Breadth Of Use Research Articles

Learning How and Learning What: Effects of Tacit and Codified Knowledge on Performance Improvement Following Technology Adoption

ABSTRACTThis paper examines effects of tacit and codified knowledge on performance improvement as organizations gain experience with a new technology. We draw from knowledge management and learning curve research to predict improvement rate heterogeneity across organizations. We first note that the same technology can present opportunities for improvement along more than one dimension, such as efficiency and breadth of use. We compare improvement for two dimensions: one in which the acquisition of codified knowledge leads to improvement and another in which improvement requires tacit knowledge. We hypothesize that improvement rates across organizations will be more heterogeneous for dimensions of performance that rely on tacit knowledge than for those that rely on codified knowledge (H1), and that group membership stability predicts improvement rates for dimensions relying on tacit knowledge (H2). We further hypothesize that when performance relies on codified knowledge, later adopters should improve more quickly than earlier adopters (H3). All three hypotheses are supported in a study of 15 hospitals learning to use a new surgical technology. Implications for theory and practice are discussed.

Facilitating mobility for psychologists: Comparisons with and lessons from other health care professions.

Psychology and other health care professions are giving increasing attention to facilitating the movement of practitioners across jurisdictions. One of the greatest deterrents to mobility is the variability in licensing requirements among states and provinces. We review the status of mobility systems for licensed members of the professions of psychology, optometry, dentistry, medicine, nursing, and pharmacy. Each profession has, at a minimum, addressed the issue of mobility and licensure. With the exception of medicine, each profession currently has in place a version of licensure by endorsement and/or by reciprocity, although the professions differ in breadth of use and user-friendliness. Implications for enhancing mobility for psychologists are discussed. Many psychologists and other health care professionals today are able to practice in venues that were once difficult to access. With the increasing use of technology, a growing number of health professionals are able to easily cross geographical borders. This may be done through implementation of telehealth practices such as triaging by telephone with a patient in another state, videoconferencing with patients in other states, and online Internet-based services (Wakefield, 1999). Health care professionals may also work for integrated delivery systems that operate in different states (Ventura, 1999). Geographically relocating between jurisdictions during a professional’s career is not unusual. Peterson and Weiher reported in 1993 that in Nevada alone, 86% of the state’s psychologists were originally from other states. Although it makes sense to facilitate the mobility process for psychologists and other health care professionals, issues of quality of care, competency of practitioners, and standards of practice are of great concern for state regulatory boards that are ultimately responsible for licensing these individuals and protecting the welfare of consumers. Before implementing a system that facilitates the mobility process, licensing boards may consider several factors. Among the most important issues is the matter of requirements for initial licensure. That is, a jurisdiction may not be willing to accept a professional’s application for licensure based solely on the fact that the person already holds a license from another state. For example, the type of educational degree, accreditation status of the educational institution, type and amount of supervised experience, passing scores on national examinations, additional state or regional competency examinations, jurisprudence and ethic exams, years of experience, and disciplinary actions are all additional factors that may be considered. Not surprisingly, the process of implementing a system for easing mobility of health care professionals is often slow and arduous. Psychology has begun to implement systems that facilitate mobility. In February of 2001, the Committee for the Advancement of Professional Practice (CAPP) was given formal approval by the American Psychological Association (APA) Council of Representatives to continue with plans for the development of professional mobility mechanisms (Levant, 2001). Before this, CAPP was engaged in delivering various programs, discussions, and conferences to create an environment in which existing mobility mechanisms could be further enhanced. At this time, CAPP’s plans included informing members about the various mobility mechanisms that were already in existence; differentiating between endorsement and reciprocity processes, with endorsement being the more widely accepted mobility mechanism; and noting that individual state and provincial boards were responsible for making decisions about licensure and mobility. To understand how useful, effective, or cumbersome mobility systems will be, it is helpful to see what other health care professions are doing similarly or differently to address the issue. In this article, we review the factors that may ease or impede mobility of health care professionals within the United States and illustrate the systems that have been designed to address the mobility issue within the fields of psychology, optometry, dentistry, medicine, nursing, and pharmacy. Although our focus in this article is on mobility and licensure issues that are present in the United States, the issues are also applicable to professionals in Canada, and in some professions a common organization or advisory group applies to jurisdictions in both the United States and Canada. We note in our discussion when policies apply to both states and provinces. Canadian prov

Determinants of the degree of complementary and alternative medicine use among patients with cancer.

