In this knowledge, information, and digital era, human capital is more of an important source of competitive advantage than ever before. In fact, organizations spend a significant amount of their resources to train and develop their human capital. Most recently in 2007, a study by learning and talent management firm Bersin & Associates concluded that employers spend $55.8 billion a year (Paton, 2007). The goal of these and many effective training programs is for trainees to master knowledge, skills, and behaviors and apply them to their daily activities. Employees can then be part of a competitive advantage by becoming a source of intellectual capital (Noe, 1999).
As organizations currently function in increasingly dynamic environments (D'Aveni, 1994) that require fast action in high-velocity settings (Eisenhardt, 1989), it is important for research to recognize and investigate the differences of these settings and the types of training that will be effective in each. This study intends to bridge this gap to investigate the model of training that is used in high-reliability settings. We expect that in high-reliability settings, where work is highly uncertain and may be nonroutine, standard models of training may not be sufficient to produce reliable work practices. We conducted a qualitative analysis of a high-reliability organization through observation sessions, shadowing and interviews with the permanent and transient staff in a level one trauma center to determine just how training occurs. A dynamic model of training of how employees are trained in a high-reliability organization is the main contribution of this paper.
FROM TRADITIONAL TO DYNAMIC TRAINING AND LEARNING THEORY
There are many different training methods available to employers when setting up various training programs. They can range from presentation methods, hands-on methods, in addition to group building methods (Lee, 1990) and more. According to Noe (1999), each training method has its own advantages and disadvantages. For example, presentation methods are effective when trying to communicate information to a large number of people. Additionally, hands-on methods are effective to get the employee involved in the learning itself. Learning, one of the outcomes of training, has many of its own outcomes. According to Gagne and Medsker (1996) there are five general learning outcomes: verbal information, intellectual skills, motor skills, attitudes, and cognitive strategies. These outcomes are generally the variables of interest when examining if learning has occurred. In academia, there have been several theories that try to explain how people learn and achieve these outcomes, such as reinforcement theory and reward systems (e.g. Lawler, 1996) and adult learning theory (e.g. Tough, 1979).
Another theory in the training literature is social cognitive theory developed by Bandura (1986), a framework intended to analyze human motivation, thought, and action and its relation to learning and training. Through this model, individuals learn from direct experience that may occur vicariously by an individual observing others' behavior and the consequences of their actions. Bandura's model of observational learning or behavior modeling includes a four step process. In the first step, attentional processes determine what is attended to and observed by the individual; through retention processes in the second step, the individual retains the experience so that it serves as an internal model for response production; production processes in the third step include organization of the individuals skills into a response pattern or behavior; and finally, motivational processes in the fourth step determine whether or not these acquired skills will be put to use (see Bandura, 1986 for a detailed description). Through this model, an individual attends to behavior to be learned, retains the information and experience in order to reproduce it, and is motivated in some way to repeat this behavior and put it to use.
In high-reliability settings several factors suggest the need to understand the different learning and training methods used over and above more traditional settings. First, unlike traditional work settings where work is routine and clear, work is highly uncertain and may often be nonroutine in high-reliability settings. High-reliability work settings are organizational entities made up of multi-disciplinary teams that must constantly provide reliable performance while facing an uncertain and rapidly changing input environment. In these complex high-velocity work environments, all too easily communication and coordination failures can lead to system-wide breakdowns that often have catastrophic impacts (e.g., Grabowski & Roberts, 1997; Weick & Roberts, 1993); coordination and integration of individual activities and contributions is of paramount concern. Recent studies in a wide variety of high-reliability work environments, such as air traffic control rooms (e.g. Bentley et al., 1992), space mission control rooms (e.g. Watts, Woods, Corban, & Patterson, 1996), and hospitals (e.g. Bardram, 1997), have developed a complicated picture of their coordination processes. Although research shows that there is an emphasis on formal and improvised procedures in these organizations (e.g. Bigley & Roberts, 2001; Weick & Roberts, 1993) in order to combat uncertainty, standard models of learning and training may not be sufficient to produce reliable work practices.
Second, high-reliability organizations are ones that must operate error-free or risk devastating consequences. Traditional models of learning and training may not be satisfactory and must be adapted to these situations. For example, adult learning theory suggests the trainee should have a high degree of control over his / her learning. In a nuclear power plant, this theory suggests that the trainee should be able to control the safety systems as he / she learns. With one error, this could cause devastating consequences if the trainee was "in charge" of learning. Thus, we expect there will be differences in learning and training in these highly reliable settings.
As there have been a number of studies investigating modeling in training (e.g. May & Kahnweiler, 2000), we intended to further this research by investigating how modeling is used in a high-reliability environment. In this paper, we present a study of learning and training in a leading trauma center. Trauma centers have highly uncertain environments in which reliable work practices are critical in order to avoid fatal errors. Our findings, described in detail below, indicate there is a dynamic learning model where trainees learn through attention, guided participation, and self-management. Further, acuity level, individual differences, and goals intervened to influence the learning environment. Findings further the social cognitive approach of learning and training.
A qualitative method should be used in a situation "when little is known about a phenomenon... or when the research question pertains to understanding and describing a particular phenomenon or event about which little is known (Morse & Field, 1995: 10)." Our review of the literature indicated that not much is known about training in high-reliability settings. Thus, we employed a focused ethnography approach (Boyle, 1994), in order to (1) explore the richness of the context, (2) understand training phenomenon in a high-reliability organization, and (3) develop a dynamic model of training in our research site that can be tested.
3.1 Research Setting and Sample
Our site was the trauma unit (TU) at Mercy Hospital (MH), a leading level one teaching hospital located in a large urban area in the Mid-Atlantic of the U.S. The purpose of a level one trauma center is to provide quality care to patients and as a teaching hospital, they provide an environment in which to enhance physician learning. MH is a 250-bed facility. The TU, a ten patient bay facility that can admit as many as 20 patients, faces a complex and uncertain environment as well as a high volume of admissions...
Dynamic learning theory: training in high-reliability organizations.
|Author:||Gardner, Sharyn D.|
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