Maria Gustavsson

Facilitating expansive learning in a public sector organization

The aim of this article is to discuss how learning opportunities can be organized to promote expansive learning in work practice. The discussion draws on results from a case study examining local development work and conditions that facilitate processes of expansive learning in a work team within a public sector organization in a Swedish municipality. An interactive research design was used. Data were collected over almost four years through individual and group interviews with 12 workers in a work team and their three managers. In addition data were collected through observations of team meetings. The findings demonstrate that work can be organized as a learning environment to facilitate expansive learning even in a resource-limited public sector organization. Furthermore, patterns of expansive learning were evident in the work teams new work activities and new relationships in the organization. The findings also demonstrate the need to support managers in developing a role to facilitate expansive learning. However, the need for and extent of external support for promoting expansive learning in practice vary in different situations and stages during the development work.

Management for sustainable health: A TQM‐inspired model based on experiences taken from successful Swedish organizations

Purpose - The purpose of this paper is threefold: to describe how a large organization has successfully worked to achieve sustainable health, compare the work of the large organization with methodo ...

The potential for learning in industrial work

Purpose – The purpose of this article is to discuss the potential for learning that is present for process operators in their work at a paper mill. The term learning potential is used to denote the opportunities operators have for learning in their daily work.Design/methodology/approach – A case study of the work and learning of process operators in four different shift teams in four different departments at a paper mill, using diaries and interviews, provides the data for identifying potential for learning in the work of process operators.Findings – Findings show that the work of operators is dominated by an adaptive form of learning, that is becoming better at an already known task, and solving daily work problems. At the same time there is potential for a more development oriented learning, but with a local and ad hoc emphasis in the shift teams. However, the desire and willingness of the operators is important for the utilization of existing learning potential.Research limitations/implications – In ge...

Lean production tools and decision latitude enable conditions for innovative learning in organizations: A multilevel analysis

The effect of lean production on conditions for learning is debated. This study aimed to investigate how tools inspired by lean production (standardization, resource reduction, visual monitoring, housekeeping, value flow analysis) were associated with an innovative learning climate and with collective dispersion of ideas in organizations, and whether decision latitude contributed to these associations. A questionnaire was sent out to employees in public, private, production and service organizations (n = 4442). Multilevel linear regression analyses were used. Use of lean tools and decision latitude were positively associated with an innovative learning climate and collective dispersion of ideas. A low degree of decision latitude was a modifier in the association to collective dispersion of ideas. Lean tools can enable shared understanding and collective spreading of ideas, needed for the development of work processes, especially when decision latitude is low. Value flow analysis played a pivotal role in the associations.

Investigating Work Conditions and Burnout at Three Hierarchical Levels

Objective: To investigate the differences and the association between work conditions and symptoms of burnout at the three hierarchical levels: subordinates, first-line managers, and middle managers. Methods: Analyses were based on questionnaire data from 4096 employees in nine organizations, containing three hierarchical levels: subordinates (n = 3659), first-line managers (n = 345), and middle managers (n = 92). Results: Work conditions were found to differ between the three hierarchical levels, mostly between subordinates and managers. Managers experienced fewer symptoms of burnout than subordinates. Furthermore, the association between work conditions and burnout differed for subordinates, first-line managers, and middle managers. Conclusions: Occupational health research needs to focus more on differences between hierarchical levels regarding work conditions and burnout.

Evaluation of job stress models for predicting health at work

OBJECTIVES Few workplace health promotion (WHP) interventions are designed to improve work conditions. Methods for measurement of work conditions are often developed from a risk factor perspective rather than a WHP perspective. More knowledge is needed on the work conditions that promote health in order to develop a good work environment. The purpose of the present study was to investigate if the Demand Control Support model, the Effort Reward Imbalance model and the Job Characteristic Inventory are correlated, if the subscales predict health and to analyze which combination of subscales is the most useful predictor of health longitudinally. PARTICIPANTS The study used questionnaire data from 662 civil servants at baseline and at follow-up 2 years later. METHOD The data were analysed by multiple regressions. RESULTS A new model; effort, reward, and variety, was found having a higher predictive power to predict health than the original models. CONCLUSIONS To promote health at work, social relations and health-mediating work conditions are important because these conditions may buffer health. Health can be assumed to be a resource that is created in everyday activities and interactions in workplaces, and there is a need to develop health measure instruments based on holistic health theories.

