Nye kompetansekrav i offentlig sektor: Digitaliseringens konsekvenser for arbeid med ulik grad av spesialisering (CORPUS)

• Sadorge, Christopher (2026). Making work flow: The constitutive role of knowledge domains in co-design processes. Learning, Culture and Social Interaction. ISSN 2210-6561. 58. doi: 10.1016/j.lcsi.2026.101007. Fulltekst i vitenarkiv Vis sammendrag

  Professional practices periodically have to be adjusted. Professionals are therefore increasingly involved in co-design activities where they need to manage professional knowledge, cultural resources, and conflicting concerns when developing workflows. This study aims to obtain a better understanding of professionals' knowledge work in developing new workflows, focusing on how healthcare teams mobilise and integrate knowledge resources during co-design. Over a year and a half, meetings were observed where healthcare professionals and software engineers worked together to design a technology for recording and sharing patient information across healthcare units. Healthcare professionals contributed to the co-design by sharing knowledge and local concerns about implementing workflows into the system. Drawing on the concept of epistemic space, the analysis focuses on how healthcare professionals collaboratively identified and evaluated knowledge resources within two medical domains in which the resources framed problems and facilitated collective inquiry. This study shows that, depending on the cultures of the two knowledge domains and by participants' interactions with the available knowledge resources and their meaning potential, the team's work evolved differently: the infection care domain provided minimal guidance on organising workflows, leading the team to consider multiple infection variations, while medication management, governed by laws, regulations, and checklists, required extensive sense-making of formalised resources. These findings underscore that the conditions for co-design vary notably across knowledge domains, as domain-specific features shape how professionals mobilise, interpret, and integrate knowledge resources.

• Brandenberger, Isabel Alexandra & Mäkitalo, Åsa (2025). Care with assistive technologies: professional responsibility when learning to navigate the unforeseen in homecare services. Journal of Workplace Learning. ISSN 1366-5626. doi: 10.1108/JWL-05-2024-0111. Fulltekst i vitenarkiv Vis sammendrag

  Purpose This study aims to explore how responsibility is managed by an interprofessional team of healthcare professionals when unforeseen challenges in the use of assistive technologies in homecare raise concerns for care. Design/methodology/approach An ethnographic approach was used to study the daily work of integrating assistive technologies into homecare services. By observing 27 interprofessional team meetings, this paper investigated how challenges in using these technologies for specific cases were handled collectively through professional discussions. Sociomaterial and practice-theoretical perspectives were used to analyze actors and relations expressed as healthcare professionals discussed their concerns, and how responsibilities were reconsidered in ongoing patient care. Findings In analyzing the meeting discussions, this paper found that unforeseen challenges put the professional responsibility of the healthcare team at stake in knowing how to respond. This paper found that healthcare workers collectively managed distributed responsibilities by a) reviewing specific user cases and b) reconsidering responsibilities. This paper propose that this “responsibility work” and the care for entanglements it entails contribute to the stabilization of homecare service practices by embedding the use of technology in the constantly changing health needs of users. Originality/value This article proposes the notion of responsibility work as a constitutive part of practitioners’ knowing and learning at work in complex organizations under digital transformation. In such work, the complexities stemming from emerging concerns and specific entanglements are collaboratively managed as matters of care through professional discussions in situated workplace practices.

• Brandenberger, Isabel Alexandra; Hasu, Mervi & Nerland, Monika (2023). Integrating technology with work practices in primary care: Challenges to sustainable organizing "from within". Learning Organization. ISSN 0969-6474. doi: 10.1108/TLO-01-2023-0009. Fulltekst i vitenarkiv Vis sammendrag

  Purpose This paper aims to generate a better understanding of how challenges and opportunities for sustainable change during digitalization relate to the organizing work of change agents mandated to facilitate technology adoption from within local work organizations. Design/methodology/approach This study examines the work of welfare technology coordinators, health-care professionals who are mandated to facilitate the use of technologies in home-based services in a Norwegian city. Data comprise ethnographic observations of meetings and work practices, interviews and documents collected over one year. A practice-based approach was applied to analyze how the welfare technology coordinators go about integrating technologies with the work practices, and the forms of negotiations this work implies in their work community. Findings The analysis identified four sets of practices in the coordinators’ work: exploring and integrating new technologies into work practices, legitimizing aims and values, formalizing routines and responsibilities and critically considering existing and envisioned service practices. Through these practices, emerging problems and disconnections in the service organization were attended to in a continuous manner. Originality/value The study contributes to the literature by examining the work of internal change agents mandated to facilitate multiple and simultaneous technology adoption and demonstrates the importance of recognizing the continuous efforts and negotiations of these agents as significant to sustainable organizing.

