Institutional Ethnography (IE) in Healthcare and Healthcare Education

This session will highlight work that applies Dorothy Smith’s IE theory and methods to healthcare and healthcare education, at a time where neoliberal and new public management (NPM) ideals are increasingly re-organizing healthcare and healthcare education. Griffith and Smith (2014) describe how in NPM there is, “adoption and adaptation of strategies and textual technologies that revolutionized corporate management during the 1980s and 1990s”; these practices and objectives are imposed on front line public services such as healthcare in a “move towards more explicit and measurable (or at least checkable) standards of performance” (Hood, 1995). Since Smith first highlighted NPM as a dominant system of governance, its ideological systems and processes continue to evolve--likened for example to audit culture (Murray, 2018), and contributing to increasing “industrialization” (Fog and Montori, 2019).

This session will explore ruling relations in healthcare and healthcare education, including old and new technologies of governance. Presenters will use IE’s theory and methods to show how, in practice, these are driving institutional interests in healthcare and healthcare education, as opposed to the interests and experiences of patients or practitioners or educators.