Creating a community of inquiry in a healthcare organization

This insider action research study was undertaken in a national healthcare organisation in Ireland over a twenty-eight month period from 2010 to 2013. The focus of the research was to study the establishment of a quality patient safety audit (QPSA) team, created to fill an assurance gap for clinical and social service at corporate governance level in the observed healthcare organisation. This audit team, once recruited, consisted of fifteen individuals with varied professional experience (both clinical and administrative/ management) and levels of seniority from different geographical locations within the studied organisation. The primary aim of the research account was on the learning that was generated internally by establishing the aforementioned team, underpinned by a critical action learning ethos. This project sought to document the creation of a suitable team environment and to track this team from establishment through to the observed evolution of a community of inquiry (COI) in the practice of audit. Using the stages within the experiential learning cycle (Kolb 1984) to guide team interventions and the researcher’s own critical reflection, this approach was the antithesis to subject-led teaching approaches to management, and ignited transformation dialogue and actions that facilitated individual and team engagement, immersion and growth when completing audits and working within the audit team. The action research (AR) methodology contributed to the researcher’s own learning and when used to underpin the practice of the audit team, ensured quality in inquiry. Furthermore, findings that emerged from each AR cycle were fed back directly into practice with the aim of bringing about sustained improvement. A key contribution of this research is that COI theory acted as an organising principle, underpinned by a critical action learning ethos in this study, resulting in a ‘favourable voice climate’ that allowed voices to be heard and acted upon. Notably, this created a tension as before team members could hear anything worth hearing, they needed to contemplate the power dynamics of the space they operated in and social actors therein and examine their own willingness to hear and be heard. Fundamental to this approach was that the grounding of learning in practice, combined with exposure to new perspectives and interpretation of organisational and managerial situations, tapped into the collective insights of individuals to inform practice.