• Nerland, Monika; Hasu, Mervi & Grisot, Miria (2023). Discourses of Digitalisation and the Positioning of Workers in Primary Care: A Norwegian Case Study. Social Inclusion. 11(4), s. 172–183. doi: 10.17645/si.v11i4.7121. Fulltekst i vitenarkiv Vis sammendrag

  Primary health services are subjected to intensified digitalisation to transform care provision. Various smart and assistive technologies are introduced to support the growing elderly population and enhance the opportunities for independent living among patients in need of continuous care. Research has shown how such digitalisation processes evolve at the intersection of different and often competing discourses, oriented towards service efficiency, cost containment, technological innovation, client‐centred care, and digital competence development. Often, increased technology use is presented as a solution to pressing problems. However, how discourses are negotiated in work contexts and their mechanisms of social inclusion/exclusion in evolving work practices have received less attention. This article examines how care workers in the primary health sector are discursively positioned when care technologies are introduced in the services. We employ a perspective on discourses and subject positions in analysing strategic documents and interviews with care workers in a large Norwegian city. We show how managerial discourses that focus narrowly on the implementation and mastery of single technologies provide limited spaces for workers to exert influence on their work situations, while discourses that emphasise professional knowledge or broader technological and organisational aspects provide a variety of resources for workers’ agency. The way care workers adopt and negotiate subject positions varies based on their tasks and responsibilities in the organisation. We discuss the need to move beyond “solutionism” in efforts to digitalise care work in order to provide inclusive spaces supporting the contributions of various worker groups.

• Sadorge, Christopher; Nerland, Monika & Mäkitalo, Åsa (2023). Conditioning the work of colleagues: health professionals’ explorative work in technology design. Vocations and Learning. ISSN 1874-785X. doi: 10.1007/s12186-023-09331-0. Fulltekst i vitenarkiv Vis sammendrag

  Abstract Professional learning at work is related to the opportunities to participate in explorative and constructive practices. Co-designing tools and technologies to support work offers such opportunities, which need to be better understood in the field of professional and vocational learning. As digitalisation initiatives become more ambitious and aim at wider service reorganisation, more professionals from nontechnical domains become involved in the work of designing technologies and developing routines for their practice. This study explores how health professionals participate in the design of a technology for the registration and sharing of patient information across healthcare units in a Norwegian city. Over a year, we observed the design meetings with a team of health professionals and IT developers. The health professionals were mandated this task as part of their regular work to ensure that the way of categorising and displaying patient information would serve the services’ needs. The interactions in the design meetings were analysed to examine how categories of patient information were explored and negotiated as objects of design. Our findings show how the team needed to test candidate categories for various contexts of use. This implied both negotiation of future service routines and efforts to reconfigure tasks and responsibilities in multiple service contexts. This work brings extended responsibilities and opportunities for learning to health professionals. We discuss how their decisions are consequential beyond their own workplace as the information system and its categories condition the work of colleagues in the wider service chain.

• Sadorge, Christopher; Nerland, Monika & Grisot, Miria (2023). The Generative Role of Objects in Infrastructure Design: A Case of Designing a System for Continuity of Care. Computer Supported Cooperative Work (CSCW). ISSN 0925-9724. doi: 10.1007/s10606-023-09485-4. Fulltekst i vitenarkiv Vis sammendrag

  Abstract This study explores the generative role of objects in design work. While the CSCW literature includes a range of contributions on infrastructure design and ways of accounting for diverse existing systems, practices and perspectives in design, the focus has typically been on the point of use, rather than the earlier stages of design processes. However, as more worker groups become involved in design there is a need to understand the microdynamics of collaborative design in this phase and the interplay between problem framing and exploration. We examined how the design of an information system in the health sector evolved through the instantiation and exploration of intermediary objects that become generative in the design process. The data comprised observations over 2 years from design meetings with a team of health professionals and software developers mandated to develop a system for the registration and sharing of patient information across primary care units. The analysis showed how intermediary objects formed focal points from which infrastructure design problems were framed and collectively explored. These processes required considerable negotiation and exploration within and between the interdependencies that become relevant in the design process. We identified how intermediary objects take different representational forms and become generative in two ways: By producing new or transformed objects, and by revealing layers of complexity inherent in the design problem. We discussed implications of the analysis as regards aspects of the infrastructure design that can be handled in the design team versus aspects that should be delegated to local adaptation.

