University students’ regulation of learning and text processing – examples from medical and teacher education

The general aim of the thesis was to study university students’ learning from the perspective of regulation of learning and text processing. The data were collected from the two academic disciplines of medical and teacher education, which share the features of highly scheduled study, a multidisciplinary character, a complex relationship between theory and practice and a professional nature. Contemporary information society poses new challenges for learning, as it is not possible to learn all the information needed in a profession during a study programme. Therefore, it is increasingly important to learn how to think and learn independently, how to recognise gaps in and update one’s knowledge and how to deal with the huge amount of constantly changing information. In other words, it is critical to regulate one’s learning and to process text effectively. The thesis comprises five sub-studies that employed cross-sectional, longitudinal and experimental designs and multiple methods, from surveys to eye tracking. Study I examined the connections between students’ study orientations and the ways they regulate their learning. In total, 410 second-, fourth- and sixth-year medical students from two Finnish medical schools participated in the study by completing a questionnaire measuring both general study orientations and regulation strategies. The students were generally deeply oriented towards their studies. However, they regulated their studying externally. Several interesting and theoretically reasonable connections between the variables were found. For instance, self-regulation was positively correlated with deep orientation and achievement orientation and was negatively correlated with non-commitment. However, external regulation was likewise positively correlated with deep orientation and achievement orientation but also with surface orientation and systematic orientation. It is argued that external regulation might function as an effective coping strategy in the cognitively loaded medical curriculum. Study II focused on medical students’ regulation of learning and their conceptions of the learning environment in an innovative medical course where traditional lectures were combined wth problem-based learning (PBL) group work. First-year medical and dental students (N = 153) completed a questionnaire assessing their regulation strategies of learning and views about the PBL group work. The results indicated that external regulation and self-regulation of the learning content were the most typical regulation strategies among the participants. In line with previous studies, self-regulation wasconnected with study success. Strictly organised PBL sessions were not considered as useful as lectures, although the students’ views of the teacher/tutor and the group were mainly positive. Therefore, developers of teaching methods are challenged to think of new solutions that facilitate reflection of one’s learning and that improve the development of self-regulation. In Study III, a person-centred approach to studying regulation strategies was employed, in contrast to the traditional variable-centred approach used in Study I and Study II. The aim of Study III was to identify different regulation strategy profiles among medical students (N = 162) across time and to examine to what extent these profiles predict study success in preclinical studies. Four regulation strategy profiles were identified, and connections with study success were found. Students with the lowest self-regulation and with an increasing lack of regulation performed worse than the other groups. As the person-centred approach enables us to individualise students with diverse regulation patterns, it could be used in supporting student learning and in facilitating the early diagnosis of learning difficulties. In Study IV, 91 student teachers participated in a pre-test/post-test design where they answered open-ended questions about a complex science concept both before and after reading either a traditional, expository science text or a refutational text that prompted the reader to change his/her beliefs according to scientific beliefs about the phenomenon. The student teachers completed a questionnaire concerning their regulation and processing strategies. The results showed that the students’ understanding improved after text reading intervention and that refutational text promoted understanding better than the traditional text. Additionally, regulation and processing strategies were found to be connected with understanding the science phenomenon. A weak trend showed that weaker learners would benefit more from the refutational text. It seems that learners with effective learning strategies are able to pick out the relevant content regardless of the text type, whereas weaker learners might benefit from refutational parts that contrast the most typical misconceptions with scientific views. The purpose of Study V was to use eye tracking to determine how third-year medical studets (n = 39) and internal medicine residents (n = 13) read and solve patient case texts. The results revealed differences between medical students and residents in processing patient case texts; compared to the students, the residents were more accurate in their diagnoses and processed the texts significantly faster and with a lower number of fixations. Different reading patterns were also found. The observed differences between medical students and residents in processing patient case texts could be used in medical education to model expert reasoning and to teach how a good medical text should be constructed. The main findings of the thesis indicate that even among very selected student populations, such as high-achieving medical students or student teachers, there seems to be a lot of variation in regulation strategies of learning and text processing. As these learning strategies are related to successful studying, students enter educational programmes with rather different chances of managing and achieving success. Further, the ways of engaging in learning seldom centre on a single strategy or approach; rather, students seem to combine several strategies to a certain degree. Sometimes, it can be a matter of perspective of which way of learning can be considered best; therefore, the reality of studying in higher education is often more complicated than the simplistic view of self-regulation as a good quality and external regulation as a harmful quality. The beginning of university studies may be stressful for many, as the gap between high school and university studies is huge and those strategies that were adequate during high school might not work as well in higher education. Therefore, it is important to map students’ learning strategies and to encourage them to engage in using high-quality learning strategies from the beginning. Instead of separate courses on learning skills, the integration of these skills into course contents should be considered. Furthermore, learning complex scientific phenomena could be facilitated by paying attention to high-quality learning materials and texts and other support from the learning environment also in the university. Eye tracking seems to have great potential in evaluating performance and growing diagnostic expertise in text processing, although more research using texts as stimulus is needed. Both medical and teacher education programmes and the professions themselves are challenging in terms of their multidisciplinary nature and increasing amounts of information and therefore require good lifelong learning skills during the study period and later in work life.

