Kaveriporukasta liiketoiminnaksi : Tuotannon häiriöt ja organisaation oppiminen nopeasti muuttuvassa yrityksessä

In the 1990 s the companies utilizing and producing new information technology, especially so-called new media, were also expected to be forerunners in new forms of work and organization. Researchers anticipated that new, more creative forms of work and the changing content of working life were about to replace old industrial and standardized ways of working. However, research on actual companies in the IT sector revealed a situation where only minor changes to existing organizational forms were seen .Many of the independent companies faced great difficulties trying to survive the rapid changes in the products and production forms in the emerging field. Most of the research on the new media field has been conducted as surveys, and an understanding of the actual everyday work process has remained thin. My research is a longitudinal study of the early phases of one new media company in Finland. The study is an analysis of the challenges the company faced in a rapidly changing business field and the attempts to overcome these challenges. The two main analyses in the study focus on the developmental phases of the company and the disturbances in the production process. Based on these analyses, I study changes and learning at work using the methodological framework of developmental work research. Developmental work research is a Finnish variant of the cultural-historical activity theory applied to the study of learning and transformations at work. The data was gathered over a three-year period of ethnographic fieldwork. I documented the production processes and everyday life in the company as a participant observer. I interviewed key persons, video and audio-taped meetings, followed e-mail correspondence and collected various documents, such as agreements and memos. I developed a systematic method for analyzing the disturbances in the production process by combining the various data sources. The systematic analysis of the disturbances depicted a very complex and only partly managed production process. The production process had a long duration, and no single actor had an understanding of it as a whole. Most of the disturbances had to do with the customer relationships. The nature of the disturbances was latent; they were recognized but not addressed. In the particular production processes that I analyzed, the ending life span of a particular product, a CD-ROM, became obvious. This finding can be interpreted in relation to the developmental phase of the production and the transformation of the field as a whole. Based on the analysis of the developmental phases and the disturbances, I formulate a hypothesis of the contradictions and developmental potentials of the activity studied. The conclusions of the study challenge the existing understanding of how to conceptualize and study organizational learning in production work. Most theories of organizational learning do not address qualitative changes in production nor historical challenges of organizational learning itself. My study opens up a new horizon in understanding organizational learning in a rapidly changing field where a learning culture based on craft or mass production work is insufficient. There is a need for anticipatory and proactive organizational learning. Proactive learning is needed to anticipate the changes in production type, and the life cycles of products.

Kouluruokailuhenkilöstö matkalla kasvattajaksi

The National Board of Education in Finland has defined school catering as a part of education in comprehensive schools. School catering is defined in Finnish law and is financed by the municipalities. The emphasis on supplementary education in the school curriculum obliges the whole staff to learn new professional roles and to co-operate in the school com-munity. An in-service training programme, Smart Catering Staff (SCS) was designed and put into practice among school catering staff. The aim of the one-year SCS programme was to add to and encourage the development of the know-how of catering personnel regarding new challenges in the school community as well as to enhance and empower their educator’s role in the school. The content of the programme consisted of four two-day intensive teaching sessions as well as assignments which were carried out between theese sessions. The main contents of the SCS programme were personal and organizational learning, school curriculum concerning school catering, school culture and co-operation, customer service, and the role of catering staff as educators. The data in this action research was gathered from 2000 to 2008. The results show that the SCS programme can change the work community culture in that the catering staff is more encouraged to participate in the development projects of the school, and can see themselves more as educators alongside the teaching staff. It is concluded that in school communities all adults can be educators, but to achieve this aim empowering in-service training is needed. The school catering staff’s commitment to participation in the education align with the educational goals of the school unite children’s and teens safety nets. This can affect for example the growth of communal responsibility and prevention of alienation. Key words: School Catering, Smart School Catering Staff, Expanded Education, School Community, Action Research