The importance of work conditions and health for voluntary job mobility: a two-year follow-up

BackgroundChanging jobs is part of modern working life. Within occupational health, job mobility has mainly been studied in terms of employees’ intentions to leave their jobs. In contrast to actual turnover, turnover intentions are not definite and only reflect the probability that an individual will change job. The aim of this study was to determine what work conditions predict voluntary job mobility and to examine if good health or burnout predicts voluntary job mobility.MethodsThe study was based on questionnaire data from 792 civil servants. The data were analysed using logistic regressions.ResultsLow variety and high autonomy were associated with increased voluntary job mobility. However, the associations between health and voluntary job mobility did not reach significance. Possible explanations for the null results may be that the population was homogeneous, and that the instruments for measuring global health are too coarse for a healthy, working population.ConclusionsVoluntary job mobility may be predicted by high autonomy and low variety. The former may reflect that individuals with high autonomy have stronger career development motives; the latter may reflect the fact that low variety leads to job dissatisfaction. In contrast to our results on job content, global health measurements are not strong predictors of voluntary job mobility. This may be because good health affects job mobility through several offsetting channels, involving the resources and ability to seek a new job. Future work should use more detailed measurements of health or examine other work settings so that we may learn more about which of the offsetting effects of health dominate in different contexts.

Swedish Students' and Preceptors' Perceptions of What Students Learn in a Six-Month Advanced Pharmacy Practice Experience

Objective. To identify what pharmacy students learn during the 6-month advanced pharmacy practice experience (APPE) in Sweden. Methods. Semi-structured interviews were conducted with 18 pharmacy APPE students and 17 pharmacist preceptors and analyzed in a qualitative directed content analysis using a defined workplace learning typology for categories. Results. The Swedish APPE provides students with task performance skills for work at pharmacies and social and professional knowledge, such as teamwork, how to learn while in a work setting, self-evaluation, understanding of the pharmacist role, and decision making and problem solving skills. Many of these skills and knowledge are not accounted for in the curricula in Sweden. Using a workplace learning typology to identify learning outcomes, as in this study, could be useful for curricula development. Conclusions. Exploring the learning that takes place during the APPE in a pharmacy revealed a broad range of skills and knowledge that students acquire.

Introducing Motivational Interviewing in a Sickness Insurance Context: Translation and Implementation Challenges

Purpose Motivational interviewing (MI) is a conversational method to support clients in need of behavioral change. In an organizational reform, most Swedish sickness insurance officials were trained in MI to promote clients’ return to work (RTW) after sick leave. The aim of this article is to investigate experiences of introducing MI as a tool to promote clients’ RTW within a sickness insurance context, with special focus on the translation and implementation of the method. Methods A qualitative approach, comprising 69 interviews with officials, managers, and regional coordinators on two occasions. The material was analyzed through qualitative content analysis. Results Officials were positive about MI, but the application was limited to using certain tools with extensive individual variation. Officials struggled with translating MI into a sickness insurance context, where the implementation strategy largely failed to offer adequate support, due to low managerial priority, competing initiatives, and a high workload. Results of the educational intervention could therefore be seen on an individual but not an organizational level. Conclusions In order to translate MI into a sickness insurance context, training needs to be supported by organizational approaches that promote collective learning and sharing of experiences among officials. The results also illustrate how a method cannot be assumed to be implemented simply because training has been provided. Consequently, the application of the method needs to be carefully monitored in studies of interventions where MI is claimed to be used, in order to measure its effectiveness.

Learning to Promote Health at an Emergency Care Department: Identifying Expansive and Restrictive Conditions.

This article reports on the findings of a planned workplace health promotion intervention, and the aim is to identify conditions that facilitated or restricted the learning to promote health at an emergency care department in a Swedish hospital. The study had a longitudinal design, with interviews before and after the intervention and follow-up interviews one year after the intervention. Data were collected through individual interviews with employees and managers, in total 69 interviews. In addition, data were collected from documents. The study provided insight into conditions which were found to act as expansive and restrictive reinforcements for learning to promote health. The conclusion is that the workplace health promotion intervention was shaped by conditions that existed outside the local workplace level which restricted the workplace health promotion. Nevertheless, collective employee-driven activities had the capacity to facilitate learning for change in order to create a health-promoting workplace. The advantage of combining theories of learning and workplace health promotion provided a holistic analytical view of learning to promote health at work and helped to uncover and monitor changed conditions during a planned workplace health promotion intervention.