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SPRINGER BRIEFS IN EDUC ATION
Ulf Blossing
Torgeir Nyen
Åsa Söderström
Anna Hagen Tønder
Local Drivers for

Improvement
Capacity
Six Types of School
Organisations
SpringerBriefs in Education
More information about this series at http://www.springer.com/series/8914
Ulf Blossing · Torgeir Nyen · Åsa Söderström
Anna Hagen Tønder
Local Drivers for

Improvement Capacity
Six Types of School Organisations
13
Ulf Blossing Åsa Söderström
University of Gothenburg Karlstad University
Gothenburg Karlstad
Sweden Sweden
Torgeir Nyen
Anna Hagen Tønder
Fafo Institute for Labour and Social
Research
Oslo
Norway
ISSN 2211-1921 ISSN 2211-193X (electronic)

ISBN 978-3-319-12723-1 ISBN 978-3-319-12724-8 (eBook)
DOI 10.1007/978-3-319-12724-8
Library of Congress Control Number: 2014953308
Springer Cham Heidelberg New York Dordrecht London
© The Author(s) 2015

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Preface
How school improvement comes about in local schools is a strong interest among
the authors of this book. What the local drivers for improvement capacity are,
and how we can understand them, are the questions we investigate in this book.
Studying political school reform and how initiatives are applied in local schools,
we have taken the standpoint that knowledge about local schools and how school
leaders and teachers think about their improvement capacity is essential. In this
book, we identify six types of school organisations shaped by different sense-
making processes. We have come to understand the development of improvement
capacity as being tightly coupled to what school leaders and teachers in local
schools believe drive improvement, and to how this belief makes sense in their
local school history and in their identities as teachers and school leaders.
The data come from an evaluation of a state-financed school improvement pro-
gramme in Norway called ‘The Knowledge Promotion Reform—From Word to
Deed’. The evaluation was carried out in 2006–2010 and was based on a combina-
tion of qualitative and quantitative data.
This study is intended for researchers, graduate students, school leaders and
teacher leaders. As we aim at both research and practice we have included theory
and methodology, but also quite detailed descriptions of the schools illustrating
each of the six types. We hope these will be recognisable for practitioners and thus
inspire them to initiate improvements in their own schools.
We are very grateful to the schools in Norway and to the teachers, school lead-
ers and students who willingly and carefully engaged in our interviews. We would
also like to direct our thanks to the experts who have read the manuscript for this
book and have suggested improvements. These have been very helpful in making
our intentions and reasoning clearer.
Gothenburg, September 2014 Ulf Blossing

Oslo Torgeir Nyen
Karlstad Åsa Söderström
Oslo Anna Hagen Tønder
v
Contents
1 Introduction. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Local Support and Challenges in Educational Policy. . . . . . . . . . . . . . . . . 4
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
2 Organisational Perspectives on Schools and Change. . . . . . . . . . . . . . . 9

Instrumental and Institutional Perspectives on Organisations. . . . . . . . . . . 10
Schools’ Improvement Capacity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 14
A Socio-structural Perspective. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 15
The Need for Focusing on Teaching Practices . . . . . . . . . . . . . . . . . . . . . . 19
The Need to Consider Means- Versus Goal-Situated Strategies. . . . . . . . . 19
Four Means-Situated Strategies. . . . . . . . . . . . . . . . . . . . . . . . . . . . . 20
A Social Learning Perspective. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 22
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 23
3 Method. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 27
Sampling. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Procedure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 28
Analysis. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
School Types as Basis for Describing School Organisations . . . . . . . . . . . 31
Comments on the Construction of Types . . . . . . . . . . . . . . . . . . . . . . . . . . 33
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 34
4 Six School Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

Overview. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 36
The Idea-Driven School . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Typological Description. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Background to Vega School. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Vega School’s Infrastructure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 37
Vega School’s Improvement History. . . . . . . . . . . . . . . . . . . . . . . . . 38
Understanding and Strengthening Vega School’s
Improvement Capacity. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 40
vii
viii Contents
The Plan-Driven School . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

Background to Capella School. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42
Capella School’s Infrastructure . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Capella School’s Improvement History. . . . . . . . . . . . . . . . . . . . . . . 44
Understanding and Strengthening Capella School’s
The Model-Driven School. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Background to Rigel School . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
Rigel School’s Infrastructure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 48
Rigel School’s Improvement History. . . . . . . . . . . . . . . . . . . . . . . . . 49
Understanding and Strengthening Rigel School’s
The Problem-Driven School. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Background to Pollux School. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 52
Pollux School’s Infrastructure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 53
Pollux School’s Improvement History. . . . . . . . . . . . . . . . . . . . . . . . 54
Understanding and Strengthening Pollux School’s
The Profession-Driven School . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
Background of Sirius School. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Sirius School’s Infrastructure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
Sirius School’s Improvement History . . . . . . . . . . . . . . . . . . . . . . . . 59
Understanding and Strengthening Sirius School’s Improvement . . . 59
The Team-Driven School. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Background to Atlas School. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Atlas School’s Infrastructure. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 61
Atlas School’s Improvement History. . . . . . . . . . . . . . . . . . . . . . . . . 62
Understanding and Strengthening Atlas School’s
5 Concluding Reflections. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
The Sensemaking Organisation of Capacity. . . . . . . . . . . . . . . . . . . . . . . . 66
Supporting Local Capacity-Building . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
Support from the Central Educational System . . . . . . . . . . . . . . . . . . . . . . 70
References. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 74
Chapter 1
Introduction
Abstract International trends in education are outlined that are important for
school improvement efforts at both the national level and in local schools. Key
concepts include competitiveness, efficiency, freedom of choice, flexibility and
decentralisation. International knowledge measurement is a driving force when
national educational reforms are planned and implemented. The concrete mean-
ing of these concepts and the international knowledge measurements vary between
countries and between local schools. The aim of our study was to explore and
describe how improvement capacity in local schools is organised and to develop
an understanding of this organisation as a practice and as a sensemaking process in
local schools. We present Hopkins’ four drives towards building an effective local
capacity for improvement and consider what kind of support schools need in order
to be effective. In contrast to Hopkins, we focus on how local schools put their
improvement work into their situated and sensemaking practices, which are not
always perceived as progress from the outside. The chapter ends with an overview
of the book.
Keywords Neoliberal governance · Globalisation · Glocalisation · Decentralisation ·

Knowledge promotion reform · Building capacity · Local support
In most countries, during the first decades of the second millennium, there have
been a number of major reforms in the field of education with the aim of enhanc-
ing competitiveness. Many of these reforms are rooted in neoliberal and neocon-
servative governance ideals, where competition and choice are seen as key drivers
for increasing the public school system’s effectiveness and improving student out-
comes (see, e.g. Apple 2006; Dalin 1994; Giddens 1996; Giroux 1997; Hargreaves
1998; Kumar and Hill 2009). Concrete examples of changes being implemented
in this spirit are privatisation in the sector, decentralisation of responsibility,
results-based management and an intense control of school quality and students’
academic performance. According to Daun (2002), there are both political and
© The Author(s) 2015 1

U. Blossing et al., Local Drivers for Improvement Capacity,
SpringerBriefs in Education, DOI 10.1007/978-3-319-12724-8_1
2 1 Introduction
economic reasons for these changes. The aim is that flexibility will increase as
local responsibility increases. At the same time, higher productivity in terms of
improved student outcomes is expected.
However, higher productivity does not naturally follow in the steps of neolib-
eral governance. Teachers and school leaders still struggle with developing their
instruction in order to improve student outcomes. On the one hand, nations come
up with new reforms in an attempt to display a top-level educational system in
the global competitive, and on the other hand, school leaders struggle to build
local improvement capacity among their teachers in order to put reforms into
practice.
This study is about the organisation of local school improvement: how such
organisation is constituted in practical work and how it shapes capacity in local
schools. Ideas about what drives improvement and ways of organising this work
are intertwined and make sense for the teachers and school leaders, despite
research knowledge on what promotes the building of local improvement capacity.
The aim of this study is (1) to explore and describe the organisation of improve-
ment capacity in local schools and (2) to develop an understanding of this organi-
sation as a practice and sensemaking process in local schools. In conclusion, we
will also (3) address support issues in relation to these findings. However, a school
organisation is only local in relation to its context, and therefore, we would like to
dwell somewhat longer on the topic of neoliberalism and globalisation.
Globalisation is a term that describes how the world has “shrunk” and how inci-
dents in one country can quickly have an impact far beyond that country’s own
borders. The international market is characterised by free movement of capital,
and local economic ups and downs can have severe global consequences. Cultural
expressions, attitudes and ideas are spread and contribute to the experience of a
global get-together, which simultaneously adds diversity as well as “monoversity”.
Some concepts that are applied in the description of modern society, and that cre-
ate an image of the time we live in, are freedom of choice, individualism, flexibil-
ity and responsibility (Bauman 2002; Beck and Beck-Gernsheim 2002; Giddens
1996, 2003; Harvey 2007). In the context of this global social change, education
has become an increasingly important competitive factor both at the international
level and at the individual level. Requirements for education and mobility increase
pressure within the labour market. Beck (1998) describes how increased globalisa-
tion requires a geographical and social mobility which risks cutting off people’s
cultural and social roots. This leads to increasing individualisation, where equals
find themselves in a competition to gain and keep a position in the labour market.
The central role of education as a means for competition, both within and between
countries, in an increasingly tough global economic market, has highlighted how
countries make international comparisons of their success in their efforts to edu-
cate their citizens.
In a European perspective, education has become an important area of both col-
laboration and competition. Lawn (2011) describes a process of Europeanisation
in education among the countries in the European Union (EU). This process
is governed by the creation and use of indicators, standards and comparisons.
1 Introduction 3
Through a flow of people and ideas across Europe, and in a cross-national

organisation such as the EU, it has been possible to create both an opportunity and
a need to develop a European education policy, in which concepts such as “life-
long learning” and “standardisation” have become central features (see also Lawn
and Grek 2012).
A closer look at schools in different countries both in Europe and in the rest
of the world shows that behind the general concepts of freedom of choice, mar-
ketisation, individualism, flexibility and personal responsibility is a reality that is
both ambiguous and complex. The concrete meaning of these concepts in rela-
tion to education varies between countries and between groups of individuals
within a single country. This is a variation that Beck (2000) calls “glocalisation”.
Traditionally, the Nordic countries have carried on a tradition that has created a
Nordic model of education (Blossing et al. 2014). A coherent elementary school,
“a school for all”, has been seen as important for creating a society of equal
opportunities, regardless of economic and social conditions. In recent decades,
the Nordic countries have also been affected by the changes brought about in the
wake of globalisation. In all Nordic countries except Finland, a downward trend
in students’ progress has been shown in international meta-evaluations such as
PIRLS, PISA and TIMSS. In spite of the fact that this downward trend is just a
fall from top to a more average position internationally, this has created an image
of a school system in crisis and has led to a series of political decisions to create
a school system that can better stand up to international comparisons. This in turn
has created a pressure for reform, which has placed great demands on schools’
capacity to improve their work.
One example of such a demand for improvement was a state-financed school
improvement programme in Norway called “The Knowledge Promotion Reform—
from Word to Deed”. The Knowledge Promotion Reform was introduced in 2006
as a comprehensive school reform, covering primary, lower secondary and upper
secondary education and training. The reform placed increased emphasis on the
development of basic skills through outcome-based learning. The school improve-
ment programme “The Knowledge Promotion Reform—from Word to Deed” was
related to the implementation of the reform, the main aim being to strengthen
school improvement capacity in line with the goals of the reform.
The programme aimed to increase student achievement by starting from local
needs for school improvement and developing the school as a learning organisa-
tion. A main aim was to link together the competences of local schools, school
owners and external actors with relevant competences. The school improve-
ment programme had a budget of 195 million Norwegian kroner in 2005–2009,
and more than 100 local school improvement projects were financed by the pro-
gramme. Most of these projects involved more than one school. Finances were
awarded to the projects on the basis of a review of the quality of the applications.
Part of this financing was awarded through a special “guided round” where the
secretariat played an active role in helping school owners to formulate projects.
The aim was to ensure that the programme also reached school owners with less
experience in formulating and carrying out improvement projects.
4 1 Introduction
This book presents the results of a study of improvement work in 13 of the

