Developing a Learning Environment in Prison Health Care

This paper reports on a two year project, undertaken between 2008 and 2010 across three male prisons, two of which were adult and one young offender institution. Principles of action research and appreciative inquiry were adopted to work with action learning groups across all three prisons to support the implementation of clinical supervision, undertake a training needs analysis, develop research capacity, and support practice development initiatives identified by staff. We focus on two of these activities with the overarching aim of discussing the development of prison health care as a learning environment. We identify a framework for developing practice in prison health care which has reflection on practice at its core. We note that key to developing prison health care settings as environments for learning is the provision of time, effective leadership at all levels in the team, and effective reflection on practice that is supported through formal structures such as clinical supervision, action learning groups and informal activity amongst peers. Key importance from this work is the understanding that developing practice in the prison setting, where custodial cultures and practices can overshadow care, is a long term endeavour and requires patience and understanding of both context and culture.