Marlot Kuiper

49 Standardization in professional settings demands – also with regard to collaboration. Examples are the introduction of competency based learning (e.g. the CANMeds framework where ‘collaboration’ is deemed an important skill (Davidoff, 2010; Frank & Danoff, 2007)), Entrustable Professional Activities (ten Cate, 2005, 2013) and Medical Leadership (Voogt, 2019; Voogt, van Rensen, van der Schaaf, Noordegraaf, & Schneider, 2016). Nonetheless, professional education is still organised into divisions by common practice area. This implies that despite of an increased attention for professional collaboration, medical doctors in training are still socialized into their specialized subdomain with its ‘ways of acting’ and supervised on their individual performance, in a time where crossing professional boundaries becomes ever more important. Besides changes in governing and collaboration structures, some other developments influence the ways in which professional work can be conducted. First, ICT developments and new technologies for example create new possibilities, but also pose new challenges. New ICT systems allow for quick exchanges of information, but herewith also pose challenges, for example with regards to client’s privacy. Besides, accessibility and registration of information also allows for continues monitoring and assessment at an organisation level (Broadbent & Laughlin, 2005; Eriksson-Zetterquist et al., 2009) Next, patients and clients have become more knowledgeable and critical and claim so called ‘co-production’ of treatment. They are becoming ‘customers’ rather than passive recipients (Evetts, 2011; Lachman, 2009). The changing role of patients in the care process becomes visible through developments like ‘patient centred care’ (e.g. Epstein & Street, 2011), for example concretized by the encouragement to work with Patient Reported Outcome Measures (PROMs) in which the experience of the patient, for example concerning pain, gains a central role in clinical decision making (Black, 2013; Dawson et al., 2010). Further, and importantly, the performance of professionals seems to be scrutinized ever more, with severe consequences for them and the organisations they work in. Journalists are on the outlook; articles and documentaries that tell about medical mistakes generate good audience ratings and publicity, which make that professionals increasingly act in a ‘glass house’. This ‘personalized’ scrutiny becomes reality in public lectures, in which responsible doctors have to account for their mistakes (Van den Brink, 2018). These publicly exposed risks and incidents prompted both a political and public demand for more transparency and accountability (Weick and Sutcliffe 2003; Millenson 2002), 2