Information management in aircraft maintenance

Well managed information promotes competitive advantage and economic value for the company. The challenge is to use information effectively in complex networks. Decision making in network is complicated due to many independent sources of information. The aim of the present study was to identify and map the internal information flows and used information resourced by functions and roles, to make proposals to the case organization to improve the information management and to improve the situational awareness and process flows. In the present study, an inductive approach was applied, with the aim to find out gaps and bottlenecks of information flow of an aircraft maintenance organization and its network. The empirical part was conducted with observing the processes and with questionnaires. Theoretical part of this study consists on reviewing relevant literature on maintenance management in aviation and information management in aviation. Together with empirical evidence and the literature used in the study the gaps were found and suggestions for improvements were done. The outcome of this study contributes the organization in its bigger goal to improve the productivity. The information management of the network is one actor in the field and will pave the way to smoother operation and situational awareness. The lack of rules and requirements for information management and spreading is a challenge in information management. The excessive data overburden may cause problem in the actors’ situation-awareness due to non-availability of the right information.

Organisational purchasing of service design – Agency and client perspectives

There has been an increase in the interest in service design, as companies have become more customer-centric and their focus has shifted to customer experiences. The actual organisational purchasing of service design has been given little attention, until recent years. The purpose of this study is to explore the purchasing of service design from the perspectives of sellers (service design agencies) and buying clients (business organisations). In order to understand the phenomenon, also agencies and clients’ approaches to service design discipline, purchasing processes, challenges related to purchasing and ways of facilitating the purchasing are explored. The research follows qualitative research method and utilises abductive reasoning. A proposition framework was formed by combining services marketing, design and organisational buying behaviour literatures, and was tested against real-life business cases. Empirical data was gathered by interviewing eight service design agency representatives and five client representatives in Finland. The results of semi-structural interviews were analysed by finding repetitive themes. The proposition framework was updated according to interview findings. There were both similarities and differences in service design agencies and clients’ approaches to service design. Service design represents a strategic activity to both parties, and it helps in clients’ business development and in discovering opportunities. It is an ideology; a way of thinking and working. The driving force for purchasing service design seemed to be something else than service design itself. Projects have been bought for 1) change and innovation related development, 2) channel related development or for 3) customer experience related development. Seven purchasing challenge themes were recognised: 1) poor or differing service design understanding, 2) selling of service design, 3) varying expectations, 4) difficulty of pre-evaluation, 5) buyers and buying companies, 6) project process and nature and 7) unclear project results. These all can be considered to cause challenges in organisational service design purchasing. Challenges can be caused by either participant, the agency or the client, and take place at any point of the purchasing process. Some of the challenges could be considered as barriers to purchasing or they play a role in an unsuccessful service project – and therefore, result in an unsuccessful organisational purchase. Purchasing could be facilitated in various ways by either participant; some ways are more attitude based, others actionable improvements. Thesis’s theoretical and managerial findings can be utilised to both improve the selling and purchasing of service design services.

