Bibliographic record
Abstract
This paper explores the emotional experiences of professionals in a health and social care setting during a process of reform in the Canadian province of Quebec. Characterized as “new public management” or “new managerialism,” public health and social care services in a number of countries have undergone reforms since the early 1980s that focus on efficiency and cost reduction (Nadeau, 1996; Hornblow, 1997; Gross, Rosen, & Chinitz, 1998, Anell, 2005; Levine, 2007; Wimbush, Young, & Robertson, 2007). Although differences exist between the cultural and political contexts within which reforms are implemented, reforms regularly involve changing institutional and organizational structures, the implementation of standard procedures, and the generation of outcome measures for service. The process of reform, and the body of knowledge on organizational change however, tend to overlook the flux of emotions that take place in the everyday lives of professionals. This paper reflects on data from 25 individual interviews collected from a critical ethnography of one health and social care setting during a period of provincial health-care reform in Quebec, Canada (2004-2012). The paper provides an in-depth focus on the emotional consequences of reform as an attempt to understand and expose the human costs of change. Three patterns that professionals used to adapt to change and conflict are discussed: internalization of the reform mandate; rationalization; and creating distance between the reform and their professional or personal selves. Important in their own right, the emotions produced in a period of change provide lessons on the general stressors that surround reform, and demonstrate how health and social care professionals are often caught between policy intentions, professional values, and their personal ambitions.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.007 | 0.015 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.012 | 0.027 |
| Scholarly communication | 0.010 | 0.004 |
| Open science | 0.001 | 0.010 |
| Research integrity | 0.003 | 0.004 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".