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In case of emergency: Collaboration exercises at the boundaries between emergency service organizations
University West, Department of Nursing, Health and Culture, Divison for Health, Culture and Educational Sciences. (LINA)ORCID iD: 0000-0002-0871-0475
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Due to the emergent and dynamic nature of incidents, the complexity of emergency work is often referred to as a challenge for learning. Another recurrent challenge in emergency work is that of collaboration at and across established organizational boundaries involving actors with specific types of expertise who are operating under different regulations and responsibilities. In addition, training emergency service organizations in collaboration remains a challenge. In light of the difficulties and shortcomings that have been identified in major incident responses, the need for exercises for developing and maintaining collaborative response effectiveness prior to the next incident is often highlighted. The overall aim of this thesis is to understand how full-scale exercises can provide conditions for developing inter-organizational collaboration between the police, ambulance and rescue services at the incident site. Learning activities that carry the potential to support and develop collaborative capacity, and how the alignment of distributed expertise can be trained for, were of particular interest. Interviews with participants in eight full-scale exercises with professionals and interviews and observations of one exercise with senior-level students in Sweden served as the empirical base.Central concepts from Cultural-Historical Activity Theory (CHAT) provided theoretical tools to explore the exercises and understand boundaries between organizations with a wider, systemic approach. The empirical studies show that the participants understood full-scale exercises to be valuable opportunities for becoming involved in response work, making decisions, and acting and interacting in uncertain situations and realistic environments. As in real-life responses, exercises are characterized by the stabilization and confirmation of everyday routines on the one hand, and by improvisation and change on the other hand. The studies also show that exercises tend to focus on specific scenarios,intra-organizational routines, and leadership positions. Infrequent exercises inwhich the participants were only trained in a limited role were perceived to be in adequate for developing preparedness and collaboration. However, the analysis suggested that the way in which exercises were organized and performed had implications for how participants were trained in collaboration.Realizing the potential of boundaries as resources for learning in exercises depends on how boundaries are explicated and approached. Thus, rather than striving to ignore or eliminate boundaries in exercises, the studies illustrated the learning value of explicitly reflecting on the multiple understandings around boundaries. The studies demonstrated that much of the work at an incident site takes place around negotiations. Collaboration at the incident site was not only aquestion about boundary crossing; operational tasks may not always be aligned and have to be prioritized and sequenced. The exercises comprised work situations in which no single motive could explain or determine the collaboration,due to different types of expertise, primary responsibilities and needs forinformation. These factors were understood in terms of the concepts of boundarywork and boundary awareness. These concepts point at a more divergent understanding of collaboration that reaches beyond striving to create mutual understanding between organizations in learning activities. Differences between organizations, such as in terminology, time horizons, priorities, leadership structures, understandings of safety and how intra-organizational decisions and actions could impact the collaborating organizations' work, were central triggers for discussion and negotiation. These differences required explanations in order to make the actions and decisions of one organization understandable and justifiable to another, based on organizational mandates and types of expertise.Giving emergency services the opportunity to work together, to develop an awareness of their expectations of each other in various situations, to use and interpret their own and others' terminologies, and to identify internal hierarchies and motives for prioritizations was essential dimensions of exercises

Place, publisher, year, edition, pages
Trollhättan: University West , 2016. , 135 p.
Series
PhD Thesis: University West, 8
Keyword [en]
Exercise, Collaboration, Emergency preparedness, Emergency work, Police, Ambulance, Rescue service, Learning, Boundaries
National Category
Pedagogy
Research subject
Work Integrated Learning; SOCIAL SCIENCE, Pedagogics
Identifiers
URN: urn:nbn:se:hv:diva-9333ISBN: 978-91-87531-29-3 (print)ISBN: 978-91-87531-28-6 (print)OAI: oai:DiVA.org:hv-9333DiVA: diva2:924967
Supervisors
Available from: 2016-05-02 Created: 2016-04-29 Last updated: 2016-06-27Bibliographically approved
List of papers
1. Managing boundaries at the accident scene: a qualitative study of collaboration exercises
Open this publication in new window or tab >>Managing boundaries at the accident scene: a qualitative study of collaboration exercises
2014 (English)In: International Journal of Emergency Services, ISSN 2047-0894, Vol. 3, no 1, 77-94 p.Article in journal (Refereed) Published
Abstract [en]

Purpose The purpose of this study is to identify what is practiced during collaboration exercises and possible facilitators for inter-organisational collaboration.

