published action research paper

Towards a Checklist for Improving Action Research Quality in Healthcare Contexts

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• Published: 21 February 2023
• Volume 36 , pages 923–934, ( 2023 )

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• Mary Casey   ORCID: orcid.org/0000-0003-3305-0074 1 ,
• David Coghlan 2 ,
• Áine Carroll 3 , 4 &
• Diarmuid Stokes 5  

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Published accounts of action research studies in healthcare frequently underreport the quality of the action research. These studies often lack the specificity and details needed to demonstrate the rationale for the selection of an action research approach and how the authors perceive the respective study to have met action research quality criteria. This lack contributes to a perception among academics, research funding agencies, clinicians and policy makers, that action research is ‘second class’ research. This article addresses the challenge of this perception by offering a bespoke checklist called a Quality Action Research Checklist (QuARC) for reporting action research studies and is based on a quality framework first published in this journal. This checklist, comprising four factors - context, quality of relationships, quality of the action research process itself and the dual outcomes, aims to encourage researchers to provide complete and transparent reporting and indirectly improve the rigor and quality of action research. In addition, the benefit of using a checklist and the challenges inherent in such application are also discussed.

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Introduction

As action research grows in popularity, it becomes increasingly important to demonstrate how successful the process and the outcome of the research has been in publications. In a scoping review on the application of action research in the field of healthcare, we sought to assess the specific use of quality criteria as agreed in a scoping protocol (Casey et al. 2021 ). In accordance with our protocol, and our professional backgrounds we searched only for studies that used the action research methodology in the healthcare context. This included any professional healthcare provider, patient or recipient of healthcare products or services involved in action research. We noted that quality of the action research was underreported, and we surmise that this may also be the case in other contexts.

We found that many studies often lacked the specificity and details needed to communicate the context, quality of relationships, quality of the action research process itself or the dual outcomes, with enough precision, accuracy and thoroughness to allow readers to assess the design, execution of the work and the contribution to actionable knowledge. In our view, this leads to a perception among academics, research funding agencies, clinicians and policy makers, that action research is ‘second class’ research and that ‘anyone with common sense’ can do it. Action research has been viewed with scepticism and criticised on the basis of being subjective, anecdotal, unscientific, and not reproducible or generalisable. Indeed, Levin ( 2003 :280) suggests “there are many powerful players in the scientific world who find action research offensive and illegitimate” and this directly relates to the lack of overt demonstration of scientific rigor or quality. This has culminated in lower priority for publication, a lack of appreciation and a dearth of action research particularly within the medical literature, in view of a perception of its limited applicability to clinical practice and limited citation counts.

In our experience, there is no doubt that a lack of adherence to reporting guidelines contributes to research waste, possibly limiting the applicability and transferability of research findings to other settings. Hence a bespoke checklist such as a Quality Action Research Checklist (QuARC) provides a framework for reporting action research studies. Developing a checklist such as QuARC is intended to promote the quality of reporting of action research studies. While we are not suggesting this checklist be mandatory, we believe that its application will lead to improved conduct, and greater recognition of action research as an acceptable scientific endeavour. As action research in healthcare becomes more established (Casey et al. 2021 ), adherence to the QuARC should be encouraged to ensure transparent reporting, in order to influence and create theory as well as delivery of care, policy and clinical practice. While there are a number of quality criteria for action research available, and this article builds on a framework first published in this journal (Coghlan & Shani 2014 ) and draws on these criteria and on the analysis of a scoping review protocol (Casey et al. 2021 ) to create a Quality Action Research Checklist (QuARC). We propose that this checklist might actually improve action research and the quality of outcomes if reported. By providing this information on action research studies, QuARC might facilitate the ongoing discussions by providing factual data on both the use of checklists, and the completeness of reporting. We encourage readers to comment on QuARC so that a more responsive and acceptable checklist may be provided.

Action research is distinguished from other forms of research by its dynamic process of changing and producing knowledge that takes place in the present tense and where the data emerges through intervention and reflection-in-action and it aims at contributing to both practice and theory. Action research may be defined as.

… an emergent inquiry process in which applied behavioural science knowledge is integrated with existing organizational knowledge and applied to address real organizational issues. It is simultaneously concerned with bringing about change in organizations, in developing self-help competencies in organizational members and in adding to scientific knowledge. Finally, it is an evolving process that is undertaken in a spirit of collaboration and co-inquiry (Coghlan & Shani 2018 : 4).

Therefore, action research has a dual intention. The action intention aims to address a practical concern of individuals, groups, organisation or communities. The research intention aims to generate practical or actionable knowledge for use beyond the immediacy of the specific situation. This combination of action and research in a single paradigm distinguishes action research philosophically from those forms of research that focus on generating knowledge only. Action research studies that are not adequately reported on all aspects such as both the action and research intentions can lead subsequent researchers to inappropriately apply the research in a different context giving rise to doubts about the scientific value of the approach.

Guidelines and checklists are an important connection between the completion of a study and the sharing of the outcomes, recommendations and conclusions with the others. As one approach, a checklist can provide a structure for the reporting and it should be brief. Formal reporting guidelines have been developed for a whole range of different study types. Some examples are the Consolidated Standards of Reporting Trials (CONSORT), or guidelines for systematic reviews Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), observational studies (STROBE) and check lists for study protocols (SPIRIT), a checklist for reporting qualitative studies (COREQ) and SQUIRE is a checklist for quality improvement studies to name but a few. Such checklists help to improve the reporting these types of study and allow a better knowledge and understanding of the design, conduct, analysis and findings of published works. Moreover, using these checklists in practice enables those who use published research to have more insight into the approach itself and therefore better able to critique published work and to decide its applicability to their local contexts. Checklists may also provide a guide for researchers during a study to enable them to keep focus and to attend to how quality dimensions are present in the design and implementation of the study.

Arising out of a recommendation from our scoping review protocol (Casey et al. 2021 ) the need for a checklist to address the quality issues of action research was apparent. In many instances the qualitative checklists such as the Consolidated Criteria for Reporting Qualitative research (COREQ), had been used and suggested for use in some instances by editorial criteria. Understandably this is in the absence of any specific action research checklist. A recent replication of the development of the COREQ (Buus and Perron 2020 ) found that it was not itself trustworthy or credible and not based on a systematic, credible and rigorous synthesis of previous checklists. The lack of formally agreed guidelines for action research is surely a contributing factor to the underreporting of the quality or the rigor in action research. An over emphasis on the part of the researchers and funders on finding a practical solution and forgetting considerations of future learning may also be an issue and finally, there is some responsibility resting with word count limits imposed by different peer-reviewed journals which might explain the suboptimal reporting in action research studies. This can be particularly problematic especially if lengthy quotations typical contribute to word count and if the detailed consideration of quality issues is parked in favour of emphasis on results, while acknowledging that some journals do create the opportunity to provide additional supplementary material. With the increasing use of open access and electronic-only publications these constraints might well reduce with time. However, regardless of the publication format used, something, such as checklist or guideline is needed to encourage researchers to address the quality of their action research studies.

