Educational reforms are attempts to transform and reconstitute conceptions of knowledge, the practice of teaching and the forms of subjectivity associated with being a teacher, pupil, and parent. We will investigate a particular aspect of the extensive changes that have swept across the landscape of Swedish education over the last decades. We will show how the grading system has come to fulfill a mediating role between progressivist educational ideas and neo-liberal notions of individual choice and entrepreneurship, by way of adjudicating and mediating educational performance for individual pupils, schools, and the education system at large. The aggregated output of the grading system is used for instrumental purposes such as performance management, quality management, and bench marking in the school system. Grading and its associated practices extend throughout the entire school system, defining success and failure from individual classrooms to the national level as the dominant form of representing school performance. The grading system was initially intended to reshape the inner workings of education in Sweden but subsequently became the "gold standard" deployed in various managerial practices. Our analysis demonstrate the performative powers when seemingly innocent techniques are put to use in public sector reforms and new worlds are made and unmade by complex constellations of seemingly mundane techniques and ideational frameworks.

BackgroundThere is a need to educate a range of professionals in caring for individuals with long-term mental disability who reside within our communities. Empathy alone is insufficient. The Kognus 4-Step Education Program was developed to achieve this goal.MethodThe program consisted of independent courses, including an 18-session basic course on psychiatric disability (on-site or online), advanced courses, and highly specialized training programs (Nidotherapy/Peer Consultation). Experts lectured together with clients with psychiatric disabilities. We first report Swedish reforms in which institutionalized patients were relocated to semi-independent individual households. We then describe the design and implementation of the education program. Approximately 50% of participants who were younger than 36years old lacked any healthcare education. The participants' backgrounds, perceptions, participation in the education program, and costs are presented.ResultsBetween 2009 and 2014, 8959 participants attended the Kognus psychiatry courses online or on-site in Stockholm (basic on-site course, n=2111; online course, n=4480; advanced courses, n=2322; highly specialized programs, n=46). A total of 73% of the participants satisfactorily attended the basic sessions on-site compared with 11% of the online participants. The developers conducted the education program for the first 3years. Thereafter, another course provider continued the program with other types of participants. The program was perceived to be equally interesting and meaningful to participants with low and high levels of education, demonstrating the generalizability of the program. The quality of the basic and advanced courses was rated as 4.4 and 4.3, respectively, on a 5-point Likert scale.ConclusionsPersonnel without appropriate education who work with people with psychiatric/intellectual disabilities can be educated in large numbers. The Kognus program represents a novel and successful way of training people who have no formal education about some essentials of good mental healthcare. Moreover, the model can be easily implemented elsewhere.

Studien belyser hur gymnasielarare retrospektivt uppfattar att de forberetts for sitt yrke under lararutbildningen. Enkatsvar fran 1554 gymnasielarare kategoriserades efter den tidsperiod da de exa ...

En professionsutbildning utmarks av en spanning mellan teoretisk kunskap och praktisk yrkeskunskap. Vi vet dock inte mycket om hur en professionsutbildning bast utformas for att forbereda studenter ...

De flesta manniskor tillbringar en stor del av sina liv med att forvarvsarbeta. Arbetet och dess egenskaper paverkar den fysiska och psykiska halsan, manniskors livskvalite och arbetsgladje. Men pe ...

In Swedish emergency departments, various initiatives have been introduced in order to reduce long waiting times for patients: lean methods, targets for waiting times related to revenues, interprofessional teams, and different forms of triage systems. This study focuses on the physicians’ views on dilemmas related to these interventions. The study is based on the interviews with 14 physicians in four emergency departments. The interviews have been analysed thematically and presented in the form of brief narratives. The study follows changes from clinical practice to national policy level. The changes appear to be ineffective or counterproductive—waiting times are rather getting longer, but the measures have a number of other effects. Decisions are taken at a central level and are carried out by means of rules, incentives, and projects and end in the medical profession being displaced from the central position they have held in the working processes of health care.

