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Purpose. There is a tendency in team research to employ concepts of stepwise models, reaching from the primitive to the excellent, to suggest that a higher level of evolution is better than the basic and simple. This tendency includes typologies of teams. This article aims to question the relevance of this view.

Design/methodology/approach. Data were collected in three steps. In the first step, articles and books analyzing teams and teamwork from stepwise analytic models were collected. In the second step the collected data were classifies into different themes. Each stepwise model was classified inte one essential denomination. This classification resulted in eight themes. In the third step each theme was analyzed, which led to the fusion of some of the themes.

Findings.The conclusion is that a synchronous, complementary or mature team is not necessarily optimal. Contrary to this, a differentiated, sequential or multi team approach can be optimal for some purposes. Team research needs to establish a more open, inductive and critical attitude than at present.

Originality/value. The paper highlights the need to observe and use team theories in a balanced and critical way.

Keywords. Team, team working,team models, stepwise models, theoretical models, critical study, modelling

Paper type. Conceptual paper

AIM: To investigate both quantatively and qualitatively the differences between participation in team-based visist (TBVs) an perceived needs for TBVs from the perspectives of healthcare professionals, in the context of the Swedish three-tier national child healthcare program.

METHODS: A studfy-specific qustionnaire, including multipel-choice questions with fixed and free-text response options, was developed and used. To capture healthcare professionals' experiences and find explanations for the quantitative results in qualitative data, a convergent parallel mixed-methods study design was ued. Descriptive statistics and Mcnemar's test were used to analyze the quantitative data, and content analysis was used to analyse the qualitative data.

RESULTS: Healthcare professionals perceived the needs fot TBVs in the Swedish child helathcare services (CHS), especially in cases with complex needs. The largest differences between the perceived needs for TBVs and experienced TBVs was seen for targeted TBVs on indications associated with psyjosocial problems. The quantitative findings were explored by the qualitative findings. Both individual and organisational factors influenced TBVs.

CONCLUSION: Perceived needs for TBVs in Swedish (CHS) exceeds ints existence. Healthcare professionals require TBVs delivered by interprofessional teams, in line with proprtionate universalism. To realize this, organisational structurer (e.g. co-location and clear instructions on how to distribute TBVs) and human resources (e.g. psychologists and social workers) are needed. 

Complex healthcare needs can be met through effective interprofessional collaboration. Since 2014, Swedish Child Healthcare Services (CHS) include universal team-based visits with a nurse and a physician who perform such visits at the age of 4 weeks, 6 months, 12 months, and 2.5 to 3 years, as well as targeted team-based visits to address additional needs. The aim of this study was to describe the prevalence of team-based visits in the Swedish CHS and possible associations between team-based visits and contextual factors that may affect its implementation. A national cross-sectional survey was conducted using a web-based questionnaire distributed to all reachable nurses, physicians, and psychologists (n =3,552) engaged in the CHS. Data were analyzed using descriptive statistics and binary and multivariate logistic regressions. The response rate was 32%. Team-based visits were reported by 82% of the respondents. For nurses and physicians, the most frequent indication was specific ages, while for psychologists it was to provide parental support. Respondents working at Family Centers were more likely to perform team-based visits in general, at 2.5 to 3 years and in case of additional needs, compared to respondents working at Child Health Centers (CHC) and other workplaces. In conclusion, team-based visits are well implemented, but the pattern differs depending on the contextual factors. Targeted team-based visits and team-based visits at the age of 2.5 to 3 years are most unequally implemented.

^{This paper develops work carried out under the aegis of a European Commission-funded university continuing education (UCE) network. It compares the ways in which UCE has developed in three countries within Northern Europe. The authors firstly review the developments of university education in general in Finland, the UK and Sweden, paying particular attention to the factors that historically have influenced UCE. They then focus on developments and policy imperatives of the last decade. A number of convergences and divergences in policy and practice in the three countries are pointed to. In both Finland and the UK, UCE is well defined by state or quasi-state agencies and is an activity that has been located within well-defined structural units in most institutions. Universities in these two countries have a diverse mission based on a national lifelong learning agenda. By contrast, in Sweden, whilst there is a longstanding international tradition of adult education rooted within democratic movements and a recognition of the importance of equality of access, the provision is to a large extent embedded in universities and not manifest as UCE. What provision that does exist as UCE is patchily distributed across the university sector and nonuniform in character. UCE provision within Finland and UK to varying degrees in becoming more diverse in its make-up. The presence of new providers in a ‘CE market’, an emphasis on UCE as an economic instrument, moves towards the accreditation of provision and the loss of a particular identity for UCE are amongst factors creating increasing heterogeneity of provision in these countries.}

