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Professional conversations

‘Even for established professionals, groups learn together through an often asymmetric co-participation in practice. Clinical practice is littered with tales told in conversations about difficulties and disasters… which can lead to reconsideration of practice, reflection and adaptive learning by the wider audience’ (Pitts, 2007, p. 14).

Increasingly, the professional conversation is being formalised in health professions education and used as a stimulus and process for ongoing professional development. It aligns with reflective practice, enabling ‘reflection on action’ and ‘reflection for action’. The idea of ‘developmental dialogue’ is very common in educational activities such as peer review or observation, where experienced colleagues take the opportunity to engage in discussion around professional development. It is important, however, that care is taken to avoid the conversation turning into a chat between friends, a paternalistic debate or an opportunity for unfounded criticism. One of the advantages of the professional conversation is, however, that it can be relatively informal and responsive to day-to-day activities or problems that the learner is encountering.

Defining outcomes, a structure, prompt questions and a time frame helps to set clear boundaries around the conversation. A useful model around which to structure a more formal professional conversation is that identified by Launer (2002) describing narrative-based supervision in primary care – the ‘7 Cs’:


  • conversation
  • curiosity
  • contexts
  • complexity
  • creativity
  • caution
  • care.


Fundamental to this model is the idea that by encouraging story-telling, narrative and conversation in a structured way, the teacher can work with the learner to help them identify significant elements, learning points and areas for further reflection or development.

One way of structuring a professional conversation is around a significant event or critical incident.

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