Project Greek NHS

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Investigation into Mumford and Honey theory of learning styles as a method of
developing the clinicians that are involved in the management of the Greek NHS
trusts.

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Project Greek NHS

  1. 1. Investigation into Mumford and Honey theory of learning styles as a method of developing the clinicians that are involved in the management of the Greek NHS trusts. Acknowledgments: I would like to thank all those that have contributed to complete the following research, personally I would like to thank the following lecturers from Buckignhamsire nursing and business school those are Miss Liz Mclay from the nursing school, and Miss Farmer and Mr Roy Horn as my project supervisor from the business school. From Greece I would like to thank my aunty Miss Marika Fiotaki Karambela, Miss Tsakaraki, Mss Liea for their help to distribute my questionnaires to various NHS trust in Athens, Thessaloniki, Chania and Iraklion respectively. My parents Jamis and Androniki Grigoraki that stand by and support me financially all those months and my sister Katerina Grigoraki for her support. Purpose and Terms of reference Purpose To review Mumford’s and Honey learning style theory furthermore to use Mumford’s and Honey questionnaire in order to define the learning styles of the clinicians that are involved in the management of the Greek NHS trusts, then understand the implications of learning styles on the management development of the NHS clinicians. Research questions 1
  2. 2. Does management development of the clinicians that are involved in the management of the Greek NHS trusts have a chance of becoming more effective by defining and understanding the implications of Mumford’s and Honey learning styles? Are there differences concerning the learning styles of the clinicians that are involved in the management of the Greek NHS trusts? What are the implications of the different learning styles towards management development? Objectives: •A definition of management development, and the necessity for the Greek NHS to focus on management development. •To define and analyse Kolb and Alan Mumford’s experiential learning theory and the learning styles needed to learn from experience. •The definition of the learning styles of the three groups of clinicians that are involved in the management of the directorate by using Mumfords and Honey learning style questionnaire. •An analysis of the results that have been attained from the questionnaires according to the speciality of the clinician. •To justify the advantage of a management development that focuses on individual learning style preferences. Research Hypothesis: People develop preferences for different learning styles in the same way that they develop any other sort of style such as management, leadership and negotiation. Individuals have different learning styles, which indicates, preference for particular learning experiences. As a result of our history, and our particular past life experience and the demands of our present environment, most people develop learning styles that emphasise some learning abilities over others. 2
  3. 3. Factors that influence learning style are education and specialisation, professional carrier, current job role. Defining the learning styles of the individuals that are involved in management of the NHS trusts has the advantage to dovetail learning activities to suit the learning styles. In the context of management development knowledge of learning styles can either be used in helping to dovetail learning activities to suit learning styles or can be used as a starting point for self-development. Management development can become more effective by reflecting on our experience and understanding of the effects of our actions. Abstract executive summary The purpose of the research is to investigate experiential learning as an alternative method for the management development of the clinicians that are involved in the management of the Greek NHS trusts. At the beginning is an introduction concerning management development and the importance of developing effective managers. There is a particular focus at Mumford’s and Honey learning style theory, which is the main focus of the research. There is also a reference in the literature of other theories, which are related to management development. The research is being focused on the way that the three different groups of clinicians involved in the management of the Greek NHS trusts are the clinicians that have a speciality, (this groups consists from the following specialities Genecology, Radiology, Biopathology, Orthopaedic, Pediatrian, General medicine, Cardiologist) the second group are the pathologists, and the third group are the nurses. There is a use of Mumford’s and 3
  4. 4. Honey questionnaire as a means, of defining the learning styles of the clinicians that are involved in management. The results from the questionnaire define that there are differences concerning the learning styles of the clinicians that are involved in management, and therefore there is a validity of the theory that different educational and professional experiences influence learning styles. Experiential learning could be an alternative method of management development from other traditional methods of management development. Experiential learning in the Greek NHS trusts, is an alternative method to other organisation let management development programmes that their main purpose is to transmit knowledge to individuals. Traditional education is the prevailing medium of exchanges between the trainee and the trainers it is usually a one sender many receivers process that is passive for the receivers. Chapter 1 Introduction The Greek NHS trusts is an organisation that faces continuous new challenges due to its large size and the diversity of its stakeholders and services. The shift to an older population within the Greek community has influenced the means of allocating resources needed to provide all effective health service. 4
