A mirror in which to practice -- using action learning to change end-of-life care

While action learning is a familiar tenet of much management and leadership development activity within the NHS it is not commonly utilised within the education and development of doctors where didactic methods remain the preferred mechanism to impart factual knowledge necessary to fulfil the autonomous practitioner role. Within the specialism of palliative medicine, the implementation of a national end-of-life (EoL) care strategy will challenge this predilection. The new strategy seeks to enable more people to die in the place of their choosing as such it requires clinicians outside the speciality of palliative care to make it a routine part of their practice. Since doctors are trained to cure or extend life, the strategy requires specialists to change their practice, behaviour and communication to engage the patient and family in decision-making and planning for the EoL. An intensive development programme utilising action learning methods is currently being piloted in two acute hospital settings to equip a small group of specialist senior clinicians to deliver the required changes. This paper describes the use of action learning within this context to explore its utility with an uninitiated and sceptical audience.