• Nerland, Monika (2022). Organisational learning in complex epistemic environments: reflections from studies of professional work in Norway. Learning Organization. ISSN 0969-6474. doi: 10.1108/TLO-02-2022-0025. Fulltekst i vitenarkiv Vis sammendrag

  Purpose The aim of this invited paper is to explore how more complex epistemic environments generate opportunities and challenges for organizational learning in professional realms. Based on these explorations, a second aim is to discuss whether there are specific conditions in Nordic working life that facilitates or restricts such learning opportunities. Design/methodology/approach The paper discusses conditions for organizational learning in terms of changing knowledge practices and relations. Examples from studies of knowledge work in the Norwegian education and health sectors are provided to illustrate how professionals become involved in epistemic practices as part of their work and how these practices are changing in relation to evolving knowledge cultures. Findings The paper conceptualises and discusses how knowledge practices are changing in relation to specific and increasingly complex epistemic environments. It is argued that features such as low power distance, high levels of higher education participation, well-developed digital infrastructures and a general trust in professionals are conducive to learning. At the same time, taking advantage of learning opportunities are increasingly depending on individuals’ agency and capacities to cope with new demands. Originality/value To better account for the complexity of epistemic environments, organisational learning can be seen as a matter of connecting epistemic practices in the local work organisation to wider knowledge circuits.

• Dæhlen, Åsmund & Grisot, Miria (2021). User mobilization in bottom-up infrastructural transformation. Reports of the European Society for Socially Embedded Technologies. doi: 10.18420/ihc2021_017. Fulltekst i vitenarkiv
• Dæhlen, Åsmund & Grisot, Miria (2021). User Participation in Infrastructuring: Exploring the Space for Action. I Parmiggiani, Elena; Kempton, Alexander Moltubakk & Mikalef, Patrick (Red.), Proceedings of the12th Scandinavian Conference on Information Systems (SCIS2021). Association for Information Systems (AIS). ISSN 9788230350546. Fulltekst i vitenarkiv Vis sammendrag

  This paper addresses participation in the design and transformation of an information infrastructure in healthcare. Recent work on the transformation of health information infrastructures shows that bottom- up user-driven processes are preferred, however, the role of users in infrastructuring remains under researched. This study addresses this gap by investigating user representatives' work in the design of an infrastructure. Grounded in the Scandinavian tradition of Participatory Design, this study conceptualise participation as space for action. This study is based on empirical research conducted on a project developing a digital application for sharing patient data in patient handovers. The context of the study is primary care services in Norway. Our findings show how user representatives engage local organizations as both facilitators for their own design process, i.e. designers preparing and transforming their local services, and as participants into design of the infrastructure, i.e. designers shaping technology. We contribute to literature on infrastructuring by showing how user representatives explore possbilities for action shaping the infrastructuring process.

• Nerland, Monika & Hasu, Mervi (2020). Challenging the belief in simple solutions: The need for epistemic practices in professional work. Medical Education. ISSN 0308-0110. doi: 10.1111/medu.14294. Fulltekst i vitenarkiv Vis sammendrag

  Context As a contribution to the State of the Science issue on ‘The problem with solutions’, this paper discusses how technology‐mediated and assumedly simple and straightforward solutions to professional problems in fact require extensive work from professionals in order that generalised tools and procedures can be made sense of, adapted and employed in local practice. Theoretical perspective The authors introduce a perspective on epistemic practices in professional work and learning in order to conceptualise and discuss the diversity of the knowledge‐related actions required to perform professional services. They discuss how the growing numbers and diversity of knowledge‐generating actors who aspire to inform professional practice create ‘multi‐charged’ work settings, imbued with multiple objectives and purposes. This development presents new epistemic challenges to professionals, which require extended capacities for knowledge work. Summary The authors give examples from empirical studies conducted in Nordic health care settings, which relate to nurses’ engagement with repositories of clinical procedures and to the development of new medical technologies for clinical use. They show how work performance in both cases depends on a range of epistemic practices (ie, collective ways of exploring, assessing, critically examining and justifying knowledge claims), which are necessary if the general tools and technologies are to be put to work in the local environment. This forms a core dynamic in practitioners’ work‐based learning as it moves between what is known and what remains to be explored or improved. Conclusions The paper argues that the widespread belief in simple or versatile solutions is challenged by research that reveals the diversity of the knowledge practices needed to perform professional services. The paper suggests that professional communities might pay more attention to epistemic practices as means to handle complexity. It raises intriguing questions and discusses implications for medical education.

