How The Multi-Levels of Individual Learning and Team Learning Interact in Public Healthcare Organisations

This study seeks to increase understanding of organisational learning by researching actual learning processes in public healthcare organisations to enhance understanding of how the multi-levels of individual and team learning interact. A preliminary conceptual framework is developed, drawing upon the multi-levels of learning within organisational learning and the Crossan et al. (1999) 4I framework. A single interpretive case study in the public health service in Ireland is carried out, involving three rounds of semi-structured interviews with Non-Consultant Hospital Doctors (NCHDs), supported by a review of relevant professional documentation and researcher reflective log entries. The findings suggest a greater proportion of individual and team learning occurs in informal settings where interpreting and developing understanding takes place either in dyads, small groups, or with the whole team. The willingness and confidence to share insights, intuitions and to ask questions are triggers for learning. This learning occurs in a public healthcare context where an experience hierarchy, interpersonal relationships and social dynamics form the backdrop to all learning interactions. The training received by NCHDs may vary depending on how effectively they build interpersonal relationships, take advantage of informal spontaneous learning opportunities and manage the social dynamics within their team. A revised learning framework is presented which provides greater insight into how the multi-levels of individual and team learning interact in public healthcare organisations, thereby extending organisational learning theory in the public healthcare setting. The findings have practical relevance to those interested in the effectiveness of post-graduate training and learning of NCHDs in the public healthcare system. They also have practical relevance for enhancing the effectiveness of teamwork and learning interactions, contributing to high quality safe healthcare and responsiveness to change. While the study was carried out in the public hospital system, it may also have relevance within the private hospital sector, community healthcare settings and potentially other contexts. Including other members of the multi-disciplinary team (MDT) within future studies could also help to enrich understanding of how the interaction of individual and team learning occurs within teams.