The Rationale for Developing a Checklist for Action Research

As academics, researchers, editors, reviewers attempt to strengthen the knowledge base and demonstrate scientific research principles they increasingly rely on the use of well-established reporting guidelines. That said, we acknowledge there is no empirical basis that shows that the introduction of a checklist for action research studies will improve the quality of reporting of action research. However this also holds true in relation to introducing and indeed using other reporting checklists. However, research has shown that these checklists have improved the quality of reporting of some study types (Moher et al. 2001 ; Delaney et al. 2005 ). In a recent meta review study de Jong et al. ( 2021 ), found that reporting quality improved following the COREQ publication with 13 of the 32 questions showing improvement. We believe that the effect of QuARC is likely to be similar. Realising that, in contrast to most other research fields, no widely used comprehensive checklist, nor uniform and accepted requirements for publication of action research exist, we aim to design a checklist for quality in action research. QuARC is not intended to be regarded as a mandatory set of requirements. Rather, we emphasise its utility as a guide to draw the attention of the authors of action research papers about some important choices to be considered. This applies both to how research is designed and implemented, and how it is reported. This will encourage more detailed and transparent reporting and therefore help to improve the rigor and quality of action research. Moreover, we believe that the contribution of QuARC will be greatest for an author when it is consulted throughout a study, and then again when checking that the final publication sufficiently addresses research quality.

Nevertheless it can be a matter of personal proclivity as to the value of checklist and whether or not articles should be scored instead of being appraised in a descriptive way. In some instances, a checklist for action research may be seen as being reductionist and an antithesis to the whole philosophical underpinning of action research as an approach. Checklists can also be seen as an attempt to legitimize action research through the development and dissemination of a bespoke checklists mimicking influential quantitative health research, which is oriented to measurement and objectivity. According to Buus and Perron ( 2020 ) checklists can de-politicise research and create an illusion of rationality and objectivity. However, the use of a checklists might be beneficial for new or inexperienced researchers designing an action study. Checklists may guide those unfamiliar with action research with hints and directions to avoid commonly made mistakes. The same holds true for reviewers assessing an action research study for publication, particularly if the reviewer has content expertise but not methodological expertise in this area. In the context of practitioners, where action research has a growing audience, the potential impact on patient care and clinical practice demands that the strongest possible evidence is provided on whether the particular change or improvement intervention works. Hence, the dual focus of action research on action and theory generation makes the study and reporting of work in action research extremely challenging, particularly for the many “frontline” healthcare professionals who are implementing improvement programmes.

The COREQ was first published in 2007 and consists of 32 items that are mostly used for interviews and focus groups. The checklist is grouped into three domains (research team and reflexivity, study design and data analysis, and reporting), thus creating a comprehensive checklist covering the main aspects of a qualitative study design which should be reported. The Standards for Quality Improvement Reporting Excellence (SQUIRE) was first published in 2008. The current reporting quality guideline for Quality Improvement (QI) studies is SQUIRE 2.0, published in 2015, SQUIRE 2.0 is intended for any study that reports on systematic, data-driven efforts to improve the quality, safety and value of healthcare. The SQUIRE checklist consists of a checklist of 19 items that need to be considered when undertaking and writing studies of quality improvement initiatives. Most of the items in the checklist are common to all scientific reporting. As QI studies may use a variety of intervention steps, such as iterative Plan-Do-Study-Act cycles, Lean six sigma and Total Quality management, and action research steps, the SQUIRE guidelines may have been deemed appropriate. However, the applicability of SQUIRE 2.0 depends on a study’s objectives, rather than its design; namely, that the study sought to report on a systematic effort to improve the quality, safety and value of healthcare at a systems-level. Both the COREQ and SQUIRE are now included in the EQUATOR network and are required by many clinical journals for submission. Table  1 provides an outline of the main content of these two checklists.

Uses of Checklists for Designing and Evaluating Research

The purpose of a checklist for action research is to (a) help researchers to design rigorous action research studies (b) assist researchers in reporting their studies in sufficient detail, (c) assist academic and future users in evaluating the methodological rigor of a published study, and (d) assist readers in evaluating the comprehensiveness of a report of a study. From our experience and having completed a preliminary review of the literature there is a paucity of studies examining the credibility and outcomes of using checklists for planning, reporting or evaluating action research studies. Sandelowski and Barroso ( 2002 ), examined the role that checklists play, and asked a panel of very experienced qualitative researchers to review the same papers using a qualitative guide. They concluded that there was no consensus between experienced reviewers. More recently, Sandelowski ( 2015 ) suggested that reviewers do not simply apply a set of criteria, but also select and use knowledge and prior experiences when they engage with a research report. Sandelowski ( 2015 ) suggested that reviewers of quality develop a kind of intangible aesthetic appreciation of what constitutes ‘good’ or ‘bad’ research practice for different kinds of approaches. They argue that because of a reviewer’s particular knowledge and embodied perspective on research practices, knowledge from an evaluation is negotiated and situated, and procedural transparency impossible. In this context, the use of a checklist could enhance the reviewer’s attempts to provide transparency and quality. Like Sandelowski ( 2015 ) who cautioned against the idea that a checklist can be comprehensively developed to cover all aspects of quality and is more likely to result in emphasising the technical and procedural aspects of the research, it may be argued that judging rigor and quality of action research studies is essentially a subjective exercise which may only be potentially enhanced by the use of a checklist. Indeed, the use of a checklist can lead reviewers to claim levels of credibility without considering the limitations of the particular tool in use. In some ways a checklist can position scholars as more legitimate than others whilst its non-use may inhibit access to publication and prevent access to the findings being used by other researchers or policy makers while also affecting the authors research careers. In this way checklists can be a social technology where the use or non-use of the checklist helps legitimise the project and the academic work. It is important therefore to consider that checklists are not politically neutral therefore it is incumbent upon developers to bring such reflections into a more open and transparent dialogue about generation of knowledge underpinning the checklist and to invite critique and comment. This article proposes to make the development process of the QuARC checklist transparent and replicable.

Data Sources

The strategies discussed are based on our own experiences and the supporting literature on quality and rigor in action research. There are many ways to develop a checklist such as based on consensus statements from expert groups. Another way is to use Delphi techniques or systematic literature reviews and another way is to identify and amalgamate items from previous checklists into more comprehensive, consolidated ones (Buus and Perron 2020 ). This latter approach is used in this paper combined with expertise of the authors.

Developing a Quality Action Research Checklist (QuARC)

According to Hammersley ( 2007 ) items on a checklist may be operationalised as criteria or guidelines. “Criteria are standardised and observable indicators that are explained so that reviewers can use them with little error and with high inter-reviewer reliability. Using a valid list of criteria should comprehensively inform reviewers whether something is present, valid or of value” (Buus and Perron 2020 :6). This suggests that guidelines could be more loosely interpreted depending on the reviewer’s or author’s skills rather than on the application of a standardised item. There are several action research quality frameworks published in the form of discussions and suggested questions such as Eden and Huxham ( 1996 ) and Bradbury-Huang, ( 2010 ) or core factors Coghlan and Shani ( 2014 , 2018 ). We employed the latter in our scoping review protocol (Casey et al. 2021 ) as, in our view, it provides a comprehensive framework that expresses the relationships between context, quality of relationships, quality of the action process as well as concern for outcomes such as the actionability and contribution to knowledge creation. We used it again here as the basis of the QuARC.