  5. 5. The development of the technical infrastructure of the organisation is very critical in order to improve the quality of service. Improving the infrastructure of the organisation without investing in the development of human resources would not improve the overall service. ,The current research is focused on experiential learning. Experiential learning is the theory that would be used as the main theory of the project. Alan Mumford and Honey have created the theory of learning styles, which is based on experiential learning. The rationale of the theory is that management development based on individual experience would have better results, in order to develop the capabilities of the individuals, and become better and more effective managers. The research is focused on three different groups of clinicians that are involved in management within the Greek NHS. Those are the clinicians that have a speciality, the pathologists and finally the nurses. The use of the questionnaires will contribute in defining the diversity of the learning styles of the above three groups that are involved in the management of the different departments of the Greek NHS trusts. An overview will take place that concerns other theories related to experiential learning of management development. The research hypothesis is based on the rationale, of Kolb’s 1984 theory which Mumford and Honey have further developed. The results from the primary research will provide useful information concerning the learning style of the clinicians that are involved in management. It will define the diversity of the learning styles and the factors that influence the learning style of the individual, which according to Kolb, could be previous education, job role and 5
  6. 6. specialisation. It will provide useful recommendations towards a management development strategy that will focus on experiential learning. Mumford’s and Honey learning style theory is the starting point of the primary research, and the result of the questionnaires will define the learning styles of the three different groups of clinicians within the Greek NHS directorate. Mumford and Honey have developed an 80 item user-friendly questionnaire. (See appendix one) The recommendations and the conclusions will be based on the rationale, of Mumford and Honey learning style theory. There is a reference of other theories of management development the relations with other theories of management development and the reasons that those theories have been rejected at the current research. The results of the primary research will define the learning styles and the diversity of the learning styles of those clinician’s that are involved in management. The finding of the primary research and the context of Mumford’s learning style theory will be followed in order to come to the conclusion and recommendations towards a management development programme that begins to focus on the learning style of clinicians. The dissertation is divided into sections the beginning being the literature review, listed as follows: 1. The importance of management development at the Greek NHS trusts. 2. The strengths and weaknesses of Mumford and Honey theory. 6
  7. 7. 3. A brief overview of other theories related to management development, and an analysis concerning the reasons that those theories have been not considered as the main theories of the dissertation 4. Analysis of the results of the questionnaire 5. Conclusions and recommendations, and appendices Literature review: Chapter 2 2.1 Defining management development a review of the literature As an initial step a definition of management will take place, which will contribute in defining the nature and the constitution of the managerial process. Management development is defined variously in the texts as: "A conscious and systematic process to control the development of managerial resources in the organisation for the achievement of goals and strategies" (Molander et al 1986 pp34) 7
  8. 8. "An attempt to improve managerial effectiveness through a planned and deliberate learning process" (Mumford et al 1987 pp 223 – 243) “I use management development to describe the total process by which managers learn and grow in effectiveness…Management development is perceived as an attempt to increase managerial effectiveness through planned and deliberate learning processes We have to take account of both formal and informal processes (Mumford, et al 1989 pp 125 – 126). Management development is the planned process of ensuring through an appropriate learning environment and experience the continuous supply and retention of effective managers at all levels to meet the requirements of an organisation and enhance its strategic capability. (Harrison et al 1995) "The function which from deep understanding of business goals and organisation requirements, undertakes (a) to forecast need, skill mixes and profiles for many positions and levels. (b) to design and recommend the professional, career and personal development programmes necessary to ensure competence. (c) To move from the concept of management to the concept of managing." (Storey et al 1989 pp 3-19) The above definitions are useful starting points in order to define management development. The weaknesses of the above methods are that they tend to constrain the notion of development as being formalised, planned and deliberate. According to Mumford development is also a continuous, ever-changing process in which managers often learn informal, unplanned experience. (Mumford et al 1993) 8
