This thesis has sought to examine the conceptualisation(s) of the field of Olympic education identified in the English language literature, and to evaluate the planning of Olympic education in practice, specifically in relation to the preparation of Olympic education programmes and systems for the Tokyo 2020 Olympics and Paralympics. When Pierre de Coubertin introduced the modern Olympic Games, one of the ideas for the revival of the Games was to educate young people through sport. Despite Coubertin s educational philosophy, the Olympic Games have long failed to represent ideals of fair play, equal opportunity, and international harmony but being replaced by bribery, corruption, commercialism, drug use and gender discrimination instead. The IOC has strengthened the roles and mission of the Olympic bodies in particular relation to the promotion of Olympic values and Olympism through the implementation of Olympic education. As a policy aim for the Olympic Movement, the development of Olympic education programmes has become a key goal for the IOC and thus host cities/nations. Providing a concept of Olympic and Paralympic education programmes in preparation for staging the Olympic Games is a compulsory requirement for host cities and nations. However, in spite of the IOC s recent explicit and intended commitment to the development of Olympic education policies in practice, explanation of Olympic education as a concept and a set of practices is imprecise and relatively underdeveloped in the Olympic related area. In addition, there is a lack of understanding of how universal values and concepts of Olympic education are perceived and communicated in culturally diverse contexts. The thesis is divided into two related parts, which seeks to provide two fundamental contributions to knowledge in this field. Part One is focused on a meta-narrative review of the English language literature on Olympic education. The methodology of a meta-narrative review is an extension of the systematic review process and facilitates the identification of the contribution of research traditions to the phenomena under review, in this case the conceptualisation and operationalisation of Olympic education. Through the process of meta-narrative review, six research traditions were identified: educational philosophy; critical sociology; curriculum development; education psychology; development of evaluation measures; and policy analysis and evaluation. II The results of the review identified how Olympic education has been conceptualised with various unfolding storylines in different research traditions, and this analysis subsequently provided the basis for the second key element of the study in the form of templates against which to evaluate the Olympic education programmes and systems associated with Tokyo 2020. Part Two employs a case study approach and is focused on the analysis of six cases using a realist evaluation methodology, employing analytic logic models and analysis of Context-Mechanism-Outcome (CMO) configurations. This facilitates the development of explicit and/or implicit causal claims about changes brought about by Japanese Olympic education programmes. The research has also contributed to developing a critical review of Olympic education programmes in a culturally specific, non-western context. Provision of Olympic education, within the context of national legislation requiring its introduction into the school curriculum developed by various stakeholders, represents a unique and culturally specific context for its study. Not only its education system, but also the cultural and historical values embedded within Japanese Olympic education programmes derive from the Japanese understanding of Olympism and universal Olympic values based on the Japanese values such as harmony, in particular applied in the effort in the recovery from national disasters, moral values learned from Judo and physical education, and Japanese ways of expressing hospitality. Thus, this case study of Tokyo 2020 acts as an exemplar in the diffusing of ways of developing and delivering the benefits of Olympic education programmes in culturally specific context.

