Reciprocal learning in partnership practice: an exploratory study of a home visiting program for mothers with depression

Abstract

This paper reports on a small exploratory study that investigates the place and role of reciprocal learning within a partnership-based home visiting program for mothers experiencing depression. The study is one important example of an increased focus on reciprocal learning within practice that has significant implications for the development of professional education and, more generally, for workplace learning and ongoing professional development. The study addresses two major gaps in the research literature: a lack of detailed accounts of how partnership based approaches are taken up and developed in Australian health care; and a lack of attention to learning as a focus and outcome of partnership-based practice. Using information from in-depth interviews with nurses and mothers we describe and analyse the experience of participants, their learning and knowledge development, the techniques used to facilitate learning, and the development of a relationship between mother and nurse, and mother and child. We identify a fundamental repositioning in practice that was being enacted and learned by all nurses, and a shift in practice strategy from expert assessment and knowledge provision, to practice as a process of shared inquiry and learning. We identify key relational strategies developed by the nurses and commented on by the mothers. We identify a shift in how the mothers experienced the locus of knowing and decision making in relation to their child/children and their parenting. Nurses enhanced their ability to formulate effective interventions for mothers, to build a deeper understanding of mothers’ experience, and to challenge or reinforce their own existing beliefs and knowledge. We suggest much of what was described by both the nurses and mothers within this study can usefully be described in terms of reciprocal learning, or as pedagogy. Such findings, we argue, have significant implications for the conceptualisation of health professional practice, the identification of the capabilities required to deliver partnership forms of practice, and, critically, for the redesign of curriculum in the area of health professional education.

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