Coghlan and Shani ( 2014 , 2018 ) present an action research framework, based on a comprehensive review, analysis and synthesis of published literature and a set of empirical field studies in a variety of organizations. It has four factors; context, quality of relationships, quality of the action research process itself and outcomes.

Context : As action research generates localised theory through localised action knowledge of context is critical. The context of the action refers to the external business, social and academic environment and to the internal local organizational/discipline environment of a given organization. Knowledge of the scholarly context of prior research in the field of the particular action proposed and to which a contribution is intended is also a prerequisite.

Quality of relationships : The quality of relationship between members and between members and researchers are paramount. Hence the relationships need to be managed through building trust, concern for the other, facilitating honest conversations, equality of influence in designing, implementing, evaluating the action and cogenerating the emergent practical knowledge.

Quality of the action research process itself : The quality of the action research process is grounded in the intertwining dual focus on both the action and the inquiry processes as they are enacted in the present tense. The inquiry process is systematic, rigorous and reflective such that it enables members of the organization to develop a deeper level understanding and meaning of a critical issue or phenomenon.

Outcomes : The dual outcomes of action research are some level of sustainability (human, social, economic, ecological) and the development of self-help and competencies out of the action. Support for social change may also generate outcomes that “foster practice and political transformation at the micro or macro levels” (Cordeiro and Soares 2018 :1016) and the creation of new knowledge from the inquiry.

These four factors comprise a comprehensive framework as they capture the core of action research and the complex cause-and-effect dynamics within each factor and between factors. They provide a unifying lens into wide variety of the reported studies in the literature, whether or not the factors are discussed explicitly and a high-level guide for the action researcher. The framework allows the distinct nature of each action research effort to emerge and it consolidates the added value of each study. It stands up to the challenges of action research values, design, implementation and evaluation, teaching and doctoral examination (Coghlan et al. 2019 ).

The Four Factors as Quality Criteria

Coghlan and Shani ( 2014 ) propose that good action research may be judged in terms of the four factors introduced above: how the context is assessed, the quality of collaborative relationships between researchers and members of the system, the quality of the action research process itself as cycles of action and reflection are enacted and how the dual outcomes reflect some level of sustainability (human, social, economic and ecological), and the creation of new knowledge from the inquiry. This article draws on these four factors to create a checklist to assist action researchers, editors and examiners to judge the quality of an action piece of work. Table  2 provides a sample of questions which may be posed to an action research account. It is intended that the questions focus attention on both action and research.

Context sets the stage for action research. By context is meant that the setting that precedes and follows an action research initiative is influencing it. It is within a context that issues/challenges/problems that action research seeks to address arise. It is said that action research is conducted on issues people care about. What people care about lies within an external and internal context. Externally, there is a global context of socio-economic inequality, poverty, famine, the displacement of peoples from their homeland, the destruction of the environment. That list is extensive. These may occur and have an effect in a local context where there are challenges for social services, education, housing, community and so on. Internally, within an organizational setting - service delivery, organising, resourcing, staffing, climate, skill development may be drivers of organizational change and of inquiry. For researchers there is an academic context to each of these in how previous researchers, particularly action researchers, have investigated the issue. Accordingly, a quality requirement of an action research initiative is how well it demonstrates its foundation in both the practical and academic contexts.

Quality of Relationships

A common action research caption/slogan is that action research is research with people, rather than on or for them. Research with is probably the most significant characteristic of action research and is created by the context. According to Cordiero and Soares ( 2018 : 1016) “democratic processes that engage participants from the beginning tend to result in more substantial changes and may improve the quality of the action research”. Therefore, within this participatory paradigm there are fundamental questions to be asked about the quality of relationship and between members and researchers. Accordingly, a quality requirement of an action research initiative is how well it demonstrates the quality of collaboration in how the project was codesigned, jointly implemented and evaluated and how the emergent practical knowledge was cogenerated.

Quality of the Action Research Process

The quality of the action research process is grounded in the intertwining dual focus on both the action and the inquiry processes and is influenced by the quality of relationships. The commonly expressed action research cycles express how the process is iterative and learning and knowledge production is emergent, that is, they emerge through the iterations of the collaborative engagement in constructing the issue, in planning, in implementing, in evaluating, in framing the learning and articulating the knowledge generated. Accordingly, reasoning is abductive as puzzles and anomalies are caught and questioned. These processes take place in the present tense, and it is through being attentive and questioning as the process unfolds that learning and knowledge emerges. The action process focuses on addressing the practical issue and may benefit from project management or change processes methods. The inquiry process is systematic, rigorous, reflective and resilient such that it enables members of the organization to develop a deeper level understanding and meaning of a critical issue or phenomenon. In this process tools of rigorous analysis from qualitative methods may be useful. Accordingly, a quality requirement of an action research initiative is how well it engages in the cycles of action and reflection as they unfolded and how the outcomes are transparent from these processes.

The dual outcomes of action research are some level of sustainability (human, social, economic, ecological) and the creation of new knowledge from the action and inquiry. What is often problematic about accounts of action research is that the action outcomes are described with the benefits to the system articulated but the contribution to knowledge for those who were not directly involved is minimised or even omitted. This is the loop back to the context. The action research initiative is a response to issues in the context – both the practical context of needed action and the academic context of practical knowledge. The dual outcomes then become part of the context for future action and research.

Implications for Research in Healthcare

As the scoping review focused on the application of action research in the field of healthcare, we reflect on the implications of QuARC for the field of healthcare, not denying its applicability to other fields. Healthcare scholars engaging in action research projects can use this checklist regularly to evaluate the quality of their research thereby assisting organisational managers in proposing workable solutions. Furthermore, these strategies allow healthcare scholars to conduct rigorous, in-depth action research without geographic limitations, providing greater possibilities for international collaborations and cross-institution research well beyond the current context.

What then might be the implications for action researchers, research supervisors and journal editors and reviewers? As a concrete way of enacting QuARC, Shani and Coghlan ( 2021 ) in a reflective review of action research in the field of business and management invited readers to engage in their own reflection on their judgements in reading accounts of action research in terms of the four factors. They posed the following questions.

With regard to the presentation of context, how might you judge that contextual data are captured in a rigorous, systematic manner so that the rationale for the action and the research is solidly grounded? How might you be satisfied that the action research builds on both the organisation’s experience and on previous research? Related to this is what we consider to be best research practice to provide a rationale or justification for the selection of the particular research approach, in this case that of action research.

Is there an explicit discussion of how the action research relationships were formed, built and sustained, with an account of enablers, obstacles and difficulties that may have arisen? Is the work evaluated in terms of the quality of the relationships? How might you judge that the quality of relationships meet a standard of collaborative endeavour that action research espouses?

Does the account demonstrate a rigorous and collaborative engagement in the action research project’s design, and subsequent enactment of cycles of planning, taking action and reflection so that the path to the organizational and theoretical outcomes are transparent? How might you weigh the action research account to your satisfaction?

Are both forms of outcomes presented? To what extent are they humanly, socially, economically and ecologically sustainable? How is organizational learning demonstrated? What actionable knowledge has been cogenerated? What are your criteria for actionable knowledge?

