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HELSEVEL-V-Gode og effektive helse-, omsorgs- og velferdstjenester

Contradictory institutional logics in interaction? The interface between the education system and field of health and welfare services

Alternative title: Motsetningsfylte institusjonelle logikker? Samspillet mellom utdanningssystemet og helse- og velferdsfeltet.

Awarded: NOK 9.4 mill.

The project investigated the interface between the education system and the fields of practice (the work organizations of the health and welfare services) with a specific focus on nursing and social work. The data sources included surveys and interviews with teachers, employers and practitioners, group interviews with service users, written texts and documents such as job advertisements, textbooks and curriculums. Some findings are presented below: An analysis showed that, in the views of the services users, helpful relations occur when professionals respond rapidly and are available, capable of driving the process forward and explorative, that is, when they bring focus to the users' resources. Important were also that the professionals were knowledgeable about rules, measures and other services, that they shared their knowledge with the users, and that they were competent in interprofessional collaboration. Not only service users expected interprofessional and interorganizational collaboration. So did the national authorities and the healthcare and welfare services. An analysis of the development of new national curricula for healthcare and social service professionals (the Rethos process) showed that despite this request, the most radical proposals for interprofessional collaboration had minor impact on the final curricula. Each education were in position to shape their own curricula. Welfare educations too understand holistic approaches to the client and a focus on the client?s resources to be important professional competence. A review of 'core literature' in the curriculum of social work educations provided insight into key topics that the educations emphasised as important to act professionally and ethically in a work setting. Social workers were seen to counterbalance dark sides of the bureaucracy, whereas values associated with bureaucracy were rather invisible. The Norwegian Labour and Welfare Service has often asked for employees with 'relevant' higher education rather than specific professional educations. Our analyses showed this did not imply that professionalism was considered unimportant. Rather, frontline managers requested both knowledge, skills and professionalism from job applicants. Another analysis showed that also employers who recruit nurses and engineers requested more than mere expertise. Organisational reforms change the workplaces of health and social care professionals, and subsequently also their tasks and the work roles. The strategies and circumstances of managers, especially frontline managers, were important factors that bear an impact on the development of new professional roles and the transformation of existing professions. This was demonstrated in an analysis of social work within frontline offices of the Labour and Welfare Service. The capacity for managers to enact professional change through and together with the professionals themselves seemed to be a central requirement for managing change in public service contexts characterised by a high degree of professional work. Educating professions to health and social services under continuous reforms is demanding. An analysis of nurse teachers showed that flexibility, professional development, and professional learning were required in order to cope with the continuous changes in educational institutions as well as services. In addition, of course, the teachers needed professional nursing competencies, teaching, managerial and researching competencies as well as competencies in the application of digital technology. Analyses of the social work education showed that practice education served a central role in the development of the student?s competencies. Meanwhile, in order for the students to find placement learning to be meaningful, teachers in the educational institutions must work together with placement supervisors in integrating the teaching with learning during placement.

Prosjektet har bidratt til økt forståelse av spenninger mellom utdanningssystemet og arbeidsorganisasjonene i helse- og velferdsfeltet gjennom vitenskapelige analyser som belyser ulike interessenters perspektiver og ulike virkemidler for å forme utdanningenes praksisorientering. Prosjektet har også bidratt gjennom å legge til rette for diskusjoner mellom forskerne og ulike interessenter i feltet, ved å fasilitere dialog mellom fagfolk og brukere i velferdstjenestene, og ved å formidle kunnskapen fra prosjektet ut til aktører i feltet. Et virkemiddel har vært et Refleksjonspanel bestående av representanter for tjenestebrukerne, NAV og helsetjenestene, helse- og sosialutdannerne og studentene. Et konkret resultat har vært et samarbeid om et pedagogiske verktøy (dialogkonferanser) som kan kanalisere brukernes erfaringer inn i tjenesteutvikling. En veileder er utviklet og er åpent tilgjengelig for andre som vil ta i bruk slik metodikk for tjenesteutvikling.

This project investigates the crucial interface between the education system and the field of practice - the work organizations of the health and welfare services. The research agenda is to examine different perceptions of the required qualifications for high-quality work performance in the field of health and welfare services. The research questions are: a) How do the institutional logics of the education system and of the health and welfare services respectively, appear in their perceptions of what it means to be a 'qualified practitioner'? b) What kinds of competence do the employers in the health and welfare services request and to what degree are their requests in accordance with the views promoted from other positions in the field? c) To what degree can partnership and practice education provide a bridge between the logic of the education system and the logic of work place organisations? d) To what extent does public sector reform and reorganization of the labour and welfare service, introduce shifts in perceptions of competent social welfare practice, as seen from the perspective of service users, in the eyes of practitioners and managers within the labour and welfare services, and in curricula of social work educations? The data sources include surveys to and interviews with employers and practitioners, interviews with service users, written texts and documents such as consultation documents, job advertisements, text books and curriculums. The project is organized in collaboration between the Centre for the Study of Professions (CSP), the Work Research Institute, the Faculty of Social Science, and the Faculty of Health Science, in collaboration with a stakeholder panel of service providing organisations/employers, teachers, students and users/ civil society organization of those the health and welfare services aim to serve.

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HELSEVEL-V-Gode og effektive helse-, omsorgs- og velferdstjenester