Jane LaChance

December 23, 2007

I. "MY SYNTHESIS PRODUCT SHOWS THAT..."

A. I can convey who I want to influence/affect concerning what (Subject, Audience, Purpose).

I was initially motivated to explore and understand more about my subject in order to use this knowing in practice; specifically a new goal of private practice. As I read, wrote, revised and reflected in my journal as well as discussed in class, I became increasingly more aware of some confusion around my objectives. I felt stuck, uncertain and somewhat discouraged. After my synthesis instructor advised looking to stories in practice, my second reader advised looking for movement and members of my “story group” suggested writing about my patient stories, I combined this input, felt freed up and became clearer about what I wanted to convey. Although I am the primary audience, a reader outside CCT offered positive response; informative, stimulating and engaging. I believe that I achieved my goal of learning more and, in fact, I was inspired to experiment with my new knowledge which has been very exciting. I wanted to demonstrate my progress or movement through the program; beginning bias, assumptions to more creative/critical thinking; my story around the project. I chose to begin each section with my progress and in retrospect this may have been somewhat fragmented to the reader.




B. I know what others have done before, either in the form of writing or action, that informs and connects with my project, and I know what others are doing now.

I learned and know that there is an abundance of information about my topic; multidisciplinary in nature with a growing interest and use in nursing/medicine. I also connected with others’ identification of fragmented health care that is my own experience. Story/narrative is being used some practice; Dr Charon for example, is an excellent example of bringing story to medical practice. An overabundance of information proved somewhat distracting for me since I kept reading and reading. This seems to be a pattern that I am more becoming more aware of. This contributed to my less than robust theoretical underpinnings to my project.


C. I have teased out my vision, so as to expand my view of issues associated with the project, expose possible new directions, clarify direction/scope within the larger set of issues, and decide the most important direction.

I am so pleased about teasing out my vision; my thinking skills, problem solving strategy and reflective practice have transformed my personal, professional and even spiritual self. I’m happy; recognizing my certain talents, skill and strengths can be used in new ways. I’ve learned to be a better risk taker, to ask for support and to make mistakes along the way. I feel very clear on my next steps. In addition, I am energized about my storytelling; thinking about how to take “Donna’s story” on the road, audition for local storytelling festival that, in the past, I would only wish about. I don’t want to struggle with taking on too much so I will continue to evaluate and prioritize. I’m very grateful for the opportunity to have participated in CCT, able to look back to see where I’ve been and look to the future with renewed energy.


D. I have identified the premises and propositions that my project depends on, and can state counter-propositions. I have taken stock of the thinking and research I need to do to counter those counter-propositions or to revise my own propositions.

I’m clear about my values and beliefs and am finding a balance between values, beliefs and practice that requires an ongoing evaluation. I’m able to take on other perspectives so that I can remain receptive to new information and ideas that may motivate change in current premises. I need to remember this, hold emerging ideas lightly so that appropriate revisions are welcome. This has struggle potential since I can hold on tightly, resist revision and risk getting stuck.

E. I have clear objectives with respect to product, both written and practice, and process, including personal development as a reflective practitioner. I have arranged my work in a sequence (with realistic deadlines) to realize these objectives.

I have clear objectives regarding my hopes and dreams. In 2008, I will continue my exploration of current nurse case management companies in the area, prepare to sell my house in early spring, downsize to condo living, quit my full time job and work per-diem only so that I can transition to Tour Guides for Health in the fall, Demo tape completed for “Health Talk by summer with assistance for marketing local station, LANES workshop commitment by 11/2007. There is an audition in the spring for Three Apples Story Festival that I’d like to carry out. I feel optimistic. I have support and can ask for help so struggle potential limited.


F. I have gained direct information, models, and experience not readily available from other sources.

I love books and the information throughout the pages. However, I have appreciated discussion with nurses who have stepped out on their own and who are always very supportive. My interview with Dr Zarren last year was memorable with and interesting twist of questions that motivated me to look within and past discomfort. He seems to show up in the hospital hallways just at the right time; check on my progress, ask a question or two and offer support. In addition, I am participating in story groups and organizations that are a valuable source of information and support.


G. I have clarified the overall progression or argument underlying my research and the written reports.

Although I could see the overall progression of my project, my writing could have been more articulate. The underlying research could have been more elaborate. Looking back, I believed that I was in the right track. More frequent check ins as well as closer contact with my readers would have helped. However, as stated earlier, I believe that my goals were achieved.


H. My writing and other products Grab the attention of the readers/audience, Orient them, move them along in Steps, so they appreciate the Position I've led them to.

My writing has improved since my start in the CCT Program and I believe it grabbed the reader’s attention. My telling of Donna’s story was attention getting, discussion time following the story would have been helpful but, in the end, the listener hears what is needed. As stated earlier, my orientation of steps was not as clear as it should have been. One reader outside of CCT did express understanding of my progress.


I. I have facilitated new avenues of classroom, workplace, and public participation.

My practice has transformed and each day I look for avenues to elicit someone’s illness story, recognize meaning and redirect my care as appropriate, coordinate outside care as appropriate and share the story. I am a more thoughtful, compassionate and empathetic person. My long term projects will further influence workplace; caregivers, people and families.


J. To feed into my future learning and other work, I have taken stock of what has been working well and what needs changing.

Change for the future; jump into process, open to evolution, risk failure, reflect past/future changes, balance uncertainty with confidence, listen, broaden perspective, be open/receptive, be patient, find support/community. My daughter recently told me, “Mom, life is just one big revision…” It makes sense to me.

