Purpose This paper aims to investigate the conditions under which learning and innovation occur within nursing homes by focusing on how the dynamics of the distribution and transformation of ideas and knowledge may be viewed as a prerequisite for innovation in both formal, planned learning situations and informal, everyday practices. Design/methodology/approach Data was produced via fieldwork, which included participant observations, conversations and research interviews with staff and managers at a Norwegian nursing home. The paper is inspired by situated learning theories and communities of practice, as the social context emerges as the site where learning and innovation are cultivated. Findings The nursing home sustains learning at the centre of its enterprise through managers’ and staff’s participation in planned learning situations and thereby highlights a focus on learning in their everyday practices. The conditions for the interplay between planned learning situations and everyday learning workplace practices are identified as the effort to create a joint enterprise and reflexive practices. Social implications The Global North is ageing. Consequently, there is an increasing need for facilities and adequately trained professionals to support an ageing population. Addressing these challenges will require an increased focus on developing supportive learning environments and furthering our knowledge about the interconnections between learning processes and innovation. Originality/value This paper contributes knowledge regarding nursing homes as professionally exciting places to work alongside conditions that allow for learning and innovation to be cultivated and thereby increase the quality of elderly healthcare services provided.
BackgroundDrop out from upper secondary school represents a risk for the future health and wellbeing of young people. Strengthening of psychosocial aspects of the learning environment may be an effective strategy to promote completion of upper secondary school. This paper is a study protocol of a school based cluster randomized controlled trial (RCT) evaluating two school-based interventions, namely the Dream School Program (DSP) and the Mental Health Support Team (MHST). The interventions aim to improve psychosocial learning environments and subsequently school achievements and decrease drop-out and absence.Methods/DesignThe COMPLETE RCT is aimed at youth in upper secondary school, grade 1 (age 15-16 years), and examines the effect of the combination of the DSP and the MHST; and the DSP only, compared with a comparison group on the following primary outcomes: student completion, presence, average grade, and self-reported mental health. Seventeen upper secondary schools from four counties in Norway were randomized to one of the three arms: 1) DSP and MHST; 2) DSP; and 3) comparison (offered DSP intervention in 2018/2019). The study will evaluate the interventions based on information from two cohorts of students (cohort 1 (C1) and cohort 2 (C2)). For C1, data was collected at baseline (August 2016), and at first follow-up seven months later. Second follow-up will be collected 19 months after baseline. For C2, data was collected at baseline (August 2017), and first and second follow-up will be collected similarly to that of C2 seven and 19 months respectively after baseline. Process evaluations based on focus groups, interviews and observation will be conducted twice (first completed spring 2017).DiscussionThe COMPLETE trial is a large study that can provide useful knowledge about what interventions might effectively improve completion of upper secondary school. Its thorough process evaluation will provide critical information about barriers and points of improvement for optimizing intervention implementation. Findings can guide school development in the perspective of improving psychosocial learning environments and subsequent completion of upper secondary schooling.Trial registrationThe trial was retrospectively registered in the ClinicalTrials.gov register on December 22.2017: NCT03382080.
In the Nordic countries, there are increasing concerns for the growing number of young people who are in neither education nor employment who are simultaneously struggling with mental health issues. These are challenges that cut across different welfare policy areas. This article is based on experiences from the youth group and the challenges they describe in their everyday lives, as well as accounts from public authorities and the welfare services in Iceland, the Faroe Islands and Norway. The article is based on qualitative interviews with 22 young people and 58 practitioners within the welfare authorities and services in Norway, Iceland and the Faroe Islands, conducted in 2014 and 2015. The authorities and service areas represented are public employment services, education, social services and health. The young people that are included in the study have in common that they have not completed (or never started) education, they have weak or no ties to the employment market and most also articulate having mental health challenges. In the article, we discuss how the services' specialized silo organizations limit their ability to attend to the complexity of problems characterizing this group. Our findings show that the authorities of the three countries only to a limited extent coordinate their policies and services to this group of young people. Those who are capable of attending to the complex needs of the youth are, rather, individual actors, so-called enthusiasts, working closely around the youth and in extensive collaboration with other services.
Schools play a central role in preventing mental health problems from affecting the development and educational opportunities of youth. While school health and social pedagogical support services have expanded in many countries, they are still not considered sufficient in meeting the needs of vulnerable youth. We find particular challenges in the development of sustainable collaboration to support the target group. In this article, we present and analyze empirical data from ongoing trailing research on an interprofessional team focusing on the health and psychosocial conditions of students in various upper secondary schools in Norway. In the article, we discuss what conditions need to be in place for inter-professional collaboration to succeed in the efforts to support students at risk of dropping out of upper secondary school. The article is theoretically influenced by boundary literature and analyzes challenges and opportunities in boundary crossing between different professions and service areas. In the article, we argue for the need to spend time on establishing a reflecting understanding of which qualities the various actors possess and what they should contribute with to create a collaboration that constitutes more than the coordination of what already exists, thereby creating intersecting practices; so-called third spaces.
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