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This paper presents a research study that demonstrates the inadequacy of the traditional biomedical approach to caring for older people and shows the benefits of using a more holistic, bio‐psychosocial approach. An ethnographic inductive approach was taken. Non‐participant observation was performed on complete episodes of nursing practice, followed by semi‐structured interviews to explore and ratify theories in use. Phase one of the data analysis used qualitative inductive analysis to generate main categories and themes. Phase two was a process of factor isolation, which identified factors of practice theories in use. The themes identified were: nursing therapeutics; preventative nursing; communication; nurse‐patient relationships; collaborative nursing; nursing assessment; decision making; and management of patient care. Further analysis identified that important theoretical factors included: encouraging; responding; comforting; explaining; maintaining ability; judgement in action; and collaborating. This knowledge is embedded in the practice theories of practitioners but it is only by exploring and critiquing these that we can hope to understand the complex nature of nursing practice as it relates to the care of older people.

Patient-centred care and patient involvement are increasingly central concepts in health policy in the UK and elsewhere. However, there is little consensus regarding their definition or how to achieve “patient-centred” care in everyday practice or how to involve patients in service redesign initiatives. The purpose of this paper is to explore these issues from the perspective of key stakeholders within National Health Service (NHS) hospitals in the UK.

Semi-structured interviews, covering a range of topics related to service redesign, were conducted with 77 key stakeholders across three NHS Trusts in the West Midlands. In total, 20 of these stakeholders were re-interviewed 18 months later. Data were managed and analysed using the Framework Method.

While patient-centred care and patient involvement were regularly cited as important to the stakeholders, a gap persisted between values and reported practice. This gap is explained through close examination of the ways in which the concepts were used by stakeholders, and identifying the way in which they were adapted to fit other organisational priorities. The value placed on positive subjective experience changed to concerns about objective measurement of the patients as they move through the system.

Increased awareness and reflection on the conceptual tensions between objective processes and subjective experiences could highlight reasons why patient-centred values fail to translate into improved practice.

The paper describes and explains a previously unarticulated tension in health organisations between values and practice in patient centred care and patient involvement in service redesign.

Against a British policy backdrop, which places an ever- increasing emphasis on workplace learning in pre-service professional programmes, the purpose of this paper is to investigate the contribution of the mentor to professional knowledge development in nursing, paramedicine, social work and teaching.

Taking the form of a literature review, it explores the influence of policy, professional and theoretical conceptualisations of the mentor role, and structural factors influencing the mentor’s contribution to professional knowledge.

Where there are clearly delineated policy obligations for the mentor to “teach”, mentors are more likely to make connections between theoretical and practical knowledge. When this responsibility is absent or informal, they are inclined to attend to the development of contextual knowledge with a consequent disconnect between theory and practice. In all four professions, mentors face significant challenges, especially with regard to the conflict between supporting and assessor roles, and the need to attend to heavy contractual workloads, performance targets and mentoring roles in tandem.

The authors argue first for the need for more attention to the pedagogy of mentoring, and second for structural changes to workload allocations, career progression and mentoring education. In order to develop more coherent and interconnected professional knowledge between different domains, and the reconciliation of different perspectives, it would be useful to underpin mentoring pedagogy with Bhabba’s notion of “third space”.

The paper makes a contribution to the field since it considers new obligations incumbent on mentors to assist mentees in reconciling theoretical and practical knowledge by the consequence of policy and also takes a multi-professional perspective.

The authors' aim was to investigate mechanisms and perceptions of control following the implementation of a new “pay‐for‐performance” contract (the new General Medical Services, or GMS, contract) in general practice.

This article was based on an in‐depth qualitative case study approach in two general practices in England.

A distinction is emerging amongst ostensibly equal partners between those general practitioners conducting and those subject to surveillance. Attitudes towards the contract were largely positive, although discontent was higher in the practice which employed a more intensive surveillance regime and greater amongst nurses than doctors.

The sample was small and opportunistic. Further research is required to examine the longer‐term effects as new contractual arrangements evolve.