Introduction : Le cadre de la gouvernance clinique a été développé afin d’atteindre de hauts standards de qualité de soins et de services, en conjuguant les notions d’amélioration continue de la qualité, d’excellence clinique et d’imputabilité corporative. La présente démarche doctorale avait pour objectif de comprendre le processus d’institutionnalisation de la gouvernance clinique dans un centre de réadaptation. Méthodologie : Une synthèse méta-narrative de 65 documents répertoriés dans 4 bases de données bibliographiques sur la conceptualisation et la mise en œuvre de la gouvernance clinique a été menée. Une étude qualitative de cas unique a été menée dans un centre de réadaptation en déficience intellectuelle et en troubles du spectre de l’autisme, au Québec (Canada). En mobilisant les cinq construits du cadre conceptuel basé sur théorie du processus de normalisation (cohérence, participation cognitive, action collective, suivi réflexif et contexte organisationnel), une analyse thématique des entrevues individuelles auprès de 22 participants (5 administrateurs, 11 gestionnaires et 6 cliniciens) et de 3 groupes de discussion auprès de 8 cliniciens et de 4 proches d’usagers a été menée. Enfin, une analyse d’une centaine de documents administratifs du Centre a été effectuée. Résultats : L’analyse de la littérature a permis de constater que le cadre de la gouvernance clinique est un concept en évolution et encore perçu comme une avenue intéressante pour l’amélioration de la qualité des soins. Toutefois, la confusion autour de sa définition et de sa conceptualisation ainsi que les difficultés de sa mise en œuvre demeurent des enjeux pour les organisations. Par la mobilisation du cadre de gouvernance clinique, la haute direction du centre de réadaptation à l’étude a souhaité systématiser le processus d’amélioration continue de la qualité des services offerts aux usagers et à leurs proches par l’adoption des bonnes pratiques de gouvernance. Ce virage a été bien reçu par les administrateurs et les gestionnaires, résultant sur une participation active et un fort engagement aux activités de leur part. La complexité du cadre et l’absence d’implication des cliniciens dans le processus de mise en œuvre ont créé chez ces derniers une appréhension quant à l’apport de la gouvernance clinique pour la pratique clinique et le bien-être des usagers. Les cliniciens ont dénoncé l’absence d’arrimage entre la théorie et les réalités de la pratique clinique ; la grande vitesse d’implantation et une approche décisionnelle de type top-down comme des enjeux de l’institutionnalisation de la gouvernance clinique. Pour les gestionnaires, les défis ont été la mise en place des moyens de communication efficaces ; l’arrimage des mécanismes de gestion et la disponibilité des ressources humaines. Pour les administrateurs, l’enjeu principal a été l’instabilité des contextes organisationnels interne et externe qui a ralenti la mise en œuvre et freiné l’élaboration d’un processus évaluatif. Conclusion : L’institutionnalisation de la gouvernance clinique dans les établissements non hospitaliers offrant des services sociaux passe par la valorisation de ce concept comme un projet commun au bénéfice de l’usager en vue de renforcer la participation et l’engagement de tous et l’adoption d’une approche de partenariat entre les usagers, leurs proches et les autres acteurs de l’organisation. / Introduction: Clinical governance framework was developed in order to achieve high standards of quality of care and services, by combining the concepts of continuous quality improvement, clinical excellence and corporate accountability. The aim of this doctoral thesis was to understand the implementation process of clinical governance in a rehabilitation center. Methods: A meta-narrative synthesis on the conceptualization and implementation of clinical governance was conducted. 65 tittles screened in 4 international databases were analysing. A qualitative single case study was conducted in a rehabilitation center for intellectual disabilities and autism spectrum disorders, in Quebec (Canada). By mobilizing the five constructs of the conceptual framework based on normalization process theory (coherence, cognitive participation, collective action, reflexive monitoring and organizational context), a thematic analysis of individual interviews with 22 participants (5 administrators, 11 managers and 6 clinicians) and tree focus groups with 8 clinicians and 4 relatives of users were conducted. Finally, an analysis of around hundred administrative documents from the Center was conducted. Results: The literature revealed that the clinical governance framework is an evolving concept and still seen as an interesting avenue for improving the quality of care. However, confusion over its definition and conceptualization, and the difficulties of its implementation remain challenges for organizations. By mobilizing the clinical governance framework, the senior management of the rehabilitation center under study wished to systematize the process of continuous improvement of quality of services offered to users and their families, by adopting good governance practices. This shift was well received by administrators and managers, resulting in active participation and a strong commitment to activities. The complexity of the framework and the absence of involvement of clinicians in the implementation process have created in them an apprehension regarding the contribution of clinical governance to clinical practice and the well-being of users. Clinicians have criticized the lack of alignment between theory and the realities of clinical practice; the high speed of implementation and a top-down decision-making approach as issues of the implementation of clinical governance. For managers, the challenges have been the establishment of effective communications; the alignment of management mechanisms and the availability of human resources. For administrators, the main issue was the instability of the internal and external organizational contexts which slowed down the implementation and the development of an evaluation plan. Conclusion: The implementation of clinical governance in non-hospital facility requires the promotion of this concept as a joint project for the benefit of the user with a view to strengthening the participation and commitment of all and the adoption of a partnership approach between users, caregivers and other actors in the organization.