ID-5184 Wonca Abstracts supplement A-K 13-10-23 - Flipbook - Page 340
WONCA 2023 Supplement 1: WONCA 2023 abstracts (A–K)
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Rationales, relationships and resources: How institutional
entrepreneurship could help us recover, reconnect
and revive
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A/Prof Sneha Kirubakaran1,2, Koshila Kumar2, Prof Paul Worley2,5, Joanne Pimlott2,3,
Jennene Greenhill2,4
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University of Queensland, 2Flinders University, 3University of South Australia, 4Southern Cross
University, 5Riverland Mallee Coorong Local Health Network
The current primary care workforce landscape is a result of multiple old and new forces, such as
increasing health needs, pandemic impacts and declining career aspirations. Nonetheless, institutional
entrepreneurship (IE) theory from the business domain articulates that crises and problems in a
situation can make it ripe for innovation and reform. IE illuminates three requisites for successful
innovation and reform: convincing rationales, collaborative relationships and collecting resources.
Using IE as a theoretical basis, the authors studied the establishment of new medical schools to
address workforce needs in medically under-served areas across three continents. Their multiple case
study research examined new medical schools in Australia, Canada and Botswana. Adapting and
expanding IE, they devised a novel conceptual framework, the Eight Cs framework (8CF). The 8CF
explains that successful innovation and reform is possible when ‘Catalysts act within their Contexts to
undertake various tasks of Conducing, Convincing, Collecting, and Connecting in order to produce
desired Consequences and overcome Challenges’.
Catalysts are the human agents of change and innovation. They are creative, visionary leaders who use
mechanisms of agency and power to collectively and individually effect change. They identify beneficial
or detrimental aspects of their Context and utilise them to advantage. They use entrepreneurial skills
when Conducing (making more favourable) their Contexts. They use sociopolitical devices such as
power, persuasion, trust, symbiosis, sharing and bricolage when Convincing stakeholders with various
arguments; when Connecting with various partners; and when Collecting required resources. Catalysts
harness the utility of field structure, human agency, power dynamics, political diplomacy and social
accountability to produce desired Consequences and overcome Challenges.
Particularly illuminating was the impact that socially accountable medical schools can have on the
primary care workforce. This paper will present the research findings and its implications for recovery,
reconnection and revival in the current primary care situation.
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