Professional autonomy of Victorian surgeons in the context of law and ethics

An analysis of legislation and court decisions demonstrates that the privilege of autonomous decision making by surgeons in Victoria has become progressively constrained. Factors that have led to this include workforce issues and the protection of the public combined with increasing involvement of the courts in questions involving medical ethics.

An exploration of issues of management and intention to stay : allied health professionals in south west Victoria, Australia

Management of allied health staff and services often has implications for staff stability and retention. A survey of allied health staff in South West Victoria was conducted in 2003 to explore issues relating to recruitment and retention. Findings relating to management and retention of staff in their current job are addressed in this report. A total of 138 staff returned their questionnaires. Results were related to Maslow's hierarchy of needs, level of belonging, with professional needs identified as feeling supported, orientation to the position, clear job description, and able to recommend the position to others. Qualitative data showed that recommending the position was associated with job satisfaction, autonomy, flexibility, and variety of work. The immediate management structure was significantly related to retention. Reasons given for intending to leave were related to management categories. These were management structure, lack of career structure, and lack of professional support. Reasons given by respondents for not recommending their current position were as follows: not for long-term career, risk of deskilling if staying too long, and financially unrewarding. These reasons were also related to management. Positive reasons for staying, which were related to management, included flexible work conditions, variety of clinical and management experience, good working environment, good support, and autonomy. Recommendations are given for organizational development and training for managers.

Scope of practice in forensic nursing

1. There is significant role variation, across the Western world, in relation to how forensic nurses practice. 2. The authors conducted a pilot survey of forensic nurses in Australia, New Zealand, the United States, and the United Kingdom to examine forensic nursing practice, role definition, and role boundaries. 3. Issues arising from the data include the visibility of forensic nurses, the client group, forensic-specific education, and role development.

Within and against performativity : discursive engagement in adult literacy and basic education

The field of adult literacy and basic education (ALBE) has undergone dramatic changes in recent years with the advent of labour market programs, accreditation, competency-based assessment and competitive tendering for program funds. Teachers' working conditions have deteriorated and their professional autonomy has been eroded. ALBE has been increasingly instrumentalised to fulfil the requirements of a marketised economy and conform to its norms. The beliefs and value systems which traditionally underpinned the work of ALBE teachers have been reframed according to the principle of 'performativity' and the demands of the 'performative State' (Lyotard, 1984: 46, Yeatman 1994: 110). The destabilisation of teachers' working lives can be understood as a manifestation of the 'postmodern condition' (Lyotard 1984; Harvey 1989): the collapse of the certainties and purposes of the past; the proliferation of technologies; the impermanence and intensification of work; the commodification of knowledge and curricula; and the dissolving of boundaries between disciplines and fields of knowledge. The critiques of the modernist grand narratives which underpin progressivist and critical approaches to adult literacy pedagogy have further undermined the traditional points of reference of ALBE teachers. In this thesis I examine how teachers are teaching, surviving, resisting, and 'living the contradictions' (Seddon 1994) in the context of struggles to comply with and resist the requirements of performativity. Following Foucault and a number of feminist poststructuralist authors, I have applied the notions of 'discursive engagement' and 'the politics of discourse' (Yeatman 1990a) as a way of theorising the interplay between imposed change and teachers' practice. I explore the discursive practices which take place at the interface between the 'new' policy discourses and older, naturalised discourses; how teachers are engaged by and are engaging with discourses of performativity; how teachers are discursively constructing adult literacy pedagogy; what new, hybrid discourses of 'good practice' are emerging; and the micropractices of resistance which teachers are enacting in their speech and in their practice. My purpose was to develop knowledge which would support the reflexivity of teachers; to enrich the theoretical languages that teachers could draw upon in trying to make sense of their situation; and to use those languages in speaking about the dilemmas of practice. I used participatory action research as a means of producing knowledge about teachers' practices, structured around their agency, and reflecting their standpoint (Harding 1993). I describe two separate action research projects in which teachers of ALBE participated. I reflect on both projects in the light of poststructuralist theory and consider them as instances of what Lather calls 'within/against research' (Lather 1989: 27). I analyse written and spoken texts produced in both projects which reflect teachers' responses to competency-based assessment and other features of the changing context. I use a method of discourse mapping to describe the discursive field and the teachers' discursive practices. Three main configurations of discourse are delineated: 'progressivism', 'professional teacher' and 'performativity'. The teachers mainly position themselves within a hybridising 'progressivist /professional teacher' discourse, as a discourse of resistance to 'performative' discourse. In adapting their pedagogies, the teachers are in some degree taking the language and world view of performativity into their own vocabularies and practices. The discursive picture I have mapped is complex and contradictory. On one hand, the 'progressivist /professional teacher' discourse appears to endure and to take strength from the articulation into it of elements of performative discourse, creating new possibilities for discursive transformation. On the other hand, there are signs that performative discourse is colonising and subsuming progressivist /professional teacher discourse. At times, both of these tendencies are apparent in the one text. Six micropractices of resistance are identified within the texts: 'rational critique', 'objectification', 'subversion', 'refusal', 'humour' and 'the affirmation of desire'. These reflect the teachers' agency in making discursive choices on the micro level of their every day practices. Through those micropractices, the teachers are engaging with and resisting the micropractices and meanings of performativity. I apply the same multi-layered method of analysis to an examination of discursive engagement in pedagogy by analysing a transcript of the teachers' discussion of critical incidents in their classrooms. Their classroom pedagogies are revealed as complex, situated and eclectic. They are combining and integrating their 'embodied' and their 'institutional' powers, both 'seducing' (McWilliam 1995) and 'regulating' (Gore 1993) as they teach. A strong ethical project is apparent in the teachers' sense of social responsibility, in their determination to adhere to valued traditions of previous times, and in their critical self-awareness of the ways in which they use their institutional and embodied powers in the classroom. Finally, l look back on the findings, and reflect on the possibilities of discursive engagement and the politics of discourse as a framework for more strategic practice in the current context. This research provides grounds for hope that, by becoming more self-conscious about how we engage discursively, we might become more strategic in our everyday professional practice. Not withstanding the constraints (evident in this study) which limit the strategic potential of the politics of discourse, there is space for teachers to become more reflexive in their professional, pedagogical and political praxis. Development of more deliberate, self-reflexive praxis might lead to a 'postmodern democratic polities' (Yeatman 1994: 112) which would challenge the performative state and the system of globalised capital which it serves. Short abstract Adult literacy and basic education (ALBE) teachers have experienced a period of dramatic policy change in recent years; in particular, the introduction of competency-based assessment and competitive tendering for program funds. 'Discourse politics' provides a way of theorising the interplay between policy-mediated institutional change and teachers' practice. The focus of this study is 'discursive engagement'; how teachers are engaged by and are engaging with discourses of performativity. Through two action research projects, texts were generated of teachers talking and writing about how they were responding to the challenges, and developing their pedagogies in the new policy environment. These texts have been analysed and several patterns of discursive engagement delineated, named and illustrated. The strategic potential of 'discourse polities' is explored in the light of the findings.

