Knowing, Being and Becoming a Person-Centred Nurse Leader: Findings from a Transformative Professional Development Programme
Round 1
Reviewer 1 Report
Comments and Suggestions for AuthorsThis is a very interesting, significant and well-written article. I would suggest that you explain in a few sentences what the CCCI methodology is when you first introduce it so that figure 1 makes more sense. At this point, figure 1 seems to come out of the blue. Also, it would be helpful to explain briefly what Queen Anne's leadership standards are so that selection criteria for programme participants will be more clearly understood. Also, it appears that participants may have each been assigned a coach. Is this true? If so, it would be helpful to state this when you describe the programme. In addition, I was not exactly clear what you mean by you statement that ultimately leadership depends on the attributes of the participants. Can you more clearly explain this? Attributes can mean many things.
Author Response
Comment 1: This is a very interesting, significant and well-written article.
RESPONSE: thank you, we appreciate the feedback.
Comment 2: I would suggest that you explain in a few sentences what the CCCI methodology is when you first introduce it so that figure 1 makes more sense. At this point, figure 1 seems to come out of the blue.
RESPONSE: The following sentence has been added - A CCCI methodology combines collaborative inquiry (cf Bridges and McGee 2011) with critical creativity (Titchen & McCormack 2010). Critical creativity combines being critical with being creative, i.e. integrating cognitive critique with creative practices.
Comment 3: Also, it would be helpful to explain briefly what Queen Anne's leadership standards are so that selection criteria for programme participants will be more clearly understood.
RESPONSE: We assume you mean the QNIS Excellence Profile? If so, we have added the following link to make the elements of the profile more clear - In recognition of the need to develop enhanced ‘change-making’ skills in community nurses the organisation designed a programme underpinned by the QNIS Excellence Profile which focuses on
Comment 4: Also, it appears that participants may have each been assigned a coach. Is this true? If so, it would be helpful to state this when you describe the programme.
RESPONSE: yes this is true. We have clarified the existing reference to the coaching with the following. - ... individual co-active coaching (through an individually assigned coach) ...
Comment 5: In addition, I was not exactly clear what you mean by you statement that ultimately leadership depends on the attributes of the participants. Can you more clearly explain this? Attributes can mean many things.
RESPONSE: We have read through the paper and cannot find the statement you are referring to. If you can direct us to the specific sentence, we can address it. Thank you
Reviewer 2 Report
Comments and Suggestions for AuthorsThank you for an interesting article demonstrating the ongoing nature of transformative practice and its reliance on critical self-reflection, aptly described as “journeying with self”. In addition to valuable lessons to be learnt from the development programme, participant reflections add to the post-pandemic considerations.
A few minor suggestions are presented for your consideration, as follows:
Selection of participants
In this section the selection of participants seems to relate to the development programme. If I understand correctly from Figure 1, however, the participants worked individually, in dyads and small groups during data collection. Please clarify the grouping of participants in this research either in this section or the data collection section.
Data collection and analysis
Please clarify the nature of the data e.g., written or electronic text, and briefly describe data management.
Ethical considerations
I suggest reiterating that ethical practice is embedded in collaborative inquiry where participants hold one another accountable to communal values.
Results and conclusions
Self-critique in relation to literature would be an added benefit in the discussion of the results. Having reflected on the development programme, what critical questions would the authors pose for future consideration?
Language/technical re-checking of the document could be beneficial to correct minor errors for example:
“…person-centre workplace…” (first bullet under What is known about the topic?).
“A detailed data extraction was developed…” (last sentence under Data collection and analysis).
“…the rationale being that evaluation integral to the programme.” (last line of Ethical considerations).
“the group identify…” (under Theming in Figure 1).
“…workplace.-The…” (under Results).
“e,g” (under Discussion).
Referencing is inconsistently applied in the text and in the list of references. Please correct according to the journal’s referencing guidelines.
Author Response
Thank you for your positive feedback on our paper - we appreciate it.
We have tried to address your identified minor comments below.
Comment 1: In this section the selection of participants seems to relate to the development programme. If I understand correctly from Figure 1, however, the participants worked individually, in dyads and small groups during data collection. Please clarify the grouping of participants in this research either in this section or the data collection section.
Comment 2: Please clarify the nature of the data e.g., written or electronic text, and briefly describe data management.
RESPONSE: Thank you for these comments. W have dealt with them through this one response as they are connected. We have altered the text in the whole 'Data collection and analysis' section as follows - The data collected in this project consisted of three types of data, constituting the everyday inquiry records maintained by participants – creative expressions, reflective diaries and journals, and project notes of specific discussions. These methods are described in detail in McCormack et al (2021). Throughout the programme, participants retained their own data in an ‘evidence folio’ provided by the programme leaders and were asked to bring their folio of evidence to the data analysis workshop. They were also asked to anonymise any data they wished to and redact any data they didn’t feel comofortable sharing with others. In this way, participants retained control of their data and its analysis. The analysis of data was consistent with CCCI and was conducted as a one-day workshop. Participants engaged in a cycle of creative hermeneutic analysis focusing on the key questions below.
- What impact has the programme had on your practice and workplace?
- How did the programme content enable you to deal with uncertainty, anxiety and trauma through the pandemic.
The critical creative hermeneutic process followed the steps outlined in Figure 1, which was adapted from the data analysis described in the Evaluation Framework (McCormack et al 2021). Participants worked as a whole group (all 20 participants), in small groups of 6-7 people, in dyads and as individuals as they moved through the steps of data analysis. All the data sources were revisited to provide a robust audit trail for the common themes identified through the critical creative hermeneutic process. A detailed data extraction was developed and following review of the outcomes from this process, further refinement was undertaken by the authors of this paper and a final set of themes generated as described in the results section of this paper.
Comment 3: I suggest reiterating that ethical practice is embedded in collaborative inquiry where participants hold one another accountable to communal values.
RESPONSE: We have changed the following sentence to reflect this helpful feedback - This collaborative enquiry was underpinned by a robust ethical framework that reflected the principles of person-centred research and was embedded throughout the delivery and evaluation of the programme, which, consistent with the underpinning values of collaborative inquiry and the shared values of the development programme, participants hold one another accountable for working with and adhering to these shared values.
Comment 4: Self-critique in relation to literature would be an added benefit in the discussion of the results. Having reflected on the development programme, what critical questions would the authors pose for future consideration?
RESPONSE: Thank you for this helpful comment. We have added the following text to the conclusion - This research adds to a growing body of evidence that highlights the importance of healthful workplace cultures for effective person-centred practices and staff wellbeing. However, we are conscious that the work articulated in this paper is intense and requires a high level of commitment from participants and supporting organisations. A key question in moving forward then is how we can replicate such programmes at scale and enable these transformative processes to be normalised in all leadership development programmes that have the intent of developing person-centred practitioners and cultures.
All grammatical errors have been fixed and references re-donoe in line with journal requirements.
Round 2
Reviewer 1 Report
Comments and Suggestions for AuthorsExcellent changes. The sentence about attributes of practioners was the last sentence in the abstract. I thought it was also in the body of the article but I couldnt find that.
