‘Our surgeons want this to be short and simple’: practices of in-hospital medication review as coordinated sociomaterial actions

ABSTRACT

Medication review, a systematic assessment of a patient’s medicines by a health care professional, is intended to prevent medication-related harms. A critical element of medication review concerns whether medication review is conducted in a coordinated way. This article draws from a case example of implementing medication review in two surgical wards of a Swedish regional hospital and aims to analyse how medication review is being accomplished with respect to the coordination of its actions. Using a practice-based ethnographic approach, we present several coordination mechanisms by illustrating how practices are connected to materials involved in medication review. Also, we show how common orientations, ends, and understandings expressed in different medication review practices contribute to the coordination of the practices. In conclusion, this article highlights the complexity of establishing and sustaining medication review as a coordinated practice in routine health care. By closely examining sociomaterial connections, this article sheds new light on the neglected issue of artefacts and arrangements in constituting and transforming a highly complex medication practice.     

The two faces of political science studies—junior and senior students’ thoughts about their education and their future profession

The article reports on an empirical small scaled interview study among junior and senior students in the political science programme in a Swedish University. The aim is to describe how students at various stages of their studies conceive of their education as well as their future professional life. Questions about their identity as students have also been posed. The results indicate that a programme with a major emphasis on political science appears to have two different faces as experienced by the students. The first half of the programme is experienced as traditional liberal arts studies, i.e., the students enrol in a ‘personal bildung project’ and conceive of political scientists as a kind of watchdog for democracy. Students in the latter part of their studies report an emerging identity as investigators and civil servants and an appreciation of the parts of the studies that enhance their generic skills.     

A winding road – professional trajectories from higher education to working life: a case study of political science and psychology graduates

This qualitative and longitudinal study focuses on graduate employment and the development of graduate employment paths. The aim of this article is to explore the present professional trajectory from higher education to working life, with particular reference to graduates from two different study programmes at Linköping University in Sweden: Political Science and Psychology. More specifically, the article focuses on how graduates construe their professional trajectories in terms of their envisaged future work as senior students, and later as novice and early-career professionals with 18 and 34 months of work life experience. The results indicate that graduates’ professional identities and vision of their future work change over time. The set of categories, depicting the graduates’ vision and experiences of their professional trajectories, do not seem to follow a specific temporal and logical progression in their career. Rather, they appear in different order and at different points in time after graduation. The results, instead, endorse the discourse of lifelong learning and the need for flexibility and employability on the labour market.     

Creating a ‘world class’ programme: reciprocity and constraint in networked global collaboration

The article reflects on the construction of a common Master’s programme across four universities located on four continents, in order to explore the role of networks in international educational collaboration. The study draws on the documented processes of the principal members of the programme team. It is presented as a case study of the development of the programme that uses ideas drawn from actor‐network theory to draw attention to the conjunction of human and non‐human actors that shaped the resulting web‐based courses. Constraints arising from major institutional and systemic obstacles were addressed through the effects of the actor‐network. The reciprocity of action and de‐centring of individual activity made possible through the collaboration enabled the human actors to sustain a level of innovation within their own institutions that would not have been possible through them acting alone.     

Questioning to learn and learning to question: Structure and function of problem-based learning scenarios in environmental science education

In problem-based learning, scenarios relating to real life areused as a point of departure for the learning process. Eventhough the importance of suitable cases or scenarios in bringingabout a fruitful learning process is emphasised in theliterature, few studies focus on how they actually function inthe learning process. This study focuses on how the scenariosused in a ten-week introductory course of a new four-yearundergraduate programme in environmental science functioned interms of the structure and content of the questions they evoked.Data were gathered through diary notes from nine groups ofstudents, comprising 5–8 students per group. The data weresubjected to a qualitative analysis aimed at describing thestructure and content of the questions generated by the groups.Five different kinds of questions were identified and labelled;encyclopaedic, meaning-oriented, relational,value-oriented and solution-oriented. All scenarios generated questions pertaining to all five categories in all groups, butthe emphasis varied. The results are discussed in relation to thedesign of scenarios, and in relation to students' approaches tolearning.     

PBL from the teachers' perspective

The background of the project Problem Based Learning in Environmental Sciences' was a dissatisfaction with the lack of inspiring connections between current research and undergraduate education. The PBL approach was adopted in order to raise the level of activity in undergraduate learning. Another reason was the emphasis on problem orientation in PBL which includes an important proportion of interdisciplinarity in finding appropriate solutions to environmental problems. The aim of this study was to evaluate the implementation of PBL in environmental education from the teachers' perspective. Seven teachers were interviewed. The interviews were transcribed and subject to a qualitative analysis. The teachers were in general positive to continue to work with the PBL program. They appreciated the closer contact with the students. Difficulties experienced comprise a lack of consensus amongst the teachers and lack of time for discussion and planning during the project. The teachers conceived of the essence of PBL either from a learning perspective or a teaching perspective. Characteristic of the learning perspective is a focus on the students' learning process, while in the teaching perspective focus is on the methodological teaching aspects of PBL. There were also two different perspectives on the teacher's role as a tutor in PBL, that are categorised either as a supportive role or a directive role. Characteristic of the supportive role is an integrated view of the tutors' role. The students' activity, responsibility and influence on the education was emphasised. The supportive tutor's role was mainly focusing the group process. The directive tutor's role were characterised by a restricted view or uncertainty of the teacher's role in PBL. The different ways of conceiving PBL may explain some of the experienced difficulties amongst the teachers.     

Conceptions of mentoring: An empirical study of conceptions of mentoring during the school-based teacher education

This article discusses the mentoring given by the mentor (cooperating teacher) during the practical part of teacher training. This mentoring is empirically described by studying and describing how it is conceived of by a group of mentors and student teachers. The differences in conceptions found concerning the functions are discussed in terms of a reflecting and a taken-for-granted perspective of professional knowledge of teachers. As regards conceptions of the content, it is discussed whether student teachers' practice teaching is an object of reflection or an occasion for practice. Conceptions and patterns of behaviour as regards the form of mentoring are discussed in terms of a principle-oriented strategy and an episode-oriented strategy. The variation described in this way in terms of the disparate perspectives could reflect different types of theoretical awareness of the phenomenon of mentoring that exist among mentors and student teachers.