Milleniaalit tietotyössä – organisaatiositoutumisen näkökulmia henkilöstöpalvelualan yrityksessä

Tämän tutkielman tavoitteena on selvittää, mitkä tekijät vaikuttavat henkilöstöpalvelualan yrityksessä työskentelevien y-sukupolveen kuuluvien tietotyöläisten organisaatiositoutumiseen ja näin löytää keinoja edistää tämän henkilöstöryhmän sitoutumista. Päätutkimuskysymys on ”Miten tietotyötä tekevän milleniaalin organisaatiositoutumista voidaan edistää?”. Tutkielma on kvalitatiivinen tapaustutkimus, aineisto kerättiin puolistrukturoiduilla haastatteluilla. Aineisto analysoitiin teoriaohjaavasti organisaatiositoutumiseen, milleniaaleihin ja tietotyöhön liittyvää teoreettista viitekehystä tukena käyttäen ja abduktiivista päättelyä hyödyntäen. Tutkimustulosten mukaan tietotyötä tekevä milleniaali on sitoutunut työhönsä, työyhteisöönsä ja organisaatioon. Organisaatiositoutuminen muodostuu useammasta kuin yhdestä komponentista ja on aineiston mukaan muodoltaan niin affektiivista, normatiivista kuin jatkuvaakin. Nykyorganisaatiossa sitouttavat erityisesti hyvä esimiestyö, työn haastavuus, mahdollisuudet työnkuvan monipuolistamiseen, uramahdollisuudet ja ammatillisen kehittymisen tukeminen. Tulevaisuudessa tietotyötä kohdeyrityksessä tekevät milleniaalit toivovat, että organisaatio panostaisi sitouttamisen edistämiseksi erityisesti yksilön arvostamiseen, työntekijöiden ammatilliseen kehittymiseen, urasuunnitteluun, palkitsemiseen, esimiestyöhön ja yhteisöllisyyteen.

Ethical leadership as a way to promote work-related well-being

The purpose of this study was to clarify the connections of ethical leadership with the work-related well-being of employees. Additionally, the role of occupational health care in ethical leadership that promotes work-related well- being was analyzed. The objective of the study was to produce knowledge to support the development of ethical leadership and work-related well-being as well as to find ways for occupational health care to support organizations in these actions. The target groups of this study consisted of the managers (N=43) and employees (N=336) working in one organization in the Finnish energy industry. The population was studied in November 2014 using census. The data was gathered with two different web-based surveys containing structured and open questions. The survey for managers consisted of background questions and statements concerning ethical leadership, work-related well-being and occupational health care. The employee questionnaire consisted of questions about background and statements about work-related well-being and ethical leadership. The structured questions were analyzed with SPSS Statistical Program and the open questions using inductive content analysis. At least 80 % of the managers saw their actions as ethical in all but one part of ethical leadership. The work-related well-being of the employees was found best in the area of ability to work (91 % agreed) and lowest in the area of experience of ethical leadership (67 % agreed). The results showed a strong positive connection between ethical leadership and all the components of work- related well-being. The managers and employees were generally quite happy with the services of occupational health care but managers saw some problems with the collaboration with occupational health care. Several ways to improve work-related well-being and collaboration with occupational health care were found. One of the most important things was thought to be offering ways to maintain ability to work and making these actions visible. Investing in ethical leadership and work-related well-being is extremely important for the success of an organization and the societal benefits cannot be forgotten either. The role of occupational health care in promoting the health and well-being of employees is substantial. Occupational health care should offer managers more tools to recognize difficult situations and acting in them as well as encourage managers to seek help from occupational health care without hesitation in problematic situations of leadership.

Modularity in Health and Social Services: Perspectives on Organization and Management