Increased surveillance and feedback mechanisms associated with new pay‐for‐performance schemes have the potential to constrain and shape clinical practice.

The paper highlights the emergence of new tensions within and between existing professional groupings.

This series of papers aims to explore the transition from higher education into work. It reports on research undertaken over a period of two years and which sought to track a number of young graduates as they completed their studies and embarked upon career of choice.

The approach adopted is defined and discussed as one of “common sense”. Alongside the notion of “common sense” the paper deploys two further concepts, “convention” and “faith” necessary to complete a rudimentary methodological framework. The narratives which are at the heart of the papers are built in such a way as to contain not only the most significant substantive issues raised by the graduates themselves but also the tone of voice specific to each.

Five cases are presented; the stories of five of the graduates over the course of one year. Story lines that speak of learning about the job, learning about the organisation and learning about self are identified. An uneven journey into a workplace community is evident. “Fragmentation” and “cohesion” are the constructs developed to reflect the conflicting dynamics that formed the lived experience of the transitional journeys experienced by each graduate.

Whilst the longitudinal perspective adopted overcomes some of the major difficulties inherent in studies which simply use “snap shot” data, the natural limits of the “common sense” approach restrict theoretical development. Practically speaking, however, the papers identify issues for reflection for those within higher education and the workplace concerned with developing practical interventions in the areas of graduate employability, reflective practice and initial/continuous professional development.

The series of papers offers an alternative to orthodox studies within the broader context of graduate skills and graduate employment. The papers set this debate in a more illuminating context.

The purpose of this paper is to understand the role played by tacit knowledge in marketing decision making in small and medium-sized enterprises (SMEs) and to extrapolate the ramifications, in terms of practice and theory generation.

To provide support for the existence of tacit expertise, research was framed around three key questions and in-depth interview data drawn from SME senior managers. Although limited in number, interviewees represent a range of different types of SME businesses.

In SMEs, tacit knowledge presents a reservoir of expertise that reflects the recondite characteristics of marketing decision making. Strategies in marketing were found to be about locally situated networks, intersubjective knowledge and intuitive based judgements that led to important company advantages in the market place.

Based on an analysis of the findings and despite the abstruse nature of tacit knowledge, this paper tentatively suggests ways for marketers to unravel it. The suggestion is that tacit and locally significant experience and expertise in marketing is a basis for theory and practice, with potential for dissemination.

Tacit knowledge is a notable, yet widely overlooked area of SME marketing. Highlighted here are both managerial and learning challenges in terms of better conceptualising the understanding of marketing and SME activity regarding this largely unarticulated base of practice.

Notes the increased emphasis on community care in the NHS and suggests that “informal welfare” models of delivering such care pose particular quality and quality assurance problems. Consumer satisfaction in the community context is taken to mean both user satisfaction and carer satisfaction. Presents results from a Northern Ireland study of carers. The carers interviewed drew a distinction between quality and quantity of services received. Individual services were rated highly but there was demand for more and anxiety about future needs. Personal costs of care in lost employment, relationship and financial opportunities were also indicated. Concludes that carers are a valid and useful source of quality feedback.

Evidence is presented to show that the body plays a continuing and fundamental part in the process of thinking and the development of the knowledge used to think. The conclusion is that, if this is true, then there is a crucial part of our subjective knowledge base which cannot be represented in an objectified scheme, whether for artificial intelligence (ai) or information retrieval (ir), and therefore we cannot expect to get a computer to think as a human being thinks.

Quality management methods have been introduced into health care with variable success. Industrial approaches, such as standardization, are not always applicable professional services, because of fundamental differences in conceptions of aims and the predictability of the results of action. Processes in health care can be classified into standard, routine and non‐routine depending on the level of repetition and amount of variation, variety and uncertainty. Quality problems are different in each type: standard processes may produce deviations from targets, routines errors in classification, and non‐routines failures in interpretation. Different management approaches for each type are discussed. A metaphor to assist discussion, The Broom, is introduced.