allergic to enterprise - stacy johnson
DESCRIPTION
Presentation from Inspiring Enterprise 2011TRANSCRIPT
Condition Critical: Overcoming Allergic Reactions
to Entrepreneurship and Enterprise in Healthcare
Education.
Stacy Johnson
Plan• Learner’s key questions• Relevance• Congruence• Utility• Pyramid exercise• Mapping exercise• Questions and Discussion
Disclaimers• My working definition of entrepreneurship• Entrepreneurship, enterprise, innovation: well
which is it?• My emphasis on praxis and emancipation• Emphasis on teaching and learning: reaching the
hard to reach • Holistic entrepreneurship education: the
triumvirate of knowledge, attitudes and skills
Entrepreneurship
“….the transformation of an idea into an enterprise that creates value: economic, social, cultural, or intellectual.” (University of Rochester 2008)
Enterprise, innovation and entrepreneurship
• The enterprise concept: the skills and mindset for making things happen
• The entrepreneurship concept: making it happen, transforming ideas into going concerns
• The innovation concept: entrepreneurship and enterprise are pre conditions for innovation
(NCGE 2009)
Learner’s key questions
Gaining “buy in” is contingent on supplying satisfactory answers to learners’ key questions.
1. What does this have to do with me?
2. Are these principles compatible with my professional and personal values?
3. How does it help me to meet my objectives (individual, professional, organisational)?
Establishing RelevanceWhat does this have to do with me (my job, my degree)?
• Understanding situation and unique challenges
• Understanding context
• Understanding the learner’s objectives
Nurses Oppressed?• There is some literature regarding the low status,
marginalisation, oppression and subordinate position of nurses
• Sociological perspectives: gender, women’s work, doctor/nurse relationship
• My conceptual analysis approaches the issue from the perspective of economic theory
• Monopsonic labour leads to poor terms and conditions and an element of professional and economic oppression
Monopsony in the UK Nursing Labour Market
Monopsony exists when there is a single employer
of a particular form of labour• 75% of UK nurses work in the NHS
(ICN 2008)• The UK nursing labour market operates under
monopsonistic conditions • UK Government/DoH is (currently) a
monopsonistic employer
Five faces of oppression (Young 1990)
• Exploitation
• Marginalisation
• Powerlessness
• Cultural imperialism
• Violence
ExploitationThe transfer of the results of the labour of
one social group to benefit another
• Economic oppression
• Professional oppression
Economic Oppression• Limited choice of employer: monopsonistic
employers can exploit their position and not employ those who refuse to work for a low wage
• Lower earnings than similar jobs: confronted with a monopsonist employer, workers are forced to accept a lower wage
• With the existence of a monopsony employer wages are likely to fall
• Opportunity deprivation: Less access to entrepreneurship education
Occupation Gross Annual Income 2006 2007 Nurses 21,871 23,044
School Teachers 30,428 31,340
Lawyers 49,378 50,649
Police officers 34,988 36,025Occ. therapists 22,316 23,778
Physiotherapists 21,894 23,153
Social workers 25,259 26,306
Source: UK National Office of Statistics 2008, Annual Survey of
Hours and Earnings (ASHE)
Professional Oppression• Nursing practice and education forced to change
to meet the needs of– The medical profession – The NHS: managerialism, costs containment – The political needs of the government of the time: the
replacement agenda, • Main employer, NHS
– pays to educate: pre-reg-deaneries, post-reg-hospitals managers
– determines numbers trained– Influences courses developed and provided
MarginalisationMarginalization is the process by which categories of people are sidelined from full participation aspects of social life
• Within the healthcare sector, organisational conditions offer less opportunity for participation in the knowledge economy e.g. – Insurance: indemnity– Insurance: reimbursement
• the styles of discourse, systems of power-knowledge, institutional structures and practices- all combine to marginalize nurses
• Nurses are prevented from fully benefiting from the commercial gains of innovation, entrepreneurship and enterprise in the way that other professions do
• Not exposed to or presented with the same access to entrepreneurship and enterprise education as other students in HEIs
PowerlessnessThe powerless are those who lack authority or power...those over whom power is exercised without their exercising it; the powerless are situated so that they must take orders and rarely have the right to give themThe current health service model disempowers nurses
– Nursing influence in the UK health sector– Education: funding – Monopsony power: employer has considerable power
over wage rates employee has lower relative bargaining power under monopsonic conditions
Cultural ImperialismHow the dominant meanings of a society render the particular perspective of one's own group invisible at the same time as they stereotype one's group and mark it as the other
– Clinical– Angels, poorly paid – Sexualised
• This form of oppression is particularly evident in mass media representations of oppressed groups,
The Public Image of the Modern Nurse?
The Public Image of the Modern Nurse?
(Horizontal) ViolenceHorizontal violence is hostile and aggressive behaviour by individual or group members towards another member or groups of members of the larger group. (Duffy1995)
• inter-group conflict• ‘bullying’ • associated with oppressed groups• results from an internalised negative self perception and
low self esteem arising form being part of the oppressed group
A solution in nursing entrepreneurship?
• Multiple firms: address monopsonic conditions• Increase wage rate: competition for labour • Increase professional influence: greater choice of employer
and self employment• Increase power: bargaining power• Professional Autonomy
And….• Innovation• Enterprise
Establishing CongruenceAre these principles compatible with my professional and personal values?
• Exploring attitudes and beliefs• Challenging attitudes and beliefs• Identifying core values and how entrep allows
them to maintain these: the best for the patient through increased professional power, innovating our way out of trouble
Entrepreneurship
“ the transformation of an idea into an enterprise that creates value: economic, social, cultural, or intellectual.”
