.

The value of the pre-hospital learning environment as part of the emergency nursing programme

BackgroundProfessional nurses enrolled in a post-basic emergency nursing programme presented at a tertiary nursing education institution in South Africa are placed in different clinical learning environments to reach the set clinical outcomes and gain appropriate clinical experience. These students are placed in the hospital environment (emergency department and critical care unit) and pre-hospital environment (road ambulance services) to ensure they gain the necessary clinical exposure in order to learn the relevant and necessary skills and knowledge which in turn will help them become safe and independent emergency nurse practitioners. Controversy about the value of placing emergency nursing students in the pre-hospital environment has raised questions from specifically the private healthcare sector. During the pre-hospital placement, emergency nursing students are absent from the hospital environment which is costly and, according to the healthcare services, unnecessary. ObjectiveThe study explored the views of the emergency nurse students regarding the value of rotating through the pre-hospital learning environment during an emergency nursing programme. MethodsA qualitative, explorative, descriptive and contextual research design using an Appreciative Inquiry approach was used to collect the data. Through purposive sampling a total of 45 emergency nursing students participated. Data was collected by means of self-reported Appreciative Inquiry interview guides and individual Appreciative Inquiry interviews. The data was analysed using content analysis. ResultsFour major themes were identified: an unpredictable environment, role players in emergency medical services, team work, and competencies. ConclusionThe research findings support the value and continuation of utilising the pre-hospital clinical learning environment for placing post-basic emergency nursing students when enrolled in the emergency nursing programme.

Using Photovoice to Enrich Appreciative Inquiry Interviews in Action Research Projects

Using photovoice in the Discovery and Dream phases of the 4D Appreciative Inquiry process can provide a visual focal point for participants. This is especially relevant when working in an international context, where participants don't share a common frst language, or with participants who frequently post photographs on social networks.

Why is it suddenly so easy to change?

Purpose – The purpose of this paper is to contribute with knowledge concerning how to drive, generate and energize change and development in social systems. A potential key to meet this challenge is the strength-based change management approach called appreciative inquiry (AI). A central component of AI is the “AI interview”, which has evolved into a distinct activity that enables the past and the future to be used as a generative source for on-going learning about strengths, opportunities, aspirations and results. The AI interview has in previous studies shown an often surprisingly high ability to generate development and change in social systems. However, the understanding of the generative “mystery” of the AI interview, focusing on the value experienced by both the people conducting the interview and those being interviewed, is still in need of further exploration. Furthermore, the evident generativity of the AI interview has not yet been integrated to any large extent into quality management. The purpose of this paper is to change that. Design/methodology/approach – The researchers have studied the customer experience of conducting an AI interview based on feedback from 97 AI students at Mid Sweden University. Findings – Among the results, eight categories of value are identified. Originality/value – The paper contributes with new knowledge concerning the values experienced during participation in an AI interview. The paper also highlights ideas on how the generativity of the AI interview could be increasingly integrated into quality management.

Faculty and students perceive common tenets associated with medical student curriculum reform

Objectives: Medical school faculty and students actively engaged in curriculum reform often experience angst. Change management literature emphasizes that grounding change in common values is critical to managing stakeholder angst and ultimately successful change. However the literature provides only limited descriptions of the shared underlying features as perceived by faculty and students associated with curriculum reform. This study sought to bridge this gap by identifying the underlying student and faculty beliefs associated with success in medical student education programs and reform. Methods: A qualitative study approach using an appreciative inquiry interview methodology was selected given its proven success as an inquiry technique for change management. To identify cross-cutting curriculum success tenets, a purposeful sample of 24 stakeholders participating in an established curriculum and/or new integrated curriculum were selected: 12 students and 12 faculty seven of whom were curriculum/college leaders. Two rounds of appreciative inquiry interviews focusing on successes associated with medical student education were conducted. Interviews were digitally recorded, transcribed, coded, and then analyzed to delineate common themes and crosscutting tenets using constant comparative methodology. Results: Analysis revealed six underlying themes associated with success for students and faculty: engagement of students and faculty in education, sense of community and collaboration, faculty/student relationships, active learning, faculty excitement/willingness to teach leads to impactful student learning, and identity/professional formation. Conclusions: The identified tenets associated with successful medical student education programs can be used to manage a critical element of curriculum form: stakeholder change angst.

The effects of appreciative inquiry interviews on staff in the UK National Health Service

To obtain preliminary data on the short- and medium-term effects and personal acceptability of appreciative inquiry (AI) in staff development in health care. AI is a non-problem-solving management approach focusing on developing current successes into the future through reflection at individual and group level. Individual one-hour interviews were undertaken with nursing staff on a national paediatric liver in-patient ward. They were asked to recount stories based on their experiences of successful delivery of health care, with active listening, followed by reflection on the process. A total of 32 staff members took part with only two refusals. Data were written and analysed by an open coding method. Follow up was obtained two years later using a written, open question method. The process was emotional-but well received. Staff described quality in interpersonal interactions, preventing errors and engaging their personal values in their work. No improvement in recruitment or retention was shown but a high level of sickness absence fell significantly during the period of the project. Two years later, significant positive effects were recalled and attributed to the interviews by many respondents. AI appears a cost-effective way of connecting professionals' motivation toward quality in their work with strategic intentions. The interviewer was a medical consultant and ward manager, implying either that the interviews could have worked as a form of managerial supervision or improvements could be a Hawthorne effect. Other unknown influences were likely to be occurring on the ward during the study period. Short AI interventions on an individual basis can change sickness absence, at least while the interventions are continuing. It is an important tool for staff motivation with the potential for connecting strategic with micro-operational levels. AI is an approach to NHS management with wide application including appraisal, personal development and mentoring. It can be a positive introduction to reflective practice. AI is gaining recognition for its value in staff and service development in health care. The paper shows service and personal effects, cost-effectiveness and illustrates how to use AI for these purposes.