一种团队学习风格与变革管理的医疗案例研究述评

发布时间：2016-05-02 20:47

1. Research purpose and synopsis of the paper1.研究目的和纸张的简介

This paper mainly discusses a case study of healthcare institution in a change context, the main subject is team member learning style, the purpose is to explore how team member learning style impact on the effectiveness and success of management change. Based on the major findings, lessons and experience could be drawn out for further management change in a healthcare context. 

This paper is an empirical analysis study. It is divided into four parts. First, it outlines the major context and purpose, summarizes current researches, as well as the theoretical basis of the study. Then it introduces the methodology, a combination of qualitative research and quantitative research. Further the major findings are concluded based on the analysis of the raw data. At last, the limitation and significance of the whole study are discussed. 

2. Methodology assessment: combination of quantitative and qualitative research评估方法：定量和定性研究相结合

Methodology is important in any study, as it can explain how the study collects and uses data from the respondents, reliable methodology makes study go smoothly and can also guarantee the reliabilities of the major findings. 

As Pertersilia (1990) and Taylor (et al., 1999) suggested, case study is often used in the field of implementation science. For this study, the main purpose is to discuss how the team learner styles impact on the transition period in the healthcare context, therefore a real case of a hospital is chose. The main approach is a combination of qualitative analysis and quantitative analysis, specifically, including structured questionnaire, semi-structured interviews, and non-participant observation. These are the most frequently used methods to assess the process of policy implementation. (Scheirer and Rezmovic, 1983)

Quantitative research defines the aspects of objects in a statistic way, questionnaire is the representative approach. It quantizes phenomena and problems, through data collecting and analyzing, it identifies and interprets the phenomena and problems. In this study, both electronic and paper versions questionnaires are designed to measure the team learner style. During the investigation, proper procedures are designed and respondents are chosen intentionally. From March 2007 to July 2007, reliable surveys were completed and returned. The advantage is obvious, it is authentic and effective, however structured questionnaire may limit the range of respondents’ choice, the validity of some information may be reduced. 

Qualitative method is the opposite concept of quantitative method (Taylor, 1999). Qualitative method is not based on digitalized codes; it defines and deals with phenomena and problems through exploring and interpreting them. Through qualitative research, human behaviors and ideas, as well as the specific purpose and personal views could be discussed in depth, which greatly contribute to further discussion. Semi-structured interview is time-consuming work, but can always get the first hand materials. In this study, interviews were conducted during the transition and post-transition period, besides face-to-face interviews, phone interviews were also conducted. These approaches deepen the understanding of the change process; also help to understand the true feelings and ideas of team learners. Interviews method also has some disadvantages, such as, the respondents may be prejudice, and interviewee is often influenced by the environment, etc.

Non-participant observation is also a qualitative method. Based on the observation, data collected from interviews and narrative analysis could be gathered, organized and categorized. (Howell, 2012) In this study, observation was conducted in two levels team meetings, that is transition leadership team (ACC) and respective unit departments. Through analyzing, some common themes and constructive findings could be summarized. That’s why non-participant observation is an important method and greatly complements qualitative method.


The above research methods have advantages and disadvantages respectively. The combination of questionnaire, interview, and observation, could complement one another, which guarantee the objectiveness and enhance the accuracy of the whole study. In doing research, such a combination may give full play to the advantages, avoiding disadvantages, finally make the research findings more accurate. 

3. Major arguments and findings主要论点和结论

The theoretical base of this paper is mainly from Kolb’s Experiential Learning theory (1984). According to Kolb, individual experience, perception, cognition, and behavior contribute to explain member’s learning style. This study adopts Kolb’s theory, and it further investigates “the profile and ratio of team learning style distribution for improved organizational performance in a change context”, that is, the healthcare institution transition within a change management context. Data collects from three different sources, the survey data, the archived data, and the field notes from observations and conversation with employees. Specifically, 23 senior managers’ learning styles were surveyed; with the help of these senior managers, 77 questionnaires were collected from their team members. In order to further examine the communication and interaction patterns, semi-structured interviews, non-participant observation, and meeting notes were employed to analyze team members’ learning style. 

