Well-Being on the Healthcare Frontline: A Safe Laboratory for Critical Action Learning

Abstract

This article explores the potential for using an emancipatory education model, based on the work of the Brazilian pedagogue Paulo Freire, to promote the wellbeing of frontline healthcare workers. It is argued that a three-stage PIP model (problem, information, planning), an emancipatory method used widely within trade union education programmes, can be understood as a methodology based on the principles of critical action learning (CAL) in that it adopts a critical perspective and examines power relations, explores emotional experience and is action oriented. Further, that because this model of learning is based on collective reflection it is a methodology which prioritises building relationality. This autoethnographic study offers three vignettes of wellbeing interventions carried out with healthcare workers using a PIP model. It proposes that addressing wellbeing in the current healthcare context, highlighted during the Coronavirus crisis, requires a critical and relational approach that supports healthcare workers to collectively address problems at work. As such, it is argued that the PIP model provides an alternative approach to wellbeing from the dominant and individualistic positive psychology model. This article contributes towards the utilisation of a CAL framework within the workplace and offers practical insights for management learning within the wellbeing field.

Action against inequalities: a synthesis of social justice & equity, diversity, inclusion frameworks

“…Another key concept in the Freirean TMF is critical consciousness, which serves to identify an additional cause of inequalities: under Freire's conceptualization, individuals experiencing inequalities often do not have access to knowledge which gives them vision of inequalities, and are thus further barred from opportunities to act as transformers of an inequitable society [84]. Action is positioned as central to this TMF, as Freire further expands the concept of critical consciousness into three elements of critical reflection, political self-efficacy, and critical action [85,86]. Freirean theory suggests that individuals who experience inequalities can reduce inequalities when they take action [87], which in turn rests upon a pedagogy which supports this action.…”

Algorithmic violence

“…While universities routinely offer wellbeing programmes for staff, this is dominated by a focus on positive psychology and short-term and individual interventions (Kotouza, Callard, Garnett & Rocha, 2022), supplied by contractors providing Employee Assistance Programmes (EAPs) including those provided by large online therapy and health platforms. Experience of EAPs is mixed but, in the UK, they often only offer short-term (six sessions) limited Cognitive Behavioural Therapy (CBT) placing pressure on both client and therapy practitioner to show high recovery rates, as is required across the wellbeing and short-term therapy sector (Cotton, 2021). In many cases it could be argued that trade union structures and HSE management systems, such as the HSE Stress Management system, offer a more solid basis for organisational change.…”

“…Psychoanalytic ideas allow us to think deeply about the interpersonal and unconscious aspects of bullying, including the exploration of anxieties in work, projections and social defences against anxiety within groups and organisations (Armstrong & Rustin, 2015). Psychological research includes work on the increase of bullying as a result of public sector management -mainly based on studies of performance management systems and algorithmic management in the health sector (Rizq, 2014;Cotton, 2021) This psychoanalytic model recognises the intersubjective nature of bullying where the victim is engaged in a dynamic relationship with the bully. This is where internal and often unconscious aspects of the self, such as critical voices and trauma can become activated as if an 'internal bully' (Cotton, 2017) has become enlisted in the attack.…”

Identity Work and Pedagogy: Revisiting George Herbert Mead as a Vehicle for Critical Management Education and Learning

“…It was argued that students are conscripted into the belief that they, as managers, will enjoy 'discretion or the least specificity of role prescription' while simultaneously building 'rules and rationality… into them' (ibid: 558). This value-driven criticism is the hallmark of critical approaches to teaching, as reflected in, for example, calls to reflexively challenge power differentials between teachers and students (Cunliffe & Sadler-Smith, 2015) through critical action learning (Willmott 1994;Cotton, 2020). As a result, critical forms of learning are now widely published in textbooks (e.g., Fulop & Linstead, 1999;Knights and Willmott, 2017) and through journals such as Management Learning, the Journal of Management Education and the Academy of Management Learning and Education in ways that are beginning to impact the theory and practice of Higher Education.…”