Under de senaste decennierna har offentliga verksamheter i Sverige: skola, socialtjänst samt hälso- och sjukvård, fått nya grundläggande förutsättningar för sin verksamhet bl.a. genom den så kallade ramlagstiftningen från 1980- talet. I spåren av detta har ett intresse av att alltmer organisera verksamheter i ”team” vuxit fram. Generellt sett är team som etablerats på senare år, särskilt inom offentliga verksamheter, inte studerade i någon större omfattning. De studier som är gjorda visar att arbetsklimatet är av särskild betydelse för processer i verksamheten och för arbetets resultat. Denna studie syftar till att belysa fenomenet arbetsklimat i teamarbete utifrån tre teman: arbetsklimatets innebörd, arbetsklimatets ”rötter” och konsekvenserna av arbetsklimatet. Rapporten bygger på två empiriska delstudier utifrån angivna tematik, en intervjustudie och en fokusgruppsstudie

Based on research about teamwork in human service organizations in Sweden, such as e.g. example education, the concept of collaborative health, CH, is introduced and found to be a relevant expression in educational psychology for the physical, psychological and social health resources that the individual uses in teamwork and that are, simultaneously, influenced by the teamwork.

                      Collaborative health is examined in this article through a social constructivistic approach and viewed in the perspective of earlier concepts in social psychology and working life research, such as psychosocial stress and burn-out.

                      The need for a holistic team theory as a prerequisite for future research in this area is emphasized. A core criterion in, and an indispensable part of, this team theory is the access to relevant and logical concepts, one of which is collaborative health.

                      The article concludes that the concept of collaborative health has a role to play in a relatively new research area. There is even a need for this concept in the complex collaborative and co-operative teamwork of education and other human service organizations of today.

I debatten om ökade sjukskrivningstal har läkarna hamnat i fokus. Landstinget Västmanland vände sig hösten 2002 till Mälardalens Högskola med en önskan om att få en studie genomförd rörande läkares sjukskrivningspraxis. Genom studien ville man få till stånd en dialog med familjeläkarna kring sjukskrivningsproblematiken och vilka möjligheter som fanns att utveckla nya rutiner för utfärdande av sjukintyg och rehabiliterande insatser. Samtidigt påpekade man att Landstinget i egenskap av arbetsgivare hade ett stort ansvar vad gällande den egna personalens hälsa och tillfredsställelse i arbetet.

Håkan Sandberg, universitetslektor vid Institutionen för Vård- och Folkhälsovetenskap genomförde våren 2003 en undersökning där familjeläkare intervjuades om sjukskrivningsproblematiken och sin egen roll som sjukskrivare. Studien har avsett att fånga läkarnas uppfattning inom ett antal områden som exempelvis:

• förklaringar till de ökade sjukskrivningstalen

• beslutssituationen vid själva sjukskrivningen och den praxis som läkare tillämpar

• uppfattningar om hur praxis kan förändras

Studien är intressant i ljuset av offentliga utredningar och olika förslag som framförts om hur läkares sjukskrivningspraxis kan förändras. Förslagen har handlat om att förstärka den försäkringsmedicinska delen av läkarutbildningen, om fortbildningsinsatser inom området, men också om sjukskrivningsförfarandet, om sjukintygets utformning och om att göra en förnyad bedömning av annan läkare än den sjukskrivande efter 20 dagars sjukskrivning

Vid Mälardalens högskola har sedan en tid det kontinuerliga arbetet med kvalitetsutveckling bl.a. inneburit en uppmärksamhet mot forskningsbasen i utbildningen. Frågan om forskningsbasen operationaliseras i detta projekt till en fråga om hur studiehandledningar i utbildningen kan tydliggöra utbildningens forskningsbas. Det har i föreliggande rapport varit nödvändigt med betydande avgränsningar, särskilt när det gäller frågan om val av perspektiv och teoretisk inplacering.

