Chapter 8 Mentoring Institutional Change: Intergenerational Construction of Meso-structure and the Emergence of New Logics in American Healthcare

Abstract

The emergence of an evidence-based medicine logic represents a major change in the large and complex field of American healthcare. In this analytical case study, we show that the intellectual school of evidence-based medicine became an important meso-structure that facilitated the growth of the new logic in American healthcare. The new intellectual school was a community of scholars who generated shared rules and resources through intergenerational mentoring. The school engaged in advocacy to advance new intellectual paradigms for conceptualizing healthcare quality that, when connected with material practices in the field of American healthcare, came to form a new institutional logic.

Understanding the unobserved influences on the careers of ethnic minority women: implications for human resource management

“…This study's examination of professional BAME women's careers considers whether other scripts beyond what we call the traditional 'P-O fit career script' can help understand and explain their trajectories and outcomes. In line with Andresen et al's approach, we identify alongside career scripts another career mesostructure that serves as an intermediate level structure that guides and channels interactions that in turn can shape less proximate structures (Dokko et al, 2019), namely reference groups. As Grote and Hall (2013, p. 270) state: reference groups are "powerful in shaping individuals' interpretations of and actions in the world, thereby connecting the individual with social systems."…”