Design/methodology/approach Interviews with 23 participants from four exercises in Sweden were carried out during autumn 2011. Interview data were subjected to qualitative content analysis.

Findings Findings indicate that the exercises tend to focus on intra-organisational routines and skills, rather than developing collaboration capacities. What the participants practiced depended on roles and order of arrival at the exercise. Exercises contributed to practicing leadership roles, which was considered essential since crises are unpredictable and require inter-organisational decision-making.

Originality/value The results of this study indicate that the ability to identify boundary objects, such as injured/patients, was found to be important in order for collaboration to occur. Furthermore, lessons learned from exercises could benefit from inter-organisational evaluation. By introducing and reinforcing certain elements and distinct aims of the exercise, the proactive function of collaboration exercises can be clarified.

Place, publisher, year, edition, pages
Emerald Group Publishing Ltd. United Kingdom, 2014
Keyword
Collaboration, Exercise, Police, Ambulance, Accident, Fire department
National Category
Pedagogical Work Public Administration Studies Business Administration Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
NURSING AND PUBLIC HEALTH SCIENCE, Public health science; SOCIAL SCIENCE, Business administration; SOCIAL SCIENCE, Public administration; SOCIAL SCIENCE, Sociology
Identifiers
urn:nbn:se:hv:diva-6143 (URN)10.1108/IJES-02-2013-0003 (DOI)
Available from: 2014-04-08 Created: 2014-04-08 Last updated: 2016-06-27Bibliographically approved
2. Organisering av en fingerad verklighet: Om övningar mellan blåljusorganisationer
Open this publication in new window or tab >>Organisering av en fingerad verklighet: Om övningar mellan blåljusorganisationer
2013 (Swedish)In: Nordiske organisasjonsstudier, ISSN 1501-8237, Vol. 15, no 3, 34-64 p.Article in journal (Refereed) Published
Abstract [en]

This study aimed to elucidate exercise participants’ understanding of critical aspects of organizing and implementation of collaboration exercises with police, fire department and ambulance services. The focus is critical aspects in exercises that have, or are expected to have, bearing on the participants’ ability to learn. Collaboration exercises are used as a tool to reinforce and develop the preparedness for future incidents. The need for such exercises was usually advocated after critique to actions during largescale real-life incidents. The study had a qualitative approach and is based on phenomenographic analysis of interviews with participants from four exercises with different scenarios. The identified critical aspects of exercises were related to realism, acceptance for mistakes, exercise extent and aims and opportunities for joint discussions. The management of an accident can be described to a large extent depend on the organizations’ joint ability to adapt to the prevailing situation and to collaborate. For exercises to contribute to these abilities, they could benefit from shifting the focus to how to organize exercises that allow participants to test different decisions and actions, with less emphasis on the choice of scenario.

Abstract [sv]

Denna studie syftade till att belysa övningsdeltagarnas uppfattningar av hur samverkansövningar mellan polis, räddningstjänst och ambulans organiseras och genomförs. Särskilt fokuserades kritiska aspekter i övningar som har, eller förväntas ha, betydelse för deltagarnas möjligheter att lära. Samverkansövningar används som ett verktyg för att förstärka och utveckla gemensam beredskap inför framtida olyckor och katastrofer. Behovet av övningar på olika nivåer brukar aktualiseras efter kritik mot hanteringen av omfattande verkliga händelser. Studien hade en kvalitativ ansats och byggde på fenomenografisk analys av intervjuer med deltagare från fyra övningar med olika scenarier. Analysen visade att realism i övningarna, utrymme för misstag, övningarnas omfattning och syfte samt möjlighet till uppföljning uppfattades som särskilt kritiska aspekter. Hanteringen av en olycka beror i stor utsträckning på organisationernas förmåga att anpassa sig till den rådande situationen och utfallet av samverkan mellan organisationer. För att övningar ska bidra till dessa förmågor och fylla ett proaktivt syfte, bör fokus tydligare riktas mot organisering av övningar i syfte att ge deltagarna utrymme att pröva olika beslut och ageranden, och med mindre betoning på scenarioval.

