This ‘A Qualitative Space’ article takes a critical look at Dorothy Smith’s approach to inquiry known as institutional ethnography and its potentiality in contemporary health professions education research. We delve into institutional ethnography’s philosophical underpinnings, setting out the ontological shift that the researcher needs to make within this critical feminist approach. We use examples of research into frontline healthcare, into the health work of patients and into education to allow the reader to consider what an institutional ethnography research project might offer. We lay out our vision for potential growth for institutional ethnography research within the health professions education field and explain why we see this as the opportune moment to adopt institutional ethnography to meet some of the challenges facing health professions education in a way that offers informed change.
This article is based on an institutional ethnographic inquiry into the work of paramedics and the institutional setting that organizes and coordinates their work processes in a major City in Canada. Drawing on more than two hundred hours of observations and more than one hundred interviews with paramedics (average length of 18 minutes) and other emergency medical personnel, this article explores the standard and not so standard work of paramedics as they assess and care for their patients on the front lines of emergency health services. The multiplicity of interfacing social, demographic, locational, and situational factors that shape and organize the work of paramedics are analyzed. In doing so, this article provides insights into the complex work of an understudied yet ever-important profession in health care.
most research in the field of autism focuses on the medical and psychological characteristics of the disability. Research that focuses on caregiving emphasizes the stresses and pathological features associated with having a child with autism. As such, the more positive aspects of caregiving have been left in abeyance, portraying caregiving and autism as characterized by only negative experiences, prognoses, and outcomes. Based on mothers' reflections, this article reports on some of the positives of caregiving. The findings provide a glimpse into a seldom studied side of caregiving-events and experiences appraised by mothers in a positive and sometimes joyous light-and the impact they have on mothers' experiences. Furthermore, practical implications for social service professionals and families are discussed.
In this article I use insights offered by the poststructural shift and linguistic turn in social scientific inquiry, specifically discourse analysis, to explore mothers' talk about the placement of their child with autism outside of the home. By viewing mothers' talk as data, I bring to light the discourses and interpretive practices that mothers drew on to organize their talk of placement. In doing so, I provide insights into how mothers gave meaning to processes of placement while also expanding on commonsensical discursive notions of "good" mothering, caregiving, and family. Implications of the findings are discussed.
In this article, I take readers inside of an ambulance and explore how paramedics work in and on their "apparatus unit" to make it a workable fit. This taken-for-granted work is important because much is at stake in the back of the ambulance, particularly in relation to quality of care and safety. I draw on data from an institutional ethnography into the socially organized work and work settings of paramedics, which included more than 200 hr of observations and more than 100 interviews with paramedics. The findings shed light on the situated work processes of paramedics as they orient and respond to their "apparatus unit" and enact quality and safety in practice. This article adds to the sociological literature on work and occupations as well as safety and quality in health care of an increasingly important group of health care and emergency services professional.
The family, as a social institution in Qatar, is the main care provider for its older adult members. In this paper we examine what caregivers do -their work practices -and the different roles and responsibilities that home caregivers perform when providing care for elderly persons in Qatar. The findings of this study were based from a larger study using qualitative descriptive design. This article demonstrates the work practices and main challenges that caregivers face while taking care of their elderly. We argue that a main source of stress for caregivers is the lack of formal services and supports geared towards individuals caring for their ageing loved ones; addressing this service gap would alleviate some of the demands associated with caregiving. The paper will present exemplars of caregivers taking care of their elderly relative. These exemplars are used to support the analysis which is clustered around identified related themes. The main findings regarding the challenges that caregivers face include: feelings of responsibility; dependency on caregiver; emotional care; social planning; problem solving; and environmental quality. All of the themes impacted the health of the caregivers and led to stress and burden on the life of the caregiver.
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