This study explored the use of complementary and alternative medicine (CAM) by degree of use (nonuse, light, moderate, and heavy) by patients with cancer as it relates to sociodemographic and disease characteristics, subjective well-being, and dissatisfaction with the health care system. One hundred and forty-three (143) patients with cancer of Asian, Caucasian, and Pacific Islander ethnicities originally recruited through the state-wide population-based Hawaii Tumor Registry and interviewed approximately 3 years postdiagnosis. This study introduced a multidimensional measure, degree of CAM use, to rank participants by quantity of CAMs used as well as frequency, intensity, and breadth of use. Predictor variables explored were sociodemographic variables, disease site, quality-of-life measures, satisfaction with conventional treatment and physicians, satisfaction with medical information, and perceived severity of illness. Heavier CAM use was related to being female, Caucasian, having more education, having breast cancer, and having greater symptoms of nausea and vomiting. Heavier use was also associated with lower doctor satisfaction and a greater perception of disease severity. Sociodemographic and clinical variables accounted for the largest proportion of the variance in degree of use, but subjective well-being and health care satisfaction provided incremental increases in the variance explained. This study is one of few studies exploring predictors for the quantity or degree of use of CAM by patients with cancer. Understanding factors related to these patients' heavier or lighter CAM use has implications for health care offerings and cancer treatment decision-making.

DIFFERENT PATTERNS OF PERFORMANCE IMPROVEMENT FOR TACIT AND EXPLICIT KNOWLEDGE: AN EMPIRICAL TEST.

This paper explores the roles of explicit and tacit knowledge in performance improvement as experience is gained with a new technology. We propose that the same technology can present simultaneous opportunities for improvement along distinct performance dimensions, such as efficiency and breadth of use. Drawing from research on new technology implementation and knowledge management, we develop a framework relating type of knowledge (tacit or explicit) to type of user of a new technology (individual or group) to suggest implications for performance improvement curves. We then develop propositions to describe patterns of performance improvement obtained using a new technology as a function of the type of knowledge involved in a particular dimension of performance. To explore these theoretical propositions, we analyze data from 311 surgical procedures at 15 hospitals learning to use a new cardiac surgery technology. We find that organizational experience determines efficiency improvement, which relies on tacit knowledge, while industry experience shapes patterns of improvement in breadth of use, which relies on explicit knowledge.

Drivers for software development method usage

In this research, the authors examine factors affecting the use of product development methods. Based on established behavioral theories, they develop and test a model that can explain, and hence predict, the extent of use of development methods. Although their model can be adapted to any development process, they apply it to software development. To test their model, they examine the combined effects of a number of important usage factors that contribute to the depth and breadth of use of two software development approaches: the waterfall model and prototyping. Two main constructs, process quality and facilitating conditions, are found to be the drivers of method usage. The dominating "facilitating conditions" and "process quality" indicators vary from one method to another product quality was not found to be a statistically significant factor in explaining usage. The authors' results are consistent with the view taken by the software process improvement movement, i.e., that a quality process will result in a quality product.

Recent Synthetic Applications of Chiral Aziridines

Due to their ready availability in chiral form, and propen- sity to undergo regio- and stereoselective ring opening, aziridines have found widespread use in asymmetric synthesis. This review at- tempts to summarise the breadth of use of chiral aziridines in syn- thesis that has recently been reported. Particular emphasis is put on the effect of substituents on ring openings, rearrangements and use as chiral ligands and auxiliaries.

Standardsoftware und organisatorische Flexibilität

In recent years the deployment of standard business application software (SAS) in companies has strongly increased. However, there are not few people who argue that cost savings due to the use of standard products have involved restrictions concerning the set of possible organizational options and restrict the range of feasible competitive advantages. This paper investigates these theses by the example of the Siemens AG. It is shown that the use of SAS is not appropriate for all the problems under consideration. But if there is a situation that justifies the use of SAS, then one can recognize a differentiation potential in form of the depth and breadth of use as well as the speed of implementation. Furthermore, it is shown that certain restrictions concerning the organizational scope of action are actually present, but similar restrictions appear if individual software is used. In addition we show that by means of standardization a firm can reach significant cost savings for company wide processes like human resources or consolidation.

Comparison of Three Psychological Defense Mechanism Questionnaires

The Defense Mechanisms Inventory (DMI), the Coping Operations Preference Enquiry (COPE), and the scales developed by Joffe and Naditch (J&N) were compared using multitrait-multimethod logic. Convergent validity was tow as measures of the same defense were not highly correlated across instruments. Similar patterns of correlations occurred within instruments but the J&N scales, and particularly the DMI scales, had high interscale correlations so overall discriminant validity was limited. These results suggest that either the defense constructs or at least some of the defense scales studied lack validity. Another possibility is that the scales are valid, but assess different parameters of defensiveness (e.g., intensity versus breadth of use of mechanisms). Comparisons of the scales' predictive validity should help resolve these points.