schools that were involved in this school improvement effort. These 13 schools
belonged to five case studies, which took place in two phases, two projects being
selected in the first phase and three projects in the second. Case selection was
made on the basis of two variables: the schools’ initial improvement capacity and
the degree and type of support for the project from external competence units. The
aim was to include projects and schools which had different values for these var-
iables, for instance, schools with both high and low initial improvement capac-
ity, and schools receiving more and less external support. A total of four of the
chosen projects came from the “guided round”, as we expected these schools to
have a lower initial improvement capacity, on average, than others. However, some
of them turned out to have a higher initial improvement capacity than expected,
which was part of the reason for choosing several projects from the guided round
in the second phase selection as well. The case schools were geographically dis-
persed and included four projects that involved primary and lower secondary
schools, and one project involving upper secondary schools.
The Knowledge Promotion Reform, which the school improvement pro-
gramme was intended to support, has been extensively evaluated, and a number
of evaluation reports have been published. Despite being perceived by central
government as being a break with previous reforms in its emphasis on learning
outcomes, research has found the new curricula in various subjects to be charac-
terised more by continuity than by radical change. The researchers note a dispar-
ity between the general part of the curriculum, which had clearly changed, and
the subject-specific parts, where changes were less evident (Dale et al. 2011). The
ambiguity and lack of support from national education authorities in the early
phase of implementation has left room for local interpretations and the continua-
tion of established practises. However, there is evidence that school owners, prin-
cipals and teachers do support the intentions of the reform, despite the lack of a
clear national implementation strategy (Aasen et al. 2012; Hodgson et al. 2012).
However, researchers have not found evidence of changes in classroom practices
from 2007 to 2010, although assessment practices have been improved (Hodgson
et al. 2012).
Local Support and Challenges in Educational Policy
The central parts of the educational policy outlined above focus on increased local
responsibility, more inspection and a clearer obligation to account for the local
authorities. This means that teachers and school leaders need to review their stu-
dents’ outcomes and their social development as well as the school organisation’s
capacity to improve. This was the major theme of the Norwegian school improve-
ment programme. In addition, there was also an investment in a supporting net-
work of external agents helping the schools with evaluation, guiding or lecturing,
and also an increased responsibility for the local authority.
Local Support and Challenges in Educational Policy 5
The strategies in the “Knowledge Promotion reform—from Word to Deed”

programme coincides with Hopkins’ (2007) conclusion that the realisation of
educational policy at the local level is dependent on the degree of support from
the central parts of the system, as well as on the extent of the challenges at the
local level. Hopkins also concludes that reform work needs to focus on learn-
ing, instruction routines and improvement capacity. He points out that a school’s
improvement capacity is crucial when it comes to maintaining the initial imple-
mentation of reforms, and making them sustainable. We will later go more care-
fully through the notion of improvement capacity and present our own perspective.
However, let us first stay with the four drivers, identified by Hopkins’ (2007), in
the local implementation of building capacity:
• Professionalised teaching
• Personalised learning
• Networking and innovation
• Intelligent accountability
Hopkins suggests that these drivers require systematic leadership, which pays
attention to all of the drivers and is engaged in shaping professional learning com-
munities with a focus on student learning. Professional teaching puts the needs of
the student at the centre and provides for professional learning. Professional teach-
ing asks, on a diagnostic basis, how to tailor teaching to suit the current students in
the school. Keeping the school open to input through networking stimulates inno-
vation. Intelligent accountability represents a quality check and encompasses a
balance between national summative requirements and the professional formative
need for self-evaluation and support.
However, Hopkins’ four drivers for capacity building raise the question of how
a school should develop in order to encompass those characteristics. To answer
this question, Hopkins describes three types of school, which encompass capac-
ity to different degrees: the ineffective school, the low-achieving school and the
effective school (Hopkins 2001). In relation to this, he describes what kind of
support each type of school needs. However, we suggest that the positions local
schools are in, regarding their social and organisational life, are not degrees of a
continuing development, where adjusted investments could be put in place to take
the school to the next level. Instead, we will show how local schools are robust
social and organisational entities that put improvement work into their situated
and sensemaking practices, which not always are perceived as progress from the
outside.
The organisation of this book is as follows. Chapter 2, “Organisational perspec-
tives on schools and change”, accounts for the perspectives we have identified as
being relevant to our aims. The new institutional perspective, as well as the field
of organisational development (OD), informs the external versus internal tensions
that exist in local schools. Simplified institutional theory has developed notions
for understanding organisational behaviour in relation to external regulation, while
OD relates to the inner needs of an organisation. We also draw on practice theory
as a relatively new umbrella term that gathers together different theories which are
6 1 Introduction
concerned with human agency, change and stability. We continue with schools’
improvement capacity, focusing on the social structural perspective on improve-
ment capacity, which we use in our analysis. Chapter 3, “Method”, accounts for
our data sources, our choice of theoretical perspective and the notions used in the
analysis. Chapter 4, “Six school types”, is the main chapter in that it aims at giv-
ing a rich description of the six school types. Each type starts with a typologi-
cal description which gives an illustration of the main characteristics of the type.
Thereafter follows a background description of a specific school which is chosen
to illustrate the type. Next follows a description of the school’s infrastructure, and
then the school’s improvement history. Each type concludes with a section on
understanding and strengthening the school’s improvement capacity. The aim of
this section is to provide reasoning for teachers and school leaders, who may rec-
ognise their own schools in a particular type; the type descriptions may work as
a reflective background when they go on to their improvement work in their own
schools. The book ends with Chap. 5, “Concluding reflections”. We summarise
our findings and develop an understanding from the basis of our theoretical per-
spective. We discuss support issues and end with methodological reflections.
References
Aasen, P., Møller, J., Rye, E., Ottesen, E., Prøitz, T., & Hertzberg, F. (2012). Kunnskapsløftet
som styringsreform—et løft eller et løfte? Forvaltningsnivåenes og institusjonenes rolle i
implementeringen av reformen [The knowledge reform as steering reform—A promise or a
boost?]. Rapport 20/2012. Oslo: NIFU.
Apple, M. W. (2006). Educating the “right” way. Marketing, Standards, god and inequality.
New York: Routledge.
Bauman, Z. (2002). Det individualiserade samhället [The individualised society]. Uddevalla:
Daidalos.
Beck, J. (1998). Morality and citizenship in education. London: Cassell.
Beck, U. (2000). What is globalization? Malden, Mont: Polity Press.
Beck, U., & Beck-Gernsheim, E. (2002). Individualisation: Institutionalised individualism and
its social and political consequences. London: Sage.
Blossing, U., Imsen, G., & Moos, L. (Eds.). (2014). The Nordic education model. ‘A school for
all’ encounters neo-liberal policy. Dordrecht: Springer.
Dale, E. L., Engelsen, B. U., & Karseth, B. (2011). Kunnskapsløftets intensjoner, forutsetninger
og operasjonaliseringer. En analyse av en læreplanreform [The intentions of the knowledge
reform preconditions and operationalisations. An analysis of a curriculum reform]. Oslo:
University of Oslo.
Dalin, P. (1994). Utbildning för ett nytt århundrade [Education for a new century]. Stockholm:
Liber.
Daun, H. (2002). Educational restructuring in the context of globalization and national policy.
New York, London: Routledge Falmer.
Giddens, A. (1996). Modernitetens följder [The consequences of modernity]. Lund:
Studentlitteratur.
Giddens, A. (2003). En skenande värld. Hur globaliseringen är på väg att förändra våra liv [A
runaway world: How globalization is reshaping our lives]. Kristianstad: SNS Förlag.
Giroux, H. (1997). Crossing the boundaries of educational discourse: modernism, postmodern-
ism and feminism. In A. H. Halsey, H. Lauder, P. Brown, & A. S. Wells (Eds.), Education,
culture, economy and society (pp. 113–130). Oxford: Oxford University Press.
References 7
Hargreaves, A. (1998). Läraren i det postmoderna samhället [Changing teachers, changing

times]. Lund: Studentlitteratur.
Harvey, D. (2007). A brief history of neoliberalism. Oxford: Oxford University Press.
Hodgson, J., Rønning, W., & Tomlinson, P. (2012). Sammenhengen mellom undervisning og
læring. En studie av læreres praksis og deres tenkning under Kunnskapsløftet [Consistency
between teaching and learning. A study of teachers’ practice and their thinking during the
knowledge reform]. NF-rapport nr. 4/2012. Bodø: Nordlandsforskning.
Hopkins, D. (2001). School improvement for real. London: Routledge Falmer.
Hopkins, D. (2007). Every school a great school: realizing the potential of system leadership.
Maidenhead: Open University Press.
Kumar, R., & Hill, D. (2009). Neoliberal capitalism and education. In D. Hill & R. Kumar (Eds.),
Global neoliberalism and education and its consequences. New York: Routledge.
Lawn, M. (2011). Standardizing the European educational policy space. European Educational
Research Journal, 10(2), 259–272.
Lawn, M., & Grek, S. (2012). Europeanizing education: Governing a new policy space. Oxford:
Symposium Books.
Chapter 2
Organisational Perspectives on Schools
and Change
Abstract The chapter builds on institutional theory and how it explains stability
and change in organisations. Loose coupling is described as a common phenom-
enon to uphold a harmonious relationship between the demands of the external
environment and the inner life of the organisation. Organisational development
(OD) is presented as a framework to understand the work processes in school
organisation when school leaders and teachers do improvement work. The concept
of improvement capacity is defined in a socio-structural perspective, encompass-
ing the infrastructure of the school organisation, the improvement processes, the
improvement roles and the improvement history of the organisation. Finally, this
is framed in a practice and sensemaking perspective. The organisational perspec-
tive is contrasted with the need to focus on the teaching situation. The concepts
of means and goal-situated strategies are introduced, and four common means-
situated strategies are described. We argue for the need for goal-situated strategies
and underpin this with a social learning perspective.
Keywords Institutional theory · Change · Loose coupling · Organisational devel-

opment · Infrastructure · Improvement process · Practice theory · Sensemaking ·
Goal-situated strategies
When analysing schools at the organisational level, different theoretical perspec-

tives can be fruitful for understanding and discussing conditions for change. In this
section, we will focus on institutional theory and organisational development (OD)
theory. The combinations of those perspectives provide a structural as well as an
agency perspective, which are needed when analysing local improvement capacity.
Eventually, we frame this in a sensemaking and practice theory perspective.
There are pros and cons to using an organisational perspective to understand
school improvement. One advantage is that it enables us to get hold of the more
general and structural aspects that benefit change and which can be used in reform
initiatives. A disadvantage is that local sensemaking and teachers’ professional
work could get lost. We have therefore, within the framework of schools’
© The Author(s) 2015 9

