Course Syllabus

Research Project Description

Background and rationale

One of the biggest challenges to the healthcare sector – both currently and in the years to come – is the shortage of health professionals. There are several mentions about this issue both in Europe and the USA. Also, there may be several strategies to address this challenge. One is to improve the recruitment and retention of healthcare workers e.g by creating and enforcing a positive work environment and a positive story about the health professional job and career.

Another important strategy that employers in the healthcare sector may use, and do use, is to attract and recruit health professionals from other countries. In Denmark alone, the proportion of healthcare professionals in the public hospitals from another country/culture of origin than Danish has more than doubled (Statistikbanken, Statistics Denmark, 2024) during the last 15 years and it is expected that this development will continue.

Although this may increase the number of head counts in the healthcare sector, it also means that the healthcare workplace becomes increasingly international and multi-cultural. This may constitute a challenge to the work environment as the “push” on the existing working culture may be perceived to be high among the existing staff. Also, the new international colleagues may struggle with unfamiliar norms, communication styles, and inclusion, complicating their integration.  

Research questions

This project will investigate the (inter) cultural elements of this strategy to resolve the staff shortage in the healthcare sector through the following research questions:

• Why is it relevant to talk about culture and intercultural understanding in the context of healthcare?
• What does the intake of staff from other cultures mean to the work environment at healthcare workplaces considering factors such as communication dynamics, teamwork efficiency, job satisfaction, and patient care outcomes?
• How do colleagues, local managers, and overall organizational leadership address the increasing numbers of socio-cultural meetings - if at all - at the healthcare workplace?
• What role do the policies and values of the surrounding healthcare system play on how the topic of intercultural understanding is perceived and handled at the healthcare workplaces?
• What may be the best ways to integrate intercultural understanding and communication into healthcare management?

Aim and learning goals for the research assistants

The main aim for the research assistants will be to collect data for – and write - a research paper on this topic under the guidance of their research mentor.

The research project will include both theoretical – and multidisciplinary - perspectives on culture, intercultural understanding – and management - at the workplace. It will apply a mixed methods approach for the collection of theoretical and empirical evidence in Denmark and the USA. This approach includes literature review, descriptive statistics, semi-structured interviews in both countries, and observation at the healthcare workplace, if possible.

As to learning outcomes, it is anticipated that the research students will

• learn how to carry out a multi-disciplinary research project that uses various methods within the field of qualitative research and literature review.
• work on a research project with a topic which is high on the health policy agenda, and highly relevant for the management of healthcare staff, today and in the future.
• learn about different cultures, intercultural understanding, leadership and management strategies for healthcare staff
• develop a critical understanding of methods and data in this field.

Scope and available literature

The project will look at healthcare workplaces in both Denmark and the USA. Intercultural teams may be a more recent phenomenon in Denmark than in the USA and there may be experiences and learnings to exchange and learn from in both countries.

As to relevant theories, there is a large body of literature on culture, cultural dimensions, sociocultural meetings in tourism and at global workplaces – especially in international corporations - to draw on. The same goes for management theories e.g. on relational co-ordination, capacity building, teamwork etc. Also, published empirical studies from healthcare workplaces have been carried out and will included in the project.

The students will borrow two basic books from the DIS Library:

- Hofstede G., Hoftstede GJ., Minkov M. Cultures and Organizations: The    Software of the Mind. Intercultural Cooperation and Its importance for Survival (2010).  3rd edition. McGraw Hill Books

 - Gullestrup Hans. Cultural Analysis - towards cross-cultural understanding (2006). Aalborg University Press & Hans Gullestrup.  

These books will provide a basis for describing and understanding culture in the context of organizations such as healthcare workplaces.

The project will be structured around five work packages to be carried out during three-four semesters starting from Fall 2026:

Work Package 1: Culture and intercultural understanding at the healthcare workplace

This work package will investigate the relevance of addressing culture and intercultural understanding in the context of healthcare. Specifically, it will look at different theoretical definitions of “culture” and provide a framework for how to analyze culture in the context of healthcare. For instance, it will identify specific situations at the healthcare workplace where cultural differences between staff, staff and managers, or staff and patients and their kins may play a crucial role and impact the work environment.

Work Package 2: The barriers and facilitators of internationalization of the healthcare workplace

The aim of the work package is to identify the pros- and cons of internationalization of the healthcare workplace. It will investigate the perceptions of healthcare staff and managers on the impact of the increasing internationalization of the staff for team efficiency, work environment- and culture, patient communication and management.

Work Package 3: Current management strategies to enhance intercultural communication at the healthcare workplace

This work package will look at what teams and managers actually do – if anything – to improve the intercultural understanding at the healthcare workplace in Denmark and the USA.  Do they think it is important? And if so, what are their views on why this is important?

 Work Package 4: Policies and values of the surrounding healthcare system

This work package will investigate the role of staff and management policies and values of the surrounding healthcare system and political environment, e.g. at the EU level or at a national level.

Work Package 5: Effective strategies to improve intercultural understanding

The aim of this work package is to identify strategies that may – or have proven to be – effective in improving the intercultural understanding at the healthcare workplace.    

Research Mentor 

Lone Bilde

M.Sc. (Economics and Languages) 1993, B.Sc. (Economics and Languages), 1988, Bi-lingual correspondant (French), Copenhagen Business School,  Completed 8 of10 modules of BA in Leadership, 2009-2012, Copenhagen Business College, ICF - Certified Coach (Sofia Manning), 2024. Furthermore, postgraduate education in health economics, epidemiology, measurement of health-related quality of life, and (bio) statistics.