Social Media as a Form of Organizational Knowledge Sharing

This study investigates the role of social media as a form of organizational knowledge sharing. Social media is investigated in terms of the Web 2.0 technologies that organizations provide their employees as tools of internal communication. This study is anchored in the theoretical understanding of social media as technologies which enable both knowledge collection and knowledge donation. This study investigates the factors influencing employees’ use of social media in their working environment. The study presents the multidisciplinary research tradition concerning knowledge sharing. Social media is analyzed especially in relation to internal communication and knowledge sharing. Based on previous studies, it is assumed that personal, organizational, and technological factors influence employees’ use of social media in their working environment. The research represents a case study focusing on the employees of the Finnish company Wärtsilä. Wärtsilä represents an eligible case organization for this study given that it puts in use several Web 2.0 tools in its intranet. The research is based on quantitative methods. In total 343 answers were obtained with the aid of an online survey which was available in Wärtsilä’s intranet. The associations between the variables are analyzed with the aid of correlations. Finally, with the aid of multiple linear regression analysis the causality between the assumed factors and the use of social media is tested. The analysis demonstrates that personal, organizational and technological factors influence the respondents’ use of social media. As strong predictive variables emerge the benefits that respondents expect to receive from using social media and respondents’ experience in using Web 2.0 in their private lives. Also organizational factors such as managers’ and colleagues’ activeness and organizational guidelines for using social media form a causal relationship with the use of social media. In addition, respondents’ understanding of their responsibilities affects their use of social media. The more social media is considered as a part of individual responsibilities, the more frequently social media is used. Finally, technological factors must be recognized. The more user-friendly social media tools are considered and the better technical skills respondents have, the more frequently social media is used in the working environment. The central references in relation to knowledge sharing include Chun Wei Choo’s (2006) work Knowing Organization, Ikujiro Nonaka and Hirotaka Takeuchi’s (1995) work The Knowledge Creating Company and Linda Argote’s (1999) work Organizational Learning.

Työntekijän näkökulmat ja oppiminen ulkoistusprojektissa : "Aluks pelkää muutosta ja sit pelkää, ettei mikään muutukaan."

The aim of this master s thesis was to clarify employees views on outsourcing. The main questions of the study were 1) How the employees dealt with the change created by outsourcing and what things they felt important when implementing the change? 2) What kind of organizational questions the employees paid attention to when moving from one organization to another? 3) What kind of management issues the employees brought up in the outsourcing process? and 4) How the employees reflected change while experienced outsourcing? The theoretical foundations of the study were Jack Mezirow s theory of transformational learning and Yrjö Engeström s theory of expansive learning. The management of outsourcing was viewed by John P. Kotter s change management model. Research casted light on transformation and learning on four levels of analysis: on individual, organizational and management levels and on the level of reflection. The target of the study were the outsourced employees, who were moved from a Finnish public corporation to a private ITC organization along with the services they produce. The study material was eleven interviews from the outsourced employees. The study was implemented by fenomenographical theme analysis. The analysis revealed results in all four levels. On the individual level the main results were the importance of systematic and open information, meaning of social and technical integration and the feeling of employee s own control. On the organizational level the move from the public sector to private and all the changes in organizational culture and in fringe benefitswere fundamental. Organizational learning was analyzed with expansive learning theory. Expanding was perceived in four dimensions: temporal dimension, spatial dimension, responsibility-moral dimension and developmental dimension. On the management level the actions of one s closest manager was vital, as was the upper management s clear engagement and a shared view of the necessity of a change. In the data was found employees reflective talking, which was indicating the meaning of the change and which was interpreted from the learning point of view. According to this study, it is possible to identify and analyze reflective talk and that way have information about employees learning in an organizational change. It was prominent to notice how reflection in the process of outsourcing is extremely versatile and extensive.