II. DEVELOPING AS A REFLECTIVE PRACTITIONER, INCLUDING TAKING INITIATIVE IN AND THROUGH RELATIONSHIPS

1. I have integrated knowledge and perspectives from CCT and other courses into my own inquiry and engagement in social and/or educational change.

All of my courses have contributed to my inquiry and engagement in change; my understanding and practice of critical and creative thinking has transformed my story; my sense of self, relationships and place in the world. One important perspective is that inquiry rather than having the “right” answer is necessary to initiate change. Indeed, the “right” answer can be an obstacle to change. This represents a major shift for me. One valuable tool that I have learned to integrate into inquiry is problem identification; to clearly identify the problem facilitates solution. As a reflective practitioner, I am able to take initiative to think critically and creatively about problems. I’m more aware of my assumptions, bias and foundations for beliefs that influence my thinking and behavior. I have improved my listening skills and am better able to suspend judgment. I am committed to seeking alternative solutions and have improved my ability to hold multiple perspectives. In addition, allowing time for pause, play and reflection generate problem solving. I have made significant changes in my nursing practice including my commitment to private practice. This is a direct result of CCT. In addition, my practice of life is renewed with new possibilities, enhanced relationships and improved communication.

2. I have also integrated into my own inquiry and engagement the processes, experiences, and struggles of previous courses.

I have new regard for the process; prior to CCT I not only wanted fast solutions but I attempted forcing solutions. I am better able to sit with uncertainty, trust that my thinking skills and problem solving strategies will reveal solutions. I can reflect, free write, brainstorm, utilize thinking strategies like SCAMPER, utilize action research process and seek support.
My experiences and struggles reflect my growth and development as well as recognition that I can succeed.




3. I have developed efficient ways to organize my time, research materials, computer access, bibliographies, etc.

I have developed improved computer skills which is very helpful. I’m better organized around research, prioritizing my time, aware of my tendency to become distracted with more information and am able to refocus more quickly. I’m more aware of my personal stall tactics for putting off writing. This is helpful as I carry out my next steps since I have significant research to carry out before I roll out Tour Guides for Health. I’m more aware of the breath of research materials which is very exciting.



4. I have experimented with new tools and experiences, even if not every one became part of my toolkit as a learner, teacher/facilitator of others, and reflective practitioner.

Experimenting with new tools and experiences has been enlightening and fun. My practice as nurse case manager has changed based on changes resulting from new information, knowledge and use of tools. For example, I scrutinized elements of my practice after learning about metacognition; thinking about thinking. Although every class offered new tools, Dialogue was a powerful experience for me that inspired me to continue inquiry and reflection. My grown up children have benefited from my experience as well since I am a better listener, suspend judgment and ask questions. We have enjoyed improved relationships.




5. I have paid attention to the emotional dimensions of undertaking my own project but have found ways to clear away distractions from other sources (present & past) and not get blocked, turning apparent obstacles into opportunities to move into unfamiliar or uncomfortable territory.

CCT has demonstrated that recognizing emotions and identifying the source of emotions is liberating, clearing the way and learning from past and present experiences. I started CCT wanting to identify my creative thread but overwhelmed at times by my uncertainty and fear of failure. There is such a sense of freedom in learning to sit with uncertainty, to allow the process to take place and recognize the possibilities. My Synthesis project has inspired several ideas that have been discussed earlier. In addition, new ideas are taking shape; for example, I wonder about collecting illness stories by interviewing individuals, constructing a story, compiling a collection for telling or possible publication.




6. I have developed peer and other horizontal relationships. I have sought support and advice from peers, and have given support and advice to them when asked for.

As a member of the CCT community, I have access to my peers and have sought advice and support. I am in communication with several of my fellow students and have established ongoing relationships. This is also a new practice for me since I have had difficulty asking for help in the past. I have come to recognize this support as essential to reflective practice.





7. I have taken the lead, not dragged my feet, in dialogue with my advisor and other readers. I didn't wait for the them to tell me how to solve an expository problem, what must be read and covered in a literature review, or what was meant by some comment I didn't understand. I didn't put off giving my writing to my advisor and other readers or avoid talking to them because I thought that they didn't see things the same way as I do.

I believe that I took the lead by regular contact early in the course. I recognized my advisor and readers as midwives who were helping me to give life to my project. My responsibility was always to carry out the necessary work and writing. Sometimes a single comment could move me significantly and other times I needed time to process what initially seemed confusing.




8. I have revised seriously, which involved responding to the comments of others. I came to see this not as bowing down to the views of others, but taking them in and working them into my own reflective inquiry until I could convey more powerfully to others what I'm about (which may have changed as a result of the reflective inquiry).

This has been the most serious work that I have completed. My revisions were always in response to readers and my commitment to convey to others in a clear, descriptive and strong manner.




9. I have inquired and negotiated about formal standards, but gone on to develop and internalize my own criteria for doing work—criteria other than jumping through hoops set by the professor so I get a good grade.

My work has been primarily for myself; I set out to identify, understand and implement how illness stories work. It has been a powerful experience for me. My standards are high and criteria disciplined. I am confident that I have the necessary skills to continue and implement my plans to reach my goals.




10. I have approached the CCT synthesis course and the CCT program as works-in-progress, which means that, instead of harboring criticisms to submit after the fact, I have found opportunities to affirm what is working well and to suggest directions for further development.

My Synthesis project represents a beginning, new direction with multiple routes. I have an improved understanding of my strengths, skills and potential obstacles. The CCT faculty has been attentive, accessible and offer helpful suggestions…midwives teaching skills, strategies, supporting and waiting for what takes shape and helping to realize this.