Teaching and Learning in the Health Professions By David Kember et al Blackwell Science 192 Pages£16. 99 For those coming to ideas of reflective practice and action research for the first time, this book provides an excellent starting point.

Indeed, it does considerably more than that, providing an exploration of some of the issues involved in establishing coherent links between theory and practice.

The book's aim is 'to enable students in the health professions to combine the theory aspect of their courses with the professional practice element by encouraging them to adopt reflective practice'.

The authors, a group of academics at Hong Kong Polytechnic University, approach their task through action research into the planning, delivery and evaluation of five courses run for various healthcare professions - post-experience nurses, clinical educators, physiotherapists, occupational therapists and radiographers.

In each case there are useful illustrations of the problems of achieving and maintaining a culture in which students feel comfortable reflecting on their progress. A specific example of this is the tension that emerges when deciding whether what students write in their reflective journals should be assessed by the tutors. If the journals are for the students' eyes only, with no assessment or tutor feedback taking place, students tend to think that the journal is not an important part of the course. On the other hand, if the journal is to be assessed, the students might be less than completely open in disclosing their thoughts about their progress. In this dilemma the tutors decided on a compromise position - that some measure of disclosure was necessary. Students were therefore required to disclose at least one extract from their journal, allowing other parts to enjoy a greater degree of confidentiality. This illustrates how the tutors sought to deal with 'messy' problems in Schon's 'swampy lowlands' of ill-defined problems, which become apparent when one reflects on one's practice. The book thus concerns reflective practice by both students and tutors.

I found the action research approach of the book - with its emphasis on cycles of planning, action, observation and reflection - appropriate, though, inevitably, those of a more positivist bent are likely to have difficulty in empathising with what they would see as the 'subjective' elements of the approach, such as discussions about the affective outcomes of reflective practice.

The theoretical ideas in the book are clearly summarised and effectively used in analysing the very practical tasks of planning and delivering higher education courses for health care professions.

Paul Thomas Independent lecturer, researcher and consultant in management & policy evaluation.