Change and conflict in health visiting practice : dilemmas in the assessment of professional competence in the education of student health visitors

• Main Author: Twinn, Sheila Frances
• Published: University College London (University of London) 1989
• Subjects: 370; Education & training
• Online Access: http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.283735

Recent events in professional practice have highlighted the growing concern amongst professionals as to the extent to which the interpretation of professional knowledge reflects the changing characteristics of practice situations. Authors have attributed this crisis in confidence to the development of an epistemology of practice grounded in a model of technical rationality. This traditional model based on a process of instrumental problem solving, using scientific theory and techniques, has accentuated the gap between the theory of practice and the reality of the practice set t ing. A similar phenomenon is apparent in health visiting practice and raises a fundamental question in professional education: what is understood by competent practice. Although defining competence in practice has been the focus of much research, some critics now argue that the most important areas of professional practice lie beyond the conventional boundaries of professional competence. Indeed the understanding and appreciation of the concept of professional artistry is fundamental to the process of defining competence in practice. It is my belief that this concept plays a major role in the level of competence displayed by practitioners. The empirical work therefore was designed to examine a fundamental issue in professional education: the relationship between the interpretation of professional practice and the process of assessing competence in practice. The multistage mixed research design used to analyse and explore the different interpretations of professional knowledge and adopted paradigms of practice not only demonstrates the current emphasis on an epistemology of practice grounded in a model of technical rationality but also the lack of a theoretical framework for the process of assessing competence in practice. Indeed the findings demonstrate the need to develop a conceptual framework for practice which not only acknowledges the essential role of the concept of professional artistry in the interpretation of professional practice but also facilitates the development of an epistemology of practice grounded in reflection-in-action. It is these findings which highlight the critical role of the Fieldwork Teacher in facilitating these processes.