Aim The study aim was to explore the issues and challenges facing undergraduate nursing education in one Canadian province from an institutional theory perspective. The research questions were: What is the institutional field of nursing education? What are the issues and challenges facing nursing education? How is the institutional field of nursing education contributing to the issues and challenges? How are the issues and challenges contributing to the institutional complexity? Background Nursing education is essential for the health care of society, yet face various issues and challenges at the system level. Institutional theory has been used in higher education to better understand how higher education institutions are structured and operate. Institutional theory has not been used in nursing education. The issues facing nursing education have been examined from a critical or descriptive perspective, but a system-level perspective is missing. Institutional theory could fill this gap and examine the institution of nursing and how its structure, behaviours, and rules influence those issues and challenges. Methods An exploratory single-case study with embedded units design was used. Theoretical propositions from institutional theory informed the sample, recruitment, data collection, and data analysis. In 2019, representatives from organizations comprising the institutional field of nursing education and senior-level administrators were interviewed and relevant documents were collected and reviewed. The data were analyzed using deductive and inductive thematic analysis, building a case description, and visual analysis techniques. Findings The findings from sixty documents and seven interviews suggested the institutional field of nursing education is composed of postsecondary institutions, health service organizations, the regulatory body, the ministry for health, and the ministry for postsecondary education. The issues and challenges facing nursing education included demands on curricula, teaching and learning values versus practice, the relationship between education and practice, limiting financial supports, clarity of the RN role, and need for faculty. The institutional field of nursing education is complex and includes dominant organizations, such as the regulatory body and health service organization, and the non-dominant organization, postsecondary institutions. Discussion / Conclusion The use of institutional theory was beneficial to explore the issues and challenges facing undergraduate nursing education from a system-level perspective and captured the complexity within the system. The institutional field including the influences of structure, dominance, and complexity impact the issues and challenges facing nursing education. The institutional perspective of the issues and challenges diverges from previous examinations. In addition, the use of institutional theory in higher education offers strategies for advocacy in nursing education. Recommendations for nursing education practice, policy, and research include: (a) awareness of the organizations comprising the institutional field of nursing education, (b) including the nursing education accreditation body and the professional association within the interorganizational structures, (c) acknowledgement of the sources of dominance within the field, and (d) developing strategies for academic nurse leaders to navigate the complexity of nursing education. The most urgent consideration arising from this research is the dominant forces from regulation and health service organizations and the subsequent non-existence of the professional voice of nursing for nursing education within the institutional field. / Graduate

This research focuses on the influence of institutions on entrepreneurship among Kuwaiti youth. It aims to capture the role played by institutions on youth entrepreneurship at the backdrop of a dampening ‘spirit’ for it. This research is currently very important due to various economic and geo-political factors leading to an economic downturn, which has led to the need for entrepreneurial ventures. It reviews and consolidates concepts and factors purported to facilitate and increase entrepreneurship for the benefit of the society and economy of Kuwait. This research uses a social constructionist approach to make sense of how institutions influence Kuwaiti youth in their quest to become entrepreneurs. It exposes institutional endorsement and legitimacy from formal and informal institutions. It shows the use of regulative, normative and cognitive dimensions and influences on entrepreneurial intentions and actions. This research shows how institutions interact with Kuwaiti youth and what role they play in the formulation of intentions and actions concerning entrepreneurship. A number of key formal and informal institutions have come to the fore that influence one another (in)directly as living entities, and likewise influence the youth (in)directly. The research contribution also shows that young people have to approach some key institutions and in return their desire to become entrepreneurs is strengthened or weakened depending on how institutions respond and what role they are willing to play in their lives.