Akademisering är som begrepp tydligt knutet till att den kunskap som utbildningen arbetar med är forskningsbaserad, dvs. att den bygger på en utbildning som utgår från en forskning som generellt sett är vedertagen och accepterad. Högskolelagen menar att en högskolemässig utbildning bl.a. innebär att kunna efterforska och fastställa värdet av kunskap och dess utveckling på en vetenskaplig nivå. Frågan om forskningsbas i högskolan är mycket ringa studerad, men studier av hur forskningsrapporter används i skolan visar att lärare rankar dessa lågt och istället litar på sin egen erfarenhet. En genomgång av pedagogiska perspektiv på lärande visar att det är möjligt att särskilja såväl utlärandet (teaching) som inlärandet (learning) med avseende på ”djup”. Att nå ett ”djup” i inlärningen är starkt beroende av en utbildning där forskningsbaserat kritiskt tänkande och hög egenaktivitet kommer studenten till del.

Genom dessa teoretiska studier tillsammans med användandet av en datainsamling i form av s.k. critical friends, som studerat och kommenterat frågan om forskningsbas med fokus på studiehandledningar, dras i denna rapport ett antal slutsatser i form av implikationer för utbildningen på högskolan. Dessa implikationer berör såväl studiehandledningarna i sig som hela utbildningskontexten.

The aim of this paper is to focus on the development of HE/CE in Sweden as a transition from a non-academic context to an academic context and a current trend back to a non-academic context considering the nature of the transitions, facilitating factors in theses processes and consequences of the transitions.

Generally health professional higher education has been transformed from being short and work-base to become a nuiversity programme. This is supported by non-controversial Higher Education Acts and facilitated by ideological, economic/organizational and political points of view that emphasise labour markets needs for women, equalities between the sexes, professional groups struggling for authorisation and professional position (status) and growing complexity in work tasks with demands for quality development. The consequences are a gradually growing self-esteem and self-awareness among professionals beneath physican status, signified by non-physicians taking managerial positions, as well as a growing awareness of the need for teamwork.

A transition in perspective concerning the uesfulness of an academic approach in higher and continuing education for health professionals is ongoing. We seem to be standing of the top of an 'academic hill', and can see transitions towards formal learning in non-traditional learning contexts as well as an acceptance of the importance of non-formal learning in all kinds of contexts.

Theoretical, ideological and economic arguments influence te transitions as well as the students' aspirations and attempts to seek meaning. Which context or mix of context is most productive for the learning processes necessary for health professionals? Today high-quality collaborative efforts such as action research and clinical teaching are stressed. In Sweden this clearly appears as a transitions from a 'university agenda' to a 'collaborative agenda' in which the labour-market has a growing influence upon HE/CE and research. The result of this study is also discussed in terms of a 'collaborative view' and a 'competitive view'.

Sjuksköterskan har en akademisk utbildning med huvudämnet vårdvetenskap och andra ämnen som medicinsk vetenskap, samhälls- och beteendevetenskaper. Detta är en grund för att ta sig an arbetet. Med dessa grundläggande kunskaper skapar sedan erfarenhetsbaserad kunskap där tyst kunskap (tacit konwledge) upptar en betydande plats ett fortsatt lärande. För en kontinuerlig kompetensutveckling och för att kunna medverka till förbättringar i vården, krävs också att sjuksköterskan arbetar på en lärande arbetsplats.

Vi samarbetar med varandra, inte minst i arbetslivet. Vi är unika persopnligheter men är samtidigt människor som alla andra. Vi ingår i olika grupper och har våra sätt att möta andra. Både det personlighetspsykologiska och socialpsykologiska perepektivet är sammansatt av olika kunskapsområden som bl.a. handlar om våra förmågor till bedömning och beslut samt den känslomässiga styrning vi alltid lever med, en styrning vi både kan bemästra och ibland får ge vika för. Allt detta ramas in av den kultur vi lever i, de erfarenheter vi tillägnar oss och det vi är som homo sapiens. Denna bok eftersträvar en syntes av dessa kunskaper just med tanke på våra arbeten i team.

De pedagogiska perspektiven i sjuksköterskans arbete har blivit allt viktigare. Kunskaper i pedagogik och didaktik är idag helt nödvändiga för natt patienter och närstående ska kunna mötas av god omvårdnad. Men pedagogiken är också central för studenters, handledares och yrkesverksamma sjuksköterskors utbildning och kompetensutveckling. Boken täcker de delar som studenter, handledare och yrkesverksamma behöver avseende pedagogik.