Yhteisöllisyys voimavarana yliopisto-opetuksen ja -opiskelun kehittämisessä

A sense of community as a resource for developing university teaching and learning The aim of this doctoral research was to determine how a sense of community can be a resource for developing university teaching and learning. The theoretical background is linked to social sciences, social psychology, university pedagogy and educational sciences. The thesis is comprised of two separate studies. Study I consisted of an action research project in which a model of cooperatively developing a teaching and learning culture was created and tested. The focus of study I was the university pedagogy programme of the Faculty of Agriculture and Forestry. The results demonstrated that the theoretical framework and the methods of cooperative learning provide useful tools for developing an academic learning and teaching culture. The approach helps to create a benevolent learning atmosphere. The cooperative learning culture used in the action research project reflected the traditional academic learning culture and also caused a collision between the two cultures. The aim of study II was to determine how Open University students and Bachelor’s degree students experience their teaching-learning environment and the importance of the learning community and peer support to their studies. The results indicated that, with the exception of support from other students, the Open University students experienced their teaching-learning environments on average more positively than the Bachelor’s degree students. According to the Open University students, their own motivation and interest was the most important factor that enhanced studying. Furthermore, the most common factors delaying their studies were their life situation and a lack of time. The sense of community and social relations mainly promoted studying. Open University students experienced that they were supported by their teachers, tutors, other students, the working community, family and hobbies. The research demonstrated that the methods that make good use of communal resources are negotiation of shared goals and rules, working in various small groups, emphasis on shared and individual responsibilities and assessment of the product and the process of learning. The resources of the academic community can be developed if the members of the community develop, in addition to the communal working methods, their communal sensitivity. In other words, they should have an understanding of social psychological and sociological concepts that they can use for observing communal phenomena.

Owner-driven decision support in holding-specific forest planning

Socio-economic and demographic changes among family forest owners and demands for versatile forestry decision aid motivated this study, which sought grounds for owner-driven forest planning. Finnish family forest owners’ forest-related decision making was analyzed in two interview-based qualitative studies, the main findings of which were surveyed quantitatively. Thereafter, a scheme for adaptively mixing methods in individually tailored decision support processes was constructed. The first study assessed owners’ decision-making strategies by examining varying levels of the sharing of decision-making power and the desire to learn. Five decision-making modes – trusting, learning, managing, pondering, and decisive – were discerned and discussed against conformable decision-aid approaches. The second study conceptualized smooth communication and assessed emotional, practical, and institutional boosters of and barriers to such smoothness in communicative decision support. The results emphasize the roles of trust, comprehension, and contextual services in owners’ communicative decision making. In the third study, a questionnaire tool to measure owners’ attitudes towards communicative planning was constructed by using trusting, learning, and decisive dimensions. Through a multivariate analysis of survey data, three owner groups were identified as fusions of the original decision-making modes: trusting learners (53%), decisive learners (27%), and decisive managers (20%). Differently weighted communicative services are recommended for these compound wishes. The findings of the studies above were synthesized in a form of adaptive decision analysis (ADA), which allows and encourages the decision-maker (owner) to make deliberate choices concerning the phases of a decision aid (planning) process. The ADA model relies on adaptability and feedback management, which foster smooth communication with the owner and (inter-)organizational learning of the planning institution(s). The summarized results indicate that recognizing the communication-related amenity values of family forest owners may be crucial in developing planning and extension services. It is therefore recommended that owners, root-level planners, consultation professionals, and pragmatic researchers collaboratively continue to seek stable change.

Hur höra tyst kunskap? Utveckling av en metod för studier av tyst kunnande

Det tysta kunnandet utgör en stor del av kunskapsresursen både hos oss som individer och i arbetsorganisationerna. Trots att vi omger oss med böcker, manualer och databaser, som alla är exempel på explicit kunskap, så är det ”den rätta känslan”, erfarenheten och våra färdigheter som avgör om och hur vi klarar av våra uppgifter. Dessa begrepp är alla relaterade till den tysta dimensionen av kunskap. En dimension som traditionellt karaktäriserats som abstrakt, individuell, omedveten, praktisk, erfarenhetsbaserad och framför allt svår att uttrycka. Alla dessa är karaktärsdrag som ställt speciella krav inom kunskapsforskning och -ledning. Resultatet av detta är att både forskning och ledning av det tysta kunnandet har åsidosatts till förmån för forskning och ledning av explicit kunskap. Ett bidragande problem har varit bristen på lämpliga metoder för att ur ett företagsekonomiskt perspektiv studera och leda tyst kunnande. Ett annat problem har varit oklarhet i begreppet tyst kunskap. Detta har lett till brist på förståelse och/eller missförstånd. För att råda bot på svårigheten att uttrycka vårt tysta kunnande har människan utvecklat olika begrepp som i vår vardagskommunikation symboliserar tyst kunnande. Begrepp som intuition, människokännedom, förhandlingsförmåga och kultur används vanligt och med dem uttrycker vi den tysta dimensionen av kunnande. Dessa begrepp utgör även grunden för den intervjumetod som utvecklats för att empiriskt studera eller i ledningssyfte kartlägga tyst kunnande. Metoden använder dessa ”Epitet för Tyst Kunskap” (ETK) som bas för stimuluskort-intervjuer. Intervjuer som visat sig öka möjligheten att utforska och kartlägga tyst kunnande i organisationer oberoende av om man är forskare eller företagsledare.

