A profession refers to a vocation or an occupation that requires training and advanced study in a specialized field. In other words, an individual who has a guaranteed competence in a specific field or occupation is called a professional. Amitai Etzioni termed medicine and law as the traditional professions (Kovner, 2008, p.438). He also recognized engineering and nursing as professions, though he made distinctions relating to the length of professional training. Thus, he suggested that professions regarded as lesser needed less than five years of training. This paper applies the sociological theory of professions to examine the extent to which health care organizations have characteristics needed to support organizational learning. It focuses on the aspects of the theory that are significant for organizational learning in health care organizations.
Theories on Professions
The earliest attempt by Abraham Flexner to explain a profession led to many later works. As a basis for a profession, Flexner argued for six criteria, such as; an intellectual orientation, self-regulation and organization, use of institutionalized knowledge and techniques, teachable techniques, practical application of this knowledge and techniques, and service orientation (Kovner, 2008, p.438). Flexner did not consider social work as a profession since it did not meet any of these criteria.
There are other perspectives in the sociology of professions. These theories are instructive for the insight they offer us in understanding the structure of the professions. Professions are emphasized as a microcosm of the larger social system in the works of William Goode (Goode, 1957, p.194). A profession is viewed by this theory as a sub-society with many of the same features as the larger one. However, it also views it as maintaining a special relationship with the larger society since it has a considerable level of control over clients due to their helpless position (Goode, 1957, p.195). This special relationship to the larger society results in strong socializing experiences for those joining the profession. Those who turn to be professionals learn to abide by the strict code of regulations and become members of the local and national professional associations.
One of the special features of professional roles is based on somebody of codified knowledge. All professional roles are viewed as institutionalized influence roles. In the health care profession, there is a strong dependence on the specialist expertise (knowledge) of the individual profession. Therefore, the institutionalized influence role enables members of the profession to have knowledge and expertise about the necessary sanctions over their clients. Thus, the act of offering a client advice based upon specialized medical knowledge makes up the main activity of the members of the profession (Rue, 1961, p.325).
Health care occupations are characterized by consensus, cooperation and interdependency as a function of complementary professional roles. It is characterized by an increasingly fragmented specialized professional labor division. Each profession has a distinct role and socialized membership with an institutionalized set of hierarchical relations between them (Armor, 1969, p.324).
The Concept of Organizational Learning
Organizational learning refers to the procedure of finding and rectifying errors that occur. In this context, errors are features of knowledge that curtail learning. When the procedure allows the organization to execute its present policies or attain its intended objectives, the process may be referred to as single-loop learning.
Learning processes in organizations take place at three levels; individual level, team or group level, and organizational level. Learning at the individual level enables each health care professional to acquire a certain amount of knowledge through education and experience maintaining that professional knowledge up to date and expanding upon it. At the individual level, learning manifests itself in terms of improved professional work techniques and improved treatment results.
Learning also takes place at team or group levels. At this level, a group or a team of health care workers who work together in a care process develop collective knowledge, skills and competencies. Learning involves collective knowledge and skills acquired in the process of collaboration of the group or team members and the mutually reinforcing competencies. At the team level, learning manifests itself in the improvement of results in a particular process under the team’s responsibility (Kovner, 2008, p.448).
Lastly, learning takes place at the organizational level. Organizational learning is centered upon the knowledge acquired and developed in order to be able to collectively implement the mission of the organization. Learning is directed at the achievement of organizational goals. Organizational learning includes improving the quality of an organization’s overall functioning and developing new services and products. Learning in organizations is manifested in the improvement of the performance of the organization as a whole. Kovner (2008) contends that “organizational learning relates to the experience based on the improvement of the implementation of organizational goal” (p. 438).
In its simple form, organizational learning occurs when an error is detected and consequently rectified. This process is referred to as single-loop learning. Single loop learning does not change the organization or the principle of the health care process. In single-loop learning, an assessment is made whether the health care process met the applicable standard; if it did not, adjustments are made. Many projects of quality improvement nature can be referred to as single-loop learning.
Double-loop learning entails changing the underlying principles. Double-loop learning is about why health care is delivered in a certain way, why health care professionals collaborate in a particular manner, and to achieve more fundamental and sweeping changes. Learning managers in health care are able to discover and rectify the errors by identifying their own double loop hidden theories of action. Difficulties and the inability to discover faults or errors in health care arise because of poor organizational learning. Undesirable habits and attitudes that make organizations conceal their problems, result in rigidity and deterioration. This can be reversed by double lop learning (Kovner, 2008, p.438).
The theories of professions offer health care organizations a chance to improve the safety of their clients and the quality of care by making use of the knowledge of their workers by examining data on errors. The double-loop learning perspective enables health care services to be delivered in a prescribed way to avoid errors. In other occupations, organizational development and learning strategies have enhanced the focus on ways to effectively and efficiently extract and share what is to be learned about quality and safety. Based on single-loop learning, health care organizations support organizational learning, for instance, through identifying and rectifying events that are undesirable before they cause harm. Such a recovery may happen due to a specific safety investigation or by careful observation. Thus, health care organizations can make assessments to find out if the laid down standards are adhered to (Kovner, 2008, p.438).
In sum, progressive health care organizations must have characteristics required to support organizational learning. They can be characterized based on dimensions such as structure, capacity to absorb new knowledge, and receptive context for change at different levels. At the individual level, a health care professional gathers a specific amount of knowledge through education and experience. At the team level, health care workers are able to collaborate in a care process where they acquire collective knowledge, skills and competencies. Lastly, at the organizational level, organizational learning relates to creating knowledge about learning processes at the organizational levels.
Armor, D., 1969. The American School Counselor. New York: Russel Sage Foundation.
Goode, W., 1957. Community within A community: The Professions, American sociological Review, 22, pp.194-200.
Kovner, J, Knickman, J, & jonas, S., 2008. Jonas and Kovner’s Health Care Delivery in the US by Kovner Authority. New York: Springer Publishing Company.
Rue, Bucher., & Anselm, S., 1961. Professions in the Process. The American Journal of Sociology, 66, pp. 325-334.