The Discursive Governing of Elementary School Student Identity in Norwegian Educational Policy 2000–2015

Drawing on a study of five Norwegian white papers from the period 2003–2013, this article illuminates how student identity is discursively negotiated and constructed in educational policy documents in a period of transformation in Norwegian education. By employing discourse analysis using ‘the student’ as a nodal point, the white papers are analysed in four phases: (1) identify identity resources, (2) construct subject positions, (3) cluster subject positions into student identities, and (4) identify the discursive governing of student identities. Our analysis of the documents shows how the policy documents draw on traditional and well-known educational discourses, but also how a new discourse, ‘The discourse of compliance’, emerges in this period. In particular, the article discusses possible challenges and dilemmas that might arise, such as the challenge of ‘metonymic transfer’ and ‘the temporal dilemma’, when student identity is negotiated and constructed in the intersection of different educational ideologies and discourses. The article also elucidates how ‘The discourse of compliance’ is relevant for the development of the new Norwegian educational reform of 2020. Our findings are of interest for all actors within the educational context and underscore the importance of investigating student identity in policy research. The article also lays the groundwork for several suggested approaches for further research on the topic.publishedVersio

Power dynamics and interprofessional collaboration: How do community pharmacists position general practitioners, and how do general practitioners position themselves?

Power differentials and medical dominance can negatively affect collaboration between physicians and pharmacists. Norway is recognized as having a relatively egalitarian work sector, which could affect power differentials. In this qualitative study, we used positioning theory as a framework to explore the aspect of power dynamics between Norwegian general practitioners (GPs) and community pharmacists. We used the concepts of reflexive and interactive positioning to identify how GPs positioned themselves and how they were positioned by pharmacists in six focus groups. Data were analyzed using systematic text condensation. We found positioning theory to be a useful lens through which to study power dynamics in relation to collaboration between community pharmacists and GPs. Our findings imply that the presence of medical dominance poses challenges even in an egalitarian Norwegian setting. However, although both GPs and pharmacists draw on a ‘medical dominance’ storyline, we have also identified how both pharmacists and GPs draw on alternative and promising storylines of collaboration between the two professions.publishedVersio

Narrative construction of teacher identity

There has been an overemphasis within narrative approaches to teacher identity to use autobiographical material and personal accounts from teachers or teacher students as material sources for analysis. Very few studies draw on alternative empirical sources as a point of departure to investigate the narrative construction of teacher identity. This thesis therefore investigates how teacher identity is narratively constructed by three significant actors within the Norwegian elementary school system. In addition to a) transcribed texts from interviews with female elementary school teachers the project draws on texts from two other sources: b) public school policy documents and c) written material from the Union of Education Norway. These three actors are perceived as three different, but equal sources of material that are explored in three separate studies that constitute the core of this thesis. Public narratives about teachers are the unit of analysis in this thesis. The material is analysed within a theoretical and methodological framework inspired by a combination of poststructuralist, discursive and narrative approaches to identity and research. This framework has generated five analytical concepts that are divided in two main categories. The first category is called “narrative resources” and refers to the ‘what’ of identity construction, in my case, subject positions and constructions of identities. The second category is called “narrative editing” and refers to the different ways storytellers draw on and combine the narrative resources, or the ‘how’ of identity construction. This thesis focuses on three such editing techniques, namely; positioning, narrative plots and counter narratives. The identity construction of “The teacher as pupil centred, caring and including” is identified as especially paramount in all the three studies. Consequently discussions centre on how this teacher identity has gained such a prominent position. These findings are firstly interpreted as an indication that the three sources of material are inscribed in and informed by the same powerful Scandinavian educational discourse on individualisation. Secondly the thesis claim that this identity constructions also might gain prominence because it represent what is perceived as a necessary adjustment or alternative to certain teacher identities, educational values and conceptions of learning and childhood. Finally the thesis show how this teacher identity is constituted in a web of multidimensional dichotomies, and how it is the sum of these that contribute to the constitution, fixation and dominance of the teacher as pupil-centred, inclusive and caring in the public narratives. The project illuminates how analysis of narratives and statements can give insight in to some of the forces that move within educational discourses. The three studies underscore how complex and multifaceted the narrative construction of teacher identity can be and consequently provide an understanding of elementary school teachers that goes beyond the most obvious cultural stereotypes. The thesis shows that to get a conception of why teachers are positioned within certain identities, it is vital to understand how they come to be positioned in such a way