Thesis advisor: Marilyn Cochran-Smith / This dissertation presents an ethno-case study explaining how students at a conservative Christian high school were socialized into ideas about civic and public life in a pluralistic society. Drawing on democratic educational theory and institutional theory to analyze ethnographic data gathered during a full school year of observations, interviews, and document collection, this dissertation addresses the following questions: (1) What are the logics, practices, and symbolic representations concerning civic identity and participation in democratic society conveyed explicitly and implicitly at a conservative Christian high school? (2) How do students understand and engage with ideas about civic identity and participation conveyed at that school? (3) How do families understand and engage with these ideas about civic identity and participation? This dissertation argues that the school was organized around a theo-political institutional logic committed to the absolute truth of Christianity. This logic was symbolically represented in the language and concepts of the “Christian worldview” and reinforced through consistent and recurrent school practices that shaped students’ behavior and their ways of interpreting the world. This theo-political logic, which was pervasive throughout formal and informal curriculum and instruction at the school, presented an all-encompassing vision of Christianity as “the truth” and offered a coherent connection between doctrinal beliefs and actual behavior. This logic was also notable for what it omitted and lacked, particularly acknowledgment of the racialized nature of schooling and society, attention to the pluralism of worldviews in a diverse democratic nation, and recognition of the systemic and structural causes of injustice in society. The emphases as well as the omissions of the theo-political logic at the school shaped students’ civic identity as first and foremost a religious identity, which meant engaging with society to promote conservative social policies, candidates, and political perspectives. The dissertation shows that students largely embraced the theo-political logic that animated the school, and their parents chose the school because of the presence of this logic. / Thesis (PhD) — Boston College, 2023. / Submitted to: Boston College. Lynch School of Education. / Discipline: Teacher Education, Special Education, Curriculum and Instruction.

In the aftermath of the terrorist attacks of September 11, 2001, it became apparent that the way organizations conduct business activities within and between themselves would be forever altered. Specifically, the way the firms share and distribute goods became an important area of interest to ensure the security of their supply chain partners and ultimately, society in general. Supply chain security (SCS) is defined as activities that protect supply chains from damage, terrorism, and contraband. This dissertation adds to an emerging knowledge base – SCS efforts. More specifically, this dissertation attempts to address three key areas concerning SCS: 1) understand what type of SCS activity taxonomy exists; 2) understand what is driving those taxonomy categories to exist; and 3) understand what, if any, relationship between the SCS taxonomy categories and organizational performance exists. To gain this knowledge, inductive and deductive techniques were utilized. First, in-depth semi-structured interviews with 19 executives across a variety of industries concerning SCS issues were conducted to help frame the research and develop research hypotheses. Through content analyzing the interview transcripts, it became salient that institutional environmental pressures were what respondents indicated were the causes of security activities. As such, Institutional Theory was used as a theoretical framework for the dissertation. Second, a survey method was used to collect data concerning supply chain security activities, pressures that cause them, and organizational performance. In the empirical examination of SCS, it was found that three categories of security exist. The taxonomy that emerged had three categories that were named Security Pros, Follow-the-Leaders, and Necessary Evils. The next part of the empirical examination was to determine which, if any, of the identified drivers impact the SCS categories. Using multiple discriminant analysis, it was determined that customers and societal pressures are significant in impacting the SCS categories. Finally, a multiple analysis of variance was conducted to determine if different types of SCS categories were associated with different types of organizational performance. The results indicated that different groups were not related to different levels of firm, customer, market, and supply chain performance.

Yes / The race against ‘Digital Darwinism’ in public sector had caused failures of several high profile large-scale Digitally Enabled Service Transformation (DEST) projects. While technical and managerial issues are often emphasised as the factors underpinning such failures, the vital role of key actors and the interplay between these actors and structures is underplayed when examining the causes of DEST failure. To enable a richer understanding of DEST, this paper proposes an analytical lens combining Institutional Theory (IT) and Structuration Theory (ST) to explore the case of ‘Universal Credit’, a very large and ambitious DEST project in the UK. Analysis reveals that the institutional actors and structures played significant roles in the transformation process. Albeit governing the actors’ actions, institutional structures are shaped through actions that are influenced by knowledge, power and norms. Hence, recognising and addressing these subliminal factors are critical to promote actions that can facilitate DEST success. The contributions of this case study are two-folds. Theoretically, it provides a distinctive conceptual approach to study DEST; and practically, the lessons help in signposting better managerial practices.