Se alle arbeider i NVA

• Lunde, Ida Martinez & Nerland, Monika (2026). Making Novel Technology Work: Analysing Emerging Human–Technology Configurations in Primary Care. Fulltekst i vitenarkiv
• Nerland, Monika & Mäkitalo, Åsa (2025). Learning through metawork in digitalised healthcare: The case of monitoring patient falls. Fulltekst i vitenarkiv
• Nerland, Monika & Brandenberger, Isabel Alexandra (2025). Hva krever digitaliseringen av helsearbeidere? Fulltekst i vitenarkiv
• Lunde, Ida Martinez; Nerland, Monika; Sadorge, Christopher & Grisot, Miria (2024). Implementing Electronic Health Records: Shifts and Obstacles in Machineries of Knowing. Fulltekst i vitenarkiv
• Christensen, Marit Eline Lervik (2024). Digitale dingser er bare en liten del av løsningen på bemanningskrisa i helsetjenestene. Forskning.no. ISSN 1891-635X. Fulltekst i vitenarkiv
• Hasu, Mervi & Saari, Eveliina (2024). Human resources organising in the early phase of digitalisation in primary health service organisations: Case examples from Norway and Finland Thematic track: Future directions in technological development. Fulltekst i vitenarkiv Vis sammendrag

  This paper explores human resourcing strategies in the early phase of digitalisation in two primary health service organisations. The Norwegian case organisation (‘urban-distributed’) comprises several independent urban city districts responsible for local services and several specialist central agencies, such as the health agency, responsible for care development in medical, dental, psychosocial care, public health and development of the municipality’s professional systems. Economically, this local context can be characterised as ‘resource-rich’ environment. The Finnish case organisation (‘rural-integrated’) is responsible for both social and health care in a broad geographic region and comprises urban and large rural municipalities. This local context, in turn, can be characterised as ‘resource-scarce’ environment. We anticipated variation in the resourcing strategies of the two cases based on the developmental and demographic characteristics of both health care systems. We aimed to investigate how the different local contexts are displayed in the work resourcing arrangements of these organisations, particularly how the context-specific environments address organising work roles and establishing anticipated competences in different ways. The primary data comprised eight semi-structured interviews from the urban-distributed case and eight semi-structured interviews from the rural-integrated case concerning digital changes in homecare services. The interviews covered various positions, from leaders to new operative roles dedicated to enhancing digital change, and they represented different organisational functions. Supplementary data included strategy and planning documents. The analysis revealed both similarities and differences in the resourcing strategies in the two cases. Both organisations used project-based organising and established new work roles dedicated to digital change that led to allocating resources from care units to development functions. We found differences concerning organising the shift from project organising to daily care work. The new work roles were titled differently in the two cases, characterising the specific local contexts and orientations to change. We interpreted the resourcing strategy of the urban-distributed case as standard technology-driven and implementation-oriented (hierarchy), while the rural-integrated case seemed to apply a bricolage-model (Fuglsang & Sørensen, 2011), that is, a mixed technology- and rehabilitation-based strategy. We discuss on the consequences of the characteristics of public service work organising under digitalisation, and reflect upon the opportunities for sustainable service work practices in the future.

• Hasu, Mervi (2024). Kompetansekartlegging i helsesektorens digitaliseringsprosesser. Fulltekst i vitenarkiv Vis sammendrag

  Innføringskompetansen for helsepersonell er nødvendig fordi stadig flere ansatte i helsesektoren er involvert i å få de digitaliserte tjenestene og prosessene til å fungere i det daglige arbeidet. Kjernemodellen av innføringskompetansekartlegging illustrerer hvordan vi adresserer nøkkelelementer for innføringskompetanse i digitalisering for arbeidsenheter i tjenestene. Vi mener at innføringen krever kollektiv innsats. Fire elementer: Å forstå forskjellene mellom initiativene - Å forutse tilpasningsbehov - Å planlegge ny arbeidsflyt - Å forme nye arbeidsroller og oppgaver. Hvilken innføringskompetanse som trengs, kan ikke identifiseres uten at man først finner ut hvordan digitaliseringen vil endre arbeidet i en bestemt del av tjenestene. Det som følger med arbeidet rundt innføringen, handler mye om vurderingsaktiviteter, og kompetanse til å vurdere hvordan tjenesteprosessen fungerte før den planlagte endringen, og hvordan den skal drives etter implementering. Dette første poenget handler om kompetanse for å vurdere digitaliseringens konsekvenser for arbeidet. Når det gjelder det andre punktet, kan arbeidsenheten etablere en felles forståelse på initiativet for den spesielle tjenesten og lokal bruk. Det vil si: hva er det som kjennetegner vår digitaliserings-satsing denne gangen? Dette kan kreve litt «imaginær» tenkning og forsøke å forutse fremtiden. Dette poenget gjelder om kompetanse for å vurdere omorganiseringsbehov. Endringer i form av digitalisering innebærer ofte behov for å endre hele eller deler av arbeidsprosessen og kommunikasjons-kanaler mot brukerne. Å vurdere behov for reorganisering, krever evne til å ta et «fugleperspektiv», på hvilken informasjon som behandles av hvem, og hvilke tiltak som gjøres hvor. Dette tredje poenget handler om kompetanse for å planlegge ny arbeidsflyt. Viktigst - og kanskje også vanskeligst - er å vurdere hvilke konsekvenser endringene vil ha for ressursbruk etter at endringene er gjennomført. Dette krever nøye forhandlinger blant ansatte for å danne realistiske arbeidsroller og oppgaver. Sist - men ikke minst - handler kompetanse om å vurdere konsekvensene av de endringene for tjenestebrukere og ansatte. Ansatte har sikkert faktiske erfaringer om fordelene og ulempene, men de kan trenge et felles rammeverk for en mer systematisk vurdering av gevinster. For å konkludere: vi adresserer dette kartleggingsverktøyet til personell som jobber tett med tjenester. Men ledere spiller en betydelig rolle i å muliggjøre deltakelse og støtte ansatte i deres innsats. Det er allerede gjort mye arbeid med kompetanseutvikling på dette feltet. Likevel er vi sikre på at det er behov for mer fokus på den hverdagslige arbeidspraksisen i helsesektoren, for å dra nytte av digitaliseringen på realistiske og bærekraftige måter.