U. Blossing et al., Local Drivers for Improvement Capacity,
SpringerBriefs in Education, DOI 10.1007/978-3-319-12724-8_2
10 2 Organisational Perspectives on Schools and Change
improvement capacity, included a section on the need for focusing teaching

practice and the concrete strategies teachers and their school leaders choose to
improve the students’ learning situations.
Instrumental and Institutional Perspectives

on Organisations
From an instrumental or rational perspective, organisations can be seen as instru-

ments designed to achieve specified goals through coordinated action (Scott 1987;
Brunsson 1989). Individual members of organisations participate in the collective
production of goods and services through formal systems of rules and authority.
Organisational action is supposed to generate certain outcomes, and these out-
comes can and should be evaluated and compared between organisations. Within
this perspective, organisational change is understood as the result of conscious
choice. The essence of OD and reform within the instrumental perspective would
be to define the goals to be reached and then to choose the means best suited to
achieve the desired results. Another basic assumption within the instrumental per-
spective is that organisations are able to learn from their own experiences. If the
organisational outcomes or results are not in accordance with the specified goals,
it is assumed that the organisations will be able to adjust their practices in order to
obtain a better match between objectives and actual results in the future.
Another theoretical perspective is the institutional perspective. Within this per-
spective, it is assumed that every organisation has a distinct history. Over time,
organisations develop a set of norms, rules and routines that play an important role
in guiding everyday action. Organisational actions reflect values, interests, beliefs
and expectations that are relatively stable and persistent (March and Olsen 1989).
Over time, perceptions are also developed within the organisation regarding how
various tasks should be solved and how good results can be achieved. The devel-
opment of an institutional identity within an organisation could mean that some
thoughts and actions are no longer being questioned or debated, but are more or
less taken for granted by members of the organisation (Meyer and Scott 1983).
Organisational structures and processes can be institutionalised in the sense that
they are “infused with value beyond the technical requirements of the task at
hand” (Selznick 1984, p. 17).
From an institutional perspective, one would expect that organisations
develop an ability to resist organisational changes if these changes violate basic
values, interests and beliefs that have been established within the organisation.
This does not mean that changes do not happen. Organisations are capable of
constant adaptation to policy signals, reactions and changes in the external envi-
ronment. In general, these changes tend to be small and gradual, and they may
not necessarily be given much explicit attention within the organisation (March
1981). Large and sudden changes that are in conflict with the institutional
identity of the organisation would only be expected to take place in cases where
Instrumental and Institutional Perspectives on Organisations 11
a considerable gap has developed between the results obtained by the organisation
and the expectations of its constituencies (Cyert and March 1963).
In the case of Norway, in 2001, the country experienced a “PISA shock,”
with student performance being well below the expected level, given the public
resources spent on education. The PISA results, along with other international
skills surveys, such as TIMSS, stimulated much public and political debate about
the need for national school reform. The perceived crisis within the Norwegian
educational system laid the foundations for comprehensive school reform with a
strong focus on learning outcomes and the development of new assessment prac-
tices at the national level. Helge Ole Bergesen, who was state secretary in the
Ministry of Education and Research in the conservative government from 2001 to
2005, wrote about the Norwegian “PISA shock”.
With PISA, the debate climate changed abruptly, radically and irrevocably: mediocre
school results and declining skills could no longer be dismissed as claims by campaign-
ing conservative politicians or aging teachers in newspaper columns. The surveys revealed
and documented that our students do not have particularly good skills at the end of lower
secondary education. (Bergesen 2006, p. 42, our translation).
The orientation of the political climate towards change was supported by research-
based findings. Evaluations of the previous education reform in primary and lower
secondary schools, the Reform 97, documented that performance requirements
in schools were vague, that teachers were reluctant to defining explicit learning
goals, and that pupil feedback was rare (Haug 2004). Hence, there were several
drivers pushing for change.
Within the Norwegian Parliament, there was broad political support for a new
school reform and an increased focus on learning outcomes and quality assess-
ment in education. An important question is to what extent the perception of an
education crisis was shared by actors at the local level, creating a foundation for
profound and lasting changes within each school.
Institutional theories about organisations emphasise the importance of the
relationship between an organisation and its environment. Different actors, stake-
holders or constituencies in the environment of the organisation may attempt to
gain insight into the activities of the organisation and may try to influence organ-
isational actions in various ways. As a consequence, the boundaries between an
organisation and its environment might become blurred and contested. The rela-
tionship between an organisation and its constituencies can have a major impact
on the efficacy of reform measures as well as change processes, both within and
between organisations. However, actors in the external environment are not con-
cerned only with the actual results achieved by the organisation. To some extent,
the organisation will also be assessed in terms of the extent to which it applies
models, practices and working methods that are perceived as rational, legitimate
or modern by external actors. Such assessment could be viewed as particularly
important if it is difficult for actors in the environment to assess the actual quality
of work within the organisation. The same may be true if the relationship between
the results obtained and the methods and work practices applied are uncertain or
ambiguous (Meyer and Scott 1983).
When norms and perceptions in the environment do not correspond with estab-
lished norms, values and beliefs within the organisation, an assumption according
to institutional theory would be that organisations develop double sets of struc-
tures and processes. These two sets are not allowed to interfere with each other,
but are kept separate, loosely coupled or decoupled (Meyer and Rowan 1977;
Brunsson 1989; Weick 1976). Formal structures and processes can be designed
primarily to comply with external requirements and expectations. Meanwhile,
actual behaviour and core activities within the organisation may be governed by
another set of structures and processes. The concept of loose coupling or decou-
pling in the organisational literature illustrates the inconsistency that may develop
between organisational structures that are visible from the outside, and the struc-
tures and processes that actually control the internal operations of organisations.
In schools, classroom instruction may be insulated from externally driven pressure
for change. Teaching practices may be decoupled from administration and policy-
making. When expected changes do not take place within schools, reforms tend to
be repeated again and again (Cuban 1990).
Norwegian educational policy during the first decades since 2000 can be char-
acterised as a series of reforms followed by research-based evaluations. The reform
evaluations have shown that the changes in pedagogical practice have been mod-
est. As is well documented in the international research literature, this story is in
no way unique to Norway. One of the explanations offered by Norwegian evalua-
tors has been that some of the political intentions behind the reforms would actually
require profound changes in beliefs and values concerning education and learning,
something that has not been reflected in the actual reform measures (Haug 2004).
Researchers have also pointed out that there tend to be a number of unresolved ten-
sions and dilemmas within the reforms. Some of these tensions are inherent in the
pedagogical project itself and must to some extent be resolved at the local level,
by school leaders, administrators and teachers, both collectively and individually
(Karseth et al. 2013, p. 246). Some examples of such issues are the tensions between
administrative control and professional autonomy, between collective and individual
learning processes and between learning processes and learning outcomes.
Institutional theories point to the values and norms in the local school as impor-
tant when it comes to making changes. OD delves still further into the inner life
of the local school. OD provides for a structural perspective on organisations and
at the same time makes the human interplay visible. OD theory depends on open-
system theory and understands organisations metaphorically, as living organisms,
where input, throughput, output and feedback are the notions that account for the
information and working process in the organisation (Burke 2008). Miles (1965)
was one of the first to apply this metaphor and proposed the concept of the healthy
organisation model to explain the change process among school leaders and teach-
ers. OD understands schools as systems of human beings, according to Schmuck
(1995a, b). Those human beings work with different tasks and they move between
different systems when they switch from one task to another. An important task for
an OD leader is to make the different subsystems effective, which is, to a major
extent, about enhancing the interpersonal competencies in the organisation.
Instrumental and Institutional Perspectives on Organisations 13
Ekholm (1971, 1989) developed the healthy organisation model from Miles
(1965) to an infrastructure model consisting of eight subsystems. The eight sys-
tems indicate the living organism or the social life in the school organisation on a
structural level. The systems are the grouping system, the communication system,
the goal management system, the power and responsibility system, the decision-
making system, the norm system, the reward system and the evaluation system.
How teachers and students are grouped in a school, how curriculum goals are dis-
cussed and managed, how the power to make decisions as well as the responsibil-
ity to execute them is distributed, what teachers signal to each other that desirable
behaviour should be, what behaviours are rewarded or punished by social atten-
tion, and finally how information about the status of the organisation are collected,
put together and evaluated—all this makes up a kind of infrastructure in which the
social working life takes place. The infrastructure is supposed to shape the daily
work and can be very salient for a new teacher in a school. It exists before the
teacher enters the school and makes certain actions possible and others impossible
to execute.
A clear structure and strong communication system point to a social life in
the school organisation where information feedback works and secures adaption
to organisational needs and societal demands. The grouping system and also the
communication system stand out as important in this respect, as they decide which
teachers will meet in certain groups and communicate. This way of understand-
ing school organisations has been used empirically in a longitudinal study of 35
schools from 1980 to 2001 in Sweden (Blossing 2004, 2008; Ekholm et al. 1987)
and is also used in this study (as part of the improvement capacity).
An ontological question underlying both institutional and OD theory is the rela-
tionship between agency and structure. Traditionally, institutional theory has been
involved in describing the influence of structure on organisations and their mem-
bers, while OD has focused on agency. Much OD theory stems from the work of
OD consultants and change agents working with schools and other organisations
to instigate change. The change agents lead, in a very practical way, group work
focusing on the values of the participants in order to make them visible and pos-
sible to unfreeze, in line with the legacy of Lewin (1947). Another core task in the
OD manual is to gather data about the local organisation and review its norms and
structures and their capacity to work in line with the goals of the organisation. In
this way, one can assert that the OD consultant, in his or her practical work as an
agent of change, tries to overcome the dualism between agency and structure.
OD theory is a good example of what is called practice theory. Nicolini (2013)
describes practice theory as the engagement of a range of researchers and theo-
rists, such as, for instance, Giddens, Marx, Wittgenstein, Bernstein and Schatsky,
in overcoming the opposition of agency and structure and trying to understand
social and human everyday practice. Introducing practice theory, Nicolini (2013,
p. 3) lists five features: (1) the importance of activity and the characteristics of
its processes, (2) the critical role of the body and material things, (3) individual
agency, (4) knowledge as the capacity to carry out a social and material activity
and (5) the importance of power and politics.
With the help of these points, we can centre our interest: we are interested in
the practice of improvement work, and in the agency of teachers and school lead-
ers and the kind of activities and processes they carry out while being physically
located in their school organisation and framed in an institutional structure. Wenger
(1998) states that “Practice is, first and foremost, a process by which we can expe-
rience the world and our engagement with it as meaningful” (p. 51). In our devel-
opment of the analyses, we have used Weick’s (2001) theory of how sensemaking
constitutes the work of an organisation. Weick’s views fit well into the framework
of practice theory when he declares that “Reality is ongoing accomplishment:
Sensemaking is about flows, a continually changing past, and variations in choice,
irrevocability, and visibility that change the intensity of behavioural commitments”
(p. 11). A fundamental feature of Weick’s theory is that sensemaking is a retrospec-
tive process: looking back and remembering, in line with the symbols and ideas
that make the wider reality possible to grasp and can work as a rational reasoning
which accounts for the actions of yesterday and also guides those of tomorrow.
Does the practice of improvement work differ from ordinary practice in any
way? Yes, it does when it comes to schools that are successful in their improve-
ment efforts. Research, which we will account for in the following chapters, shows
that teachers and school leaders in these schools make their practice conscious,
by looking back at their improvement history and by shaping new sensemade pat-
terns which lay the basis for innovative actions that improve student learning. And
no, because research shows that many schools fail in this process. They look back
and restructure their sensemaking in terms of whatever evidence they can find to
explain their students’ underachievement. It is the situation that this project aims
to address: to develop an understanding of organisation as a practice and sense-
making process in local schools, and finally also to address support issues which
could help teachers and school leaders to look back and see conditions in their
improvement work that they have not seen before and thus enable them to plan for
new actions.
Schools’ Improvement Capacity
In this chapter, we move on to the rationale of learning in and between organi-