Why educators should bring an end to pedagogy

As Australia is moving towards a national curriculum there are also activities to nationalise teacher education. This involves various departments of state and federal governments, third-party bodies funded by government such as the Curriculum Corporation and Teaching Australia, and non-government organisations such as the Business Council of Australia. These agencies are producing models and principles which aim on establishing standards of best practice for how they want teachers to teach. Within all of this activity the term ‘pedagogy’ is often employed to represent aspects of these best practices. Examples include ‘productive pedagogies’, ‘new pedagogies’, ‘pedagogical content knowledge’ and ‘pedagogical strategies’. However these are all means only without any end purposes which identify them as being valuable for education. In this paper I will argue that in order to have educative value teachers themselves must exercise a degree of professional autonomy to bring their own end purposes to their choice of pedagogy.

Working and learning in vocational education and training in the knowledge era : final report of the professional development for the future project

This Report summarises the outcomes of the phases of the Professional
Development for the Future Project and presents the implications of this research for professional development of staff in Vocational Education and Training (VET), as they become knowledge workers.

These shifts are occurring within the knowledge era. Distinguishing features of this era are summarised into four broad areas:
- the importance and value placed on knowledge in organisations
- the time span of discretion
- the complexity of relationships, and
- the ubiquitous nature of information and communication technology.

It is within this context that work is currently performed, and understanding this context provides the foundation for considering new capabilities required in the knowledge era.
Key capabilities required of knowledge workers to work effectively in the
knowledge era were drawn together from an analysis of the theoretical literature and the results of interviews with knowledge workers. The core capabilities identified include:
- adaptive problem solving – becoming designers as well as problem -
solvers
- rapid knowledge gathering and sharing with others
- discriminating between relevant and irrelevant information, and
- understanding and working effectively with the organisation’s culture.

Knowledge era characteristics and knowledge worker capabilities have been mapped to each other illustrating conceptual linkages between these two areas.