Detta kapitel redovisar pedagogiska grunder för sjuksköterskans pedagogiska vårdarbete. Kapitlet beskriver översiktligt pedagogik, kunskap, kompetens och lärande, speciellt med tanke på sjuksköterskans arbete. Boken har sin tyngdpunkt på lärande i vårdkontexten.

Detta kapitel tar upp pedagogiska perspektiv och teorier om lärande, framför allt när det gäller individens lärande. De fyra grundläggande perspektiv, som också interfolieras med teoretiska resonemang är:

1. Lärande genom förmedling.

2. lärande genom självstyre.

3. Lärande genom dialog.

4. Lärande - en helhetssyn.

Denna bok beskriver hur begreppet samarbetshälsa under de första åren av 2000-talet har formulerats som ett teoretiskt begrepp. En första empirisk studie som utgår från begreppet presenteras också. Med sin bakgrund som teamforskare, presenterar och diskuterar författaren också tidigare arbetslivsforskning och centrala begrepp i denna, begrepp som också tangerar samarbetsförhållanden i arbetslivet.

Kapitlet fokuserar sjuksköterskans pedagogiska arbete med patient och närstående. Samspelet mellan sjuksköterskan och patienten samt anhörig är inte "symmetriskt" vilket ofta leder till att sjuksköterskan är "lärare" och de övriga "elever". Samtidigt kommer rollerna ibland att vara ombytta och sjuksköterskan är den som lär sig i samspelet. För att sjuksköterskan ska kunna förverkliga en personcentrerad vård är det viktigt att hen arbetar utifrån medvetna pedagogiska val.

Föreliggande lärobok är en omfattande metaanalys av forskning och litteratur kring samtal i vården med sjuksöterskan i centrum. Boken tillför dessutom ny kunskap bl.a. genom den referensgrupp som kontinuerligt har kommenteat och exemplifierat texten.

Based on empirical research about teamwork in human service organizations in Sweden, the concept of collaborative health (CH) encapsulates the physical, psychological and social health resources the individual uses in teamwork; resources which at the same time are influenced by the teamwork. My argument built on empirical research leading up to identifying and defining the core concept in this article, is that teamwork affects team members' health and this in turn affects the teamwork and its outcome. In this paper collaborative health is viewed from a social constructionism perspective and discussed in relation to earlier concepts developed in social psychology and working life research, including psychosocial stress and burnout. The paper also introduces the concept of functional synergy, which in this context is defined as the simultaneous presence of sharp goal-orientation and synergy in teamwork. The need for a holistic team theory is emphasized as a tool in research on teamwork. Such a theory relies on identifying sound and illuminating constituent concepts. I suggest that collaborative health could be a useful concept for better understanding the complex collaborative and co-operative teamwork of human service organizations of today.

The concept of collaborative health has been found to be an adequate expression of the physical, psychological and social health resources the individual uses in collaboration, health resources which also are affected by teamwork collaboration (Sandberg, 2010). The aim of this study is to elucidate the concept of collaborative health in different working life contexts and thereby develop the meaning of this concept. In 2009 – 2010 individual interviews were undertaken with 19 experienced professionals from the welfare sector as well as trade and industry in Sweden. The main result of this study is described as “cultures of collaborative health”: The resource culture; the mission culture; the relational culture and the human value culture. These four cultures express partly overlapping ways of describing meanings of collaboration at work with consequences for collaborative health. Conflicts in the collaborative situations are discussed as a consequence of the individuals’ different, sometimes clashing, “paradigmatic positions” with regard to which culture they tend to emphasize when reflecting upon a satisfying collaboration. The main result of this study gives rise to a conceptual development of collaborative health. Further empirical studies are needed in order both to clarify the methodological issues and to bring stronger evidence in support of the usefulness and meaning of collaborative health, possibly directing the concept to a position of being well defined and generally useful, e.g. as the core concept in an instrument relating working life conditions to health. The concept of collaborative health might have the power of bringing a somewhat new perspective to research and management of working life.