Unraveling the helix of change : An activity-theoretical study of health care change efforts and their consequences

M.A. (Educ.) Anu Kajamaa from the University of Helsinki, Center for Research on Activity, Development and Learning (CRADLE), examines change efforts and their consequences in health care in the public sector. The aim of her academic dissertation is, by providing a new conceptual framework, to widen our understanding of organizational change efforts and their consequences and managerial challenges. Despite the multiple change efforts, the results of health care development projects have not been very promising, and many developmental needs and managerial challenges exist. The study challenges the predominant, well-framed health care change paradigm and calls for an expanded view to explore the underlying issues and multiplicities of change efforts and their consequences. The study asks what kind of expanded conceptual framework is needed to better understand organizational change as transcending currently dominant oppositions in management thinking, specifically in the field of health care. The study includes five explorative case studies of health care change efforts and their consequences in Finland. Theory and practice are tightly interconnected in the study. The methodology of the study integrates the ethnography of organizational change, a narrative approach and cultural-historical activity theory. From the stance of activity theory, historicity, contradictions, locality and employee participation play significant roles in developing health care. The empirical data of the study has mainly been collected in two projects, funded by the Finnish Work Environment Fund. The data was collected in public sector health care organizations during the years 2004-2010. By exploring the oppositions between distinct views on organizational change and the multi-site, multi-level and multi-logic of organizational change, the study develops an expanded, multidimensional activity-theoretical framework on organizational change and management thinking. The findings of the study contribute to activity theory and organization studies, and provide information for health care management and practitioners. The study illuminates that continuous development efforts bridged to one another and anchored to collectively created new activity models can lead to significant improvements and organizational learning in health care. The study presents such expansive learning processes. The ways of conducting change efforts in organizations play a critical role in the creation of collective new practices and tools and in establishing ownership over them. Some of the studied change efforts were discontinuous or encapsulated, not benefiting the larger whole. The study shows that the stagnation and unexpected consequences of change efforts relate to the unconnectedness of the different organizational sites, levels and logics. If not dealt with, the unintended consequences such as obstacles, breaks and conflicts may stem promising change and learning processes.

Intercultural Learning and Hybridity in the Culture Laboratory

The number of immigrant students in vocational education and training is steadily increasing in Finland. This poses challenges for teachers and schools. This research focuses on emerging questions of intercultural learning in the context of immigrant training, and on a method the Culture Laboratory that was developed in an attempt to respond to the challenges. The main methodological and theoretical framework lies in cultural-historical activity theory, developmental work research, and in the concepts of the intercultural and hybridity. The empirical material consists of videotaped recordings of discussions in the Culture Laboratory. The five main research questions focused on the strengths and limitations of the Culture Laboratory as a tool for intercultural learning, the significance of disturbances in it, the potential of suggestions for intercultural learning, paper as a mediating artifact , and the concept of intercultural space. The findings showed that the Culture Laboratory offered a solid background for developing intercultural learning. The disturbances manifested revealed a multitude of scripts and activities. It was also suggested that the structure of expansive learning could start from externalization instead of internalization. The suggestions the participants made opened up a hybrid learning space for intercultural development, and offered a good springboard for new ideas. Learning in Paperland posed both challenges and opportunities for immigrant students, and different paper trails emerged. Intercultural space in the Culture Laboratory was a developmental zone in which a hybrid process of observing, comparing, and creating took place. Key words: intercultural learning, immigrant training, cultural-historical activity theory, developmental work research,

Assessing organizational culture in complex sociotechnical systems : Methodological evidence from studies in nuclear power plant maintenance organizations

