The concept of "appreciative inquiry" has been around since 1980 but is gaining traction as its application is being recognized for fostering collaboration, affirming strengths, enhancing capacity, and embedding knowledge. Appreciative preceptors share stories of success and optimize strengths by cultivating orientees' unique skills and talents. While providing feedback to an orientee who has just admitted a patient for the first time, rather than pointing out that the orintee forgot to ask the patient about what he does to manage his pain at home, the preceptor may ask, "What did you do in the patient interview that was effective?" "What was the high point of your interaction with him?" "If you had the opportunity to interview him again, how do you imagine yourself being more patient centered?"

David Cooperrider, a doctoral student at Case Western Reserve University in Cleveland, Ohio, coined the term "appreciative inquiry" after listening to physicians who share their stories of amazing successes and life lesson failures. As he listened to their narratives, he was intrigued by their resounding stories of success and the optimism and positivity with which the stories were shared (Cooperrider & Srivastva, 1987).

Appreciative inquiry is both a philosophy and a methodology for positive change (Cooperrider & Whitney, 2005). It is a strength-based approach to enhance innovation and facilitate learning. By concentrating on assets and core values, individuals recognize those factors that give purpose and meaning to their work (Barrett & Fry, 2008).

There are four phases that are associated with appreciative inquiry: (a) Discovery, (b) Dream, (c) Design, and (d) Destiny. Discovery is where the inquiry takes shape as stories are solicited and collected about when the organization or an organizational process or product was performing at its very best. Collecting the life-affirming stories provides the genesis for further capacity building. The Dream phase extends to gathering the collective wisdom via stories with what is currently being done and imagining the future vividly. The Design phase bridges the best of what is with the best of what can be. This phase provides the opportunities for interested individuals to invest in the project they want to personally see become a reality as a result of their contributions. The Design phase is assembling all of the ideas, dreams, visions, and talents and bringing the ideas to life. (Cooperrider & Srivastva, 1987). The fourth phase in Cooperrrider's original work was called Delivery. It was changed to Destiny because he felt it did not go far enough in conveying the magnitude of the appreciative inquiry philosophy (Cooperrider & Whitney, 2000).

Mohr and Watkins (2002) believed that Cooperrider's model needed to start earlier in the process of acknowledging assets, so they added the Define phase. They posited that Define is the beginning of the process and establishes the focus of the inquiry.

Appreciative inquiry is predicated on five general principles:

* Constructionist: Knowledge is shaped by experiences and conversations we have with each other.

* Simultaneity: Change begins at the moment you ask the question.

* Poetic: Organizations are an open book.

* Anticipatory: A deep change results in active images of the future.

* Positive: The more positive the question, the greater and longer-lasting the change (Cooperrider & Whitney, 2005).

Asking questions is inherent to the orientation process as well as in everyday clinical practice. The type of questions that are used in assisting new nurses to transition positively to a new clinical setting should be those that create energy and hope and recognize contributions (Preskill & Catsambas, 2006). Practitioners of appreciative inquiry recognize that nursing work is focused on deficits-generating problem lists, identifying shortcomings, and recognizing disabilities. This problem orientation can impede our ability to use language and engage in thinking that is asset and strength based. The challenge is to rethink our questioning technique to promote learning and possibilities. Consider using the following questions to help yourself appreciate your learning journey, your contributions, and the contributions of others in the healthcare organization in which you work.

* What are your personal and professional goals? What factors influenced you to establish these goals for yourself? How do you know what your colleague's goals are? What specific strategies do you use to help them achieve their goals?

* Recall a mentor who was a positive influence on your career. What was it about you at that time that made you receptive to learning from this person? What characteristics of this person inspired you to become the nurse you are today?

* Reflect on your experience as a new nurse and recall a time when you felt so proud of your interaction with a patient. What made it so memorable for you?

* Think about an error that you made at work that was received with understanding and forgiveness. What were the behaviors that your colleague exhibited that helped to make it a positive learning experience?

* Think about a teacher that made a complex topic understandable. What was it about the teacher that made the concepts come alive for you?

* What aspect of your work do you value most? What makes it so rewarding for you?

* Recall one of your most outstanding achievements in your current position of which you are very proud. What makes that contribution stand out from all of others?

* Think about a clinical leader who you admire. What are the leadership qualities that resonate with you? How does this person positively impact you?

* Think about the individuals with whom you work. How do you convey gratitude for their contributions?

* Reflect on the work of your healthcare organization. What are the characteristics that make it a gratifying place to work? What are the ways it promotes learning?

* If you had three wishes for your organization, what would they be?

* Imagine that you are speaking to the public at a wellness program about the profession of nursing. Describe your three key points.

Appreciative inquiry is not a panacea for all orientation woes. It does, however, enable preceptors and educators to move in the direction of what is persistently, positively, and passionately explored.

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