sations. It is important to understand this since the decentralisation and local
accountability presuppose that schools are characterised by a culture which has
the capacity to take on requirements from the central education system and adjust
these to the local culture. Newmann et al. (2000) define school organisations’
learning capacity by using the notion of improvement capacity. This is understood
as the self-renewing ability that constitutes the collective competence of a school
aiming at effective improvement. They propose that this ability consists of four
components that can be summarised as follows:
• The knowledge, skills and dispositions of individual staff members.
• A professional learning community.
Schools’ Improvement Capacity 15
• Curriculum coherence: the coordination of the school’s curriculum for student

and staff learning.
• Technical resources: high quality curriculum, instructional material, assessment
instruments, technology, workspace, etc.
The theorising of learning organisations, and also of school improvement, leans
heavily on the assumption that schools need to strengthen the parts of the organi-
sation that make up their improvement capacity, in order to improve student
outcomes. When these parts are strong, the school possesses a “development
department” which can take on deficiencies, develop procedures and conduct
improvements. Since Newmann, King and Young’s work, the literature on improve-
ment capacity and building capacity has grown considerably, especially through
the development of the concept of professional learning communities (Hord 2004,
Stoll et al. 2006) and the theory of community of practice (Wenger 1998, Wenger
et al. 2002). In the Norwegian context, Oterkiil and Ertesvåg (2012) have combined
school-based theories with the Burke and Litwin (1992) model of organisational
change in order to assess schools’ readiness or capacity to implement an anti-bul-
lying programme. With the same goal, Roland (2012) has used Domitrovich et al.
(2008) on implementation quality as a measure of improvement capacity.
Harris (2001a), and also Stoll (2009), conclude that building capacity is all about
learning. Stoll develops the capacity concept to encompass a “generic and holistic
concept; the power to engage in and sustain continuous learning of teachers and the
school itself for the purpose of enhancing student learning, influenced by individual
teachers within a school; the school’s social and structural learning context; and the
external context” (Stoll 2009, pp. 116–117). She widens the concept by addressing
seven issues and their importance for capacity building, including context depend-
ency, the broader aims of schooling, focusing on the present as well as the future,
distributed leadership and networking and systemic capacity. However, the sev-
enth issue, and the one that is important for sustainability, is developing a “habit of
mind” in those involved in building capacity for continuous learning.
A Socio-structural Perspective
In this book, our intention is to hold onto the social and organisational perspective
of change and not reduce it to a habit of mind. This implies that we pursue a meth-
odological aim of maintaining an organisational and socio-structural perspective
on improvement capacity and moreover, as we have described above, a focus on
practice and agency. We use a framework developed by Blossing (2008) which has
its roots in organisation development theories (Burke 2008). It can be summarised
in the following four points:
• Infrastructure of the school organisation.
• Improvement processes.
• Improvement roles.
• Improvement history of the organisation.
The first aspect deals with the question of how to describe an organisation in terms
of a somewhat more overall structure. Schlechty (1976) developed a structure to
describe the position of the students in different types of school organisations. He
classifies schools as bureaucratic or professional, based on the ways these organi-
sations manage their students. Morgan (1986) uses metaphors to explore possible
structures in an organisation. He imagines organisations as brains, organisms or
even prisons.
The best model to choose in order to describe the structure of an organisation
depends on what aspects of the organisation are of interest and which functions
and processes are in focus. In this case, we are interested in a local organisation
normally consisting of between 20 and 60 adults, and we are interested in cap-
turing the daily working processes or the social working life, mainly between
teachers and school leaders. We use a model called “the infrastructure of the local
organisation,” originally put forward by Miles (1965) and developed further by
Ekholm (1989). Hopkins et al. (2013) use the infrastructure concept to describe
the formal structure of a school organisation and apply it in a study of instruc-
tional reform in mathematics. They refer to institutional theory but otherwise give
a rather vague definition of infrastructure. It turns out to refer to the social net-
works among teachers and especially the positioning of teacher leadership and the
importance of this when it comes to advice and information seeking for improv-
ing instruction. We argue that a more comprehensive model of the organisational
infrastructure is needed, which captures the situation of the organisation as well as
the functions of social life in the local organisation.
The description of the infrastructure of the local school that we use derives
from Miles (1965) and Ekholm (1971, 1989) and consists of eight systems (see
p. 10). The infrastructure shapes the daily work and can be very salient for a new
teacher in a school, but it can also be influenced and changed by the teachers and
school leaders. The grouping system in a school, together with the goal manage-
ment system, constitutes basic parts of the practice when building a functioning
organisational infrastructure. When the goals of the organisation are discussed and
worked on and when this process is conducted in groups where the members of
the organisation have possibilities to meet, the coupling between the school’s goals
and the practical work is strengthened.
The second aspect, the improvement processes, focuses on important events or
situations which drive the improvement work forward, for example evaluations,
making an inventory of problems to deal with, peer tutoring, school site visits or
literature reading. In relation to our interest in structure and agency, the improve-
ment processes focus on the agency dimension. In the frame of OD, Schmuck and
Runkel (1994) define processes as shorter so-called micro processes, being the
parts that make up the longer and more complex macroprocesses. The macropro-
cesses of a whole school improvement process are described in several phases, as
initiation, implementation, institutionalisation and diffusion (Miles et al. 1987).
These phases do not follow each other rectilinearly, but rather they overlap with
each other. Fullan (2001) describes them as themes. Other researchers, such
as Miles and Louis (1990), talk about a growing or evolutionary planning and
Schools’ Improvement Capacity 17
identify phases such as vision building, pressure, empowerment, resourcing, assis-

tance and problem solving. In terms of time, these processes can last from 5 to
8 years, which is therefore the time it takes for an innovation to become a routine
in a local school (Ekholm 1990).
Results from this research show that many schools have developed a talent for
performing intensive initiating or introductory phases when new ideas are pre-
sented to the teachers in the school. These schools plan introductory periods dur-
ing which teachers are sent to courses or in which teacher teams study literature
and maybe also visit other schools in which a certain teaching model has already
been implemented. Experts also visit those schools and give lectures about the
knowledge in the area requested. Moreover, the schools may have conducted a
school-based evaluation which illuminates the school’s improvement capacity, and
thus they hope to use this evaluation as a basis for improvement.
A problem, as we understand it, is that the school leaders and teachers in these
schools perceive the introductory phase as the whole of the improvement process
and that they understand the process to be complete after maybe only one year of
effort in the initial phase. However, to transform this initial learning into practical
work, the implementation process is the most critical phase in the improvement
process. In this phase, opposition to the innovative ideas is common and needs
to be communicated. Moreover, real changes with practical consequences only
take place when teachers and students implement the new ideas together. In this
phase, it is important for the principal and other school leaders to be consistent
and continues to support teachers by facilitating an exchange of experiences as
teachers try out the new ideas in practice. If teachers and school leaders persist for
a longer time, maybe 3–5 years, the process eventually moves into an institution-
alising phase when the new ideas become practical routines in the daily work of
the school.
The third aspect deals with which roles it is possible to take on in the infra-
structure and how they vary in importance during an improvement process. Miles
and Ekholm (1985), who developed the infrastructure model, have also indi-
cated that the work of implementing new ideas into daily routines is promoted
by certain roles in the organisation. The different roles are to be understood as an
extended leadership for change, although they were described decades before dis-
tributed leadership made its entrance in the research literature (see, for instance,
Gronn 2002; Timperley 2005; Harris 2009). We use an adjusted set of the roles
applied by Blossing (2000) in his study of practical school improvement in five
Swedish schools.
In the initiating phase, the visionary has the important function of commu-
nicating the broader aim of the improvement work and thereby creating a basic
understanding. In the implementing phase, when concrete action is required, it
is important that the inventor can communicate how to put the visions and goals
into practice at the local school. It is thereafter important to let early appli-
ers go ahead and try out the concrete proposals. The driver is needed in the
implementing phase when defence mechanisms are starting to work. The driv-
er’s work consists of speeding up the practical work. When courage is lost, the
goal keeper performs an important function in reminding people of the aim of

the new ideas. The inspector gathers information about the work and proposes
actions to keep the improvement process on track. It is also important that the
preserver gets space in the school organisation. He or she keeps in mind which
routines actually work and are good and makes sure that these do not vanish
amid the flow of new ideas. The visionary eventually returns and follows up
what has happened in the improvement work and reviews whether steps have
been taken to achieve the vision.
In a survey of five schools, Blossing (2000, 2003) shows how these roles can
vary between schools. In the survey, the teachers stated who took on these roles
within their schools. In two schools, the principals appeared as clear goal keepers,
visionaries and drivers. The principals made clear what goals were important for
the schools in the coming year and pushed for the work to start in different groups.
The team leaders, or special needs teachers, appeared as inventors and appliers. In
some of the other schools, the principals were not very apparent in the improve-
ment work, and in some, not at all, according to the statements of the teachers. It
is interesting to observe that it was in schools where the principals appeared most
clearly, that other leaders, for example team leaders, also executed a visible leader-
ship for development. The preserver appeared to be a role that really did not work
in any of the schools. When voices in favour of preserving old and well function-
ing routines were heard, they were often perceived as opposition to school devel-
opment and were reduced to silence.
The process of improvement work in a school is closely linked to the history of
the organisation and especially its improvement history, which is the fourth aspect
in the organisational perspective we have put forward. In a review of research on
strategic organisational change, Pettigrew (1985) concludes that in most cases,
research on change is impaired by three problems: it does not pay attention to
the whole of the situation, nor the orientation of the process and it is lacking in
its historical connection. By using the infrastructure model, we think we meet
the requirement to pay attention to the whole of the organisational situation. The
model captures the social working life of the organisation concerning the obvi-
ous routines as well as more cultural and unconscious aspects. By using this four
phase model in improvement work, we also focus on the process. According to
Pettigrew (1985), historical connections are made neither with regard to the devel-
opment of the local organisation nor to the history of the surrounding society.
These connections are of major importance in understanding changes, for instance
in organisational culture, and how these changes affect the improvement work.
Since improvement work is a long process, it is important for schools to
keep the improvement history alive through documentation and communica-
tion (Blossing 2008). In this way, the organisation will continuously adapt the
improvement works that have been decided upon. An adaptation already takes
place in the actual choice of improvement work within the frame of the school’s
goal orientation. Through such adaptation processes, a strong connection is mani-
fested to the social working life of school, which has been shown to be of major
importance for the progress of improvement work.
The Need for Focusing on Teaching Practices 19
The Need for Focusing on Teaching Practices
Despite intensive reform initiative, we can, in conformity with Hopkins (2007),