Place, publisher, year, edition, pages
Oslo: Fagbokforlaget, 2013
Keyword
exercise, collaboration, organizing, accident, crisis management, Sweden, WIL, Work-integrated Learning, övning, samverkan, organisering, olycka, krishantering, Sverige, AIL
National Category
Pedagogical Work Public Administration Studies Business Administration Health Care Service and Management, Health Policy and Services and Health Economy
Research subject
SOCIAL SCIENCE, Business administration; SOCIAL SCIENCE, Public administration; NURSING AND PUBLIC HEALTH SCIENCE, Nursing science; Work Integrated Learning
Identifiers
urn:nbn:se:hv:diva-5629 (URN)
Available from: 2013-10-11 Created: 2013-10-11 Last updated: 2016-04-29Bibliographically approved
3. Boundaries as mechanisms for learning in emergency exercises with students from emergency service organisations
Open this publication in new window or tab >>Boundaries as mechanisms for learning in emergency exercises with students from emergency service organisations
2016 (English)In: Journal of Vocational Education and Training, ISSN 1363-6820, E-ISSN 1747-5090, Vol. 68, no 2, 245-262 p.Article in journal (Refereed) Published
Abstract [en]

To prepare emergency response organisations for collaborative work in unpredictable and dynamic situations, various types of exercises are widely used. Still, our knowledge of collaboration exercises with emergency response students is limited. This study aimed to contribute to this field by exploring boundaries that emerged between collaborating organisations in exercise activities and how these boundaries could be understood for learning. Drawing on the Akkerman and Bakker framework of boundaries as learning mechanisms, this study explored an exercise, including full-scale scenarios and seminars with students from the police, ambulance and rescue services education in Sweden. Thematic analysis of interviews and observations illustrated boundaries that emerged regarding vocabulary, prioritisation, roles, knowledge gaps and overlapping responsibilities across organisations. Rather than dissolving boundaries, this article suggests that boundaries can be utilised in exercises to support the students to contextualise their knowledge in relation to the demands of collaborative work. The concepts boundary work and boundary awareness were suggested to capture more generally the dynamics of learning in exercise contexts.

Place, publisher, year, edition, pages
Taylor & Francis, 2016
Keyword
Learning in the professions, learning theory, workplace Learning, Vocational Education & Training, organisations
National Category
Nursing
Research subject
Work Integrated Learning; NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-9331 (URN)10.1080/13636820.2016.1166450 (DOI)000382690600007 ()2-s2.0-84964455408 (Scopus ID)
Available from: 2016-04-29 Created: 2016-04-29 Last updated: 2016-12-19Bibliographically approved
4. Making collaboration work: Developing boundary work and boundary awareness in emergency exercises
Open this publication in new window or tab >>Making collaboration work: Developing boundary work and boundary awareness in emergency exercises
(English)In: Journal of Workplace Learning, ISSN 1366-5626, E-ISSN 1758-7859Article in journal (Refereed) Submitted
Abstract [en]

Collaboration in emergency work is challenging on many levels. The unforeseen and temporary nature of incidents presents basic challenges. Another important challenge is boundaries between specialized and autonomous emergency service organizations. We need to know more about how exercises are performed to increase the individuals and organizations preparedness for future joint response work. The aim of this study was to explore how boundary work is carried out at the incident site during exercises, and how boundary awareness is developed based on this boundary work. The analytic focus was on how boundaries were identified, negotiated and managed in the participants work. Empirically, full-scale exercises involving police, ambulance and rescue services and with repetition of practical scenarios and joint-reflection seminars are studied. Much of the work in the exercises was performed within distinct areas of expertise, in accordance with concrete routines, skills and responsibilities. Boundary work was often organized in the form of distribution of labour or creating chains of actions. The exercises shed light on challenges related to other aspects of emergency response,such as a lack of resources, diverging primary responsibilities, time-criticality and hazardous environments. The design allowed participants to explicate boundaries, test and discuss alternative solutions, and to visualize the effects of different solutions as the scenarios were repeated. The boundaries that were identified were often of institutional character, and were also related to the specific scenarios and to the actions taken in the activities. By integrating real-life experiences of collaborative work in the exercise, the exercise gained a certain meaning that was essential for the participants to develop boundary awareness.

Keyword
Emergency work, collaboration, boundary work
National Category
Nursing
Research subject
Work Integrated Learning; NURSING AND PUBLIC HEALTH SCIENCE, Nursing science
Identifiers
urn:nbn:se:hv:diva-9332 (URN)
Note

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Available from: 2016-04-29 Created: 2016-04-29 Last updated: 2016-04-29Bibliographically approved

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