Appreciating practice in the caring professions By Della Fish Butterworth Heinemann 288 pages £16.99

Tortuous would be the best way to describe the experience of reading this book. While aimed at a comparatively select audience of diploma or degree course students and practitioners in healthcare - especially nursing, physiotherapy and occupational therapy - the list includes managers and teachers or supervisors. It is to the latter two groups that it may well present the biggest challenge.

While certainly providing an educational approach to professional development and reflective practice, it would do any reader a power of good to turn first to the definitive book on the subject by Donald Schon, Educating the Reflective Practitioner (Jossey-Bass, 1987). Here, the author leads the reader through a variety of differing approaches among professionals and the broader perspective of others' professional practice.

An annoy ing trait in Fish's book is repeated references to her other books. One would not mind if it were only once or twice, but 10 times in the first 20 pages? Nevertheless, her earlier book, Quality Clinical Supervision in the Health Care Professions , is far more readable and a good lead into this one.

Appreciating Practice in the Caring Professions is designed to be read chronologically and not dipped into. This really sets the task, and dedication to the journey is paramount. The early chapters open up an understanding of the nature of professional practice in terms of artistry, beginning with theory, then practice and literature review; then onward to one of the main themes, the viewing of professional practice as art.

Finally, the end of the first part introduces a view of practitioner research.

Pausing at this point, the author does put forward a sound argument for the lack of appreciation of the artist within, due mainly to social mores and the needs of society for rational explanations and accountability.

Part two outlines the language of art appreciation and proposes its use in the health and education professions. Examples are discussed and paralleled.

Part three enters the realm of application, the means by which a professional could start to investigate the art of their profession and the artistry of their practice. The book concludes by synthesising this application with the language of art appreciation discussed in part two.

The author is right to say that the only people who can change practice are those who carry it out, and the role of education is particularly to change the way practitioners see their practice - this book resolutely attempts to do just that.

Peter Buckley Director of service development at St Andrew's Hospital, Northampton.