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The purpose of this paper is to explore the way “hybrid” clinical managers in Kenyan public hospitals interpret and enact hybrid clinical managerial roles in complex healthcare settings affected by professional, managerial and practical norms.

The authors conducted a case study of two Kenyan district hospitals, involving repeated interviews with eight mid-level clinical managers complemented by interviews with 51 frontline workers and 6 senior managers, and 480 h of ethnographic field observations. The authors analysed and theorised data by combining inductive and deductive approaches in an iterative cycle.

Kenyan hybrid clinical managers were unprepared for managerial roles and mostly reluctant to do them. Therefore, hybrids’ understandings and enactment of their roles was determined by strong professional norms, official hospital management norms (perceived to be dysfunctional and unsupportive) and local practical norms developed in response to this context. To navigate the tensions between managerial and clinical roles in the absence of management skills and effective structures, hybrids drew meaning from clinical roles, navigating tensions using prevailing routines and unofficial practical norms.

Understanding hybrids’ interpretation and enactment of their roles is shaped by context and social norms and this is vital in determining the future development of health system’s leadership and governance. Thus, healthcare reforms or efforts aimed towards increasing compliance of public servants have little influence on behaviour of key actors because they fail to address or acknowledge the norms affecting behaviours in practice. The authors suggest that a key skill for clinical managers in managers in low- and middle-income country (LMIC) is learning how to read, navigate and when opportune use local practical norms to improve service delivery when possible and to help them operate in these new roles.

The authors believe that this paper is the first to empirically examine and discuss hybrid clinical healthcare in the LMICs context. The authors make a novel theoretical contribution by describing the important role of practical norms in LMIC healthcare contexts, alongside managerial and professional norms, and ways in which these provide hybrids with considerable agency which has not been previously discussed in the relevant literature.

The purpose of this paper is to identify and analyze the professional norms surrounding school development, with a special emphasis on school principals’ pedagogical leadership.

A norm perspective is used to identify possible links between legal norms, professional norms, and actions. The findings are based on answers given by 974 school principals in a web-based questionnaire. The design of the study and the findings are structured around three questions used to identify professional norms: what tasks principals prioritize as pedagogical leaders, where the external expectations on principals are derived from, and with whom school principals communicate regarding issues related to their pedagogical leadership.

The most evident professional norms identified in this study are that principals should: be present and close to the teaching and learning processes; involve teachers in quality development; enhance the development of formative assessments; engage in teacher development; develop the internal organization of the school to promote learning.

The norm perspective and the findings of this study could be used by principals, principal trainers, and researchers to reflect on pedagogical leadership in different contexts. A challenge for principals is to become aware of the professional norms that guide them, and to close the gap between their “desirable” norms and their actions. Action alternatives and professional norms become visible through discussions emanating from questions about what leaders do, how they do so and why they do what they do, which is a way to strengthen both the profession and the individual principals.

The research sought to expand the conceptual understanding of the antecedents of decision-making under ethical conditions. This study aims to better understand the relationships among need for cognition (NFC), the individual ethical positions of ethical idealism and ethical relativism, organizational and professional socialization, work-related norms and ethical perceptions.

The study compared the impact of environmental influences (i.e. socialization and work-related norm) and individual temporally stable characteristics (i.e. NFC and ethical position) on ethical perceptions. The research surveyed marketers and tested a hypothesized model using structural equation modeling.

NFC influences marketers’ individual ethical position, their professional socialization and their work norms. The work norms of marketers are influenced by individual ethical position and organizational socialization, but not by professional socialization. Professional socialization is influenced by ethical idealism and not ethical relativism.

A judgmental sampling technique was used and the findings cannot be generalized to other populations.

This research provides managers with alternative tools to encourage compliance with professional and corporate guidelines. If managers are seeking an enduring positive influence on work norms, they should be as concerned about the thinking of their employees and their employees’ ethical positions as they are with the vocational rules their subordinates adopt.

Society will benefit from better understanding the different ways in which the ethical perceptions of individual employees are influenced and the various ways in which managers can contribute to ethically responsible corporations.

Although NFC has been examined in other vocational and decision-making contexts, its influence on individual ethical position, vocational socialization and work-related norms has not been empirically examined in ethical contexts for business decision-making.