• Nerland, Monika & Mäkitalo, Åsa (2024). Learning by stabilizing. Health care work in the multi-layeredness of digital transformation. Fulltekst i vitenarkiv
• Grisot, Miria (2024). Data work from a design perspective. Case study on healthcare information infrastructure. Fulltekst i vitenarkiv
• Grisot, Miria & Aanestad, Margunn (2024). Infrastructuring as management practice: competence required for digital infrastructures in healthcare. Fulltekst i vitenarkiv
• Grisot, Miria (2024). Data work in the design of EHR infrastructure. Fulltekst i vitenarkiv
• Ellingsen, Gunnar Adelsten; Grisot, Miria; Hertzum, Morten & Islind, Anna Sigridur (2024). Implementing Electronic Health Records - Objectives, Obstacles, Outcomes. Fulltekst i vitenarkiv
• Sadorge, Christopher (2024). Helsepersonell som deltakerar i utvikling av IT-system. Fulltekst i vitenarkiv
• Nerland, Monika; Brandenberger, Isabel Alexandra; Sadorge, Christopher; Dæhlen, Åsmund & Aanestad, Margunn (2024). Hva krever digitaliseringen av helsearbeidere og ledere? Fulltekst i vitenarkiv Vis sammendrag

  Digitaliseringen av helsetjenestene i kommunen endrer både jobben som skal gjøres og kompetansen som kreves. I denne formidlingskonferansen presenterte forskere i CORPUS-prosjektet resultater under to tematiske bolker: 1) Hva innebærer digitaliseringen for ansatte i tjenestene? 2) Hva er implikasjonene for ledelse av utviklingsprosjekter og endringer i arbeidsmiljøene? Resultatene ble kommentert og diskutert med forskere og representanter for aktuelle praksisfelt.

• Aanestad, Margunn (2024). Hvordan kan vi oppnå det vi vil med digitalisering i helsesektoren? Magma forskning og viten. ISSN 1500-0788. doi: 10.23865/magma.v27.1439. Fulltekst i vitenarkiv Vis sammendrag

  Artikkelen diskuterer utfordringer knyttet til håndtering av store og komplekse IT-prosjekter. Framover må vi som samfunn bli bedre på å minimere og håndtere sosioteknisk kompleksitet dersom vi skal unngå flere IT-skandaler. Flere ti-års forskning på hvordan denne kompleksiteten bør håndteres i fremveksten av informasjonsinfrastrukturer har ledet fram til alternative modeller for prosjektstyring. Imidlertid får denne forståelsen i liten grad gjennomslag i praksis på grunn av styringsverktøyene man er pålagt å bruke i offentlige IT-prosjekter. Dette kan bidra til å forklare hvorfor prosjekter kan feile selv om organisasjon opplever at de har gjort alt «riktig», og til å begrunne behovet for andre tilnærminger til digitaliseringsprosesser i offentlig sektor.

• Grisot, Miria & Aanestad, Margunn (2024). INFRASTRUCTURING AS MANAGEMENT PRACTICE: COMPETENCE REQUIRED FOR DIGITAL INFRASTRUCTURES IN HEALTHCARE. Fulltekst i vitenarkiv Vis sammendrag

  In this paper we address the demands digitalization and digital transformation processes pose to management employees in healthcare organizations. Specifically, we consider the competences related to dealing with infrastructural technologies in healthcare. Research on digital infrastructures has reconsidered design proposing an expanded view which recognizes that design activities happen also as a continuous process alongside use and adaptations, including issues of maintenance, renewal or obsolescence. The paper is based on an empirical study of an ongoing digitalization in the largest city administration in Norway. The aim of the initiative is to build a digital infrastructure for sharing patient information across city districts and levels of care. Our findings show three empirically emerging themes: prioritization, mobilization and organizing. We present these as infrastructural competences and discuss them in relation to literature on digitalization and competence development in healthcare.

