Moving together – conditions for intercultural development at a highly diverse Swedish school

This thesis is a case study of a primary school in a highly diverse urban neighbourhood in Sweden. Basic pre-conditions for intercultural school development are studied by examining the overall organisation of teaching, learning and opportunities for collaboration in the investigated case. The study focuses on the targeted support measures to enhance learning for students with an immigrant background: Mother tongue instruction, Swedish as a Second Language, and tutoring in the mother tongue, as well as looking at pedagogical support provided by the school library. The latter has a mission to promote learning and inclusion, where non-native speakers of Swedish are a prioritised group. Communities of practice linked to the work organisation at a meso-level are investigated, and the collaborative relationships between professional groups at the school involved in the various support measures. Teacher relationships and categorisations implied by support measures impact the learning spaces that are shaped for students and the teaching spaces within which teachers work. Collaborative opportunities and convergence of concerns in the teaching spaces combine to shape the overall space for intercultural development. The raw data for the case study consists of interviews, national policy documents and additional information on local work organisation gained through documents and observations. Four articles resulted from the case study, each focusing a specific support measure. An overarching analysis is then made of findings from these articles and the other dimensions of the investigation. The analysis describes the organisation in terms of monocultural or intercultural school cultures, pointing to significant characteristics of the landscapes of practice, with respect to their overall implications for the spaces of school development. In the discussion, findings are considered in relation to research on professional development in education, collaboration, democracy and inclusive schooling. The relative positioning of languages and cultures is given particular attention, to ascertain if the school culture is monocultural or intercultural in the sense given by Lahdenperä (2008), and to what extent it could enable intercultural development. Such positioning plays a role interms of affordances for identity, participation and engagement discussed by Wenger (1998). This case study should be understood against the wider background of recent social developments in Europe linked to globalisation and technological changes. It is argued that looking at the concrete specifics which facilitate or obstruct school development, and simultaneously reflecting on how the different forms of teaching interrelate in the overall organisation and in policy may provide a useful vantage point from which structural changes can be contemplated.The discussion underlines the importance of the physical localisation of activities, continuity in personal contacts and time available for joint pedagogical reflection, as basic conditions for effective intercultural dialogue in the organisation. Finally, the impact of policy is considered, looking at connections between levels of policy, expressed in official steering documents, and conditions for teaching and learning at the level of an individual school.

The complexity in the implementation process of empowerment-based chronic kidney care: a case study

Background: This study is part of an interactive improvement intervention aimed to facilitate empowerment-based chronic kidney care using data from persons with CKD and their family members. There are many challenges to implementing empowerment-based care, and it is therefore necessary to study the implementation process. The aim of this study was to generate knowledge regarding the implementation process of an improvement intervention of empowerment for those who require chronic kidney care. Methods: A prospective single qualitative case study was chosen to follow the process of the implementation over a two year period. Twelve health care professionals were selected based on their various role(s) in the implementation of the improvement intervention. Data collection comprised of digitally recorded project group meetings, field notes of the meetings, and individual interviews before and after the improvement project. These multiple data were analyzed using qualitative latent content analysis. Results: Two facilitator themes emerged: Moving spirit and Encouragement. The healthcare professionals described a willingness to individualize care and to increase their professional development in the field of chronic kidney care. The implementation process was strongly reinforced by both the researchers working interactively with the staff, and the project group. One theme emerged as a barrier: the Limitations of the organization. Changes in the organization hindered the implementation of the intervention throughout the study period, and the lack of interplay in the organization most impeded the process. Conclusions: The findings indicated the complexity of maintaining a sustainable and lasting implementation over a period of two years. Implementing empowerment-based care was found to be facilitated by the cooperation between all involved healthcare professionals. Furthermore, long-term improvement interventions need strong encouragement from all levels of the organization to maintain engagement, even when it is initiated by the health care professionals themselves.