The purpose of this paper is to investigate if a rational perspective can be used to interpret cooperation problems in a health care organisation. This perspective is proposed as a complementary perspective to the cultural perspective that dominates as an explanation of cooperation problems. The focus of the research is multiprofessional teamwork in contemporary Swedish health care.

Four cases studies, in which the cooperation in daily work is described, are used to test the two perspectives. The cases concern the cooperative methods health care professionals use when work conditions depend upon an internal norm of mutual cooperation. Although the research is not designed to evaluate the two perspectives, it permits the rational explanations of cooperation problems to be compared with possibly cultural explanations.

The investigation concludes that health care cooperation problems may be primarily explained by the rational perspective, and only secondarily by the cultural perspective. The actors can be seen as underinstitutionalised in the sense they have not yet developed the intra‐organisational norms of cooperation needed for the provision of customised health care.

The paper provides a complementary explanatory framework of cooperation problems based on actors' perceptions of their self‐interests as producers. The examples of uncooperative behaviour reflect two forms of the free rider problem that Ostrom describes as a Common Pool Resource Problem. Management has to prove that cooperation is beneficial to the team members and has to promote a cooperative team spirit by instilling a common understanding of the concept of cooperation.

Training implies certain dealings in which one has to make a choice among various options. Choosing to solve a certain problem implies formulating a value judgement about the available alternatives. Such choices are generally based on ethical decisions. Hardly any ethical professional code for industrial trainers has been explicitly formulated until now. Investigates the issue of professional code and standards in this profession compared to other professions. At the same time describes a working method that benefits the process of realization necessary in dealing with the ethical issue in training.

The purpose of this paper is to propose an analytical approach that allows capturing a variety of outcomes of health care reforms. Specifically, by means of employing neo-institutional perspective, it is suggested that scholars need to take a step back and analyze the interrelation between regulatory, organizational and professional norms (dimensions). This approach improves our understanding of the complex outcomes of health care reforms. To illustrate this point, the case of coordination reform in Norway is discussed. This reform has been one of the most complex health care reforms with ambitious goals of achieving perfectly integrated care between hospitals and municipalities. The analysis through the three sets of institutional norms (dimensions) provides more comprehensive understanding of the various outcomes of the reform. The conclusion is that in order to understand the vast complexity of the outcomes of different health care reforms, we need to carefully study the institutional characteristics of rules, clinical codes of conduct, organizational characteristics as well as interplay between them. Analysis based on the three dimensions, shows that the neo-institutional approach, is of highest relevance to understand the outcomes of the complex health reforms.

Discussion in this paper is inspired by author’s PhD dissertation that comprised a study of juridification, understood as legal regulation, in treatment practice in the field of specialized health services. Three dimensions described in this paper are derived from the analysis of two types of empirical material: legal regulations and administrative guidelines in the area of patients’ rights interviews with psychiatrists and psychologists in the region of Western Norway about how they practice the regulations. The aim of this empirical study was to explore the implications the new regulations have had for clinical practice after the patients’ rights regulations became binding for clinical reasoning in Norway. This paper presents a viewpoint that applies the three dimensions derived from the empirical analysis to the discussion about the outcomes of one of the most complex Norwegian health reforms, i.e. coordination re-form. It is argued that the observations can be relevant for the analysis of the implication of health reforms in general.

The observations presented in the discussion of the possible implications of regulations of coordination reform indicate the complexity and sometimes contradictory outcomes of health regulations. There is a complex interplay between the different kinds of regulatory tools, which might have different implications at different levels. The same regulations can both strengthen and weaken established institutional order. Implications of such processes need to be empirically explored and neo-institutional approach still is of highest relevance in helping scholars understand the complex outcomes of health regulations.

Outcomes of regulations will depend on the balance between regulations and other institutional dimensions. The significant aspect of it is that this balance between the dimensions is not a zero sum equation, which means that all dimensions can be strengthened or weakened simultaneously.