• Sadorge, Christopher & Nerland, Monika (2023). Professional Learning in Design Work: Developing Patient Information Systems through Object Construction. Fulltekst i vitenarkiv
• Nerland, Monika; Hasu, Mervi & Grisot, Miria (2023). Discourses of Digitalisation and the Positioning of Workers in Primary Care: A Norwegian Case. Fulltekst i vitenarkiv Vis sammendrag

  The primary health services are subjected to intensified digitalisation with the aim of transforming care provision. Various smart and assistive technologies are introduced to handle the growing elderly population and enhance the opportunities for independent living among patients in need of continuous care. Research has shown how such digitalisation processes evolve in the intersection of different and often competing discourses, oriented towards phenomena such as service efficiency, cost containment, technological innovation, client-centred care and digital competence development. Often, increased technology use is presented as solutions to pressing problems. However, the way in which discourses are negotiated in work contexts and their mechanisms of inclusion/exclusion have received less attention. This article examines how care workers in the primary health sector are discursively positioned when care technologies are introduced in the services. We employ a perspective on discourses and subject positions in analysing strategic documents and interviews with care workers in a larger Norwegian city. We show how managerial discourses that focus narrowly on the implementation and mastery of individual technologies provide limited spaces for workers to exert influence on their work situations, while discourses that emphasise professional knowledge or broader technological and organisational relations provide a variety of resources for workers’ agency. The way care workers adopt and negotiate subject positions varies with their tasks and responsibilities in the organisation. We discuss the need to move beyond ‘solutionism’ in efforts to digitalise care work in order to provide inclusive spaces supporting the contributions of various worker groups.

• Nerland, Monika; Aanestad, Margunn; Hasu, Mervi; Grisot, Miria & Sundt-Ohlsen, Harald (2023). Nye kompetansebehov i helsesektorens digitaliseringsprosesser. Fulltekst i vitenarkiv Vis sammendrag

  Sesjon på EHiN-konferansen 2023: Hvilke kompetansebehov oppstår lokalt når helsetjenestene digitaliseres og teknologibruken intensiveres? Hva betyr dette for organisasjonene og for ansatte? Denne sesjonen presenterer nyere forskning om temaet, deriblant funn fra et pågående prosjekt der forskere fra UiO samarbeider med Oslo kommune. Sesjonen inkluderer en innledning, to foredrag basert på forskning i prosjektet CORPUS, og en kommentar fra samarbeidspartner i Oslo kommune.

• Nerland, Monika; Brandenberger, Isabel Alexandra & Hasu, Mervi (2023). Relational meta-work emerging during technology integration in primary care. Fulltekst i vitenarkiv
• Nerland, Monika (2023). Exploring professional knowing and learning in local and extended contexts of practice. Fulltekst i vitenarkiv
• Sadorge, Christopher (2022). Collaborative work in designing a system for patient information sharing in health care. Fulltekst i vitenarkiv
• Brandenberger, Isabel Alexandra; Hasu, Mervi & Nerland, Monika (2022). Reorganising practices in digitalising primary health services: The concerns of welfare technology coordinators. Fulltekst i vitenarkiv
• Hasu, Mervi; Nerland, Monika & Brandenberger, Isabel Alexandra (2022). Hvordan endrer velferdsteknologi arbeid og kompetanse i tjenestene? Presentasjon av foreløpige forskningsresultater og interaktiv seminar. Fulltekst i vitenarkiv Vis sammendrag

  Forskningsprosjektet CORPUS utvikler kunnskap om kompetansebehov og læring i helsesektoren ved å gjennomføre nærstudier av hvordan digitalisering fører til endringer i arbeidsorganisering og oppgavefordeling, hvilke kompetanser som trengs for å takle disse utfordringene, og hvilke læringsmuligheter som tilbys i det daglige arbeidet. Innføring og bruk av velferdsteknologi i Oslo kommune har vært et hovedområde for forskningen, med bydel N.N. som en sentral samarbeidspartner. CORPUS-prosjektet er nå midtveis i sin finansieringsperiode, og vi avslutter datainnsamlingen denne våren. Vi vil presentere de foreløpige observasjonene og funnene om (1) hvordan arbeidet i tjenestene endres med implementering og bruk av velferdsteknologi, og (2) hva endringene betyr for organisering av arbeidet, arbeidsroller og kompetansekrav. I tillegg vil vi gjerne (3) høre dine synspunkter og kommentarer, og diskutere hvilke funn som er mest relevante å fokusere mer på i den gjenværende prosjektperioden.