Failures in industrial organizations dealing with hazardous technologies can have widespread consequences for the safety of the workers and the general population. Psychology can have a major role in contributing to the safe and reliable operation of these technologies. Most current models of safety management in complex sociotechnical systems such as nuclear power plant maintenance are either non-contextual or based on an overly-rational image of an organization. Thus, they fail to grasp either the actual requirements of the work or the socially-constructed nature of the work in question. The general aim of the present study is to develop and test a methodology for contextual assessment of organizational culture in complex sociotechnical systems. This is done by demonstrating the findings that the application of the emerging methodology produces in the domain of maintenance of a nuclear power plant (NPP). The concepts of organizational culture and organizational core task (OCT) are operationalized and tested in the case studies. We argue that when the complexity of the work, technology and social environment is increased, the significance of the most implicit features of organizational culture as a means of coordinating the work and achieving safety and effectiveness of the activities also increases. For this reason a cultural perspective could provide additional insight into the problem of safety management. The present study aims to determine; (1) the elements of the organizational culture in complex sociotechnical systems; (2) the demands the maintenance task sets for the organizational culture; (3) how the current organizational culture at the case organizations supports the perception and fulfilment of the demands of the maintenance work; (4) the similarities and differences between the maintenance cultures at the case organizations, and (5) the necessary assessment of the organizational culture in complex sociotechnical systems. Three in-depth case studies were carried out at the maintenance units of three Nordic NPPs. The case studies employed an iterative and multimethod research strategy. The following methods were used: interviews, CULTURE-survey, seminars, document analysis and group work. Both cultural analysis and task modelling were carried out. The results indicate that organizational culture in complex sociotechnical systems can be characterised according to three qualitatively different elements: structure, internal integration and conceptions. All three of these elements of culture as well as their interrelations have to be considered in organizational assessments or important aspects of the organizational dynamics will be overlooked. On the basis of OCT modelling, the maintenance core task was defined as balancing between three critical demands: anticipating the condition of the plant and conducting preventive maintenance accordingly, reacting to unexpected technical faults and monitoring and reflecting on the effects of maintenance actions and the condition of the plant. The results indicate that safety was highly valued at all three plants, and in that sense they all had strong safety cultures. In other respects the cultural features were quite different, and thus the culturally-accepted means of maintaining high safety also differed. The handicraft nature of maintenance work was emphasised as a source of identity at the NPPs. Overall, the importance of safety was taken for granted, but the cultural norms concerning the appropriate means to guarantee it were little reflected. A sense of control, personal responsibility and organizational changes emerged as challenging issues at all the plants. The study shows that in complex sociotechnical systems it is both necessary and possible to analyse the safety and effectiveness of the organizational culture. Safety in complex sociotechnical systems cannot be understood or managed without understanding the demands of the organizational core task and managing the dynamics between the three elements of the organizational culture.

Learning from Venice : What a unique city can teach about the aesthetic

Learning from Venice is a philosophical learning diary on what a highly original city can teach urban aesthetics. Throughout history, classical cities have been interpreted and experienced in various ways. But aesthetics has never been accentuated as much as today. Venice has been an important center of commerce, a naval power, and it has had a lot of influence in arts and culture. But in our days it is a tourist trap and a cluster of so called world heritage. The development of tourism is the main reason for the fact that many old cities have become venues for leisure and entertainment, sometimes so that everyday life itself has been pushed to the margins. There is a lot one can learn by studying the history of the aesthetic appreciation of a city. Sometimes the way a city has been enjoyed has changed following the development of traffic. In Venice water buses have replaced the slow and silent gondolas, and since the building of the railway tourists have been approaching the city from a new direction, so that her façade which was built for seafarers has almost become forgotten. There are also themes of change and mobility which are peculiarly Venetian. What is the nature of a city where there are more tourists than inhabitants? And how does one experience a city where water dominates? These questions, and many more, are discussed in Learning from Venice, and side by side with applied aesthetics, the work of philosophers like Walter Benjamin, Gianni Vattimo, and John Dewey, among many others, enter a dialogue with this extraordinary city. Themes discussed include also e.g. walking, surface and depth, Venice as kitsch, and Venice as a museum.

