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This article concerns how spaces of professional autonomy are defined and formed in Swedish higher education institutions (HEIs). Swedish HEIs have become increasingly characterised by rivalling principles of management and professional autonomy. The relational aspects of how a professional habitus is formed and negotiated in relation to management ideals and practices are investigated. The research methods used in this study were interviews with HEI management, strategic human resource management (HRM) representatives and research and teaching staff at three HEIs under different conditions of collegial influence and forms of management. The results show that professional negotiations are undergoing conversion pressures under New Public Management (NPM)-implemented governance, but because professional identities are strongly rooted in academic core values, they are relatively resistant to NPM imposition and encroachment. In light of this, the article offers a discussion on the dilemma of conforming to managerial demands and priorities without losing a professional self.

Introduction Clinical reasoning (CR) among healthcare professionals working in emergency medical services (EMS) who focus on ambulance care is a vital part of ensuring timely and safe patient care. The EMS environment continually fluctuates, so clinicians constantly need to adapt to new situations. Organizational support is described as important for CR, but overall, research on organizational influences for CR in an EMS context is lacking. An increased understanding of these influencing factors can assist in the development of EMS by strengthening CR among clinicians. Therefore, the purpose of this study was to investigate the organizational factors influencing EMS clinicians’ CR. Methods Using a qualitative single case study design, an EMS organization in southwestern Sweden was explored. Data were collected from participant observations of patient encounters, individual and group interviews with clinicians and organizational representatives, and organizational document audits. Data were analyzed using qualitative content analysis and triangulation of data sources. Results The results revealed several organizational influencing factors. Collaboration and information sharing internally and externally were emphasized as essential components influencing CR. Additionally, the structure for the clinicians’ ‘room for action’ appeared confused and created uncertainties for CR related to decision mandates. Conclusion The conclusion is that organizational factors do play an important role in clinicians’ CR. Moreover, the EMS community needs to develop suitable forums for discussing and developing these influencing factors across organizational hierarchies. Finally, clarification is needed on clinicians’ ‘room for action’ within their own organization but also with possible collaborators.