• Hasu, Mervi & Saari, Eveliina (2022). Localising strategies in the early phase of digitalisation in primary health organisations. Case examples from Norway and Finland. Fulltekst i vitenarkiv Vis sammendrag

  How do organisations that make strategic decisions to digitalise their services begin to organise the workplace for digitalisation? In other words, how do organisations with different work contexts try to localise the various digital solutions and systems in tying (or configuring) them with work practices? Neither information systems research nor organisational or workplace learning research studying digitalisation has sufficiently addressed what kinds of localising strategies occur and what kinds of competences emerge locally in various organisational contexts during localising efforts (e.g. Vallo Hult et al. 2022). Thus, especially in the early phases, working towards local digital change can be constitutive for the further trajectory of digital transformation on organisational and network levels (Törmer & Henningsson 2018). This paper explores localising strategies in the early phase of digitalisation in two primary health organisations. The Norwegian case organisation (‘urban-distributed’) comprises several independent urban city districts responsible for local services and several specialist central agencies, such as the health agency, responsible for care development in medical, dental, psychosocial care, public health and development of the municipality’s professional systems. The Finnish case organisation (‘rural-integrated’) is responsible for both social and health care in a broad geographic region and comprises urban and large rural municipalities. We anticipated variation in the localising strategies of the two cases based on the developmental and demographic characteristics of both health care systems. We aimed to investigate how the different organisational contexts are displayed in the localising strategies of these organisations, particularly how the context-specific strategies address organising work roles and establishing required competences in different ways. Hertzum and Simonsen’s (2019) qualitative analysis of local competences in an IT development project in a hospital context inspired our paper. They formed a catalogue of seven competence categories, each of which comprised multiple qualitatively characterised competences that are needed locally to configure information systems and work practices for one another. To broaden the analysis of locally required competences outside a single project level towards organisation-wide digital change, we employed a practice-based perspective on a localising strategy for digitalisation. The analysis revealed both similarities and differences in the localising strategies in the two cases.

• Mäkitalo, Åsa & Dalevi, Linn (2022). Mastering care? Welfare technologies in health care team decision practices. Fulltekst i vitenarkiv
• Sadorge, Christopher; Nerland, Monika & Mäkitalo, Åsa (2022). New challenges for health professionals. Fulltekst i vitenarkiv
• Brandenberger, Isabel Alexandra & Hasu, Mervi (2021). Implementing technologies as renegotiating of responsibilities: a study of the emerging work role of the welfare technology coordinator in municipal health care. Fulltekst i vitenarkiv
• Sadorge, Christopher; Nerland, Monika & Mäkitalo, Åsa (2021). Categorisation work in the design of health information systems. Fulltekst i vitenarkiv
• Sadorge, Christopher; Nerland, Monika & Mäkitalo, Åsa (2021). Negotiating categories in design work. A study of a team developing a patient information system. Fulltekst i vitenarkiv
• Nerland, Monika (2020). Reconfiguring relations between higher education and work: Knowledge practices and learning in the (post)digital era. Fulltekst i vitenarkiv
• Dæhlen, Åsmund (2020). MECHANISMS OF DEMOCRATIC DESIGN - Rethinking large scale Participatory Design. Fulltekst i vitenarkiv
• Liljeros, Linn & Hasu, Mervi (2022). Integrering av velferdsteknologi - en kvalitativ casestudie av hvordan to kommunale aktører bidrar til utviklingen av fremtidens hjemmetjeneste. Universitetet i Oslo. Fulltekst i vitenarkiv
• Sciuto, Katarina; Winsnes, Sigurd; Nerland, Monika & Hasu, Mervi (2021). Profesjonell agency i digitale arbeidskontekster - En kvalitativ intervjustudie blant ansatte i kommunehelsetjenesten. Universitetet i Oslo. Fulltekst i vitenarkiv Vis sammendrag