conclude that an improvement in teaching and learning which also raises stu-
dent outcomes often fails to happen. Or as we noticed in our evaluation of the
Knowledge Promotion Reform—From Word to Deed, improved results may be
reached initially and then decline (Blossing et al. 2010). As we have described
earlier, this could be explained from an institutional perspective by a loose cou-
pling between external reform demands and the internal needs of the local school.
Schools might seem to implement the changes, but the changes may only be
superficial while the core activities remain unchanged.
In our evaluation of the Knowledge Reform (Blossing et al. 2010), we could see
that the teaching situation was seldom clearly emphasised in the project plans, despite
the overarching goal in the programme being to improve both the academic and the
social development of the students. One possible explanation for this may be that the
Norwegian Directorate of Education and Training, in their presentation of the pro-
gramme, stressed the importance of the internal organisational processes of the local
schools, that is the learning organisation, as a means of improving teaching practices.
In our evaluation, we concluded that teachers and principals had indeed understood
the chosen improvement strategies as a means of improving student outcomes, but
often without clearly mapping the steps in the process and without appreciating the
role that improved teaching practices would have in this process.
An effort to strengthen a school’s internal organisational processes and improve-
ment capacity is important, but we would like to emphasise that it is necessary to
keep a focus on the teaching situation and the roles of the teachers and students in
this situation, in order to improve student learning. This has been extensively empha-
sised in the research literature both on school effectiveness (Reynolds et al. 2000)
and school improvement (Harris 2001b). Timperley (2011) places the teaching situ-
ation at the core of improvement work by describing teacher team work as being
of the utmost importance in schools where (learning how to adapt teaching to) the
learning needs of the children are in focus. Timperley sharply stresses that improve-
ment work that does not have this focus is not worth mentioning as an improve-
ment effort. In the Swedish context, Larsson (2004) argues that in order to improve
teaching, teachers have to see each other in action. This however was something that
rarely occurred in the schools he investigated.
The Need to Consider Means- Versus Goal-Situated

Strategies
The absence of a teaching focus in the improvement work of a school is clearly a

major deficiency. Another possible weakness has to do with the type of improve-
ment strategy chosen. Sarason (1971), an early and clear-sighted observer of the
inner life of schools, concludes that what starts out as a means in school improve-
ment work often tends to be transformed into an end in itself during the improve-
ment process. This provides an interesting perspective on why the Norwegian
schools participating in the programme often avoided focusing on the teaching situ-
ation. In Norwegian as well in Swedish schools, we find a dominant improvement
strategy where teachers talk to each other in groups with a view to developing their
pedagogical understanding. The idea is that these insights will cause the teachers to
reflect on their own teaching practices in turn and thereby improve their instruction.
But according to Sarason, this means-oriented strategy will not necessarily
lead to an improvement in student learning in the classroom. The rational assump-
tion that the means should lead to the desired ends does not seem to be correct.
Teachers experience these group talks as positive and this seems to promote a need
to continue with these group discussions. As a consequence, the means becomes
the end. The teachers want more positive time together—and this probably also
contributes to the learning of the teachers—but the intention that the learning
should transfer to the learning situation and to the students remains in the distance.
Instead, the group discussion itself appears to be the major goal to be achieved.
We would like to link the improvement strategies schools use to the situations in
which these strategies are used. We propose that the situation chosen makes a differ-
ence to the result. The situations can be of two different kinds: means situations and
goal situations, which imply that improvement strategies are either means or goal
situated. The means-situated strategies aim at working through means. Concerning
the goal of improving student learning outcomes, one such means strategy could be
to improve the collaboration in the teacher teams with the aim of improving instruc-
tion, with the hope that improved teaching methods will eventually improve student
learning outcomes. A goal-situated strategy, on the other hand, aims at working in
or very close to the situation that is intended to be improved. One example could
be action learning in order to improve the teaching approach in mathematics, where
people with external competence observe lessons and give feedback to teachers
who, based on these responses, develop new strategies to try out in the classroom.
Four Means-Situated Strategies
To summarise, in the evaluation of the Knowledge Reform—from word to deed, we

found four means-situated strategies that were often used. We have formulated these
as assumptions that teachers and school leaders in schools make, with reference to
different means that are expected to have an effect on student learning outcomes.
• The assumption that an improvement in teacher collaboration, and the teachers’ way
of talking about teaching, will improve teaching practices and student outcomes.
• The assumption that the development of planning and follow-up activities,
for example goal syllabuses and matrices and student development plans, will
improve teaching practices and student outcomes.
The Need to Consider Means- Versus Goal-Situated Strategies 21
• The assumption that an improvement in the well-being of the students during

the school day will improve their will and ability to perform better and thus
improve student outcomes.
• The assumption that an investment in creating order and discipline will improve
the learning environment and thus improve student outcomes.
The first assumption, we claim, is a very common supposition for organising
improvement projects. The Norwegian reform we investigated was based on this
assumption when talking about developing schools as learning organisations.
In the participating schools, we saw an effort to organise teachers in groups to
discuss their teaching. Organising the teachers in different groups was presumed
to lead to a dissemination of best practice. We did not see any major effect of this
strategy in the Norwegian case, and we argue that this strategy by itself is not
successful (Blossing et al. 2010). However, if this strategy is combined with other
strategies, such as goal-situated strategies like action learning, it might contribute
to success.
The second assumption is a reform requirement in Norwegian schools and
originates from a rational belief in the benefits of documentation and planning.
We visited schools that had put a lot of effort into creating templates to monitor
students’ performance by identifying student learning and planning follow-up
lessons. There were a lot of schools where teachers’ energy was spent on docu-
menting properly. Intense documentation threatens to shift the focus away from
the actual work of teaching students. Teachers often stated that they already knew
about student learning and achievement and that documenting reduced instruction
time. Systematically learning how to do documentation and planning is good, but
of course has to be balanced against teaching and learning activities. It should help
teachers to promote all students’ learning and not be an aim in itself.
The third assumption often forms the basis of quality control in schools. The
underlying logic is that if students feel good, the school and its teaching are good.
In our evaluation, we visited a school that had made considerable investment in
lunch break activities, such as theatre and playing guitar. The intention was that
the students could do these activities during lunch break. The teachers and school
leaders thought this would strengthen the students’ motivation and self-confidence
and would eventually lead to orderliness in the classroom, an improved learning
environment and thus would also raise student outcomes. No improvement to
teaching routines occurred during this time, but instead the teachers kept closely
to their old habits. The students did enjoy the lunch breaks more, but they still dis-
liked the traditional teaching.
Point four also focuses on peace and quiet in the classroom. The logic here
is that if one can first create peace and quiet, for example by informing the stu-
dents of rules about when to go to the school’s recreation hall, as well as how to
behave there, this will also affect orderliness in the classroom and thus again leads
to an improved learning environment. We visited a school where this assumption
was the basis for the entire improvement project. Teachers worked purposefully
to create common rules for the entire school. Each rule was associated with a
consequence if not followed. The teachers described the effectiveness of having

common rules and consequences, but they also described how following up the
rules took a lot of energy. Students described how the teachers’ efforts to set up
rules and try to be consistent in getting the students to respect them had created a
greater sense of peace in the classroom. But students also described vividly how
they spent a lot of energy circumventing rules they considered stupid and unnec-
essary. It is of course good to have rules for how youngsters and adults should
handle their social relationships, but the problem with this assumption, as with the
other three, is that many schools employ these strategies as what we call means-
situated strategies. In this example, one may ask whether the serenity in the class-
room could also have been created by focusing on creating a teaching which felt
meaningful to the students.
We argue that teachers and school leaders, through the ways in which they
approach their improvement activities, will create more or less successful struc-
tures for improvement. The case studies in our evaluation show that schools have
been goal situated and successful when it comes to the teachers’ learning environ-
ment but less successful when it comes to the students’ learning environment.
A Social Learning Perspective
Blossing and Ertesvåg (2011) have elaborated on individual learning beliefs

versus a social learning perspective when it comes to organising improvement
work. The social learning perspective is characterised by learning taking place in
the dialogue between teachers, while the individual perspective is characterised
by a belief in learning as something that only happens in the brain of the individ-
ual and that is also stored there. In such a perspective, the reliance on means-sit-
uated strategies could be understood as an expression of an individual learning
belief, where the individual teacher is supposed to store the acquired knowledge
in the brain and take it from the group discussion to the classroom. Goal-situated
strategies, on the other hand, could be understood as an expression of a social
learning perspective. In our evaluation, we conclude that schools often start out
from a social learning perspective, for example by collaborating in groups, but
soon lose this perspective and switch to an individual learning perspective. In
the organisation of improvement work, Blossing and Ertesvåg (2011) argue that
the individual perspective will, over time, come to dominate teachers’ and school
leaders’ understanding. As a consequence, they fail to organise the work in a
way that provides for the social side of learning. Besides the orientation aspect,
the social side of learning will appear in three more situations that appear to be
just as critical in successful improvement work. In sum, the four situations are
as follows:
• the situating
• the conditions for teacher participation
• the frequency of meetings
• the leadership.
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The susceptibility of different persons to this drug is so different that
the dose should first be as small as 1/400 gr., but this may be repeated
every three hours, and gradually increased to 1/100 gr., or until its
physiological effects are felt. Patients must sometimes be kept under
its influence for weeks together.25 It is, however, a remarkable fact
that occasionally a few full doses will secure an immunity from pain
for a long period. Although most useful in facial neuralgias, the writer
has known it to be effective in brachial and mammillary neuralgia.
Aconitia can now be had in granules of 1/400 gr., or can be given in
alcoholic solution.
25 See Seguin, Arch. of Med., vol. vi., 1881.
Gelsemium is also occasionally very useful in facial and even in

intercostal neuralgia, and is said to be of special service in the
neuralgia due to carious teeth. The commencing dose of the fluid
extract is five minims, which may be gradually increased to twenty,
or until a slight degree of muscular prostration, ptosis, or dilatation of
the pupil is induced.
The use of phosphorus has been revived of late years, chiefly

through the efforts of J. Ashburton Thompson, and it is at least
occasionally of service. Success is said to be best obtained by full
doses (about 1/20 gr. every three or four hours, up to 1/5 or 1/4 gr. daily
for some days), watch being kept for signs of gastric irritation. The
best preparation is an alcoholic solution (Thompson's), such as the
following:
Rx. Phosphorus, gr. j;

