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This insider action research project aimed to improve interprofessional team performance at a surgical ward. The purpose of the project was (1) to critically appraise potential deficiencies in staffs’ identification, clinical judgment, and management of deteriorating ward patients, (2) to develop an interprofessional change model, and (3) evaluate the impact of the change model and the AR process. The insider AR project took place at a large Danish surgical ward with 60 participating physicians and nurses. The study was conducted in three interconnected action and reflection cycles using mixed methods. Staff viewed the co-creation and co-inquiry as important resources in transforming the ward into a better microsystem. Microsystems as a theoretical framework was used to conceive the success of health system redesign as a matter of enabling the clinical team to meet patient needs. By combining insider AR with microsystems, this study highlights the importance of senior leaders to recognize the nature and power of using the microsystem approach for strategy, excellence, innovation, and research. Staff was able to formulate an overarching vision of interprofessionalism and this helped inspire changes in clinical practice for the benefit of our patients. [ABSTRACT FROM AUTHOR]

In this article, we present a case study of residents’ clinical experiences and communication in outpatient oncology consultations. We apply positioning theory, a dynamic alternative to role theory, to investigate how oncology residents and patients situate themselves as persons with rights and duties. Drawing from seven qualitative interviews and six days of observation, we investigate the residents’ social positioning and their conversations with patients or supervisors. Our focus is on how (a) relational shifts in authority depend on each situation and its participants; (b) storylines establish acts and positions and narratively frame what participants can expect from a medical consultation viewed as a social episode; and (c) the positioning of rights and duties can lead to misunderstandings and frustrations. We conclude that residents and patients locate themselves in outpatient conversations as participants who jointly produce and are produced by patients’ and nurses’ storylines about who should take responsibility for treatment. [ABSTRACT FROM AUTHOR]

This is a case study of a blended family undergoing home-based psychotherapy. The study uses sociocultural theory (Vygotsky) and semiotic cultural psychology (Valsiner) in order to understand the appropriation and usage of signs as regulators of behavior. Furthermore, the article draws upon Foucault’s genealogical approach and Rose’s notion of Psydiscourse. It is argued that this approach is fruitful for understanding psychotherapy as a governing discourse that influences contemporary families. Technologies of the self, such as psychotherapy and signs like ‘time-out’ and ‘stop,’ are used by family members in attempts to break a cycle of conflict—violence but they also exacerbate negative emotions, which we see in the case of conflict. The article develops a critique of the practice of punishment and reward. By analyzing psychotherapy as signs and technologies of the self impacting family life, we start understanding the barriers to well-being in families and individual lives. [ABSTRACT FROM PUBLISHER]