Previous work has identified a lack of focused research in the field of team working in university continuing education (UCE). However, teamwork could be seen as self-evident in UCE, in part because UCE is of interest to employees, employers, universities and society. The aim of this study is to describe teamwork in UCE at three universities in the UK. The main research question asks: ‘How can the organisation of UCE be described as “teamwork”?’ A case study strategy is applied for two reasons: first, this is an empirical study involving the examination of objects in their natural environment; and second, it describes a limited but complex situation entailing many relevant factors and hence multiple sources of information. There is a built-in expectation of divergence across cases, since the cases are selected to expose and analyse variation. The chosen research methods are a document study and an interview, based on the nature of the object in question, the research question being raised and the descriptive purpose of the study. The methodological frame of reference used in this study, the ‘Organisational Context’, deals with conditions as prerequisites, team processes, results of teamwork and feedback. The model is reciprocal and basic to the contextual analysis. It has been used in earlier work by Sandberg (e.g., 1997b), and could be discussed in terms of the ‘ecological’ frame of reference (Sundstromet al, 1990). The result shows that teamwork is present in many cases in UCE, but many common conditions function as obstacles to teamwork. For example, in many teams members are not permanent, furthermore, the academic system rewards individual achievement more than teamwork. The three cases in the study have significant similarities. The discussion points out that the actors in UCE have different perspectives beyond a common UCE-perspective. The difficulty in establishing the genuine teamwork necessary in UCE could be viewed as rooted in universities not having been originally created to meet the expectations of lifelong learning and continuing education.

Kapitlet fokuserar lärande och kommunikation i vården. Vetenskapen om kunskap och lärande är pedagogik och följaktiligen är detta ett vårdpedagogiskt kapitel. Det första huvudavsnitteti kapitlet ger en introduktion till vårdpedagogik och kommunikationsteori. Nästa huvudavsnitt handlar om lärande och där behandlas lärandets innehåll, lärande genom kommunikation och vilka konsekvenser lärandet har, särskilt när det gäller vård och hälsa. Det tredje huvudavsnittet sammanfattar vad vårdpedagogisk kommunikation innebär och hur det kan diskuteras.

Background Globally, interprofessional teamwork is described as a key method to promote health and prevent illness in children, namely, to achieve the goals of Child Healthcare Services (CHS). However, how teamwork should be designed within CHS to achieve the goals is unclear. This study aimed to investigate healthcare professionals' perceptions about 1) taking part in interprofessional teamwork, 2) team characteristics, and 3) whether the perceptions were related to professional affiliation or workplace. Methods A national cross-sectional survey was conducted using a web-based study-specific questionnaire sent to all accessible nurses, physicians, and psychologists in Swedish CHS (n = 3552). The response rate was 31.5%. To identify possible associations, logistic regressions were conducted. Results Almost all respondents, 1096/1119 (97.9%), reported taking part in some type of interprofessional teamwork within the Swedish CHS. Among those, the most common was team-based visits (82.2%). It was perceived that performing team-based visits resulted in fulfilled goals, expertise exceeding individual team members' competences, provision of high-quality care, and meeting children's and families' needs, to a greater extent, than if not performing team-based visits. Correspondingly, working as a team in parental groups was perceived as resulting in fulfilled goals, meeting the needs of children and their families, and continuity within the team to a greater extent than if not working together in a team. Professional affiliation was associated with different perceptions and types of teamwork. Family Centers were positively associated with all types of teamwork as well as continuity within the team. Conclusions Healthcare professionals' perceptions about team characteristics were associated with professional affiliation, workplace, and type of teamwork (defined as team activities) within the CHS. Professionals within Swedish CHS, taking part in team-based visits and in interprofessional teamwork in parental groups, perceived that the team fulfilled its goals and met the needs of children and families to a greater extent than professionals not taking part in these types of teamwork. Professionals at Family Centers were more likely to work in teams in different ways. Knowledge about interprofessional teamwork for individuals and groups in Swedish CHS might also be valuable in other healthcare settings, dealing with complex needs.

Förändringar i samhället, i sjukdomsbilder och i behandlingsmöjligheter ställer kontinuerligt krav på förändringar och förbättringar i vården. I allt detta har sjuksköterskan en nyckelroll. Ett kontinuerligt lärande i vården är ofrånkomligt och i detta har sjuksköterskan en viktig roll att spela som omvårdnadsspecialist och ofta i en position som ledare. Hen är alltså i mångt och mycket en förändringsagent.