Organizations that provide health and social services operate in a complex and constantly changing environment. Changes occur, for example, in ageing, technology and biotechnology, and customers’ expectations, as well as the global economic situation. Organizations typically aim to adapt the changes by introducing new organizational structures and managerial practices, such as process and lean management. Only recently has there been an interest in evaluating whether organizations providing health and social services could apply modularity in order to respond to some of the changes. The concept of modularity originates from manufacturing, but is applied in many other disciplines, such as information technology and logistics. However, thus far, the literature concerning modularity in health and social services is scarce. Therefore the purpose of this thesis is to increase understanding concerning modularity and the possibilities to apply modularity in the health and social services context. In addition, the purpose is to shed light on the viewpoints that are worth taking into account when considering the application of modularity in the health and social services context. The aim of the thesis is to analyze the way in which the modular structures are applied in the health and social services context and to analyze what advantages and possible barriers, as well as managerial concerns, might occur if modularity is applied in the health and social services context. The thesis is conducted by using multiple methods in order to provide a broad aspect to the topic. A systematic literature review provided solid ground for pre-understanding the topic and supported the formulation of the research questions. Theoretical reasoning provided a general overview of the special characteristics of the health and social services context and their effect on application of modularity. Empirical studies concentrated on managerial concerns of modularity particularly from the perspective of health and social services for the elderly. Results of the thesis reveal that structures in products, services, processes, and organizations are rather modular in health and social services. They can be decomposed in small independent units, while the challenges seem to occur especially in the compatibility of the services. It seems that health and social services managers have recognized this problem and they are increasingly paying attention to this challenge in order to enhance the flexible compatibility of services. Advantages and possible barriers of modularity are explored in this thesis, and from the theoretical perspective it could be argued that modularity seems to be beneficial in the context of health and social services. In fact, it has the potential to alleviate several of the challenges that the health and social services context is confronting. For example, modular structures could support organizations in their challenging task to respond to customers’ increasing demand for heterogeneous services. However, special characteristics of the health and social services context create barriers and provide significant challenges in application of modularity. For example, asymmetry of information, negative externalities, uncertainty of demand, and rigid regulation prevent managers from extensively drawing benefits from modularity. Results also reveal that modularity has managerial implications in health and social service. Modularity has the potential to promote and support new service development and outsourcing. Results also provide insights into network management and increases managerial understanding of different network management strategies. Standardization in health and social services is extensive due to legislation and recommendations. Modularity provides alternative paths to take an advantage of standardization while still ensuring the quality of the services. Based on this thesis, it can be concluded, both from a theoretical perspective and from empirical results concerning modularity in health and social services, that modularity might fit well and be beneficial. However, the special characteristics of the health and social services context prevent some of the benefits of modularity and complicate its application. This thesis contributes to the academic literature on the organization and management of health and social services by describing modularity as an alternative way for organizing and managing health and social services. In addition, it contributes to the literature of modularity by exploring the applicability of modularity in the context of health and social services. It also provides practical contribution to health and social services managers by evaluating the pros and cons of modularity when applied to health and social services.

Läheisen rooli ja tuen tarve iäkkään kotiutuessa arviointi- ja kuntoutusosastolta

Tämän tutkimuksen tarkoituksena oli kuvata läheisen roolia ja tuen tarvetta iäkkään kotiutuessa arviointi- ja kuntoutusosastolta. Tavoitteena oli saada tietoa iäkkäiden kotiutusprosessista läheisen näkökulmasta ja muodostaa käsitteellinen malli, jossa on tyypitelty läheisen erilaiset roolit, niihin vaikuttavat tekijät ja tuen tarpeet iäkkään kotiutuessa arviointi- ja kuntoutusosastolta. Tutkimus oli kuvaileva tutkimus, jossa sovellettiin metodologista triangulaatiota. Kotiutuva iäkäs nimesi läheisen (n=14), jolta kerättiin tutkimusaineistoa teemahaastattelulla ja kyselyllä (COPE -indeksi, Carers of Older People in Europe). Rekrytointi tapahtui viidellä arviointi- ja kuntoutusosastolla Etelä-Suomessa kesällä 2015. Teemahaastattelu analysoitiin induktiivisella sisällönanalyysillä ja kyselyn (COPE -indeksi) vastauksista laskettiin prosenttiosuudet ja kolmella osa-alueella laskettiin lisäksi summapisteiden keskiarvot. Tutkimuksen päätulos tuli teemahaastattelun sisällön analyysistä, jota vahvistettiin kyselystä (COPE -indeksi) saaduilla tuloksilla. Tämän tutkimuksen tuloksena syntyi käsitteellinen malli läheisen roolista ja tuen tarpeista iäkkään kotiutuessa arviointi- ja kuntoutusosastolta. Läheisen rooli jakautui neljään päärooliin, jotka olivat iäkkään arjen auttajan rooli, edunvalvojan rooli, tukijan rooli ja vastuunkantajan rooli. Arjen auttajan rooliin kuului läheisen käytännön järjestäjän rooli ja kodinhoitajan rooli. Edunvalvojan rooliin sisältyi iäkkään terveydellinen edunvalvojan rooli, taloudellinen edunvalvojan rooli ja puolestapuhujan rooli. Tukijan rooli muodostui iäkkään virkistäjän roolista ja muutokseen sopeuttajan roolista. Näissä rooleissa toimimiseen vaikuttavia tekijöitä olivat läheisen ja iäkkään välinen suhde, läheisen oma elämä, rooliin saatu tuki ja roolin mielekkyys. Läheisen roolissa tuen tarpeita olivat arjen tuki, roolissa toimimisen tuki, rohkaiseva ja sosiaalinen tuki. Kyselyn (COPE -indeksi) tulokset täydensivät kuvausta läheisen rooliin vaikuttavista tekijöistä ja tuen tarpeista. Keskeistä tuloksissa oli, että läheisillä oli hyvä suhde iäkkäisiin, avustaminen koettiin vaivan arvoiseksi ja muiden ihmisten koettiin arvostavan heidän toimimistaan iäkkään avustajana. Ajoittain avustaminen koettiin liian vaativana tuoden kielteisiä vaikutuksia omaan tunne-elämään ja fyysiseen terveydentilaan, tunnettiin olevan ansassa. Läheiset tunsivat saavansa hyvin tukea perheeltä, mutta sosiaali- ja terveyspalveluista saatavassa tuessa koettiin parannettavaa. Tämän empiirisen tutkimuksen tuloksena tuotettu käsitteellinen malli todentaa läheisen roolin monimutkaisuuden ja moniulotteisuuden. Läheisen roolissa tarvitaan erityistä tukea tilanteiden muuttuessa, kuten kotiutustilanteissa. Tutkimuksen tuloksia voidaan hyödyntää kehitettäessä iäkkäiden yksilöllistä kotiutumista ja tilanteeseen sopivia läheisen roolia tukevia palveluita.

