Practice development: ambiguity in research and practice

Practice development activity occupies an ambiguous position in relation to both clinical practice and research. In practice, it is seen at times as a n added extra to normal work despite arguably being an inherent part of pro fessional practice. In research, it fails to demonstrate the rigour of bein g generalisable because of its explicit location in a specific care environ ment. The study reported in this paper explored the implications of this am biguity for practitioners who seek to develop health care practice. Ten foc us groups were held with health care researchers and practitioners concerni ng the processes of developing practice in the North East of England. The r esults demonstrate how people manage themselves and the uncertainty that su rrounds the use of research in clinical practice. The paper argues for an a ppreciation of reflexive forms of research, such as action and practitioner research, which do not disassociate research and practice and in which pra ctitioners have a role in knowledge creation as well as knowledge implement ation.