In this article we analyze public sector change as a profoundly constructed phenomenon - as performative reforms. Public sector reforms, of which policy processes are an integral part, are constituted and realized through long chains of interventions. Communicative-discursive interventions posit and constitute problems as real and important, while technocratic interventions, such as plans, analyses, and schemes construct new imagined worlds for possible and attractive instrumental solutions. Our empirical results display circular movements of three modes of change, making up a continuous policy cycle in the transformation of Swedish health, reiterated on different levels of the system, in different scales, and with different actors involved. The continuity of the reforms is to a large extent the result of a successful institutionalization of the policy cycle and its content. It is stabilized as a set of discourse and social technologies, distributed throughout the entire healthcare system and almost impossible to question.

Under manga ar har det funnits ett brett missnoje med langa vantetider pa akutmottagningarna pa svenska sjukhus. Media har skrivit mycket om detta omrade, politiker och huvudman har introducerat en ...

Physicians' work schedules are an important determinant of their own wellbeing and that of their patients. This study considers whether allowing physicians control over their work hours ameliorates the effects of demanding work schedules. A questionnaire was completed by hospital physicians regarding their work hours (exposure to long shifts, short inter-shift intervals, weekend duties, night duties, unpaid overtime; and work time control), sleep (quantity and disturbance) and wellbeing (burnout, stress and fatigue). Work time control moderated the negative impact that frequent night working had upon sleep quantity and sleep disturbance. For participants who never worked long shifts, work time control was associated with fewer short sleeps, but this was not the case for those who did work long shifts. Optimizing the balance between schedule flexibility and patient needs could enhance physicians' sleep when working the night shift, thereby reducing their levels of fatigue and enhancing patient care.

After the reform in 1962 Sweden had an educational system that mixed a certain amount of level grouping and theoretical and practical streams with social coherence in the sense that classes contain ...

I en enkatstudie undersoktes relationen mellan lakares uppfattning om kollegialt inflytande och lojalitet, protest och sorti.Stark lojalitet med organisation och chef ar 2–3 ganger vanligare bland ...

The present paper argues that recent research on public sector reforms offers few contributions to the body of knowledge on this topic because it adds little to the conclusions drawn during the first generation of research in this area. Although these later studies have often been context-specific and have explored the details of the process of change in some depth, it is rather difficult to compare their results or to make reasoned judgements of the comprehensiveness and centrality of the analysed change. Although most public sector reforms that affect hospitals, schools or social services are initiated and designed by national governments, individual case studies of local administrations often fail to capture the generic traits of nationwide reforms. However, public sector change cannot be approached as if it comprises collections of nominally independent local events. The present paper argues for two new approaches to the study of public sector change: (i) the systematic categorization of the different forms of governmental intervention under study and (ii) analysis of the ways in which these forms of intervention are linked and interact. Based on extensive empirical research, this paper suggests a generic classification of these forms of intervention that can be used in empirical research on comprehensive public sector change. Consequently, five interventions in public sector organizations are suggested, namely political intervention, intervention by laws and regulations, intervention by audit and inspection, intervention by management and intervention by rationalizing professional practice. The model is particularly well suited to the longitudinal analysis of complex public sector reforms. This approach provides a conceptual tool to distinguish between interventions based on different forms of knowledge and to investigate how they are linked to each other vertically and horizontally. We demonstrate the usefulness of the model by analysing two empirical examples of reforms in which a variety of interventions were imposed at the local level, through legislation as well as a spectrum of voluntary measures proposed by government agencies, by national associations for local and regional councils and by other national or regional actors.

Ur forordet:Detta ar en deskriptiv rapport fran CHEFiOS-projektet. CHEFiOS star for Chefskap, Halsa, Effektivitet, Forutsattningar i Offentlig Sektor. Projektet har finansierats av Vinnova, Vastra ...