We invite readers of this article to pose similar questions. The strategies we are presenting are drawn from our singular experience, although they are supported by other scholars’ past efforts to conduct rigorous action research (Eden and Huxham 1996 ; Morrison and Lifford 2001 ; Bradbury-Huang 2010 , 2020 ; Casey and Coghlan 2021 ). In the future, systematic exploration of the impact of using QuARC checklist on the quality of action research inquiry would add to the growing body of literature on the quality of action research which is currently almost solely based on case exemplars. Scholars motivated to explore this topic should consider using the QuARC tool to explore their research aims and questions; this approach would allow the scholar to more clearly demonstrate the quality of their action research project work. The researcher would need to carefully document their processes and procedures, perhaps through the use of detailed methodological memos.

In this article we have made the case that in the context of a general underreporting of quality criteria in action research accounts, the provision of a checklist is of practical value. QuARC provides action researchers in nursing, midwifery and healthcare as well as research supervisors, reviewers and journal editors with a framework for assessing both the quality of a particular action research initiative and of its presented account for publication. QuARC is designed to enhance the quality of how action research initiatives are reported, which will indirectly lead to improved conduct, and greater recognition of action research as a justifiable scientific endeavour.

Data Availability

Data sharing not applicable to this article as no datasets were generated or analysed during the current study.

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Casey, M., Coghlan, D., Carroll, Á. et al. Towards a Checklist for Improving Action Research Quality in Healthcare Contexts. Syst Pract Action Res 36 , 923–934 (2023). https://doi.org/10.1007/s11213-023-09635-1

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Application of action research in the field of healthcare: a scoping review protocol

1 UCD School of Nursing, Midwifery & Health Systems, University College Dublin, Dublin 4, Ireland

David Coghlan

2 Trinity Business School, University of Dublin, Trinity College, Dublin 2, Ireland

Áine Carroll

3 School of Medicine, University College Dublin, Dublin 4, Ireland

4 National Rehabilitation Hospital, Dun Laoghaire, Co Dublin, Ireland

Diarmuid Stokes

5 The Library, University College Dublin, Dublin 4, Ireland

Kinley Roberts

Geralyn hynes.

6 School of Nursing & Midwifery, University of Dublin, Trinity College, Dublin 2, Ireland

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Version Changes

Revised. amendments from version 1.

We received feedback from two very helpful experts in the field of action research and action learning. There were a few minor changes that we made in the light of this feedback as seen hereunder. We see all action research as involving change, action, and reflection which is thus transformational and transformative in some way. We further elaborated slightly on the description of stage 5 to emphasise that there is no extant quality appraisal checklist for action research studies and that our findings will contribute to future development.  We justified our choice of action research framework on the basis that the framework by Coghlan and Shani (2018) expresses the essential relationships between context, quality of relationships, has a dual focus on the inquiry and implementation process as well as concern for the actionability and contribution to knowledge creation. These four factors comprise a comprehensive framework as they capture the core of action research and the complex cause-and-effect dynamics within each factor and between the factors. We interpret the explanatory definition of organisational context as described by Coghlan and Shani (2018) to include community healthcare context which is also seen as community care context in healthcare parlance. Therefore, our search will pick up CBPR. We have clarified that participative values are embodied within the relational component of the action research and added an additional reference. We have also justified the inclusion of a particular focus on measurement of the degree of participation as in some publications the inclusion of stakeholders in interviews and focus groups only, is taken as essentially constituting the entire spectrum of the core values of participation and inclusion of the quality of the co-researcher partnership.

Peer Review Summary

Background: Traditional research approaches are increasingly challenged in healthcare contexts as they produce abstract thinking rather than practical application. In this regard, action research is a growing area of popularity and interest, essentially because of its dual focus on theory and action. However, there is a need for action researchers not only to justify their research approach but also to demonstrate the quality of their empirical studies. Therefore, the authors set out to examine the current status of the quality of extant action research studies in healthcare to encourage improved scholarship in this area. The aim of this scoping review is to identify, explore and map the literature regarding the application of action research in either individual, group or organisational domains in any healthcare context.

Methods: The systematic scoping review will search the literature within the databases of CINAHL, PubMed and ABI/Inform within the recent five-year period to investigate the scientific evidence of the quality of action research studies in healthcare contexts. The review will be guided by Arksey and O'Malley’s five mandatory steps, which have been updated and published online by the Joanna Briggs Institute. The review will follow the PRISMA-ScR framework guidelines to ensure the standard of the methodological and reporting approaches are exemplary.

Conclusion: This paper outlines the protocol for an exploratory scoping review to systematically and comprehensively map out the evidence as to whether action research studies demonstrate explicitly how the essential factors of a comprehensive framework of action research are upheld. The review will summarise the evidence on the quality of current action research studies in healthcare. It is anticipated that the findings will inform future action researchers in designing studies to ensure the quality of the studies is upheld.

Introduction

The utility and versatility of action research has brought about an increase in the level of interest, application and usage of action research in a variety of healthcare contexts in the past 20 years as healthcare systems all over the world undergo transformative change. Part of this greater interest and usage relates to the fact that in this context of change, action research aims at both taking action in a particular system in response to particular forces, and therefore brings a change, and creating knowledge about that action that provides actionable knowledge for other health care organisations. Another possible explanation for the increased application of action research in healthcare is its participatory paradigm, which invites participants to be both embedded and reflexive in the creation of collaborative learning and of actionable knowledge where research is with, rather than on or for, people. Action research therefore attempts to link theory and practice, thinking and doing, achieving both practical and research objectives ( Casey & Coghlan, 2021 ), and therefore provides a means of improvement by narrowing the gap between researching and implementing.

A wide range of terms are used to describe action research approaches such that it is now considered as a family of approaches ( Casey et al. , 2018 ), the common approaches being appreciative inquiry, co-operative inquiry, collaborative research, participatory action research and, more recently, co-design to name a few. The action research process involves engagement in cycles of action and reflection and always involves two goals: to address a real issue and to contribute to science through the elaboration or development of theory. These are the dual imperatives of action research. The creation of actionable knowledge is the most rigorous test of knowledge creation. Action research embodies a set of principles and outlines definite steps on how to engage in the research process. These steps are cyclical and spiral in nature and iterative and some argue that two overlapping spirals of activity exist, where one spiral depicts the research activity and the other depicts the work interest ( Casey & Coghlan, 2021 ). This facilitates the researchers giving adequate consideration to their own learning and knowledge as well as to all the relevant issues prior to engaging in research activity. Thus the researchers are engaging in developmental reflexivity and adopt a critical stance on their role throughout the action research project ( Bradbury et al. , 2019 ). According to Reason & Bradbury (2008:4) action research “is a living, emergent process that cannot be predetermined but changes and develops as those who engage deepen their understanding of the issues to be addressed and develop their capacity as co-inquirers both individually and collectively’.

In one of his seminal articles on action research, Lewin (1947: 147-8) describes how action research begins and develops.

• Planned social action (intentional change) usually emerges from a more or less vague “idea”. An objective appears in the cloudy form of a dream or a wish, which can hardly be called a goal. To become real, to be able to steer action, something has to be developed which might be called a plan... It should be noted that the development of a general plan presupposes “fact-finding” … On the basis of this fact-finding the goal is somewhat altered…Accepting a plan does not mean that all further steps are fixed by a decision; only in regard to the first step should be the decision be final. After the first action is carried out, the second step should not follow automatically. Instead it should be investigated whether the effect of the first action was actually what was expected.