No / Digitally-Enabled Service Transformation (DEST) projects in public sector institutions are viewed as a choice of strategic response towards changes in policy. Such transformation can destruct institutional stability and legitimacy and result in failure if the complex institutional setting of the public sector is not comprehended in the change-institutionalisation effort. Through a multiple case enquiry, this study examines how institutional pressures contribute towards the emergence of DEST in public agencies and how newly introduced transformation is implemented and diffused within the institutional setting. The findings highlight that as a form of technology driven change, DEST is characterised and shaped dominantly by continuous interplay with institutional elements and the impact of these interactions define the institutionalisation, deinstitutionalisation and re-institutionalisation of DEST. Ability to recognise such stages and provide the required support will determine a public institution's ability to effectively manage DEST and attain its strategic goals.

Yes / This paper examines trends in the content of reporting within 135 UK Higher Education Institutions (HEIs). It explores the extent to which Integrated Reporting (IR) content elements, reflecting integrated thinking, are disclosed voluntarily and whether HEI specific features influence the resulting disclosures. Existing IR guidelines given by the International Integrated Reporting Council (IIRC) and the adoption of content analysis have provided the opportunity to examine the trend and extent of IR content elements associated in HEI corporate reports. The evidence was obtained from 405 UK HEI annual reports covering the period 2014-2016. The results indicate a significant increase in the number of IR content elements embedded in HEI annual reports. The HEI specific characteristics examined, such as a) the establishment of HEI (before or after 1992), b) adoption of IR framework and c) size of HEI, are all significantly and positively associated with IR content elements disclosure. This paper argues that institutional theory, isomorphism and isopraxism are relevant for explaining the changes in the contents of HEI annual reports. The findings also suggest that universities are beginning to adopt an integrated thinking approach to the reporting of their activities. The study is based on IR content elements only and could be extended to include the fundamental concepts and basic principles of the IR framework. There are other factors that have a potentially crucial influence on HEI core activities (such as teaching and learning research and internationalisation) which have been omitted from this study. The findings will allow policymakers to evaluate the extent to which integrated thinking is taking place and influencing the UK HEI sector in the selection and presentation of information. A further implication of the findings is that an appropriate a sector-wide enforcement and compliance body, for instance, the British Universities Finance Directors Group (BUFDG), may consider developing voluntary IR guidance in a clear, consistent, concise and comparable format. Also, it may pursue regulatory support for this guidance. In doing so, it may monitor the compliance and disclosure levels of appropriate IR requirements. Within such a framework, IR could be used to assist HEIs to make more sustainable choices and allow stakeholders to better understand aspects of HEI performance. The research has implications for society within and beyond the unique UK HEI sector. Universities are places of advanced thinking and can lead the way for other sectors by demonstrating the potential of integrated thinking to create a cohesive wide-ranging discourse and create engagement among stakeholder groups. Specifically, IR builds on the strong points of accounting, for instance, robust quantitative evidence collecting, relevance, reliability, materiality, comparability and assurability, to explain the sustainability discourse into a ‘‘language’’ logical to HEIs organisational decision-makers. Consequently, IR may generate better visibility and knowledge of the financial values of exploiting capitals (financial, intellectual, human, manufactured, social, and natural) and offer a multifaceted approach to reassess HEIs organisational performance in various sectors that support the growth of integrated thinking.

Yes / Organizations have cultural-cognitive and regulative as well as normative elements that impact their employees. Organizations, by definition, cannot achieve a pure, stable state and always go through various change processes, both incremental and radical changes. Moving from legacy business-to-business (B2B) relationship management to an artificial intelligence-based customer relationship management (AI-CRM) is a gradual but paradigm change. AI-CRM leverages intelligent systems to automate the B2B relationship activities where the decision can be taken automatically without any human intervention. Relationship management in the B2B segment is considered a strategic activity of an organization. Moving from legacy to AI-CRM to facilitate B2B relationship management activities is an important decision, and proper implementation of AI-CRM is a critical success parameter for an organization. This study combines institutional theory and the resource-based view (RBV) in B2B relationship management to understand how AI-CRM could impact the firm's performance with varied firm size, firm age, and industry type.

