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Puaca, Goran
Publications (10 of 27) Show all publications
Andersson, U., Maurin Söderholm, H., Andersson, H., Wireklint Sundström, B., Andersson Hagiwara, M. & Puaca, G. (2023). Organizational factors influencing clinical reasoning in a Swedish emergency medical service organization: An explorative qualitative case study. Paramedicine
Open this publication in new window or tab >>Organizational factors influencing clinical reasoning in a Swedish emergency medical service organization: An explorative qualitative case study
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2023 (English)In: Paramedicine, ISSN 2753-6386Article in journal (Refereed) Published
Abstract [en]

Introduction

Clinical reasoning (CR) among healthcare professionals working in emergency medical services (EMS) who focus on ambulance care is a vital part of ensuring timely and safe patient care. The EMS environment continually fluctuates, so clinicians constantly need to adapt to new situations. Organizational support is described as important for CR, but overall, research on organizational influences for CR in an EMS context is lacking. An increased understanding of these influencing factors can assist in the development of EMS by strengthening CR among clinicians. Therefore, the purpose of this study was to investigate the organizational factors influencing EMS clinicians’ CR.

Methods

Using a qualitative single case study design, an EMS organization in southwestern Sweden was explored. Data were collected from participant observations of patient encounters, individual and group interviews with clinicians and organizational representatives, and organizational document audits. Data were analyzed using qualitative content analysis and triangulation of data sources.

Results

The results revealed several organizational influencing factors. Collaboration and information sharing internally and externally were emphasized as essential components influencing CR. Additionally, the structure for the clinicians’ ‘room for action’ appeared confused and created uncertainties for CR related to decision mandates.

Conclusion

The conclusion is that organizational factors do play an important role in clinicians’ CR. Moreover, the EMS community needs to develop suitable forums for discussing and developing these influencing factors across organizational hierarchies. Finally, clarification is needed on clinicians’ ‘room for action’ within their own organization but also with possible collaborators.

 

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
health and well-being, qualitative analysis and interpretation, clinical reasoning, decision making, emergency medicalservices, work and healthcare environment
National Category
Nursing
Research subject
The Human Perspective in Care
Identifiers
urn:nbn:se:hb:diva-30241 (URN)10.1177/27536386231189011 (DOI)2-s2.0-85175415486 (Scopus ID)
Available from: 2023-08-11 Created: 2023-08-11 Last updated: 2024-02-01Bibliographically approved
Puaca, G. (2022). Institutional autonomy, managerialism and the conditions for academic freedom in Swedish higher education. In: Richard Watermeyer, Rille Raaper, Mark Olssen (Ed.), Handbook on academic freedom: (pp. 106-125). Cheltenham: Edward Elgar Publishing
Open this publication in new window or tab >>Institutional autonomy, managerialism and the conditions for academic freedom in Swedish higher education
2022 (English)In: Handbook on academic freedom / [ed] Richard Watermeyer, Rille Raaper, Mark Olssen, Cheltenham: Edward Elgar Publishing, 2022, p. 106-125-Chapter in book (Refereed)
Place, publisher, year, edition, pages
Cheltenham: Edward Elgar Publishing, 2022
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Identifiers
urn:nbn:se:hb:diva-29198 (URN)9781788975919 (DOI)9781788975902 (ISBN)
Available from: 2023-01-10 Created: 2023-01-10 Last updated: 2023-01-17Bibliographically approved
Puaca, G. (2022). Managerialism and Higher Education. In: Alpesh Maisuria (Ed.), Critical Understanding in Education: Volume: 3. Brill Academic Publishers
Open this publication in new window or tab >>Managerialism and Higher Education
2022 (English)In: Critical Understanding in Education: Volume: 3 / [ed] Alpesh Maisuria, Brill Academic Publishers, 2022Chapter in book (Refereed)
Place, publisher, year, edition, pages
Brill Academic Publishers, 2022
Series
Encyclopaedia of Marxism and Education Series
National Category
Pedagogy
Identifiers
urn:nbn:se:hb:diva-27431 (URN)978-90-04-50560-5 (ISBN)
Available from: 2022-02-03 Created: 2022-02-03 Last updated: 2022-02-07Bibliographically approved
Puaca, G. (2020). Academic Leadership and Governance of Professional Autonomy in Swedish Higher Education. Scandinavian Journal of Educational Research
Open this publication in new window or tab >>Academic Leadership and Governance of Professional Autonomy in Swedish Higher Education
2020 (English)In: Scandinavian Journal of Educational Research, ISSN 0031-3831, E-ISSN 1470-1170Article in journal (Refereed) Published
Abstract [en]

This article concerns how spaces of professional autonomy are defined and formed in Swedish higher education institutions (HEIs). Swedish HEIs have become increasingly characterised by rivalling principles of management and professional autonomy. The relational aspects of how a professional habitus is formed and negotiated in relation to management ideals and practices are investigated. The research methods used in this study were interviews with HEI management, strategic human resource management (HRM) representatives and research and teaching staff at three HEIs under different conditions of collegial influence and forms of management. The results show that professional negotiations are undergoing conversion pressures under New Public Management (NPM)-implemented governance, but because professional identities are strongly rooted in academic core values, they are relatively resistant to NPM imposition and encroachment. In light of this, the article offers a discussion on the dilemma of conforming to managerial demands and priorities without losing a professional self.