Keeping a regular check on how the inquiry process is unfolding and checking for the presence of any underlying assumptions with the group is essential ( Coughlan & Coghlan, 2002 ).

Participation as a core value in action research

Action research has its focus on generating solutions to practical problems and its ability to empower practitioners because of its emphasis on participation as a core strategy ( Reason, 1994 ) and implementation of action ( Meyer, 2000 ). Active participation in a research study can be more threatening than participation in the traditional designs and there are increasing calls for evidence of impact and outcome from participation and co-design ( Palmer, 2020 ). Participation in healthcare is rendered complex by the different lens through which different professional groups view and understand problems through different disciplinary lens while patients must engage with these against a hierarchical background. Participation has thus been described as a multivoiced process ( Hynes et al. , 2012 ) and embraces multiple ways of knowing-for-action ( Bradbury et al. , 2019 ). Indeed, there is an expectation that participation from participants and co-researchers increases involvement and commitment and sustainability of action research outcomes; however, the measurement of this has been inconsistent and almost absent. In some published accounts we have seen the inclusion of stakeholders in interviews and focus groups only, as essentially constituting the entire spectrum of the core values of participation and inclusion of the quality of the co-researcher partnership. Indeed, there is an expectation that participation from participants and co-researchers increases involvement and commitment and sustainability of action research outcomes; however, the measurement of this has been inconsistent and almost absent. For this reason we have opted to look at the degree of participation that is evidenced in the empirical studies using the ladder of citizen participation ( Arnstein, 1969 ), which although based on citizen participation in model cities in a department of housing and urban development, can form the basis for a more enlightened conversation about the type of participation evident in the selected studies. The ladder is organised into three major positions on citizen participation along a continuum of citizen control based on the concept of ability to exercise power. The ladder has eight rungs, with the bottom two rungs representing non-participation labelled as ‘therapy’ and ‘manipulation’. The middle section is labelled ‘degrees of tokenism’ and includes three rungs called ‘informing’, ‘consultation’ and ‘placation’ in ascending order. The higher rungs indicate three degrees of citizen power ranging from ‘partnership’ at the lower level, followed by ‘delegated power’, and ‘citizen control’ as the top rung of the ladder.

Indicating the quality of action research studies

Action researchers do not make claims “so much on the grounds of scientific rigour, as in terms of generating findings which are useful and relevant" ( Hart & Bond, 1995:13 ). Baskerville & Wood-Harper (1996:238) suggest that “where the change is successful, the evaluation must critically question whether the undertaken action, among the myriad routine and non-routine organisational actions, was the sole cause of success”. According to Waterman (1998:104) , “the validity of action research projects does not reside in their degree to effect change but in their attempt to improve people’s lives...through voluntary participation and cooperation”. According to Ellis & Kiely (2000:87) the validity of the research is based on the degree to which the research is useful and relevant in precipitating discussion about improvement. Morrison & Lilford (2001:441) suggest the search for knowledge can be considered scientific “if it leads to the development of theories that are explanatory: telling us why things happen as they do in that domain, comprehensively applying to the whole domain, and falsifiability: giving rise, via testable hypotheses, to empirical predictions whose persistent failure counts against the theory”. They conclude action research offers explanatory theories, and that these theories can be falsified. However, they attest these theories are context dependent and hence cannot be comprehensive.

Reason & Bradbury (2001) prefer to use the term quality rather than validity in action research as a means of expressing and judging rigour. They suggest the judge for quality action research be on the basis that it develops a praxis of relational knowledge and knowledge generation reflects co-operation between the researcher and participants. These authors also ask whether the research is guided by a reflexive concern for practical outcomes and whether the process of iterative reflection as part of the change process is readily apparent. Therefore, action research must acknowledge multiple realities and a plurality of knowing evident in the inclusion of various perspectives from the participants without attempting to find an agreed common perspective. The significance of the project is also an important aspect of quality criteria and whether the project results in new developments such as sustainable change. A framework that expresses these essential relationships between context, quality of relationships, has a dual focus on the inquiry and implementation process as well as concern for the actionability and contribution to knowledge creation was selected. Such a framework exists in the work of Shani & Pasmore (1985/2016) who suggest that the necessary evidence of the quality of their action research studies can be achieved by: i) demonstrating knowledge of the practical and academic context of the project; ii) creating participants as co-researchers; iii) enacting cycles of action and reflection as the project is being implemented and knowledge is being co-generated; and iv) generating outcomes that are both practical for the delivery of healthcare system in the project and robust for theory development about change in healthcare. A comprehensive framework of the action research process is presented by Coghlan & Shani (2018) in terms of four factors. These four factors comprise a comprehensive framework as they capture the core of action research and the complex cause-and-effect dynamics within each factor and between the factors.

• The context of the action research project refers to individual, organisational, environmental and research/consulting factors. Individual factors include ideas about the direction of the project and how collaboration can be assured. From an organisational perspective, the availability and use of resources influence of previous history, and the level of congruence between these impacts on the capability for participation. Environmental factors in the global and local economies provide the larger context in which action research takes place. An example of research factors which can have relevance relates to previous research experience and involvement a similar area or topic.
• The quality of relationship refers to trust, shared language, concern for each other and equality of influence between members and researchers.
• Refers to the dual focus on both the inquiry process and the implementation process as they are being undertaken.
• The dual outcomes of action research are some level of organisational improvement and learning and the creation of actionable knowledge.

These four factors will be used for the scoping review. A scoping review is the most appropriate approach to the literature as it provides an overview of studies, clarifying concepts or contextual information ( Pollack et al ., 2021 ) and it can be used to investigate research conduct ( Munn et al ., 2018 ; Tricco et al ., 2018 ). This aim of this scoping review is to explore whether action research studies demonstrate explicitly how the essential factors of a comprehensive framework of action research are upheld. This is a scoping protocol for this review. Our protocol includes information about the aims and objectives of the scoping review, inclusion and exclusion criteria, search strategy and data extraction.

The protocol for the scoping review is based on the work of Arksey & O' Malley (2005) . In addition, The Preferred Reporting Items for Systematic reviews and Meta-Analysis extension for Scoping Reviews (PRISMA-ScR) ( Tricco et al ., 2018 ) will guide the process. This reporting guideline is consistent with the JBI guidance for scoping reviews, ( Tricco et al. , 2018 ). These steps are:

• Stage 1 : Identifying the research question

Stage 2: Identifying relevant studies

Stage 3: study selection, stage 4: charting the data.

• Stage 5: Collating, summarising and reporting results

Stage 1: Identifying the research question

The review aims to identify, explore and map the literature regarding the application of action research in either individual, group or organisational domains in any healthcare context.

Objectives . To identify the degree to which the core factors of a comprehensive framework of action research ( Coghlan & Shani, 2018 ) are manifestly addressed. The following are the key objectives of the scoping review:

• 1. To identify the degree to which knowledge of the practical and academic context are addressed.
• 2. To establish how the quality of co-researcher relationships was maintained.
• 3. To determine how the quality of the enactment of cycles of action and reflection in the present tense were implemented.
• 4. To identify how the dual outcomes of co-generated actionable knowledge are addressed.

