Donna Frost

Chapter 1 24 competency of professionals who act within them. In many practice situations the professional cannot simply apply rules or theory as one would when faced with a predictable or easily managed problem. Instead, in the messy world of practice, complex ontological processes of problem setting and problem framing come into play, inwhich practitioners determinewhat theywill pay attention to in their decision making and interventions, and what they will ignore. In other words, they recognise the salient features of a practice challenge and frame them in a particular context, enabling them to take effective and economic action. Schön ( 1983 , 1987 , 2001 ) argues, therefore, for an alternative epistemology of practice; one which recognises the knowledge embedded in the artistic and intuitive processes he identifies in the practice of particularly competent professionals. Schön terms his alternative view of professional practice professional artistry. What is known about professional artistry? Support for the idea that nurses and other professionals use artistic and creative processes to enable this kind of practice has been found in both scholarly work (e.g. Fish, 1998 ; Titchen & Higgs, 2001 a; Whiteford, 2007 ; Finfgeld-Connett, 2008 a) and empirical research (eg. McIntosh, 1996 ; Titchen, 2000 ; Osterman, 2002 ; Manley, Hardy, Titchen, Garbett & McCormack, 2005 ; Austen, 2010 ). Flynn, Sandaker and Ballangrud ( 2017 ) for example argue that the development of excellence in the clinical practice of nurse anaesthetists, and even a safe level of competence, is not possible without paying attention to the non-technical skills as well as the technical aspects of anaesthesia practice. They refer to situation awareness, decision making, team working, managing varying tasks simultaneously and responsiveness to a changing situation. Recognising professional artistry in the practice of others is often not difficult. It is ‘inherent in the practice of professionals we recognise as unusually competent’ (Schön, 1987 , p. 13 ). Professional artistry is ‘at the heart of the kind of professional practice that is acknowledged to be outstanding and towhichwe all aspire’ (Beeston & Higgs, 2001 , p. 108 ). Nevertheless, describing the essence of professional artistry, in ways that are easily comprehended and can be learnt from by self and others, is challenging. Much of the complexity rests in the idea that the knowledge and ways of knowing used when demonstrating professional artistry are tacit or embodied, and therefore hidden from cognitive awareness. So we find that nurses who have a particular way of being with patients, as related for example in narrative accounts of especially skilled or beautiful practice (eg. Mysko, 2005 ; Gramling, 2006 ), are often presented as ‘just having’ a particular quality which makes their practice stand out