Abs. alcohol, fluidrachm vi.
Dissolve with heat.
Glycerin, fluidounce iss;
Alcohol, fluidrachm ij;
Spts. peppermint, minim v.
One teaspoonful represents gr. 1/20.
Electricity, if properly used, is capable of temporarily, and even
radically, relieving the neuralgic state. The forms most often
employed are faradic and galvanic electricity, though frictional
electricity has also been coming into use of late, mainly as a
substitute for faradism. The galvanic current is by far the most
efficacious of all. This probably acts mainly by directly inducing
better nutritive and better functional conditions in the nerves and
nerve-centres, but the fact that it is often of use in cases of
undoubted neuritis seems to indicate that it may also influence the
grosser structural changes in the affected parts, if such are present.
It is impossible to explain its action more exactly, and the teachings
of physiological experiments do not lend us much aid.
It is probably not of much consequence which pole is used in the

neighborhood of the affected nerve. It should be remembered that
the peripheral nerve-trunks are so deeply buried that the electrodes
cannot be directly applied to them, as they are to the exposed nerve
of a frog in the laboratory, and, further, that instead of being isolated
they are surrounded with tissues of good conducting power, into
which the current must rapidly flow off. For these reasons the nerve
near which either electrode is applied is virtually exposed to the
action of both poles in almost equal degree; and although it is more
customary to use the positive pole in the neighborhood of parts
which are considered to be in a state of irritation, yet clinical
experience has not justified the conversion of this custom into a rule.
Neither is the direction of the current of material consequence.
It is, however, very important in acute cases to take care that the
current-strength should not be rapidly changed; and for this reason
the electrode should be drawn slowly to a distance from the nerve
before it is removed, or left in situ while the current is gradually
diminished by a suitable rheostat. As a rule, the former method is the
more practicable.
In the treatment of acute cases moderate currents and short

applications, frequently repeated, are the best. On the other hand, in
cases of long standing, especially cases of sciatica, strong currents
are sometimes more effective, and even interruptions and reversals
of the current may be in place.
The choice of a battery is not a matter of indifference. Any stationary

battery of high interior resistance will answer the purpose, but most
of the portable (zinc-carbon) batteries in common use are
objectionable,26 for the reason that their interior resistance is so low
in proportion to that of the body that it may almost be counted out as
a factor in determining the strength of the current. The latter is liable
to rise, therefore, quite suddenly as the resistance of the body—i.e.
the vascularity of the skin—becomes modified. This objection is
obviated if a large, constant resistance (water or graphite rheostat) is
attached to the battery and kept always in the main circuit.
26 Archives of Medicine, April, 1884.
Faradism probably owes its efficiency to the indirect effects of

stimulation of the sensitive nerves of the skin. This may be produced
either by the wire brush, which causes a sharp irritation and
reddening, and is to be compared with the counter-irritants, or by the
milder application of a moist or dry electrode or the hand of the
operator. The latter procedure may be compared to the superficial
manipulation which is sometimes so grateful, especially in nervous
headaches.
The value of electricity as a general tonic should be remembered in

this connection.
Hydropathy.—Douches and baths of various kinds have doubtless

proved of much value in the treatment of neuralgia. The majority of
them, however, are difficult of application for the general practitioner,
and we confine ourselves to mentioning the tonic and soothing
action of the wet pack and of the prolonged warm bath, which should
be followed by sponging with cool water, and used under every
possible precaution against exposure.
Long-continued local applications of gentle heat (bags of sand or

salt, or hot water) are often temporarily grateful, and in the treatment
of chronic cases the daily application of hot water or ice-bags to the
spine is said to have a good effect. In acute and subacute neuritis,
and in those forms of neuralgia in which neuritis plays a large part,
such as sciatica, the persistent application of ice-bags along the
course of the affected nerve, even for days together, is sometimes of
great service. Even where we cannot be sure that neuritis is present,
long-continued applications of ice may be of use, but alternations of
cold and heat, on the other hand, are usually to be carefully avoided.
This treatment is safer in chronic than in acute cases, though it may
be useful in either.
Counter-irritation.—A spray of ether may be substituted for ice when

only a temporary chilling is desired, for its counter-irritant effect. This
has even been used on the face, the eye being protected by some
suitable covering, and a good deal of benefit is to be hoped for both
from this and from the similar use of chloride of methyl.
Debove27 has found the chloride of methyl, used in this manner,

singularly effective in the treatment of sciatica. A considerable and
long-continued counter-irritation is thus made over a large surface
and without great pain. The neuralgia is said to be greatly relieved
and a rapid cure sometimes affected.
27 Bulletin générale de Thérap., cited in the Boston Med. and Surg. Journ., vol. cxii. p.
210.
Counter-irritation is also practised by making applications of

cutaneous irritants, such as blisters, mustard, turpentine, chloroform,
or of the actual cautery carried in light superficial stripes over the
skin, and repeated if necessary at short intervals. As a rule, the
counter-irritation is more effective the larger the surface which is
covered.
The use of the cautery and of blisters is in place in almost every form
of neuralgia where the temporary disfigurement is of no
consequence.
Of other cutaneous applications, aconite and chloroform liniments,
menthol in substance or in alcoholic solution (drachm j or drachm ij
to fluidounce j), aconite and veratrine ointments, are the most useful.
A strong aconitine ointment, made with Duquesnet's aconitia and
lard (drachm j to ounce j), has been recommended by Webber28 to
be used in portions of the size of half a split pea, but, though
effective, it needs to be employed with great caution.
28 Nervous Diseases, Boston, 1885.
These applications act in part as irritants, by keeping up a play of

sensitive impressions in virtue of the lodgment which they effect in
the skin, but also, no doubt, by reducing the sensitiveness of the
cutaneous nerve-fibres, and thus removing one source of excitation
of the diseased nervous centres. The remarkable temporary benefit
sometimes obtained from the instillation of cocaine into the eye in
cases of neuralgia of the ophthalmic division of the fifth nerve bears
testimony in favor of this explanation.
Surgical operations for neuralgia are of three kinds—section

(neurotomy), removal of a piece of nerve (neurectomy), and nerve-
stretching. The two former operations are of course rarely practised,
except upon the purely-sensitive fifth pair of nerves, the latter upon
mixed nerves also.
Neurectomy is now almost always substituted for simple neurotomy,

and sometimes still more effective means are taken to prevent the
reunion of the nerve, such as doubling over the cut end, destroying
the nerve throughout the length of the bony canal in which it lies, and
even plugging the canal with cement.29
29 Heustis (Med. News, Dec. 8, 1883) found that the infraorbital nerve could be
readily drilled out with a piece of piano wire.
The inconvenience following nerve-section is as nothing compared

to the pain of a severe and intractable neuralgia. It has rarely
happened that the disease has been increased by the operation, and
under proper antiseptic precautions the surgical risks are not great.
There is some chance of permanent cure, and a much greater
chance of securing an immunity from pain for a long period.
It is important to remember that when the neuralgia occupies the

distribution of several branches of the fifth nerve, an operation on the
one primarily or most severely affected may relieve the pain in all.
On the other hand, the converse may be true,30 inasmuch as the
same district is supplied by recurrent fibres from several different
sources. Before any operation is decided on it should be
remembered that even in apparently desperate cases of trigeminal
neuralgia the persistent and thorough use of tonic and other
remedies may in the end be crowned with success, perhaps at the
moment when it is least expected.
30 Cartaz, Des névralgies envisagés au point de vue de la sensibilité récurrente.
During the past few years the operation of nerve-section has been to
some degree superseded by that of nerve-stretching, as being less
serious in its immediate (though not necessarily in its remote)
consequences, and sometimes more efficacious. Hildebrandt,
indeed, raises the question whether the traction which is apt to be
exerted when a nerve is cut is not an important element in bringing
about the result. On the other hand, cases are reported where
neuralgia which had not been relieved by stretching was cured by
resection.31
31 Nocht, Ueber die Gefolge der Nerven-dehnung.
The best showing for the operation is in the treatment of sciatica, but
most of the other superficial nerves, including the intercostals, have
been successfully treated in the same manner.
On the other hand, this treatment is not without its dangers. Apart
from the risks of the operation itself, cases have been reported in
which the spinal cord has been injured, so that chronic myelitis has
been set up, and a greater or less degree of paralysis—rarely
permanent, it is true—may be induced by the direct injury to the
nerve.
This means of treatment is therefore certainly to be thought of in
serious and obstinate cases, but not lightly decided on.
A substitute operation for sciatica is the so-called bloodless

stretching, in which, the patient having been etherized, the thigh is
forcibly flexed on the pelvis, and then the leg extended on the thigh
and the foot on the leg (dorsal flexion), and held for a short time in
this position. A very material degree of stretching of the sciatic nerve
is doubtless possible in this way, and a number of cures have been
thus effected. But, though less dangerous than the stretching of the
exposed nerve, this operation is not a trifling one.
In one case of sciatica the writer has seen a neuritis of some severity
lighted up by this operation, perhaps because the disease was in too
active a state, although it had lasted some months. The operation is
probably most indicated in chronic cases.
The anatomical effects of nerve-stretching are manifold. Nerve-fibres

are usually destroyed in greater or smaller number, and the
conducting power of the nerve correspondingly impaired. Small
blood-vessels are broken and the circulation and nutrition of the
nerve-trunks altered, and it is probable that adhesions in and around
the nerve-sheaths, where such exist, are severed. The nerve-fibres
ramifying in the inflamed sheaths of the large trunks may also be
ruptured, and it may be that the displacement of the fluid contents of
the nerve brings about better nutritive conditions.32 It is also probable
that the operation either directly or indirectly affects the nutrition of
the nerve-centres,33 and although this is not without its dangers, the
chances are in favor of a beneficial result.
32 See “Die Rückenmarks-dehnung,” Hegar, Samml. klin. Vorträge, 239.
33 Hegar, loc. cit.
Another means of directly acting on neuralgic nerves is by

subcutaneous injections of water, chloroform, ether, osmic acid,
nitrate of silver, and other substances. The deep injection of water
over the affected nerve is attended with but little danger, and is
occasionally successful. The similar use of chloroform, in doses of
15 to 30 minims, is much more often effective, but sometimes
causes great pain, and even abscess. It has been mainly used in
sciatica, also in other neuralgias, even those of the fifth pair. In this
case the injection is best made through the buccal mucous
membrane. This treatment is not without danger of causing collapse,
or even death, probably due to the wounding of a small vein. In one
case of sciatica treated by the writer the chloroform probably entered
the nerve itself to some extent, as the injection was followed by very
severe pain lasting for several hours, and eventually by some degree
of muscular wasting. The neuralgic pain, which had continued
obstinately for a long period, was, however, cured, and had not
returned at the end of some days, when the patient was lost sight of.
Osmic acid has been used recently in the same way, and the reports
show about an equal number of successes and failures. The dose is
about 8 minims of a 1 per cent. solution, and the injection may be
repeated at intervals of a few days. It has been used successfully in
various parts of the body, including the face and the fingers. The
injection causes no great pain, but occasionally, though rarely,
excites abscess.
Under the general heading of massage a number of manipulations

may be grouped which are of value in the treatment of neuralgia,
even of long-standing cases of sciatica and the like.34 When, as
often happens in the case of sciatica, the nerve is the seat of
congestion and exudation, strong and deep kneading along its
course, with vigorous stroking upward in the direction of the lymph-
vessels, is the important part of the treatment. Besides this, however,
the prolonged and gentle manipulation of the painful region may
greatly relieve the patient for a time, apparently by acting on the
sensitive nerves and exerting a sort of inhibitory action, in which it is
not at all impossible that an influence upon the attention analogous
to that of Braidism plays a part.
34 See Reibmayr, Die Massage, etc., Wien, 1883.
A striking instance of the effect of this treatment is seen in the case
of nervous headaches, which are often very greatly relieved by a
series of gentle, monotonous movements of the finger-tips, as well
as by the domestic remedy of gently and persistently combing or
brushing the patient's hair. A still more efficient application of a
similar kind is the regular vibration communicated by a large magnet
or by the instrument devised by Mortimer Granville. A thoroughly
satisfactory explanation of the action of this treatment is yet to be
furnished.
There is no doubt that in the treatment of neuralgia a persistent and

thorough use of the remedies suggested is usually the key to
success. Nevertheless, special cases are sometimes reached by
special means of treatment, and the following are appended as
occasionally useful: Ammonio-sulphate of copper (grs. ij-vj, taken in
divided doses in the course of the day); salicylate of soda, in full
doses; caffeine; tonka (fluidrachm j of the fluid extract at repeated
intervals of a few hours); oil of turpentine; muriate of ammonia.
Special Forms of Neuralgia.35
35 Consult, in connection with this subject, the sections on Symptomatology and