Review question . How do researchers address the core factors of a comprehensive framework of action research in healthcare?

According to Peters et al. (2020b) , a scoping review question should include elements of the PCC mnemonic (population, concept, and context) and it will also inform inclusion and exclusion criteria and consequently the literature search strategy.

• Population - healthcare professionals and patients and clients who work or come into contact with health care in any context of primary, secondary or tertiary settings
• Concept - studies that use an action research approach in healthcare contexts.
• Context - any part of health service in any country that people (healthcare professionals and patients or clients) interact with.

Inclusion and exclusion criteria . The inclusion and exclusion criteria for study selection are summarised in Table 1 .

The research team will undertake a comprehensive search of the literature within the following databases:

• CINAHL - Nursing and Allied Health (CINAHL Plus)
• PubMed – Biomedical and life sciences database
• ABI/Inform (ProQuest) – Business database

Using the three terms of population, concept, context (PCC framework) an initial search will be deployed on CINAHL Plus. This will be followed by the use of search terms to identify key text words used to address the major concepts of population (healthcare professionals and patients), concept (action research studies in healthcare), and context (any part of health service that people interact with). Alternative terms for each of the concepts will also be included. Then each search strategy will be adapted for each database (PubMed and ABI/Inform) and specific Boolean operators, truncation markers, and MeSH headings where necessary will be used. The inclusion of the expertise of a research librarian is invaluable at an early stage of completing a scoping review ( McGowan et al. , 2020 ); the research team worked with the expert university librarian in designing and refining the search strategy and will be included as part of the research team. We noted that while the data bases CINAHL and ABI/Inform claim to include the Action Research Journal, this is not the case. Therefore, we plan to do a manual search of the Action Research Journal and also of Educational Action Research for the past 5 years in keeping with the timeframe of the search strategy for this protocol. Sample search terms for the PubMed database are outlined in Table 2 .

Key search concepts . The key search concepts for this study are ‘people in healthcare’ AND ‘action research’ AND ‘healthcare environment’.

Endnote 9 will be used to manage the identified studies from the three databases. All duplicates will be removed within Endnote 9. The process of screening the titles and abstracts will be undertaken by four members of the team and non-relevant studies based on the criteria will be removed with the assistance of Rayyan (an online open access screening software tool). To resolve any conflict regarding the difference of opinion and in the ‘undecided, category, one member from the other team will chair a discussion to reach a consensus agreement. To improve reliability of the reviewers, a short training programme on the use of Rayyan will be undertaken by all the researchers and a small percentage of the studies will be screened independently by each reviewer and then a comparison will be reviewed for consistency of decision-making between the members. The full text article review will be undertaken by the same researchers using the same iterative steps, with the researchers reviewing the full texts independently.

We will do a small pilot study to test the use of the criteria and these can be modified as the researchers become more familiar with a sample of the studies to determine if further information is required of if fields are not relevant and should be removed. Data will be extracted using specified criteria and evidence from this process will be presented in table format.

Four members of the research team will be involved in extracting the data using a charting table created by the researchers within Microsoft Excel 365 software, as suggested by Joanna Briggs Institute (JBI) ( Peters et al. , 2017 ). The extracted data will be selected and mapped according to the specified inclusion of evidence of the quality of the action research study. Using the elements identified in the PCC framework as a guide, the initial fields will include:

• Citation details (authors and year of publication)
• Study title
• Geographical location of study
• Study setting/context
• Methodology/design – Type of action research
• ▪ knowledge of the practical and academic context,
• ▪ quality of co-researcher relationships,
• ▪ quality of the enactment of cycles of action and reflection in the present tense,
• ▪ the dual outcomes of co-generated actionable knowledge.
• ▪ Citizen power (citizen control, delegated power, partnership)
• ▪ Tokenism (placation, consultation, informing)
• ▪ Non-participation (therapy, manipulation)

Stage 5: Collating, summarising and reporting the results

Data will be collected using Microsoft Excel 365 software to capture relevant information for each study by the same four members of the research team and it will be available to all members via a shared drive. Studies will be mapped according to their contextual setting, geographical location, and year of publication. All authors will discuss the data prior to analysis, which will be a descriptive analysis, as recommended by Peters et al. (2020a) . A narrative tabular report will be produced summarising the extracted data concerning the objectives and scoping review question. The PRISMA-ScR guidelines will be used for reporting the outcomes of the review ( Tricco et al. , 2018 ). Quality appraisal of the studies will not be conducted as there is no extant quality appraisal check list for action research studies. This review aims to explore how the core factors of a comprehensive framework of action research are addressed in each study and our findings will contribute to future development of such a check list for the application of action research principles in action research studies in general. The review will consist of analysis of the evidence of the quality of their action research on: i) demonstrating knowledge of the practical and academic context of the project; ii) creating participants as co-researchers; iii) enacting cycles of action and reflection in the present tense as the project is being implemented and knowledge is being co-generated; and iv) generating outcomes that are both practical for the delivery of healthcare system in the project and robust for theory development about change in healthcare. Full adherence to ethical procedures in disseminating information will be undertaken by the research team. The report will be presented both orally and through publications at national and international conferences.

Study status

At the time of publication of this protocol, preliminary database searches had commenced.

This scoping review protocol has been designed in line with the latest evidence. Action research studies were carried out in diverse healthcare settings and there are many ways of undertaking action research in healthcare that consider the research purpose, aims and theoretical underpinnings. However, there is a need demonstrate the quality of the action research studies by choosing a coherent theoretical guidance provided by scholars. This will enable the transformation and impact of action research in healthcare settings to be evaluated and thereby improve the quality of action research studies in healthcare. The results extracted from this scoping review will identify how the quality element is addressed in current empirical action research studies within a recent five-year period. Based on the outcome of the review knowledge gaps and deficits will be uncovered in relation to demonstrating adherence to quality criteria when undertaking action research studies. A Quality check list for action research studies may be generated similar in format to extant reporting criteria for qualitative and quantitative studies. Findings from the review will be shared widely with healthcare personnel both locally and nationally and also through presentations and publication of the review in an open-access journal.

Data availability

[version 2; peer review: 2 approved]

Funding Statement

The author(s) declared that no grants were involved in supporting this work.

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Reviewer response for version 2

Victor friedman.

1 Action Research Center for Social Justice, Max Stern Yezreel Valley College, Emek Yezreel, Israel

The changes to the article are sufficient.

Is the study design appropriate for the research question?

Is the rationale for, and objectives of, the study clearly described?

Are sufficient details of the methods provided to allow replication by others?

Are the datasets clearly presented in a useable and accessible format?

Not applicable

Reviewer Expertise:

Action research, organisational learning, social inclusion, conflict transformation, action science, field theory

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard.

UCD Nursing, Midwifery & Health Systems, Ireland

Many thanks for your considered response that has helped us to improve our publication.

Kind Regards

Reviewer response for version 1

This paper presents a protocol for a scoping literature review of how action research in health care deals with quality. It argues for the need for such a review, which promises to provide a deeper, more nuanced, and empirically based understanding of what quality actually means in action research in the health care field. The paper reviews a small sample of the literature on quality in action research and points to a variety of criteria/factors for evaluating/generating quality. For their scoping review, the authors choose “four factors” for quality as presented by Coghlan and Shani (2018). The paper then presents the research question, the methods to be used for (1) identifying and selecting relevant studies to be reviewed, (2) charting the data, and (3) collating, summarising and reporting the results.