Selvregulering som pedagogisk formål: Diskursive fornyelser i «Fremtidens skole»

Ludvigsen-utvalget, NOU 2015: 8 Fremtidens skole, står på bakgrunn av sin forskningsforankring frem som dette tiårets utdanningspolitiske referansepunkt. Gjennom dokumentet blir begrepet selvregulering introdusert i norsk utdanningspolitikk. I norsk offentlighet ble rapporten fortolket både som et brudd med og som en revitalisering av skolens danningsoppdrag. Gjennom en diskursanalyse av dokumentet viser vi hvordan forventningene til fremtidens elever rammes inn av både danningsorienterte og nyliberale diskurser. Den doble diskursive innrammingen kan være noe av årsaken til at NOU 2015: 8 ble så ulikt mottatt. Våre analyser viser imidlertid at de nyliberale diskursene dominerer i dokumentet. Dette kommer særlig til uttrykk i et sterkt fokus på selvregulering og nytte. Artikkelen diskuterer fremveksten av selvregulering og konsekvenser dette kan ha for utdanningsfeltet, i lys av målsettingen om å styrke folkehelse og livsmestring

Positioning each other – a metasynthesis of pharmacist-physician collaboration

Interprofessional collaboration between different professions within health care is essential to optimize patient outcomes. Community-pharmacists (CPs) and general-practitioners (GPs) are two professions who are encouraged to increase their collaboration. In this metasynthesis we use a meta-ethnographic approach to examine the interpersonal aspects of this collaboration, as perceived by the professionals themselves. The metasynthesis firstly suggests that CPs and GPs have differing storylines about the cooperation between them. Secondly, CPs seem to position their profession in relation to the GPs, whereas GPs do not rely on the CPs to define their professional position. A successful collaboration between the two professions requires the CPs to reposition themselves through adopting a proactive approach towards the GPs. This proactive approach should comprise the delivery of specific clinical advice, as well as taking responsibility for this advice. In this way, they can build a more coinciding storyline of the joint agenda of improved patientcare

Positioning Each Other: A Metasynthesis of Pharmacist-Physician Collaboration

Abstract Interprofessional collaboration between different professions within health care is essential to optimize patient outcomes. Community-pharmacists (CPs) and general-practitioners (GPs) are two professions who are encouraged to increase their collaboration. In this metasynthesis we use a meta-ethnographic approach to examine the interpersonal aspects of this collaboration, as perceived by the professionals themselves. The metasynthesis firstly suggests that CPs and GPs have differing storylines about the cooperation between them. Secondly, CPs seem to position their profession in relation to the GPs, whereas GPs do not rely on the CPs to define their professional position. A successful collaboration between the two professions requires the CPs to reposition themselves through adopting a proactive approach towards the GPs. This proactive approach should comprise the delivery of specific clinical advice, as well as taking responsibility for this advice. In this way, they can build a more coinciding storyline of the joint agenda of improved patientcare

Complementing or conflicting? How pharmacists and physicians position the community pharmacist

Background: Interprofessional collaboration between pharmacists and physicians in primary care has been linked to improved patient outcomes. How professionals position themselves and each other can shed light upon their relationship, and positioning theory can be used as a tool to better understand intergroup relations. Objectives: 1) To identify how community pharmacists position themselves, and how they are positioned by general practitioners. 2) To assess how well these positions correspond, how the positions align with a proactive position for the pharmacists, and discuss how the positions could potentially impact collaboration. Methods: In this qualitative study, data were collected through six focus group interviews held between June and October 2019, three with pharmacists and three with physicians. The focus group interviews were conducted using a semi-structured interview guide. Data were audio recorded, transcribed verbatim, and analyzed using the Systematic text condensation method. Positioning theory was used as a theoretical framework to identify the positions assigned to community pharmacists by the pharmacists themselves and by the physicians. Results: Twelve pharmacists and ten physicians participated. The pharmacists positioned themselves as the “last line of defense”, “bridge-builders”, “outsiders” – with responsibility, but with a lack of information and authority – and “practical problem solvers”. The physicians positioned pharmacists as “a useful checkpoint”, “non-clinicians” and “unknown”. Conclusions: The study revealed both commonalities and disagreements in how community pharmacists position themselves and are positioned by general practitioners. Few of the positions assigned to pharmacists by the physicians support an active role for the pharmacists, while the pharmacists´ positioning of themselves is more diverse. The physicians´ positioning of pharmacists as an unknown group represents a major challenge for collaboration. Increasing the two professions´ knowledge of each other may help produce new positions that are more coordinated, and thus more supportive towards collaboration

Global, regional, and national disability-adjusted life years (DALYs) for 306 diseases and injuries and healthy life expectancy (HALE) for 188 countries, 1990-2013: quantifying the epidemiological transition.