This dissertation examines the factors influencing entrepreneurship in Saudi Arabia, focusing on economic, social, and cultural aspects. Three hypotheses guide the study: 1) Economic factors. 2) The social environment. 3) There is a positive relationship between prior and subsequent venture creation. Using panel data from 13 regions between 2008 and 2022, findings show that positive economic changes, higher income per capita, lower unemployment, and higher business density significantly boost new venture creation. Access to finance and prior venture creation also positively influence subsequent entrepreneurial activities. However, a higher proportion of foreign workers and marriage rates negatively correlate with new venture creation, while the female population ratio has a complex impact. This research provides insights for policymakers and entrepreneurs, emphasizing the need for supportive economic environments and policies addressing social dynamics to enhance entrepreneurial growth in Saudi Arabia.

Bakgrund: Offentliga organisationer har under de senaste decennierna utsatts för förändring, detta till följd av ett ökat krav på effektivitet. Som svar på detta har styrinstrument (management verktyg) från industriella sammanhang hämtats för att bemöta denna effektivitet, ett av dessa verktyg är Lean, som i hälso- och sjukvården fått namnet Lean Healthcare. Lean kan ses vara ett koncept som färdats från tillverkningsindustrin in till hälso- och sjukvården där den översatts, något som medfört att det teoretiska ramverket översättningsmodellen används för att förstå denna översättning i hälso- och sjukvården.   Syfte: Syftet med studien är att beskriva och förklara hur olika hälso- och sjukvårdsorganisationer översätter Lean. Detta för att bidra med kunskap om vad Lean står för i hälso- och sjukvården, samt vilka möjligheter och svårigheter som existerar.   Metodval: En kvalitativ flerfallstudie har genomförts för att kunna förstår hur Lean översatts i hälso- och sjukvården. Datainsamlingen har genomförts genom semistrukturerade intervjuer på kliniknivå vilket inneburit att vi haft kontakt med läkare, sjuksköterskor, fysiker, specialistsjuksköterskor, barnmorskor samt administrativ ledning. Vi har även tagit del av olika dokument som medfört en bredare förståelse för hur översättningen sett ut.   Slutsatser: Vi har sett hur idén, Lean, genomgått olika faser i klinikerna där det översatts till att bli något eget i klinikernas lokala praktiker. Vi kan konstatera att Lean i hälso- och sjukvården blir något som står för effektivitet, processtänk, samarbete och problemlösning, standardisering, visualisering, att ledarna investerar i sina anställda samt mätning och sökande efter överlevnadsgrad. Vidare kan vi konstatera att Lean i hälso- och sjukvården skapar möjligheter då det lett till effektivare behandlingstid, bättre tillgänglighet av personal, förkortade ledtider, förbättrade patientflöden, bättre arbetsmiljö och en bättre struktur. Svårigheter som visat sig uppkomma är att finna balans och anpassning, svårigheter med professioner, svårigheter med koppling till det industriella sammanhanget samt den komplexitet som hälso- och sjukvården består av där oförutsägbara händelser ofta uppstår. / Background and discussion: Public organizations have in recent decades been subjected to change, and this is due to an increased demand for efficiency. The control instrument (management tool) from industrial settings has been taken in response to this efficiency and one of them is Lean, in Healthcare named “Lean Healthcare”. Lean can be seen as an idea that has been translated from the manufacturing industry to healthcare, and the theoretical framework translation model has been used to understand this in this paper. Purpose: The purpose of the study is to describe and explain how different healthcare organizations translate Lean. This is to provide knowledge of what Lean stands for in Healthcare, as well as the difficulties and opportunities that exist. Method: A qualitative case study has been conducted to understand how Lean is translated into Healthcare. Data has been collected through semi-structured interviews at the clinic level, which meant that we had contact with doctors, nurses, physicists, specialist nurses, midwifes and administrative management. We have also taken note of the documents that enabled us to have a broad understanding of how the translation looked which has given us an understanding of the opportunities and difficulties that existed. Conclusions: We have seen how the idea, Lean, has undergone various phases in both of the clinics, where it was translated into something local. We can conclude that Lean in Healthcare is something that stands for efficiency, the process of thinking, collaboration and problem solving, standardization, visualization, leaders investing in their employees, and measurement of quest for survival. Furthermore, we note that Lean in Healthcare creates opportunities as it leads to more effective treatment, better availability of personnel, shorter lead times, improved patient flow, better work, better structure and a better working environment. Difficulties arise as proven by finding balance and alignment, difficulties with professions, difficulties related to the industrial context and the complexity of healthcare where unpredictable events are common.