Claire MacRae, PhD student, University of Edinburgh Supervisors: Dr Derek Jones, University of Edinburgh Dr Terese Stenfors, Karolinska Institutet
MACRO: Institutional & regulatory context MESO: Organisation “The problem” MICRO: employees Wider social, cultural & political context
Institutional & regulatory context CASE STUDY: ‘What medical CONFIGURATIONAL schools do’ ANALYSIS CRITICAL DISCOURSE ‘What medical Phenomenon schools say’ ANALYSIS of interest CASE STUDY: ‘What teachers AGENTIAL think / say /do’ CASE STUDY: ANALYSIS FIELD ANALYSIS Wider social, cultural & political context
Institutional & regulatory context ‘What medical schools do’ ‘What medical Value of clinical schools say’ teaching ‘What teachers think / say /do’ Wider social, cultural & political context
“New management “New Management Increasing regulation of Ideology” ideology” higher education Faculty development Increasing regulation of medical profession “Austerity” Cascading Teaching Extensive use of communication awards ‘implied contracts’ Increased service Resource pressures Loss of agency constraints Administration Population Measurable demographics outputs Prioritization Reduced of patient care autonomy Changing curricula ‘Public Service Values’ Implied Backgrounding Increased contracts teaching Healthcare valued accountability more highly than education Teachers do not feel recognised or valued “Consumer culture” www.smerc.co.uk
“New “New management Management Increasing regulation of Ideology” ideology” higher education “Austerity” Faculty development Decreased Increasing regulation of education medical profession Cascading Teaching funding Extensive use of communication awards ‘implied contracts’ Increased service pressures “ deagentialisation ” Increased healthcare Administration Measurable Population funding outputs demographics Imperatives Changing curricula ‘Public Service Values’ Implied Backgrounding contracts teaching Increased Healthcare valued accountability more highly than Teachers do not feel education recognised or valued “Consumer culture” www.smerc.co.uk
“New management “New Management Increasing regulation of Ideology” “Those who ideology” higher education “Austerity” Faculty can do; those development Decreased Increasing regulation of who can’t…” education medical profession Cascading Teaching funding Extensive use of communication awards ‘implied contracts’ Increased service pressures “ deagentialisation ” Increased Prioritization healthcare Administration of patient care Measurable Population funding outputs demographics Imperatives Doctors paid Prioritization Changing more than of patient care curricula ‘Public Service teachers Values’ Implied Backgrounding contracts teaching Increased Healthcare valued accountability more highly than Teachers do not feel education recognised or valued “Consumer culture” www.smerc.co.uk
“New “New “New management “New management “Those who can do; Management Management Increasing regulation of Increasing regulation of those who can’t…” Ideology” Ideology” ideology” ideology” higher education higher education Faculty development Increasing regulation of Increasing regulation of Decreased medical profession medical profession “Austerity” “Austerity” education Cascading Teaching funding Extensive use of communication awards ‘implied contracts’ Increased service Increased service Resource Resource pressures pressures Loss of agency constraints constraints Administration Population demographics Population demographics Measurable outputs Prioritization of patient care Reduced Prioritization of Increased healthcare patient care autonomy Changing curricula Changing curricula funding ‘Public Service Values’ Doctors paid more than teachers Implied Backgrounding Increased Increased contracts teaching Healthcare valued more highly than accountability accountability education Teachers do not feel Teachers do not feel recognised or valued recognised or valued “Consumer culture” “Consumer culture” www.smerc.co.uk
“New “New “New management “New management “Those who can do; Management Management Increasing regulation of Increasing regulation of those who can’t…” Ideology” Ideology” ideology” ideology” higher education higher education Faculty development Increasing regulation of Increasing regulation of Decreased medical profession medical profession “Austerity” “Austerity” education Cascading Teaching funding Extensive use of communication awards ‘implied contracts’ Increased service Increased service Resource Resource pressures pressures Loss of agency constraints constraints Administration Population demographics Population demographics Measurable outputs Prioritization of patient care Reduced Prioritization of Increased healthcare patient care autonomy Changing curricula Changing curricula funding ‘Public Service Values’ Doctors paid more than teachers Implied Backgrounding Increased Increased contracts teaching Healthcare valued more highly than accountability accountability education Teachers do not feel Teachers do not feel recognised or valued recognised or valued “Consumer culture” “Consumer culture” www.smerc.co.uk
“New management ideology” “New management ideology” “Those who can do; “Those who can do; Increasing regulation Increasing regulation those who can’t…” those who can’t…” of higher education of higher education Faculty development Increasing regulation Increasing regulation of medical profession of medical profession “Austerity” “Austerity” Decreased Decreased education education Cascading Teaching Teaching funding funding Extensive use of communication awards awards ‘implied contracts’ Increased Increased Resource constraints Resource constraints service service Loss of agency pressures pressures Administration Administration Population Population Measurable Measurable demographics demographics Prioritization of outputs outputs Prioritization of patient care patient care Reduced (organisation) Prioritization of Prioritization of Increased healthcare Increased healthcare patient care patient care autonomy Changing curricula Changing curricula Changing curricula Changing curricula funding funding (individual) ‘Public Service Values’ Doctors paid more than Doctors paid more than teachers teachers Implied Backgrounding Increased accountability Increased accountability contracts teaching Healthcare valued Healthcare valued more highly than more highly than education education Teachers do not feel Teachers do not feel Teachers do not feel Teachers do not feel “Consumer culture” “Consumer culture” recognised or valued recognised or valued recognised or valued recognised or valued www.smerc.co.uk
“New management ideology” “New management ideology” “Those who can do; “Those who can do; Increasing regulation Increasing regulation those who can’t…” those who can’t…” of higher education of higher education Programme Faculty development director Increasing regulation Increasing regulation of medical profession of medical profession “Austerity” “Austerity” Decreased Decreased education education Administrative Cascading Teaching Teaching funding funding team Extensive use of communication awards awards ‘implied contracts’ Increased Increased Resource constraints Resource constraints service service Loss of agency pressures pressures Module lead Module lead 1 Module lead2 Module lead 3 30 Administration Administration Population Population Measurable Measurable demographics demographics Prioritization of outputs outputs Prioritization of patient care patient care Clinical Clinical Reduced (organisation) Prioritization of Prioritization of teacher teacher Increased healthcare Increased healthcare patient care patient care autonomy Changing curricula Changing curricula Changing curricula Changing curricula funding funding (individual) ‘Public Service Values’ Doctors paid more than Doctors paid more than Clinical Clinical teachers teachers Implied Backgrounding teacher teacher Increased accountability Increased accountability contracts teaching Healthcare valued Healthcare valued more highly than more highly than education education Clinical Teachers do not feel Teachers do not feel Teachers do not feel Teachers do not feel teacher “Consumer culture” “Consumer culture” recognised or valued recognised or valued recognised or valued recognised or valued www.smerc.co.uk
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