  Dagens arbeidsliv preges av en stadig økende bruk av komplekse digitale teknologier som griper inn i selve arbeidsutførelsen og arbeidsdelingen. Når bruken av nye teknologier endrer rammevilkårene i arbeidet, skapes det samtidig nye muligheter og hindringer for å ta valg, handle og påvirke handlingskontekstene; ofte omtalt som profesjonell agency. Tidligere forskning har frembragt et godt kunnskapsgrunnlag om hvordan innføringen av nye teknologier og utøvelse av profesjonell agency opptrer og virker inn i organisasjoner hver for seg, men det er behov for å se på hvordan disse fenomenene samspiller og nedfeller seg i konkrete arbeidskontekster. Videre er det behov for mer kunnskap om hvordan ansattes profesjonelle agency utspiller seg ulikt når en beveger seg mellom ulike digitale arbeidskontekster. På bakgrunn av dette tar studien utgangspunkt i følgende problemstilling: Hvordan opplever ansatte i kommunehelsetjenesten muligheter for profesjonell agency når nye teknologier innføres og tas i bruk i organisasjonen? Problemstillingen besvares ved hjelp av de to forskningsspørsmålene: «På hvilke måter opplever ansatte at deres muligheter eller begrensninger for handlingsrom endres med økende bruk av digitale teknologier?» og «på hvilke måter opplever ansatte at handlingsrommet varierer mellom ulike arbeidskontekster?». Det teoretiske rammeverket som benyttes for å undersøke problemstillingen baserer seg på begrepet «digitalisering» for å belyse innføring av nye teknologi utløser sosiotekniske endringer i organisasjonen, og Eteläpelto, Vähäsantanen, Hökkä og Paloniemis (2013) rammeverk om «profesjonell agency» for å belyse hvordan individets agency oppleves i arbeidsrelaterte omgivelser. Rammeverket tar ikke spesifikt høyde for hvordan profesjonell agency utspiller seg i digitale handlingskontekster, eller hvordan individets bevegelse mellom digitale kontekster har betydning for profesjonelt handlingsrom. Dermed vil rammeverket utvides for å bedre tilpasses studiens problemområde. Denne masteroppgaven inngår i det større NFR-prosjektet, CORPUS, hvis mål er å utvikle ny kunnskap om hvordan digitalisering medfører nye krav til kompetanse og ekspertise i helse-tjenestene. For å undersøke profesjonell agency i digitale arbeidskontekster valgte vi en kvalitativ tilnærming, og gjennomførte en kvalitativ intervjustudie med en fenomenologisk grunninteresse. Datamaterialet ble samlet inn gjennom semi-strukturerte intervju av syv ressurspersoner fra én foregangsbydel for bruk av velferdsteknologi i kommunehelsetjenesten i Oslo. Rekruttering av deltakere til den kvalitative intervjustudien var basert på et strategisk- og tilgjengelighetsutvalg med bakgrunn i masteroppgavens plassering i CORPUS-prosjektet. Ressurspersonene var av empirisk interesse da de har avsatt en del av sin stilling til å arbeide med velferdsteknologi. Det innsamlede datamaterialet ble analysert gjennom en tematisk analyse. Resultatene viser hvordan digitalisering endrer rammevilkårene ressurspersonene arbeider innenfor, og at innføringen og bruken av nye digitale teknologier bidrar til å skape både nye muligheter og begrensninger for utøvelsen av profesjonelt handlingsrom. Mer spesifikt ble det funnet at ressurspersonenes muligheter for handlingsrom hovedsakelig bunner i en effektiv bruk av teknologiene og den omfattende informasjonen de frembringer. Analysene viser at digitaliseringen i helsetjenesten gjør arbeidsprosesser og samarbeidsrelasjoner mer transparente, noe som bidrar til å synliggjøre arenaer og muligheter for profesjonelt handlingsrom. Analysene indikerer videre at endringene i rammevilkårene i bydelen som følger av digitalisering har bidratt til å gjøre ressurspersonene mer proaktive. Dette ved at de nå kan utføre flere arbeidsoppgaver innenfor et bredere område, utføre oppgavene mer effektivt, samt at koordineringen av samarbeid blant de ulike aktørene i tjenesten har blitt forenklet. Samtidig ble det vist at den økende bruken av velferdsteknologi også har skapt begrensninger for ressurspersonenes opplevde og utøvde handlingsrom, som konsekvens av teknologienes kompleksitet. I den sammenheng ble det funnet at teknologiene tidvis legger betydelige beslag på tid og ressurser i tjenesten. Resultatene kan derfor bidra til å understreke viktigheten av digitale kompetanser for å utøve profesjonelt handlingsrom. Funnene i denne masteroppgaven viser videre at ressurspersonenes variasjoner i opplevd og utøvd handlingsrom kan relateres til deres arbeidsoppgaver, tidligere erfaringer og temporale orienteringer. Ansattes mulighet for å integrere digital og faglig kompetanse, samt tilrettelegging for at ansatte kan påvirke hvordan teknologiene formes og brukes lokalt, framstår som viktige betingelser for de ansattes opplevde og utøvde profesjonelle agency.

• Hasu, Mervi & Kilander, Bendik Runesønn (2021). Velferdsteknologi og digital opplæring i helsesektoren. Pedagogiske aspekter og tilrettelegging rundt nettkurs på bydelsnivå i Oslo kommune. Universitetet i Oslo. Fulltekst i vitenarkiv

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