Place, publisher, year, edition, pages
Taylor & Francis, 2020
Keywords
Higher education, academic autonomy, professional identity, habitus, doxa
National Category
Educational Sciences
Identifiers
urn:nbn:se:hb:diva-24847 (URN)10.1080/00313831.2020.1755359 (DOI)000532307300001 ()2-s2.0-85084287663 (Scopus ID)
Available from: 2021-01-21 Created: 2021-01-21 Last updated: 2021-10-20Bibliographically approved
Puaca, G. (2019). Academic Leadership and Governance of Professional Autonomy in Swedish Higher Education. In: : . Paper presented at Nästa generations lärande (NGL) 2019. Högskolan Dalarna, 16 oktober, 2019..
Open this publication in new window or tab >>Academic Leadership and Governance of Professional Autonomy in Swedish Higher Education
2019 (English)Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

This article investigates professional identities in Swedish Higher Education Institutions (HEIs). The aim is to explore how professional negotiation takes place by incorporating the perspectives of teachers, managers, and strategic human resource management (HRM) representatives through a case study of three HEIs with different conditions for collegial influence and forms of management. The study examines how spaces of professional autonomy are defined and formed and how authenticity and legitimacy are established (Davies & Petersen, 2005; Deem & Lucas, 2007). The project was designed with the intention to relate analytical distinctions of different actors’ perceptions and objectives within the institutional conditions that form the meaning and objectives of education (Vaughan, 2002). The methods used are interviews with HEI management, strategic HRM representatives, and research and teaching staff. Contemporary researchers and teachers in academia have to handle increased evaluation pressure and, in many cases, strategic planning and organization of HEIs subjected to market-based principles (Widmalm et al., 2016). One question that has been raised in the research field is whether current trends in organizing academic work also contribute to changed academic identities (Clegg, 2008). By contextualizing the objectives of HEIs from the perspectives of teachers, management, and HRM departments, the results show that professional negotiations undergo conversion pressures under New Public Management (NPM)-implemented governance. However, professional identities are, at the same time, strongly rooted in academic core values, and the article offers a discussion via the aid of Pierre Bourdieu (1998) of the possibilities of forming autonomous professional identities and independent knowledge claims in NPM-inspired HEIs.

Keywords
Higher education, academic autonomy, professional identity, habitus, doxa
National Category
Sociology
Identifiers
urn:nbn:se:hb:diva-21863 (URN)
Conference
Nästa generations lärande (NGL) 2019. Högskolan Dalarna, 16 oktober, 2019.
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, (dnr 2015-00911
Available from: 2019-10-17 Created: 2019-10-17 Last updated: 2019-10-18Bibliographically approved
Puaca, G. (2018). Academic Professions: Paradoxes of Resistance and Compliance with a Growing Loss of Autonomy. In: ECER 2018, "Inclusion and Exclusion, Resources for Educational Research?”, Bolzano, Italy, 4-7 September, 2018: . Paper presented at ECER 2018, "Inclusion and Exclusion, Resources for Educational Research?”, Bolzano, Italy, 4-7 September, 2018.
Open this publication in new window or tab >>Academic Professions: Paradoxes of Resistance and Compliance with a Growing Loss of Autonomy
2018 (English)In: ECER 2018, "Inclusion and Exclusion, Resources for Educational Research?”, Bolzano, Italy, 4-7 September, 2018, 2018Conference paper, Oral presentation with published abstract (Refereed)
Keywords
Professions, Academic autonomy, Habitus, New Public Management, Vocational higher education
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Identifiers
urn:nbn:se:hb:diva-15126 (URN)
Conference
ECER 2018, "Inclusion and Exclusion, Resources for Educational Research?”, Bolzano, Italy, 4-7 September, 2018
Available from: 2018-09-26 Created: 2018-09-26 Last updated: 2018-09-27Bibliographically approved
Puaca, G. & Carlén, M. (2018). Hela Väster: Utvärdering av ett skolutvecklingsprojekt i Borås stad. Borås: Stema
Open this publication in new window or tab >>Hela Väster: Utvärdering av ett skolutvecklingsprojekt i Borås stad
2018 (Swedish)Report (Other academic)
Place, publisher, year, edition, pages
Borås: Stema, 2018. p. 46
Series
Rapport från FoU Sjuhärad Välfärd ; 37
Series
Rapport nr 37, 2018
National Category
Sociology
Identifiers
urn:nbn:se:hb:diva-15127 (URN)978-91-85025-33-6 (ISBN)
Available from: 2018-09-26 Created: 2018-09-26 Last updated: 2018-09-27Bibliographically approved
Puaca, G., Theandersson, C. & Carlén, M. (2017). Resisting consumerist rationalities in higher vocational education. The Journal for Critical Education Policy Studies, 15(1)
Open this publication in new window or tab >>Resisting consumerist rationalities in higher vocational education
2017 (English)In: The Journal for Critical Education Policy Studies, ISSN 2051-0969, E-ISSN 1740-2743, Vol. 15, no 1Article in journal (Refereed) Accepted
Abstract [en]

