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J Health Organ Manag. 2009;23(2):225-39. doi: 10.1108/14777260910960957.

Learning from dialogue groups--physicians' perceptions of role.

Journal of health organization and management

David Bergman, Emelie Stotzer, Rolf Wahlström, Christer Sandahl

Affiliations

  1. Department of Learning, Informatics, Management and Ethics, Medical Management Centre, Karolinska Institutet, Stockholm, Sweden. [email protected]

PMID: 19711780 DOI: 10.1108/14777260910960957

Abstract

PURPOSE: The purpose of this paper is to examine the aspects of being a physician that such medical professionals mention in dialogue groups when given the opportunity to choose their own topics of discussion.

DESIGN/METHODOLOGY/APPROACH: Over a period of two years, 60 physicians participated in eight dialogue groups at one of the main hospitals in Stockholm, Sweden. Five focus group interviews were performed after the final dialogue group session.

FINDINGS: Qualitative content analysis showed that three themes dominated in the physicians' perceptions of their role: hierarchy and subgroups; understanding of learning and knowledge; clinical work. Very little time in the dialogue groups was spent discussing the third theme, i.e. problems or issues related to patients or their families. The hierarchy among doctors seemed to influence many aspects of the role of these individuals, their healthcare organisation and their work environment. The methodology in the dialogue groups challenged the prevailing hierarchical structures and seemed to improve the relations between different groups of doctors in the hierarchy. For some of the physicians, this also resulted in a new way of perceiving and acting in their professional role.

RESEARCH LIMITATIONS/IMPLICATIONS: The results of this study represent only one hospital.

PRACTICAL IMPLICATIONS: The findings may help healthcare managers understand physicians' conceptions of their role.

ORIGINALITY/VALUE: Few intervention studies have considered management programmes directed towards physicians. The present investigation is the first qualitative analysis of the use of dialogue groups within a healthcare setting.

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