Oppisopimuskoulutus yritysten tuottamana koulutuspalveluna: tavoitteista vaikutuksiin

Työpaikoilla tapahtuvan koulutuksen merkitys korostuu yhteiskunnassa kaikilla tasoilla nyt ja tulevaisuudessa. Tämä väitöstutkimus määrittelee oppisopimuskoulutuksen yritysten tuottamana koulutuspalveluna osana ammatillista tutkintoon johtavaa koulutusta, jota tuotetaan työpaikoilla ja yrityksissä. Väitöstutkimuksessa tarkastellaan niitä tavoitteita, joita yrityksissä oppisopimuskoulutukseen liittyy ja vaikutuksia, joita koulutusta tuottamalla yrityksessä syntyy. Tutkimuksen kohteena ovat eri alojen pienet ja keskisuuret yritykset (pk-yritykset), jotka ovat tuottaneet oppisopimuskoulutusta ja joilla on siitä vuosien kokemus. Lisäksi tutkimukseen osallistui pk-yrityksiä, joille oppisopimuskoulutus ja siihen liittyvä toiminta on vierasta. Tutkimus tuo uutta tietoa vain vähän tutkittuun aikuisten oppisopimuskoulutukseen, mutta ei sulje pois nuorten oppisopimuskoulutukseen liittyviä kysymyksiä. Tutkimus yhdistää oppisopimuskoulutuksen ja koulutuksen tuottamisen yrityksissä, mikä uudistaa sekä oppisopimuskoulutukseen, ammatilliseen koulutukseen, palvelun tuottamiseen että osaamiseen liittyvää teoreettista viitekehystä. Lisäksi tutkimus tuo yrityksille sekä oppisopimuskoulutuksen hallinnollisille tahoille palvelun tuottamisen ja siihen liittyvien tavoitteiden ja vaikutusten näkökulman. Väitöstutkimuksen teoreettinen viitekehys perustuu ja jakautuu kolmeen osaan: palveluun ja sen tuottamiseen, osaamispääomiin ja niiden eri muotoihin sekä vaikutuksiin palvelutuotannossa. Teoreettinen viitekehys kuvaa monimuotoisesti oppisopimuskoulutuksen ilmiötä, jonka olemus muuttuu sen mukaan, miten, kuka tai mikä taho sitä arvioi tai tarkastelee. Väitöstutkimus on empiiriseltä luonteeltaan kvalitatiivinen tutkimus, jonka aineisto on kerätty teemahaastatteluilla vuoden 2013 lopulla ja vuoden 2014 alussa. Aineisto on analysoitu sisällönanalyysillä aineistolähtöisesti. Tutkimusote pohjautuu abduktiiviseen päättelyyn. Tutkimustulokset esitetään ja luokitellaan niin tavoitteiden kuin vaikutusten osalta inhimillisen, rakenteellisen ja suhdepääoman kautta. Tutkimuksen mukaan oppisopimuskoulutuksen vaikutukset nähdään positiivisina ja neutraaleina, eikä alakohtaisia eroja vaikutusten osalta juuri ole. Myönteisten vaikutusten saavuttamiseen liittyy tärkeänä osana arvon luomisen ja tuottamisen kokemus molemmilla koulutukseen osallistuvilla osapuolilla. Lisäksi myönteisten vaikutusten taustalla ovat yrityksen sitoutuminen sekä työn ja koulutuksen johtamisosaaminen. Yrityksissä on tärkeää, että imago kouluttajana on hyvä. Oppisopimuskoulutuksen tuottamisesta syntyneet vaikutukset ovat asetettuja tavoitteita laajemmat, erityisesti rakenteelliseen pääomaan liittyvien vaikutusten osalta. Oppisopimuskoulutuksen vaikuttavuus yrityksessä syntyy asetettujen tavoitteiden ja vaikutusten välisestä suhteesta. Kokonaisuutena voidaan todeta, että oppisopimuskoulutuksen vaikuttavuus ja suorituskyky yrityksissä ovat hyvät, vaikka koulutuksen laatu vaihtelee jonkin verran. Oppisopimuskoulutuksen käynnistäminen, aloittaminen ja tuottaminen liittyvät usein niin sanottuihin oppisopimusagentteihin eli sellaisiin kehityshakuisiin henkilöihin, joilla jossakin elämäntilanteessa on ollut myönteisiä kokemuksia oppisopimuskoulutuksen mahdollisuuksista. Tutkimuksen mukaan oppisopimuskoulutuksen kustannukset koostuvat työsuhteesta, tietopuolisen koulutuksen aikaisesta työstä poissaolosta sekä ohjauksesta ja arvioinnista, mutta koulutusta pidetään taloudellisesti kannattavana. Oppisopimuskoulutuksen tuottamista estävät pääasiassa viestinnän ja tiedottamisen puute, koulutusmahdollisuuden tunnistamatta jääminen, yritysten heikko koulutuskulttuuri sekä epäselvät mielikuvat ja käsitykset. Nuorten oppisopimuskoulutuksen toteuttamisen hidasteina ovat tutkimuksen mukaan työsuhteeseen ja talouteen liittyvät seikat, nuorten kasvun vaiheeseen sisältyvät tekijät sekä monenlaiset pedagogiset ja eettiset kysymykset. Lisäksi tutkimuksessa havaittiin, että nuori on käsitteenä ja viiteryhmänä epämääräinen. Ammatillisen koulutuksen ja oppisopimuskoulutuksen eri muodot ja monet käsitteet myös aiheuttavat epäselvyyttä molemmissa tutkimuksen konteksteissa eli yrityksissä, joissa oppisopimuskoulutusta tuotetaan sekä yrityksissä, joissa sitä ei tuoteta.