Swedish higher education policy is currently moving toward consumption ideals that focus on promoting the efficiency and economic viability of student choices. This paper scrutinizes students’ practical considerations when making decisions regarding their education and future occupations and the choice rationalities and motives that these reflect. This issue is empirically investigated via a semi-structured questionnaire (n = 322) distributed to students from seven vocational Swedish human resource management (HRM) university programs. Vocational university programs like HRM are a significant growth sector in higher education. What is unclear, however, is whether these forms of education reinforce a desired policy ambition toward consumerist subjectivity among choice agents. The results of the study do not exclusively or even primarily express consumerist subjectivity. By vitalizing Pierre Bourdieu’s term “reasonable”, an organic form of reasoning becomes apparent that does not separate intrinsic dimensions of learning, knowledge, or personal and social concerns from merit and economic compensation. Moreover, the results indicate that security and interpersonal distinctions relating to professional alignment are situated in the forefront of the expressed motives for these educational choices.

Keywords
Higher vocational education, consumer, choice agents, neoliberal policy, Pierre Bourdieu
National Category
Sociology
Identifiers
urn:nbn:se:hb:diva-11894 (URN)000404658900010 ()2-s2.0-85016281094 (Scopus ID)
Available from: 2017-02-10 Created: 2017-02-10 Last updated: 2018-12-07Bibliographically approved
Puaca, G. & Carlén, M. (2017). Vem bestämmer spelplanen?: Striden om högre Utbildning. In: Marcus Agnafors (Ed.), Universitet AB: Om kommodifiering, marknad och akademi (pp. 117-137). Göteborg: Daidalos
Open this publication in new window or tab >>Vem bestämmer spelplanen?: Striden om högre Utbildning
2017 (Swedish)In: Universitet AB: Om kommodifiering, marknad och akademi / [ed] Marcus Agnafors, Göteborg: Daidalos, 2017, p. 117-137Chapter in book (Refereed)
Place, publisher, year, edition, pages
Göteborg: Daidalos, 2017
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology) Pedagogy
Identifiers
urn:nbn:se:hb:diva-12934 (URN)978-91-7173-523-2 (ISBN)
Available from: 2017-10-26 Created: 2017-10-26 Last updated: 2017-12-13Bibliographically approved
Puaca, G. (2017). Vocational higher education in the age of neoliberal conversion. In: The European Sociological Association conference 29/8-1/9 2017, Athens, Greece: . Paper presented at 13th Conference of the European Sociological Association, Athens, Greece, August 29 - September 1, 2017.
Open this publication in new window or tab >>Vocational higher education in the age of neoliberal conversion
2017 (English)In: The European Sociological Association conference 29/8-1/9 2017, Athens, Greece, 2017Conference paper, Oral presentation with published abstract (Refereed)
Abstract [en]

What is indicative of current developments in higher education institutions (HEI) is how the terms of knowledge that make up neoliberal rationalities and entrepreneurial practices are gaining influence at the expense of academic traditions. The logic behind these HEIs’ practices can be seen as the ambition to offer ’products’ in an educational ‘market’. Higher vocational education are especially exposed to these changes, in terms of how the selection and organisation of knowledge is closely related to local conditions of assigned relevance and the practical orientation of learning. In Basil Bernstein’s terms, ‘a horizontal knowledge orientation’ is prevailing. This on-going research project investigates current trends in Swedish HEIs. After the 2011 implementation of institutional autonomy reform in Sweden, HEIs have increasingly transformed into new public management-inspired organisations, where adjustments for employability and economic benefits have gained significance at the expense of academic and pedagogic values. The Swedish higher education sector as a whole, however, is characterised by diversity. The current project aims to examine which governing mechanisms and forms of autonomy are apparent in three cases of higher vocational education. The project design aims to uncover analytical distinctions of different actors' perceptions and objectives within the institutional conditions that form the meaning and objectives of education through interviews with academic professionals and decision makers in HEI. The initial results expose the intrinsic relationships among forms of collegiality, professional autonomy and management ideals in how frictions between academic integrity and adaptability to entrepreneurial practices are handled.

Keywords
Higher vocational education, neoliberalism, academic autonomy, professions
National Category
Sociology (excluding Social Work, Social Psychology and Social Anthropology)
Identifiers
urn:nbn:se:hb:diva-12933 (URN)
Conference
13th Conference of the European Sociological Association, Athens, Greece, August 29 - September 1, 2017
Available from: 2017-10-26 Created: 2017-10-26 Last updated: 2017-12-13Bibliographically approved
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