International audienceThe Global Burden of Disease Study 2013 (GBD 2013) aims to bring together all available epidemiological data using a coherent measurement framework, standardised estimation methods, and transparent data sources to enable comparisons of health loss over time and across causes, age-sex groups, and countries. The GBD can be used to generate summary measures such as disability-adjusted life-years (DALYs) and healthy life expectancy (HALE) that make possible comparative assessments of broad epidemiological patterns across countries and time. These summary measures can also be used to quantify the component of variation in epidemiology that is related to sociodemographic development. We used the published GBD 2013 data for age-specific mortality, years of life lost due to premature mortality (YLLs), and years lived with disability (YLDs) to calculate DALYs and HALE for 1990, 1995, 2000, 2005, 2010, and 2013 for 188 countries. We calculated HALE using the Sullivan method; 95% uncertainty intervals (UIs) represent uncertainty in age-specific death rates and YLDs per person for each country, age, sex, and year. We estimated DALYs for 306 causes for each country as the sum of YLLs and YLDs; 95% UIs represent uncertainty in YLL and YLD rates. We quantified patterns of the epidemiological transition with a composite indicator of sociodemographic status, which we constructed from income per person, average years of schooling after age 15 years, and the total fertility rate and mean age of the population. We applied hierarchical regression to DALY rates by cause across countries to decompose variance related to the sociodemographic status variable, country, and time. Worldwide, from 1990 to 2013, life expectancy at birth rose by 6·2 years (95% UI 5·6-6·6), from 65·3 years (65·0-65·6) in 1990 to 71·5 years (71·0-71·9) in 2013, HALE at birth rose by 5·4 years (4·9-5·8), from 56·9 years (54·5-59·1) to 62·3 years (59·7-64·8), total DALYs fell by 3·6% (0·3-7·4), and age-standardised DALY rates per 100 000 people fell by 26·7% (24·6-29·1). For communicable, maternal, neonatal, and nutritional disorders, global DALY numbers, crude rates, and age-standardised rates have all declined between 1990 and 2013, whereas for non-communicable diseases, global DALYs have been increasing, DALY rates have remained nearly constant, and age-standardised DALY rates declined during the same period. From 2005 to 2013, the number of DALYs increased for most specific non-communicable diseases, including cardiovascular diseases and neoplasms, in addition to dengue, food-borne trematodes, and leishmaniasis; DALYs decreased for nearly all other causes. By 2013, the five leading causes of DALYs were ischaemic heart disease, lower respiratory infections, cerebrovascular disease, low back and neck pain, and road injuries. Sociodemographic status explained more than 50% of the variance between countries and over time for diarrhoea, lower respiratory infections, and other common infectious diseases; maternal disorders; neonatal disorders; nutritional deficiencies; other communicable, maternal, neonatal, and nutritional diseases; musculoskeletal disorders; and other non-communicable diseases. However, sociodemographic status explained less than 10% of the variance in DALY rates for cardiovascular diseases; chronic respiratory diseases; cirrhosis; diabetes, urogenital, blood, and endocrine diseases; unintentional injuries; and self-harm and interpersonal violence. Predictably, increased sociodemographic status was associated with a shift in burden from YLLs to YLDs, driven by declines in YLLs and increases in YLDs from musculoskeletal disorders, neurological disorders, and mental and substance use disorders. In most country-specific estimates, the increase in life expectancy was greater than that in HALE. Leading causes of DALYs are highly variable across countries. Global health is improving. Population growth and ageing have driven up numbers of DALYs, but crude rates have remained relatively constant, showing that progress in health does not mean fewer demands on health systems. The notion of an epidemiological transition--in which increasing sociodemographic status brings structured change in disease burden--is useful, but there is tremendous variation in burden of disease that is not associated with sociodemographic status. This further underscores the need for country-specific assessments of DALYs and HALE to appropriately inform health policy decisions and attendant actions. Bill & Melinda Gates Foundation