According to relevant theories, team members’ learning styles can be classified as: 1) convergers, whose active experimentation and abstract conceptualization facilitates the strategic planning stage; 2) assimilators, who are mainly planners and can make good contribution for the hospital design and construction stage; 3) divergers, who are adept at interpreting the environment and creating a team culture; 4) accommodators, who are the best doers for project execution. 

Four teams’ profile and ratio of team learning style distribution are analyzed in details. The first team is Facility Team, which is made up primarily of convergers, the ratio distribution is: 4 (convergers): 3 (assimilators): 1 (divergers): 0 (accommodators). This team charges with strategically planning a large change project, and the ratio is proved effective for its function. In the change context, facility members are mainly responsible for the preparation of hospital design and hospital construction, therefore it is appropriate to have more assimilators than divergers and accommodators. The second team is Nursing Team 1. Nursing Team 1 consists of old employees and new anticipated staff. The distribution ratio of this team is: 4 (convergers): 2 (assimilators): 1 (divergers):2 (accommodators). According to the study, Nursing Team 1 can effectively delivered hospital services in the change context. Because in the transition time, it is necessary to have team members be familiar with hospital business and daily services, team members who have accommodating ability can play the coordinating role. Nursing Team 2 is the third team, which mainly consists of new hires, and divergers are the majority of the team. The distribution ratio of this team is: 1 (convergers): 2 (assimilators): 4 (divergers): 3 (accommodators). Study proves that Nursing Team 2 has some communication and performance difficulties in the change context. Compared with Nursing Team 1, Nursing Team 2 have more divergers than that in Nursing Team 1, it is not appropriate for a team to take coordinating role. Transition Team is the fourth team, which acts as the central leadership and is composed of managers, representatives, directors from various departments of the healthcare institution. The distribution ratios of this team is: 6 (convergers): 2 (assimilators): 1 (divergers): 2 (accommodators). In the change environment of the healthcare institution, transition team is easily interrupted by uncertainty and ambiguity; however the majority of convergers are an advantage to maximize clarity and progress. 


From the results, some conclusion could be drawn, that is, in a change context: 1) the most effective change leadership team favors convergers and assimilators over divergers and accommodators; 2) the most effective change implementation team favors less divergers to deliver services in the change context. Therefore, at the individual level, awareness of learner styles can smooth and enhance the effectiveness of project in a change context, and it is necessary to encourage individuals to understandand share their learner style, so as to enhance work productivity. 

4. Strengths and weakness of the paper优势和纸张的弱点

The major strength of this paper is that, based on relevant theories, an empirical study is conducted to discuss the team member leaner styles in a change context of a healthcare institution. In order to guarantee the validity of major findings, this paper employs more than one method to collect the raw data. Questionnaire results, combined with individual interviews and non-participant observation, could better correspond to the real situation, and reduce the possibility of distorting or misrepresenting the change context. Through the data analyzing, some valuable conclusions can be drawn to guide the future projects in a change context. However, this study refers to a single case study, only several sub-teams learner styles are discussed, and also no comparison is made with other medical institutions. The limited scale might be the weakness of the paper. What’s more, team member leaner style changes over time, the major findings may change along with the situation and environment. 

To summarize this paper, methodology it employs makes the major findings persuasive and makes the whole structure easy to understand. However, data collected mainly focus on the team learners’ style in or after the transition period of time, it doesn’t reveal how team learners’ style change during the whole process, also it doesn’t discuss management team’s measures in this regard. But in a given time, these findings are constructive for managing change in a healthcare context, which makes great senses for the healthcare institution. 

Reference文献

Kerry E. Howell. (2012 edition) An Introduction to the Philosophy of Methodology, SAGE 
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Petersilia, J. (1990), “Conditions that permit intensive supervision”, Crime and Delinquency,
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Scheirer, M. A., & Rezmovic, R. L. (1983). “Measuring the degree of program 
implementation”, Evaluation Review, 7(5), 599-633.
Taylor, L., Nelson, P. and Adelman, H. (1999), “Scaling-up reforms across a school district”,
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Yin, R. K. (2003). Case study research: design and methods, Thousand Oaks, Calif., Sage.

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