Lone is an experienced consultant, advisor and leader of healthcare research projects. Her area of expertise is health economics, epidemiology, financing, organization, and the management of the health sector, including health economics evaluation.

She has carried out several research projects for - and together with - multiple stakeholders in Denmark as well as internationally. She has held senior positions at the Danish Institute for Health Services Research (DSI), the Danish Institute for Local and Regional Government Research (KORA), the Danish Institute for Applied Social Research (VIVE), Novo Nordisk, Nycomed, the Danish Cancer Society, and the Danish Technical University. Lone has been with DIS since December 2022.

Roles and Responsibilities of the Research Assistant

You are expected to spend a minimum of 10 hours per week on the project. The workload may vary over the semester. If you are travelling to do field research in a different location, additional time may be required.

As research assistant, you will engage in some or all of the following:

1. Participate in weekly meetings with your research mentor at a time set collectively at the beginning of the term.
2. Participate in a research orientation at the beginning of the semester 
3. Participate in two research workshops during the semester.
4. Write an assessment of your own strengths and weaknesses in the research
process at the beginning of the semester. Revisit at the end of the semester as part of an evaluation of your own participation in, and learning from, the research project.
5. Keep a research journal and submit it in person or via email every week (or another specified interval) to your research mentor, describing the activities of the week, and outlining goals for the following week.
6. Conduct literature reviews.
7. Participate in carrying out the research project. This may include: familiarizing yourself with core concepts, literature searches, scientific paradigms, perspectives, interview techniques and analyses of data. The specific responsibilities may vary depending on how the project progresses. Be prepared to contribute to tasks that may come up during the semester. Research processes are not always predictable.
8. Present the relevance of the research and/or findings to peer(s) from other
disciplines at the DIS Festival.
9. Make a final oral and/or written presentation of the research you are involved in, depending on what is agreed with your research mentor.

Readings

The readings will be agreed upon with the Research Mentor at the beginning of the semester -the exact content will differ depending on your background. You will receive guidance concerning the basics of relevant concepts, study designs, methods of analysis, etc. There is a list of selected articles and reports to study under "Modules" .

Approach to Teaching

Generally, the mentor will help the students visualize the work ahead, so that you will feel safe about the research contribution you have to deliver in the end. She will do her best to listen to what the students have to say acknowledging that everybody has a important perspective to contribute with. Also, she will endeavour to include the students in the decisions made in the research team.

That means that a lot of brainstorming and discussion on the topic, the material, the hypotheses, the proces, and the findings will be incorporated in the project.

Evaluation and Grading

All research assistants are assessed on their participation, weekly status reports to the research mentor, self-evaluation and presentations to peers from other disciplines. Additional evaluation and grading depends on the individual research project and project phase and is outlined by the research mentor. It may include literature reviews, a poster presentation for an expert panel, a working paper, etc.

Participation* 10% of grade comprises attendance & active participation in the research orientation, research workshops, and DIS Festival	20%
Literature review	5%
Research Project Outline	10%
Presentation at DIS Festival	10%
Final Paper	55%
TOTAL	100%

Research Orientation & Workshops

Days and times are available in the Course Summary, below.

Field Research (if applicable)

Some research projects include field research. Expenses related to fieldwork will be
covered by a DIS travel grant. The fieldwork will be planned with the research
mentor at the beginning of the semester.

Approach to Mentoring

All DIS research mentors have been trained in mentoring students but their approach to mentoring may differ. Mentoring is about engaging at a different - and often deeper - level than what is typical in the class room. However, mentoring also comes with some degree of ambiguity, which is important for you to expect. The research mentor will work closely with you throughout the semester but part of the training is also for you to use your own judgment to make assessments and decisions. As part of planning your tasks and responsibilities for the semester together, the research mentor will talk to you about her/his approach to mentoring.

Expectations of the Research Assistant

The specific expectations of the individual research assistant are agreed upon at the
beginning of the semester. In general, a research assistant is expected to take initiative, take ownership of the project and work independently. You must also be prepared for meetings and be willing to part take in relevant discussions. In cases where more research assistants are involved in the same project, you will be expected to engage in some teamwork. Carrying out a research project is not a straightforward and predictable process. This is part of what makes it exciting. It also means that communication is crucial. You are expected to take responsibility for communicating about problems or issues that arise.

Data

The project will be carried out using mixed methods (see paper on Mixed Methods in the folder "modules"). It will include data from published scientific literature and "grey" literature, e.g. reports, the above mentioned books, as well as published statistical sources such as OECD health statistics, WHO and various US sources. Also, you will carry out semi-structured interviews with key stakeholders/persons. The interviews will be subject to prior consent (according to the GDPR rules) by the interviewees and data from the interviews will be collected in the form of note-taking. Notes will be deleted after the end of the semester. Also, data from the interviews will be only be used for the purpose of this research project and only in a anonomyous form so that personal statements cannot be recognised. 

Disability and Resource Statement

Any student who has a need for accommodation based on the impact of a disability should contact Academic Support in Copenhagen (acadsupp@dis.dk) or in Stockholm (academics@disstockholm.se), depending on the project location. In order to receive accommodations, students should inform the instructor of approved DIS accommodations within the first two weeks of classes.

DIS Accommodations Statement 

Your learning experience in this class is important to me.  If you have approved academic accommodations with DIS, please make sure I receive your DIS accommodations letter within two weeks from the start of classes. If you can think of other ways I can support your learning, please don't hesitate to talk to me. If you have any further questions about your academic accommodations, contact Academic Support acadsupp@dis.dk.