Treatment.
MIGRAINE AND PERIODICAL HEADACHE.—In many of the recent treatises

upon nervous disease migraine and headache are removed from the
category of the neuralgias and placed in that of the functional
affections of the sympathetic vaso-motor system of nerves. This
classification is based upon the fact that in many of these cases
marked vascular changes—congestion or anæmia, as the case may
be—are observed in the external tissues of the affected parts, while
the sensations of the patient often lead us to infer the presence of
similar conditions within the cranium. The pain and the other
symptoms of the outbreak, it is thought, are due to the changes in
blood-tension in the cortex cerebri or in the region of expansion of
sensitive nerves, or, in part, to the spasm of the muscular walls of
the vessels themselves. This theory is seductive from its appearance
of pathological simplicity and exactness, but the writer believes, with
Anstie, Latham, Allbutt, and other observers, that it is not borne out
by clinical experience, and that its adoption tends to cloak the wider
relationship that exists between the sensory neuroses.
Migraine, nervous headache, and the superficial and the visceral

neuralgias hardly differ more fundamentally from each other than
individual cases of either affection differ among themselves. It is not
improbable, as we have seen, that all the phenomena of some
neuralgic attacks are wholly or in part the expression of irritation of
the sensory nervous system from without; but in many cases, on the
other hand, the signs of the neurosal tendency are clearly marked,
and there is hardly one of the symptoms of a typical migraine of
which the analogue may not be found, though perhaps faintly
pronounced, in one or another form of superficial neuralgia, while the
relation of both to the whole family of the neuroses is still more
clearly evident.
Migraine is a disease of youth and middle life, characterized, in its

most typical form, by attacks of severe headache of a few or many
hours' duration, of gradual onset and decline, ushered in by well-
marked auras involving one or more of the cerebral functions, and
terminating in nausea or vomiting or profuse secretion of pale urine,
or in some other critical nervous outbreak. The pain is usually, but
not invariably, deep-seated. It may be confined to one side of the
head, most often the left, or may involve both sides, either from the
outset or in the course of the attack. The forehead or temple is
usually the first part to become painful, but in severe or prolonged
seizures the parietal and occipital regions are prone to be affected
likewise.
The auras are manifold and important. On the day before an attack
the patient may feel remarkably well, or may complain only of such
sensations as thirst or giddiness. The attack itself is apt to be
ushered in by visual hallucinations of dazzling and vibrating points or
serrated images, sometimes with prismatic outlines, accompanied by
a loss or obscuration of vision over one-half or some other portion of
the field, which lasts half an hour or more, and sometimes clearing
up in one part while it advances in another. Simultaneously or
immediately after this there may be tingling and a sense of
numbness of the tongue, lips, hand, or one-half of the body,
sometimes followed by partial hemiparesis, and, if the right side be
affected, by more or less aphasia or mental confusion. Occasionally
the other special senses are affected. Sometimes the aura may
constitute the whole of the seizure.
The writer has observed a case in which migraine was represented

throughout boyhood by repeated attacks of subjective numbness
and tingling of the entire right side of the face, the right arm, and the
right half of the body, with aphasia and hemianopsia, followed during
many years by trifling headache or none at all; later in life by severe
pain. Here migraine as well as neuralgia in other forms was a well-
marked family disease.
These auras are especially worthy of notice, because they

occasionally point to epilepsy, an affection with which migraine is
allied.
The pain may begin on the same side with these prodromal
symptoms or on the opposite side. Sometimes drowsiness is a
marked symptom throughout the attack, and this differs in
significance from the sound, refreshing sleep with which the
paroxysm often comes to an end. Sometimes the arteries of the
affected side seem strongly contracted, as shown by pallor and
coldness of the face and dilatation of the pupil (angio-tonic form);
sometimes, on the other hand, they are dilated and pulsate strongly,
or the latter condition may follow the former (angio-paralytic form).
The radial pulse may show corresponding modifications. These
vascular phenomena are often, however, entirely wanting.
Migraine appears to be slightly more common in women than in

men. The liability to the attacks often shows itself in extreme youth,
usually increases at puberty, and generally ceases at the age of forty
or fifty. The attacks sometimes recur at regular intervals of a week, a
month, etc., but, on the other hand, they may remain absent for
years unless brought on by some exciting cause.
ETIOLOGY AND CLINICAL RELATIONS.—Migraine is a directly inheritable

disease, and one which stands in a close relationship to the other
grave neuroses, as well as to the neuropathic temperament. Cases
are occasionally seen in which the migraine of youth gives place to
epilepsy in later years. It is often met with also in families and
individuals of neuralgic tendency, and in fact it shades off into
neuralgia of the fifth and occipital nerves on the one hand and into
periodic nervous headaches on the other. It frequently occurs in
gouty persons, and is thought to be related to the brow ague of
malaria. The attacks may be brought on by any of the causes which
depress the vitality of the nervous system, and by various special
irritations, among which errors of refraction are prominent.
The PROGNOSIS is unfavorable in well-marked cases, in which the

habit of regular recurrence is established, and where the neuropathic
predisposition is pronounced and no special exciting cause can be
found. On the other hand, there are many cases where the tendency
is less deeply rooted, and where with the removal of the exciting
cause or causes the outbreaks cease.
Finally, there is great probability that the disease will cease of itself
with advancing years, not always, however, without having left its
mark on the patient's mental and bodily vitality.
The TREATMENT should be directed first to the detection and removal

of special sources of irritation, whether in the eye, stomach, uterus,
or elsewhere. Causes of anxiety and mental strain should be as far
as possible avoided, and great caution enjoined in the use of
stimulants and narcotics. The nutrition should be maintained at its
highest level by tonics, and, if need be, by electricity, massage, and
hydropathy. Sometimes, besides this a special diet is advisable, for it
seems beyond question that some patients have fewer headaches if
they abandon all animal food, while others—whether because of a
gouty tendency is not clear—do best on a nitrogenous diet with
exclusion of sugar and starch.
Of the drugs used to control the liability to the attacks, the most
important is cannabis Indica, given in doses of about half a grain of a
good preparation of the extract several times daily for weeks or
months together. Valerianate of zinc and the iodide and bromide of
potassium in full doses are also recommended, but are less
efficacious.
In the treatment of the attack itself, besides absolute rest and quiet,
large and repeated doses of guarana or caffeine, either alone or
combined with drachm doses of bromide of potassium, are
sometimes of use if given at the very outset.
It is thought by some observers that ergot or ergotin is of value if the

vessels are dilated, and conversely nitrite of amyl or glonoine if they
are contracted. It must not be forgotten, however, in case of doubt,
that the throbbing due to the latter drugs may increase the pain.
The writer has known a strong faradic current applied with the
moistened hand to the back of the neck to relieve an attack, and
prolonged but gentle manipulation of the painful area with the finger-
tips may have a like effect if the pain is not too severe; as, for
example, toward the end of a paroxysm.
Neuralgias of the Fifth Nerve.
Three varieties of these neuralgias may conveniently be

distinguished:
1. Ordinary facial neuralgia, analogous to the neuralgias of the

other superficial nerves;
2. Intermittent supraorbital neuralgia, sometimes called brow

ague, though by no means always of malarial origin;
3. Epileptiform neuralgia (tic douloureux).
These varieties are of course closely allied, and have many features
and causes in common.
THE ORDINARY FACIAL NEURALGIA is a painful and obstinate malady,

although not so serious as the typical tic douloureux. The pain may
remain fixed in one position or it may shift from one part of the face
to another; and the latter is especially common in those forms which
occur in anæmic or ill-nourished persons. It associates itself readily
with occipital neuralgia, and sometimes also with neuralgia of the
pharynx and other parts. It occurs most often in persons of neurotic
tendencies or impaired nutrition, and may be provoked by disorders
of the ears, teeth, and even distant organs. The possibility of
aneurisms of the internal carotid or of cerebral tumor should also be
borne in mind, and signs of herpes zoster and locomotor ataxia
carefully sought for.
The relation of caries of the teeth to neuralgia of the fifth pair forms a
very important chapter, which is admirably treated by J. Ferrier.36
Opinions on this subject are conflicting and unsatisfactory, and the
fact that many patients have had nearly all their teeth drawn in the
vain attempt to get cured of one of the severe forms of facial
neuralgia often creates an impatience of further investigation in the
matter. Ferrier points out that as a rule it is not the severest cases of
epileptiform tic douloureux that arise in this way, but, on the other
hand, that it is a mistake to conclude, because a neuralgia is
benefited by medical treatment and made worse by fatigue,
exposure, etc., and because it occurs in a person of neurotic
temperament, that it is not likely to be due to this form of irritation.
The teeth need not themselves be the seat of pain, and the disease
in them may be detected only after diligent search.
36 Les Névralgies reflexes d'Origine dentaires, Paris, 1884.
The most important lesions are said to be caries, exostosis, and

other affections involving the pulp-cavity, exposure of the sensitive
dentine, ulcerations of the gums, injuries caused in extraction, and
other diseases of the alveolar process. The wisdom tooth, by its
pressure on other roots and on the gums, is not infrequently the one
at fault.
Chronic inflammation of the mucous membrane of the nose or

pharynx is said to be an occasional cause of neuralgia of the face,
as well as of the upper portions of the body.
THE INTERMITTENT NEURALGIA OF THE SUPRAORBITAL is an interesting

affection to which too little attention has been paid. One variety
seems to bear a certain relationship to migraine, inasmuch as it
occurs under similar circumstances—i.e. in distinctly neuropathic
individuals and families, and in attacks of about the same duration
and periodicity of recurrence.
Another variety approaches the other neuralgias in the longer

duration of the attacks, but is characterized by a daily seizure which
recurs with absolute regularity, coming on usually at about nine in
the morning and increasing in severity for an hour or so, then
persisting unchanged until midday or later, when it gradually
diminishes, finally disappearing in the course of the afternoon. As a
rule, it is brought on by catarrh of the frontal sinuses, often following
an acute attack of coryza. A certain amount of neurosal
predisposition is often found in this form, and the first attacks may
show themselves in early youth, rarely in the decline of life. The
writer has seen one family in which a number of members in at least
two generations have been attacked in this way, the seizures having
been brought on by exhaustion or coryza, or both combined.
This form of neuralgia is often greatly controlled by quinine if given in

sufficiently large doses (15 to 20 or 25, or even 30, grains) and as
long as four hours before the attack.
Lange37 thinks the action of galvanism is remarkably successful, but

the writer's experience does not fully bear this out.
37 Cited in the Centralbl. für Nervenheilkunde, etc., 1881, p. 10.
Seeligmüller38 speaks very highly of the effect of the nasal douche,
used for the sake of curing the catarrh of the frontal sinuses, and
potassic iodide may be useful by rendering the secretions more fluid.
38 Centralbl. für Nervenheilkunde, etc., June 1, 1880.
THE EPILEPTIFORM FACIAL NEURALGIA, OR TIC DOULOUREUX, is a chronic