The Networks of Learning in Technological Innovation : The Emergence of Collaboration Across Fields of Expertise

This study addresses four issues concerning technological product innovations. First, the nature of the very early phases or "embryonic stages" of technological innovation is addressed. Second, this study analyzes why and by what means people initiate innovation processes outside the technological community and the field of expertise of the established industry. In other words, this study addresses the initiation of innovation that occurs without the expertise of established organizations, such as technology firms, professional societies and research institutes operating in the technological field under consideration. Third, the significance of interorganizational learning processes for technological innovation is dealt with. Fourth, this consideration is supplemented by considering how network collaboration and learning change when formalized product development work and the commercialization of innovation advance. These issues are addressed through the empirical analysis of the following three product innovations: Benecol margarine, the Nordic Mobile Telephone system (NMT) and the ProWellness Diabetes Management System (PDMS). This study utilizes the theoretical insights of cultural-historical activity theory on the development of human activities and learning. Activity-theoretical conceptualizations are used in the critical assessment and advancement of the concept of networks of learning. This concept was originally proposed by the research group of organizational scientist Walter Powell. A network of learning refers to the interorganizational collaboration that pools resources, ideas and know-how without market-based or hierarchical relations. The concept of an activity system is used in defining the nodes of the networks of learning. Network collaboration and learning are analyzed with regard to the shared object of development work. According to this study, enduring dilemmas and tensions in activity explain the participants' motives for carrying out actions that lead to novel product concepts in the early phases of technological innovation. These actions comprise the initiation of development work outside the relevant fields of expertise and collaboration and learning across fields of expertise in the absence of market-based or hierarchical relations. These networks of learning are fragile and impermanent. This study suggests that the significance of networks of learning across fields of expertise becomes more and more crucial for innovation activities.

Exploring the experiences and conceptions of good teaching in higher education : Development of a questionnaire for assessing students' approaches to learning and experiences of the teaching-learning environment

The aim of this dissertation was to adapt a questionnaire for assessing students’ approaches to learning and their experiences of the teaching-learning environment. The aim was to explore the validity of the modified Experiences of Teaching and Learning Questionnaire (ETLQ) by examining how the instruments measure the underlying dimensions of student experiences and their learning. The focus was on the relation between students’ experiences of their teaching-learning environment and their approaches to learning. Moreover, the relation between students’ experiences and students’ and teachers’ conceptions of good teaching was examined. In Study I the focus was on the use of the ETLQ in two different contexts: Finnish and British. The study aimed to explore the similarities and differences between the factor structures that emerged from both data sets. The results showed that the factor structures concerning students’ experiences of their teaching-learning environment and their approaches to learning were highly similar in the two contexts. Study I also examined how students’ experiences of the teaching-learning environment are related to their approaches to learning in the two contexts. The results showed that students’ positive experiences of their teaching-learning environment were positively related to their deep approach to learning and negatively to the surface approach to learning in both the Finnish and British data sets. This result was replicated in Study II, which examined the relation between approaches to learning and experiences of the teaching-learning environment on a group level. Furthermore, Study II aimed to explore students’ approaches to learning and their experiences of the teaching-learning environment in different disciplines. The results showed that the deep approach to learning was more common in the soft sciences than in the hard sciences. In Study III, students’ conceptions of good teaching were explored by using qualitative methods, more precisely, by open-ended questions. The aim was to examine students’ conceptions, disciplinary differences and their relation to students’ approaches to learning. The focus was on three disciplines, which differed in terms of students’ experiences of their teaching-learning environment. The results showed that students’ conceptions of good teaching were in line with the theory of good teaching and there were disciplinary differences in their conceptions. Study IV examined university teachers’ conceptions of good teaching, which corresponded to the learning-focused approach to teaching. Furthermore, another aim in this doctoral dissertation was to compare the students’ and teachers’ conceptions of good teaching, the results of which showed that these conceptions appear to have similarities. The four studies indicated that the ETLQ appears to be a sufficiently robust measurement instrument in different contexts. Moreover, its strength is its ability to be at the same time a valid research instrument and a practical tool for enhancing the quality of students’ learning. In addition, the four studies emphasise that in order to enhance teaching and learning in higher education, various perspectives have to be taken into account. This study sheds light on the interaction between students’ approaches to learning, their conceptions of good teaching, their experiences of the teaching-learning environment, and finally, the disciplinary culture.