Professional development themes drawn from interviews with knowledge
workers are presented. While global trends in knowledge work have been well documented, the impact of these trends on the capabilities of workers, and the ways in which knowledge workers develop these capabilities is less well understood. Their learning methods challenge our current thinking in relation to the ways in which workers acquire skills and knowledge. Some of the professional development methods include seeking exposure to new ideas from a wide variety of sources, embracing intense learning opportunities, and using relationships to increase knowledge.

‘Thought pieces’ (see p17 ff) commissioned for this Project, as well as
subsequent interviews with the authors, provided further insights into the
professional development of knowledge workers. The implications of these insights are an extension of earlier themes and emphasise:
- the emergent nature of knowledge work
- the importance of relationships that facilitate knowledge sharing
- coherent conversations and dialogue
- collaborative work and generosity.

A key insight is the shift from thinking about knowledge work in terms of
borrowed knowledge to an emphasis on generated knowledge within a context.

Data from focus groups of the Project provide further insights for knowledge worker professional development. These augment the perspectives of the earlier data analysis but also add greater emphasis to:
- the clear and direct relationship between professional development and
work and career aspirations of knowledge workers,
- the relationship of professional development to the organisational
mission, and
- the issues of managing and leading knowledge workers and their
development.

As part of this analysis the defining features of organisational life in VET were reviewed in relation to effective professional development of knowledge workers.

The final section of the Report revisits the core dimensions of the Project.
Concise commentaries on working and learning in the knowledge era,
professional development in the knowledge era, and leadership and
management in the knowledge era are presented.

The Report concludes with a discussion of the enablers of professional
development for knowledge workers in VET. This discussion is introduced by a re-statement of the VET sector’s positioning in the knowledge era and the consequences of this for VET managers an d staff in terms of complexity, uncertainty and diminished prospects for accurate predictiveness. The enablers comprised:
- integration of information technology into socio -technical systems
- greater understanding of the organisation from within
- connecting staff to the organisation’s fundamental identity
- connecting to the work and career trajectories of workers
- establishing work structures which integrate the use of professional
development resources with knowledge work
- providing workers with the autonomy to design their own professional
development activities
- building professional development into the iterative nature of knowledge
work, and
- creating organisational contexts that value intuitive thinking and working.

Professional development needs to be thou ght of in a much broader context in the knowledge era. What each VET staff member knows and shares will become increasingly central to their work, and in that sense all VET workers require capabilities for knowledge work. This report accurately describes t he VET context, the capabilities required, and the organisational enablers that will promote ‘knowing’ and thus embed a new style of professional development within VET.

The impact of the expanded nursing practice on professional identify in Denmark

Purpose: This article explores the concept of professional identity of Danish nurses working in an expanded practice. The case study explores the experiences of a small group of Danish nurses with a new professional category that reaches into a domain that customarily belonged to physicians. The aim of this case study was to explore the impact of “nurse consultations,” representing an expanded nursing role, of 5 nurses focusing on their perception of autonomy, self-esteem, and confidence.


Methods: The case study used semistructured interviews with 5 participants triangulated and validated with participant observations, a focus group interview, and theoretically derived insights.


Findings: This study indicates that nurses working within a new expanded professional practice see themselves as still engaged in nursing and not as substitute physicians. The study also suggests that the involved nurses gained a higher sense of autonomy, self-esteem, and confidence in their practice. These elements have a positive impact on their professional identity.


Conclusion: The research demonstrates that for the nurses involved in expanded professional practice, the boundaries of professional practice have shifted significantly. The research indicates that an expanded practice generates a new domain within the professional identity of nurses.

‘It’s like Spiderman… with great power comes great responsibility’: school autonomy, school context and the audit culture

This paper explores issues of school autonomy within the context of the performative demands of the audit culture. The focus is on a case study of Clementine Academy, a large and highly diverse English secondary school. Specific situated, professional, material and external factors at the school were significant in shaping Clementine’s response to and take-up of the policy of academisation (a key reform within broader government mandates to create an increasingly autonomised education system). Factors such as the school’s intake and history, its ethos and values, its access to human and economic resources and its status and power as an outstanding school supported its confident and ‘morally’ focused take-up of this policy. Clementine’s privileged position in relation to these factors enabled the school to mediate and challenge some of the negative effects of the audit culture. This paper highlights the significance of considering these contextual factors in understanding the different ways in which schools are currently engaging their autonomy to cope with the demands of the audit culture.