(University of Rochester 2008)
Critical Pedagogy
“illuminates the relationship among knowledge, authority, and power” (Giroux, 1994: 30)
• Roots in the critical theory of the Frankfurt School, whose influence is evident in the emancipatory works of Paulo Friere, the most renowned critical educator
• The power to care
Rejection of the banking model of teaching and learning
Dialogue with nursing experts
Dialogue with nursing neophytes
We don’t have to answer pesky questions like “Are entrepreneurs born or taught” and “Can you teach entrepreneurship?”
Reflections of a Critical Pedagogue
The role of the educator in critical pedagogy
– Educational Arsonist
– Educational Activist
Transformation
• The primary preoccupation of Critical Pedagogy is with social injustice and educating people to be agents who transform inequitable, undemocratic, or oppressive institutions and social relations.
• To transform individuals from being objects of educational processes to subjects of their own autonomy and emancipation
Power
• power in the teaching and learning context • how and in whose interests knowledge is produced
and 'passed on' and view the ideal aims of education as emancipatory
• examination of what knowledge is the way in which one comes to know and who provides knowledge (Habermas, 1971).
“As a profession, we need to move beyond simply selling nursing labour to commercialising nursing knowledge”
Conscientization• Liberatory education focuses on the development
of critical consciousness• Seeks to enable learners to recognize connections
between their individual problems and experiences and the social contexts in which they are embedded.
• Coming to consciousness: “conscientization” is the necessary first step of praxis.
Praxis
The engagement in the cycle of theory, application, evaluation, reflection and then back to theory
• Social transformation is the product of praxis at the collective level
• Adopting an orientation towards critical praxis (synchronised reflection and action) will facilitate the examination of what knowledge is, the way in which one comes to know and who provides knowledge (Habermas, 1971).
Establishing utiltiy
How does it help me to meet my objectives? (individual, professional, organisational)?
• What personal objectives are there• What are the individual professional objectives?• What might be the current organisational
objectives?• How can entrep help them to meet those• What’s in it for them?
The Healthcare Entrepreneurship Pyramid
Roles of
staff
Proportion of staff involved in activity
Talent Management
Education and Training
Innovators: ideas
Entrepreneurs: new ventures
Managers;
•stewards
•infrastructure
Frontline staff
•pose clinical problems
•Apply solutions
•Engage in knowledge translation
Senior clinicians:
• lead/manage change
•provide problems
Knowledge mobilisation infrastructure
Creators of the environment in which entrepreneurship
and innovation flourish: enterprising
The Healthcare Entrepreneurship Pyramid
Roles of
staff
Proportion of staff involved in activity
Talent Management
Education and Training
Innovators
Entrepreneurs
Managers
Junior practitioners
Support staff
Senior practitioners
Knowledge mobilisation infrastructure
Creators of the environment in which entrepreneurship
and innovation flourish: enterprising
What is your pyramid?Unit of Analysis
• Sector/Economy
• Organisation
• Team
Context
• Policy landscape
Locate your learners in the pyramid
• Who are the creators of the environment in which entrepreneurship and innovation flourish?
• What activities do your innovators engage in in your pyramid?
• What activities do your entrepreneurs engage in in your pyramid?
Creators of the Environment
• What knowledge do they need
• What skills do they need?
• What attitudes need to be challenged/fostered?
Innovators
• What knowledge do they need
• What skills do they need?
• What attitudes need to be challenged/fostered?
Entrepreneurs
• What knowledge do they need
• What skills do they need?
• What attitudes need to be challenged/fostered?
Concept mapping and translationLevel of Practice
Level of Practice Professional Objectives
Organisational Objectives
Entrepreneurship concepts, skills and attitudes
Junior Clinicians Plan and deliver best patient care
Research utilisationEvidence based practice
Enterprising, ResourcefulnessEntrepreneurial orientation
Senior Clinicians Improve patient care and outcomes
Change practiceService InnovativeService improvement
Sustained regeneration Incremental innovationEntrepreneurial Leadership
(Clinical) Managers Cost effective service delivery
Service redesign New ways of workingCommissioningIncome generation
Renewal activityStrategic EntrepCorporate venturingEntrepreneurial Leadership
Concept mapping and translationLevel of Practice
Level of Practice Professional Objectives
Organisational Objectives
Entrepreneurship concepts, skills and attitudes
Junior Practitioners
Senior Practitioners
Managers
Concept mapping and translation:Level of study
Level of Study Individual objectives
Educational/Professional objectives
Entrepreneurship concepts, skills attitudes
Undergraduate Get a good jobFinish my course
Get a good degree EmployabilityEnterpriseResourcefulnessProactiveness
Masters Finish my Masters degreeMove up band
Change practiceService InnovationService improvement
Radical innovation Renewal activity Corporate entrepreneurship Sustained regeneration/incremental innovation
Doctoral Get my PhDGet lectureship
Generate new knowledge
Commercialisation of knowledgeProduct developmentBusiness plans
Concept mapping and translationLevel of study
Level of Study Individual objectives
Educational /Professional objectives
Entrepreneurship concepts, skills attitudes
Undergraduate
Masters
Doctoral
Concept mapping and translationOrganisational Level
Level Objectives (micro)
Objectives (macro)
Entrepreneurship concepts, skills and attitudes
References
• Duffy, E. (1995, April), Horizontal violence: a conundrum for nursing. Collegian. Journal of the Royal College of nursing Australia. 2(2), 5-17.
• Freire, P. (1972) Pedagogy of the Oppressed. Harmondsworth: Penguin.
• Giroux, H. A. (1994). Disturbing pleasures: Learning popular culture. New York: Routledge.
• Young, Iris. 1988. "The Five Faces Of Oppression." Philosophical Forum 19:270-90