Ethical leadership as a way to promote work-related well-being

The purpose of this study was to clarify the connections of ethical leadership with the work-related well-being of employees. Additionally, the role of occupational health care in ethical leadership that promotes work-related well- being was analyzed. The objective of the study was to produce knowledge to support the development of ethical leadership and work-related well-being as well as to find ways for occupational health care to support organizations in these actions. The target groups of this study consisted of the managers (N=43) and employees (N=336) working in one organization in the Finnish energy industry. The population was studied in November 2014 using census. The data was gathered with two different web-based surveys containing structured and open questions. The survey for managers consisted of background questions and statements concerning ethical leadership, work-related well-being and occupational health care. The employee questionnaire consisted of questions about background and statements about work-related well-being and ethical leadership. The structured questions were analyzed with SPSS Statistical Program and the open questions using inductive content analysis. At least 80 % of the managers saw their actions as ethical in all but one part of ethical leadership. The work-related well-being of the employees was found best in the area of ability to work (91 % agreed) and lowest in the area of experience of ethical leadership (67 % agreed). The results showed a strong positive connection between ethical leadership and all the components of work- related well-being. The managers and employees were generally quite happy with the services of occupational health care but managers saw some problems with the collaboration with occupational health care. Several ways to improve work-related well-being and collaboration with occupational health care were found. One of the most important things was thought to be offering ways to maintain ability to work and making these actions visible. Investing in ethical leadership and work-related well-being is extremely important for the success of an organization and the societal benefits cannot be forgotten either. The role of occupational health care in promoting the health and well-being of employees is substantial. Occupational health care should offer managers more tools to recognize difficult situations and acting in them as well as encourage managers to seek help from occupational health care without hesitation in problematic situations of leadership.