The paper makes a convincing argument for the need for such a scoping review and prevents a very clear, systematic, and well though-out protocol that should generate very useful and important knowledge. 

At the same time, I question the authors choice of a single, pre-existing framework for quality (Coghlan & Shani,2018). After presenting a number of varying approaches to quality, they write, “a connection that integrates their different forms of expertise and different initial frameworks is needed in order to generate a third framework of the local situation.” However, the authors do not actually explain how these frameworks are integrated within the Coghlan and Shani (2018) model. It seems to me that some things are missing or need to be developed a bit more:

•  Making a specific reference to the issues of reflection/reflexivity, which are featured in the literature reviewed earlier in the paper. These are not the same processes, though they related, and are an important component of action research.
• The Coghlan & Shani (2018) framework is very heavily oriented towards action research in organizations. Making a specific reference to the issue of “community,” which is a central domain in health care but is missing from the “Context” part of the framework. It does appear in Table 2. Regarding Table 2, I would add “Community Based (Participatory Research (CBPR or CBR)” to “Concept” (studies that use an action research approach in healthcare contexts).
•  “Participation” appears as a separate category outside of the framework. However, participation is applied implied in the Coghlan and Shani (2018) model by “equality of influence between members and researchers” in the “quality of relationships” (factor 3). How does quality of relationships differ from participation? Perhaps participation cold be incorporated into the framework or the framework crafted to reduce redundancy.
• I suggest that the authors take a look at the quality choice-points for action oriented research for transformation suggested by the (Bradbury et al, 2020), https://journals.sagepub.com/doi/full/10.1177/1476750320904562 . )

To sum up, Coghlan & Shani (2018) provides a very good foundation on which to build the integrative model, but a bit more work needs to be done to make it integrative and more comprehensive.

There are also a number of editing issues:

•  The authors write: “Therefore, a connection that integrates their different forms of expertise and different initial frameworks is needed in order to generate a third framework of the local situation.”  What is meant by “third framework”? What were the first and second frameworks? 
• The very next sentence says  “Such a frame exists”.  This confuses a bit more since “framework” and “frame” are not the same
• The authors write: “Individual factors include ideas about the direction and collaboration can be assured.”  There is something missing in this sentence. I think it should say “ideas about how the…” but that’s up to the authors
• The authors write: “From an organisational perspective, the availability and use of resources influence of previous history, and the level of congruence between these impacts on the capability for participation.” There is something missing in this sentence as well. I think there needs to be a comma: “use of resources, influence of previous history and…"
• The authors write: “Based on the outcome of the review knowledge gaps and deficits will be uncovered in relation to demonstrating adherence to quality criteria when undertaking action research studies.” I think there is a missing comma and should read: Based on the outcome of the review, knowledge gaps…

Finally, I want to raise a thought I had about the relationship between action research and academic writing that may, or may not, be relevant to this project and the protocol. Understandably, the authors exclude research that lacks “information and descriptions on the core tenets of action research”. However, as an associate editor of the Acton Research Journal and a frequent reviewer of action research papers, I am often struck by the difference between doing action research and writing about it for academic journals. Unlike normal research, which can be planned and controlled to a high degree, action research, by its very nature as a participative process, is emergent and responsive to changing situations, rarely actually occurring according to “plan.” Sometimes I read manuscripts that are based on quite interesting and high quality action research, but this research is not framed or presented in a way that meets academic standards. Writing up action research for academic journals is often a post hoc reflective process that addresses the question “What did we learn from this project? What kind of knowledge did we produce?” In my experience, many manuscripts fail because they do not adequately frame a question, connect with the relevant literature, or adequately present the data to back up their claims. All of these problems have more to with writing than with the action research itself. In this respect, I believe that this project looks not so much at the quality of action research as the quality of action research as reflected in academic writing. I am not sure how important this distinction is, if at all, but I did want to put it on the table.

I wish the authors all the best in carrying out this important study.

action research, organisational learning, social inclusion, conflict transformation, action science, field theory

I confirm that I have read this submission and believe that I have an appropriate level of expertise to confirm that it is of an acceptable scientific standard, however I have significant reservations, as outlined above.

Brendan McCormack

1 Centre for Person-Centred Practice Research, Queen Margaret University Edinburgh, Musselburgh, UK

Thanks for asking me to review this protocol. It is great to see this work happen and it is to be welcomed, as it is needed. Generally the protocol is really thorough and is very clear and should produce some good outcomes.

A couple of comments:

• The focus is interesting to me. You clearly set out what 'counts' as action research, which includes 'co-design work in healthcare' (much of which I struggle to see as research at all!) but don't include transformational and transformative research which is usually theoretically and philosophically robust. That seems odd!
• The databases to be searched don't include any educational or social science databases. Whilst I completely appreciate that health related publications in these databases are few, they are however places that health-focused action research gets published. I think these need to be included.
• The methods are clearly set out and are very thorough. However I found the stage 5 of the methods to be 'vague' and I am not completely sure what the processes are and how standardised they are. I think these could be further clarified.
• The dissemination ideas lack creativity and contemporary (non-academic publication focused) methods. These should be further considered.

Well done and I wish you luck with the project.

action research. participatory research. person-centred research. nursing and healthcare research

OPINION article

This article is part of the research topic.

Smart Sustainable Development: Exploring Innovative Solutions and Sustainable Practices for a Resilient Future

Action Learning for Change Management in Digital Transformation Provisionally Accepted

• 1 Frankfurt University of Applied Sciences, Germany

The final, formatted version of the article will be published soon.