affliction, characterized by the suddenness of onset and the severity
of its paroxysms of pain, which may recur every few minutes with
lightning-like rapidity, either spontaneously or brought on by motion
of the jaw or the taking of food, and disappear again as quickly. After
a group of such paroxysms as this there may be an intermission of
some hours or days. During the attack the patient is apt to rub the
seat of pain with great violence. The path pursued by the darts of
pain may be either in the direction of the nerve-trunks or in an
irregularly inverse direction.
In spite of their sufferings, these patients may present an

appearance of health. In its worst forms, and especially in advanced
life, this variety of neuralgia may be incurable, and at the best it is
sure to tax the care and skill of the physician. Anstie thinks that it is
apt to be associated with a taint of insanity.
The best TREATMENT consists in the most painstaking attention to

hygiene, in the persistent use of galvanism, arsenic, cod-liver oil,
quinine, aconite (see under General Treatment), and phosphorus.
Croton chloral is occasionally of service.
As a last resort, surgical measures (see above) may be appealed to,

but it should be borne in mind that even when the prospect seems
most hopeless the relief under medicinal and hygienic treatment may
really be near at hand. Where section of nerves is without result, the
operation of tying the larger vessels, the carotid or vertebral, on the
affected side may be tried, and offers some chance of success.
OCCIPITAL AND CERVICO-OCCIPITAL NEURALGIAS are second only to

trigeminal neuralgia in severity, though, fortunately, less common,
and either is liable by extension to give rise to the other.
Neuralgic pains in the occipital region may attend Potts's disease of
the cervical vertebræ; and this is especially important to bear in mind
because the osseous deformity is often wanting for a long time.
The writer has known a persistent pain in this region to be due to

intracranial syphilitic disease, and to cease suddenly with the advent
of more serious cerebral symptoms.
CERVICO-BRACHIAL AND BRACHIAL NEURALGIAS are less often indicative

of the neuropathic taint than the facial neuralgias; and, on the other
hand, they are, like sciatica, relatively often due to neuritis set up by
injury, amputation, strains, enlarged cervical glands, periarthritis of
the shoulder,39 etc., or associated with herpes zoster. When not due
to an unremovable cause the prognosis is favorable. The treatment
needs no special description.
39 See J. J. Putnam, “A Form of Painful Periarthritis of the Shoulder,” Boston Med.
and Surg. Journ., 1882.
INTERCOSTAL NEURALGIA is a very important form, both on account of

its frequency and obstinacy, and because it is often associated both
with anæmia and chlorosis and with affections of the visceral organs,
especially the uterus. The distressing cardiac palpitation of
neurasthenic patients often associates itself with pain in the left side,
and there is an intimate connection between neuralgia of the cardiac
plexus (angina pectoris; see below) and neuralgia of the intercostal
and brachial nerves.
Pain in this region, often due to neuritis, may accompany acute and
chronic thoracic disorders, and may be the precursor of herpes
zoster. Caries of the vertebræ and meningitis should be thought of,
and cancer if the neuralgia is very persistent, even if it is paroxysmal
in character.
TREATMENT.—Besides the general indications for treatment referred

to above, it is worthy of special note that nerve-stretching has been
successfully tried for intercostal neuralgia. In one interesting case
seven nerves were stretched at one operation.40 The reporter
discusses the surgical aspects of the operation, and points out that
the nerves should be sought for, not directly beneath the rib, but
behind and beneath it, and thinks that the failure to bear this fact in
mind might lead to puncturing the pleura.
40 Lesser, Deutsch. Med. Wochenschr., Sto. 20, 1884.
MAMMILLARY NEURALGIA (irritable breast of Astley Cooper), though

often met with in company with intercostal neuralgia, may occur
entirely independently. It is sometimes bilateral, and is apt to be
associated with irregularity of the uterine functions. Cutaneous
hyperæsthesia is often present to a distressing degree, and small
tumors of either temporary or permanent duration may make their
appearance (A. Cooper), which, however, do not affect the
prognosis.
There is no especially effective TREATMENT beyond what has been

spoken of. Surgical interference is not especially to be
recommended, though it has occasionally been useful.
LUMBO-ABDOMINAL NEURALGIA, or neuralgia of that part of the lumbar

plexus which supplies the flank and abdomen and the external
genital region. These neuralgias are apt to accompany those of the
intercostal nerves and share in their significance.
The most important facts with regard to them are that they are
intimately associated, in relation both of cause and of effect, with
affections of the abdominal and the pelvic organs and of the testis.
Neuralgias of the terminal branches of the lumbar plexus, the
obturator and anterior crural nerves, though well recognized, are
comparatively rare.
One of the chief respects in which they are important is in calling

attention to the possible presence of disease of the hip-joint or of
periarthritis of the hip, as well as of tumors or inflammation within the
pelvis.
NEURALGIA OF THE SCIATIC NERVE is one of the most severe and
common forms. While sharing in the common etiology and history of
the other neuralgias, it is peculiarly prone to be due to peripheral
causes, which give rise to thickening of interstitial and investing
connective tissue of the nerve. The distribution of the pain may be
coextensive with the whole distribution of the great and little sciatic
nerve, but far oftener the patient indicates certain regions as the seat
of his severest suffering; and these are especially the sacral region
of one side, the neighborhood of the sciatic notch, the popliteal
space, the calf, and the outer side of the foot and ankle. Not
infrequently the whole course of the sciatic nerve is traced out by the
darts of pain; and in this case it is the nerves which supply the
sheath of the sciatic itself which are supposed to be the seat of the
neuralgic process.
Sciatica is usually unilateral, but exceptionally bilateral, or attacks

the two sides alternately. The tender points most often met with are
at the sacro-iliac synchondrosis, the posterior border of the great
trochanter, just beneath the head of the peroneal bone, below and
behind the external malleolus, but numerous others are likewise
noted by Valleix. Sometimes no tender points can be found.
Sometimes, also, it is one or more of the collateral branches of the
sciatic plexus that are the seat of the neuralgia, and the distribution
of the pain and of the tender points varies accordingly.
It is in sciatica pre-eminently—in part, no doubt, because of the

frequency of neuritis—that disorders of sensibility of the skin are
noticed, as well as muscular paresis or spasm. This anæsthesia has
been studied with great care by Hubert-Valleroux and others, and it
has been shown that it is often confined to limited spots, a
centimeter or so in diameter, within which the loss of sensibility may
be nearly absolute. Nevertheless, their functional origin is proved by
the fact that under faradization they may rapidly disappear.
The duration of an attack of sciatica varies from a week or two to

months or even years, and it shows a marked liability to recur,
especially with changes of weather. First attacks occur pre-
eminently, though not exclusively, in middle life, and oftener in men
than in women, evidently because they are oftener exposed to
mechanical injury and, through their occupations, to sudden changes
of temperature and the like.
The occasional causes are numerous, and include sudden wrenches

and jars, even if not very severe, interpelvic pressure from tumors or
impacted feces, etc. Gout, syphilis, and diabetes may act as
predisposing and even exciting causes, and, it is said, gonorrhœa
likewise. Periarthritic inflammations of the hip-joint and varicose
veins frequently excite pains in the various sciatic nerve-branches
which simulate true sciatica.
As has been indicated, although sciatica may be a pure neuralgia

(see under Pathology), running its course without leading to any
appreciable change in the nerve, yet subacute and chronic neuritis is
very common, either as a primary condition or a complication, and its
presence puts a graver aspect upon the case. The pain of neuritis,
when severe, is relatively constant, remittent instead of intermittent,
dull rather than lancinating, increased by motion and pressure;
whereas the purely neuralgic pains are sometimes relieved by
movement. It is, however, doubtful whether an accurate differential
diagnosis is possible (see above). It is to this neuritis that the
muscular atrophy is due which is often so marked, and it may
likewise give rise to various cutaneous lesions of herpetic character.
The severe pain that accompanies typical herpes zoster of this
region is well known.
The TREATMENT of sciatica must vary with the probable cause of the
disease and its stage of progress. Diathetic taints are to be met if
present, and the greatest measure of physical health secured that
the circumstances possibly admit. It is a good precaution in all cases
to secure free evacuation of the bowels and to guard against
hemorrhoidal congestions.
As against the neuralgia itself, the proper means vary with the
acuteness of the attack and the presence or absence of neuritis. For
the acute stage absolute rest is almost always desirable as a prime

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Local Drivers for Improvement Capacity

Six Types of School Organisations 1st

The Precision Farming Revolution: Global Drivers of

School Peer Review for Educational Improvement and

The focus and leverage improvement book locating and

Seafood 101: How to Cook All Types of Seafood in All

Participation and Power Dynamics Between International

Leading Beyond Lean: The Seven Drivers of Productivity

Financing the Apocalypse: Drivers for Economic and

3D Management an Integral Theory for Organisations in

Local Drivers for

Local Drivers for

ISSN 2211-1921 ISSN 2211-193X (electronic)

Library of Congress Control Number: 2014953308

Springer Cham Heidelberg New York Dordrecht London

© The Author(s) 2015

Printed on acid-free paper

Springer is part of Springer Science+Business Media (www.springer.com)

Gothenburg, September 2014 Ulf Blossing

2 Organisational Perspectives on Schools and Change. . . . . . . . . . . . . . . 9

4 Six School Types . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 35

The Plan-Driven School . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 42

Keywords Neoliberal ­governance · Globalisation · Glocalisation · Decentralisation ·

© The Author(s) 2015 1

Through a flow of people and ideas across Europe, and in a cross-national

This book presents the results of a study of improvement work in 13 of the

Local Support and Challenges in Educational Policy

The strategies in the “Knowledge Promotion reform—from Word to Deed”

Hargreaves, A. (1998). Läraren i det postmoderna samhället [Changing teachers, changing

Keywords Institutional theory · Change · Loose coupling · Organisational devel-

When analysing schools at the organisational level, different theoretical perspec-

© The Author(s) 2015 9

improvement capacity, included a section on the need for focusing teaching

Instrumental and Institutional Perspectives

From an instrumental or rational perspective, organisations can be seen as instru-

Schools’ Improvement Capacity

In this chapter, we move on to the rationale of learning in and between organi-

• Curriculum coherence: the coordination of the school’s curriculum for student

identify phases such as vision building, pressure, empowerment, resourcing, assis-

goal keeper performs an important function in reminding people of the aim of

The Need for Focusing on Teaching Practices

Despite intensive reform initiative, we can, in conformity with Hopkins (2007),

The Need to Consider Means- Versus Goal-Situated

The absence of a teaching focus in the improvement work of a school is clearly a

Four Means-Situated Strategies

To summarise, in the evaluation of the Knowledge Reform—from word to deed, we

• The assumption that an improvement in the well-being of the students during

consequence if not followed. The teachers described the effectiveness of having

A Social Learning Perspective

Blossing and Ertesvåg (2011) have elaborated on individual learning beliefs

Gelsemium is also occasionally very useful in facial and even in

The use of phosphorus has been revived of late years, chiefly

Rx. Phosphorus, gr. j;

It is probably not of much consequence which pole is used in the

In the treatment of acute cases moderate currents and short

The choice of a battery is not a matter of indifference. Any stationary

Faradism probably owes its efficiency to the indirect effects of

The value of electricity as a general tonic should be remembered in

Hydropathy.—Douches and baths of various kinds have doubtless

Long-continued local applications of gentle heat (bags of sand or

Counter-irritation.—A spray of ether may be substituted for ice when

Debove27 has found the chloride of methyl, used in this manner,

Counter-irritation is also practised by making applications of

Keywords Neoliberal governance · Globalisation · Glocalisation · Decentralisation ·