Boundaries in Action : An Activity-theoretical Study of Development, Learning, and Change in Health Care Organization for Patients with Multiple and Chronic Illnesses

This study examines boundaries in health care organizations. Boundaries are sometimes considered things to be avoided in everyday living. This study suggests that boundaries can be important temporally and spatially emerging locations of development, learning, and change in inter-organizational activity. Boundaries can act as mediators of cultural and social formations and practices. The data of the study was gathered in an intervention project during the years 2000-2002 in Helsinki in which the care of 26 patients with multiple and chronic illnesses was improved. The project used the Change Laboratory method that represents a research assisted method for developing work. The research questions of the study are: (1) What are the boundary dynamics of development, learning, and change in health care for patients with multiple and chronic illnesses? (2) How do individual patients experience boundaries in their health care? (3) How are the boundaries of health care constructed and reconstructed in social interaction? (4) What are the dynamics of boundary crossing in the experimentation with the new tools and new practice? The methodology of the study, the ethnography of the multi-organizational field of activity, draws on cultural-historical activity theory and anthropological methods. The ethnographic fieldwork involves multiple research techniques and a collaborative strategy for raising research data. The data of this study consists of observations, interviews, transcribed intervention sessions, and patients' health documents. According to the findings, the care of patients with multiple and chronic illnesses emerges as fragmented by divisions of a patient and professionals, specialties of medicine and levels of health care organization. These boundaries have a historical origin in the Finnish health care system. As an implication of these boundaries, patients frequently experience uncertainty and neglect in their care. However, the boundaries of a single patient were transformed in the Change Laboratory discussions among patients, professionals and researchers. In these discussions, the questioning of the prevailing boundaries was triggered by the observation of gaps in inter-organizational care. Transformation of the prevailing boundaries was achieved in implementation of the collaborative care agreement tool and the practice of negotiated care. However, the new tool and practice did not expand into general use during the project. The study identifies two complementary models for the development of health care organization in Finland. The 'care package model', which is based on productivity and process models adopted from engineering and the 'model of negotiated care', which is based on co-configuration and the public good.

Kantoaalto koulutuksesta työyhteisön viestintäosaamiseen : lyhytkestoisen viestintäkoulutuksen vaikuttavuuden avaintekijät

The purpose of this research is to examine whether short-term communication training can have an impact on the improvement of communication capacity of working communities, and what are prerequisites for the creation of such capacity. Subjects of this research were short-term communication trainings aimed at the managerial and expert levels of enterprises and communities. The research endeavors to find out how communication trainings with an impact should be devised and implemented, and what this requires from the client and provider of the training service. The research data is mostly comprised of quantitative feed-back collected at the end of a training day, as well as delayed interviews. The evaluations have been based on a stakeholder approach, and those concerned were participants to the trainings, clients having commissioned the trainings and communication trainers. The principal method of the qualitative analysis is that of a data-driven content analysis. Two research instruments have been constructed for the analysis and for the presentation of the results: an evaluation circle for the purposes of a holistic evaluation and a development matrix for the structuring of an effective training. The core concept of the matrix is a carrier wave effect, which is needed to carry the abstractions from the training into concrete functions in the everyday life. The relevance of the results has been tested in a pilot organization. The immediate assessment and delayed evaluations gave a very differing picture of the trainings. The immediate feedback was of nearly commendable level, but the effects carried forward into the everyday situations of the working community were small and that the learning rarely was applied into practice. A training session that receives good feedback does not automatically result in the development of individual competence, let alone that of the community. The results show that even short-term communication training can promote communication competence that eventually changes the working culture on an organizational level, provided that the training is designed into a process and that the connections into the participants’ work are ensured. It is essential that all eight elements of the carrier wave effect are taken into account. The entire purchaser-provider -process must function while not omitting the contribution of the participants themselves. The research illustrates the so called bow tie -model of an effective communication training based on the carrier wave effect. Testing the results in pilot trainings showed that a rather small change in the training approach may have a signi¬ficant effect on the outcome of the training as well as those effects that are carried on into the working community. The evaluation circle proved to be a useful tool, which can be used while planning, executing and evaluating training in practice. The development matrix works as a tool for those producing the training service, those using the service as well as those deciding on the purchase of the service in planning and evaluating training that sustainably improves communication capacity. Thus the evaluation circle also works to support and ensure the long-term effects of short-term trainings. In addition to communication trainings, the tools developed for this research are useable for many such needs, where an organization is looking to improve its operations and profitability through training.