Digital Transformation is not only a technology endeavour but affects the whole organisation, like a company or Non-Profit-Organisation (Tabrizi et al., 2019). Technologies like Artificial Intelligence, Data Science or Cloud Computing are relevant (Sebastian et al., 2017) but rather enable improvements (Pasqual et al., 2023;Vogelsang et al., 2019). Real benefits can only be achieved by a new business models or innovative products that will change the way how value is created in a company (Matt et al., 2015). As this also implies structural changes, succeeding in such a journey requires skills and competencies in conducting changes in an organisation.Education in courses on Digital Transformation at university aims to prepare students for conducting such changes within an organisation-both, from a technological but also from a management perspective. However, there are some challenges in teaching change management as the topic and the consequences of a change in a corporate environment are still quite abstract for students. While individual students managed personal changes in their life, challenges in a large organisation are hard to tell by just using words. Change projects and, therefore, a Digital Transformation for revolutionising the business model of a company, change the organisational structure, affect people and their careers and may cause uncertainty (Kotter, 2012).The paper presents a case study on applying Action Learning (AL) for simulating the situation during a change and how to facilitate a change. The objective therefore is to let students experience changes in organisations in order to develop a better understanding of the need for and how to deal with resistance from employees or stakeholders during a digital transformation. AL, an experienced-based learning method, is described as e.g. learning by doing, collaborating, sharing ideas, lifelong learning as well as reflecting on practice (Zuber-Skerrit, 2002, p. 114). It focusses on taking action on important issues or problems (Hauser et al., 2023, p. 117). In addition, it is "a framework for a group of people to learn and develop through open and trusting interaction" (Pedler et al., 2005in Hauser et al., 2023, p. 116). The basis of AL is the concept of question. By asking questions, AL becomes a social process in which a lot of people start to learn with and from each other, and a learning community comes into being (Revans, 1982, pp. 66, 69,70).As well as AL, sustainable education is a cultural shift in how education and learning is understood (Sterling, 2008, p. 65). If the method is applied in higher education, it changes the learning and teaching culture. While the main objective remains knowledge transfer, experience as well as soft skills become more important including planning and organising the own learning process. AL can be used as a method to encourage students to be more independent.An AL Project starts with a specific (real) problem without a (simple) solution at handlecturers accompany the learning. Addressing the problem that confronts participants necessitates a decisionmaking process within the group. In this project the primary objective is to make knowledge from the lecture permanently available in the students' minds and also to motivate them to learn more independently, reflect and think critically. The achievement of the objective is supposed to be determined during the oral exams at the end of the semester. The postgraduate course on Business Information Systems at the Frankfurt University of Applied Sciences (Germany) has a focus on Digital Transformation. A dedicated module on Strategic Process Management teaches methods and tools for optimising processes in the course of a transformationincluding change management. While teaching, it became clear that most students have never been subject to a significant corporate change, cannot assess the necessity for facilitating such a change and dealing with resistance from employees or stakeholders. The class was therefore running into danger to just learn words by heart (written in text books on change management) but will never understand how being part of such a change feels like. Hence, the teachers introduced one session using action learning to achieve sustainability in learning by experiencing change. The second author, who is the professor in charge, has no active role during the AL training session and is deliberately not in the room. As the examining and grading person the assumption is that it could hinder the training. The professor is therefore the Learning Process Facilitator (Robertson and Heckroodt, 2022, p. 81). The first author accompanies the process as participant and take on the role of observer. Two external facilitators guide the students through the training.This training has integrated work and learning which is the basis of AL (Maltiba andMarsick, 2008 in Cho andEgan, 2009, p. 441). The (learning) success was due to the systematic approach of this AL session as well due to the guidance of the trainers. Learning from experience does need structure otherwise it can be inefficient (Zuber-Skerrit, 2002, p. 115).A professional training company with experience in change management and personal development has been hired. Two trainers of this company prepared a curriculum on how to motivate a change and, at the same time, confronted the students with a tough situation. After the training, they had to break a wooden board with their bare hands. Being shocked by this perspective, students listened to the trainers while they talked about facilitation as well as motivation and explained everything based on breaking the board. The whole training took around five hours, and at the end, each participant broke the board with their bare hands. In the pursuit of insights, data was collected through a combination of student observations and discussions and reflective exchanges with the students. The master students were hesitant in the beginningthey were expecting a lecture and got a quite different setting: visible through a circle of chairs, flip chart instead of Power Point and two people in front who do not look familiar. The students were intimidated, unsure and initially quiet. Over the day, the students thawed out and participated. At first, they could not make the connection to their lecture. The trainers supported the students in building the bridge to change management in the work context. This guidance through the trainers was necessary. Students were encouraged to ask questions and think of examples from their professional contexts; if they did not have them, references to their personal lives or volunteer work should be made. By the end of the day, students were open, asking questions, exchanging knowledge and experience, loosened up, and having fun: As the students were also emotionally involved in the training (because of the challenge) they developed an empathic understanding on how employees feel when being subject to change. This is one of the intended results since Action Learning has a "dual mission": people development and business impact (Cho and Egan, 2009, p. 441). They were able to experience transformation and change.It was a functional decision not to include the examiner in the training, because the observer also noticed that the students were somewhat restrained and sometimes looked at her. The observer was only known to the students from greeting and she also had the feeling that this made some people feel inhibited. For this reason, the external trainers, who ensure confidentiality, were ideal. The participative observation could have influenced the students' later statements.This case study is only transferable to a limited extent, since it is very specific: it only includes postgraduate student from one degree programme who mainly have done their undergraduates at the same university. In addition, for German universities, it is a rather smaller study group (10-16 students). Another special feature is the special background of the external trainers: Business information specialists and instructors for Jiu-Jitsu which both influence the case study/training.At the end of the semester, the module was concluded with an oral exam. The second author had often experienced students here in the past who reproduced knowledge but had limited understanding of what it meant and had difficulty bringing examples. This year, things were different: the students were able to give a lively account of change management based on the training and were able to substantiate the contents of the lecture with practical examples. The primary objective, as stated previously, can be seen as achieved as almost all students were able to reflect on the challenges with changes. One student struggled explaining reasons for resistance against changes in a company in the oral exam and just repeated words from the lecture slides. In this case the professor switched back to the role as a learning companion and encouraged the student to reflect on how they felt while being confronted with the wooden board challenge. Now the technical knowledge was connected to the emotional side and struggles with changes were explained in a livelier way.Action Learning as an innovative teaching method not only have advantages but also disadvantages in higher education settings. The following disadvantages and how we have tried to mitigate them should be mentioned: Applying AL is time consuming, and it has to fit in the university's schedule. We met this challenge through early and transparent (semester) planning. For AL, they were scheduled for a whole day and the session took longer than the usual lecture and exercise slot in the timetable. To counter this, the lecture room showed by a different seating (seating circle), which suggested a different teaching method, it was the day with excess length, and the integration of external facilitators made it clear that today is not a normal lecture.The case study makes the authors quite optimistic that Action Learning could be integrated in the curriculum to gain more time for the implementation and to enable a sustainable learning effect. Notably, certain factors have emerged as influential in promoting success in our case: the necessity of implementing AL in smaller group settings, the acquisition of external facilitators, the proactive scheduling of additional time slots within the semester plan, and the clear, advance communication of these schedule adjustments to enable students to align their plans accordingly. Importantly, there was an active expression of interest from some students for more sessions of this nature. In future, we are also planning to try out shorter formats to test whether AL could also be implemented in a regular course, i.e. 90 minutes.

Keywords: Action Learning, Change Management, higher education, Teaching, digital transformation

Received: 21 Feb 2024; Accepted: 11 Apr 2024.

Copyright: © 2024 Ruhland and Jung. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Mx. Anja Ruhland, Frankfurt University of Applied Sciences, Frankfurt, Germany

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Title: realm: reference resolution as language modeling.

Abstract: Reference resolution is an important problem, one that is essential to understand and successfully handle context of different kinds. This context includes both previous turns and context that pertains to non-conversational entities, such as entities on the user's screen or those running in the background. While LLMs have been shown to be extremely powerful for a variety of tasks, their use in reference resolution, particularly for non-conversational entities, remains underutilized. This paper demonstrates how LLMs can be used to create an extremely effective system to resolve references of various types, by showing how reference resolution can be converted into a language modeling problem, despite involving forms of entities like those on screen that are not traditionally conducive to being reduced to a text-only modality. We demonstrate large improvements over an existing system with similar functionality across different types of references, with our smallest model obtaining absolute gains of over 5% for on-screen references. We also benchmark against GPT-3.5 and GPT-4, with our smallest model achieving performance comparable to that of GPT-4, and our larger models substantially outperforming it.

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