The institutional dimensions can be in different balance relation with each other. The point of departure in this paper is that the legal regulations have been strengthened, i.e. expanded with regard to the coordination in health services. This development has been called juridification. The outcomes of it will depend on the balance between regulations and other institutional dimensions at work. The significant aspect of it is that this balance is not a zero sum equation, which means that all dimensions can be strengthened or weakened simultaneously.

This paper aims to center on the value of cultivating norms for market orientation (MO) in professional service firms (PSFs). Based on social capital theory, three variables for norm-based behavioral activities of MO were suggested, i.e. leadership support (LS), relationship learning in teams (RLT) and collective engagement (CE). Moreover, three variables were suggested as performance outcomes of norm-based behavioral activities of MO, i.e. employee commitment (EC), service quality provision (SQP) and two dimensions of a firm’s innovative capability (exploratory [EXPLOR] and exploitative innovation [EXPLOIT]).

Using a survey, a conceptual model was developed and empirically tested. All participants were employed in consultancy firms representing the population of PSFs.

The findings reveal that RLT, LS and employee CE are particularly suitable in forming norm-based behavioral activities of MO for PSFs. Moreover, the findings reveal that the two dimensions of a firm’s innovative capability (EXPLOR and EXPLOIT) provide strong performance outcomes for norm-based behavioral activities of MO. Moreover, the results also reveal that norm-based behavioral activities of MO for PSFs influenced both EC and SQP.

Using social capital theory, the study contributes to identifying both forming variables and performance outcomes centered on norm-based behavioral activities of MO for PSFs.

Using the example of medication safety, this paper aims to explore the impact of three managerial interventions (adverse incident reporting, ward‐level support by pharmacists, and a medication safety subcommittee) on different professional communities situated in the English National Health Service (NHS).

Semi‐structured interviews were conducted with clinical and managerial staff from two English NHS acute trusts, supplemented with meeting observations and documentary analysis.

Attitudes toward managerial intervention differ by professional community (between doctors, nurses and pharmacists) according to their existing norms of safety and perceptions of formal governance processes.

The heterogeneity of social norms across different professional communities and medical specialties has implications for the design of organisational learning mechanisms in the field of patient safety.

The paper shows that theorisation of professional “resistance” to managerialism privileges the study of doctors' reactions to management with the consequent neglect of the perceptions of other professional communities.

The purpose of this paper is to shed light on how actors within, on the surface, similar organizations cope and work with imposed institutional changes.

This research is based on an ethnographic field study addressing why, despite being exposed to the same institutional demands, organizational actors respond by developing diverging institutional orders of appropriate organizational conduct. This research examines how middle managers and frontline staff in two similar Danish social care organizations respond to demands to adopt a New Public Management (NPM)‐based logic of individualized service delivery.

The study shows how institutional diversity may underlie apparently similar organizational structures and responses. NPM‐style modernization efforts partly converged with diverse professional motives and rationales around, on the surface, similar organizational changes. The findings illustrate how differential institutional orders are maintained by middle managers and frontline staff despite exposure to the same demands.

There are different limitations to this ethnographic field study due to the character of the methodology, the limited number of organizations, informants and time span covered. Attending to micro‐level processes within organizations provides a rich understanding of how particular forms of organization and action emerge in response to institutional demands. This calls for more ethnographic research on how actors within organizations cope and work institutional change.

Relatively little organizational research has addressed how individual actors at the lower levels of organizations cope and work with institutional changes using ethnographic methodology.

Status is a central aspect of teamwork relationships and successful collaboration in teams, both online and offline. Status group membership and status perception shape behavioural expectations and norm perceptions of what is appropriate, but despite their importance have been neglected in previous research. Status effects are of special interest in online collaboration, e.g. via email, where no immediate feedback or non-verbal/paraverbal communication and direct observation is possible. The purpose of this study is to address this gap in research.

An experimental scenario study with two different professional status groups (lecturers and students) tested status effects on causal attributions, intergroup bias and emotional and collaborative responses to perceived norm violations in emails.

Results overall showed three key findings: a “black-sheep-effect” with harsher negative attributions for same status members, more aggression and less cooperation towards lower status senders and stronger (negative) emotional reactions towards high status senders.

The findings are important for managing professional online communication because negative personal attributions, strong emotions and aggressive behaviours can increase team conflict, lead to mistakes and generally undermine performance.