  9. 9. "Conceptualisation about what management development is are obvious closely wrapped up with what it is for because clearly it is not an end in itself" (Storey et al 1989 pp3-19) Increasingly the goals and objectives of management development are becoming indistinguishable from the need for organisation to respond effectively to pressure and challenges of change and renewal. In the sense management development is a tool that drives effectiveness and efficiency by equipping managers for new roles and responsibilities and supporting them in those roles. (Storey et al 1989 pp3-19) 2.2 The context of management development Management development has to tackle a variety of entities those entities are the individual the management team, the organisation, and the environmental factors: The individual has a certain management style, is ambitious, it has certain expectations and personal attitudes. The management team each individual belongs to a management team the management team has certain relationships values and homogeneity. Environmental factors the environmental factors constitute by a variety of factors such as the economic the social situation and the political for the NHS the social and the political factors are important factors that influence the NHS. The organisation itself has a certain culture structure, politics, and technology, all those factors influence the organisation in terms of the effectiveness towards management development. To examine all those factors in a simple dissertation it could not be feasible, but they provide a guideline of influences concerning the pressures and influence that a particular management development policy has to encounter. (Beardwell et al 1999 pp 392-393) 9
  10. 10. The different methods of Management Development and the focus of the study There are five distinct methods of management development which are identified as follows: 1. Structured courses leading to a management qualification 2. Skill based training 3. Experiential learning 4. Professional liaison and networking 5. Guided reading 6. Role playing 7. Seminars 8. Programmed instruction (Beardwell et al 1999 pp 402-403) The current research will focus on experiential learning and the theory that underlies experiential learning as a method of management development. Particular attention will be paid to Kolb’s theory and, the Honey and Mumford learning style theory as a theory that is an evolution of Kolb theory as the main focus of the research. 2.2 The development of Managers at the Greek NHS trusts: Management at the Greek NHS trusts is essential in order to deliver an effective service. Management at the Greek NHS is a process that cannot be avoided. The Greek government needs effective and efficient managers that are able to reflect to the changing service patterns that take place within the organisation. In Greece clinicians from different medical specialities are involved in the management of the NHS trusts. 10
  11. 11. In the last decades the Greek government has invested much capital in order to modernise and improve the service a greater portion of the money having been funded by the European Union. New hospitals have been established all around the country. Small communities are provided with basic health provision by the health centres that have been established since 1985. Investing in developing the existing facilities is important in order to upgrade the service but is not sufficient. The need for developing the human resources and especially the clinicians that are involved in management is important because they make decisions that influence the service. There is an inevitable need for a positive long-term strategy for serious investment in individual and organisational development at the Greek NHS trusts. The Greek NHS is a big and complex organisation with many different departments. The demographic changes have increased the ratio to the older population. The above shift within the Greek population has influenced the overall cost and the utilisation of the available resources to a longer-term perspective. Due to the fact that the long-term utilisation of clinical care required by the elderly population has influenced the utilisation of the technological and human health care resources both technological and human. (The organisation needs see Appendix two) The continuous changes that take place concerning the external influences of the organisation makes, it essential to develop the capabilities of managers so that they will be able to respond to those external pressures. The external influences concerning the Greek NHS are: •Introduction of new technology •Social changes and needs •Demographic change 11
  12. 12. (Beardwell et all 1999) 2.3 The need for developing effective managers: Due to the changes that take place within the organisation fabric of the NHS there is a need for continuous management development of the individual managers within the NHS trust directorate. The two key words at this case are individual and development. Managers are individual people with a variety of experiences and skills, and each one works in a specific job in a particular organisation context; therefore development must be tailored to the individual’s needs emerging from a given managers situation. Management development is about using a range of training and educational activities, workshops, or college based, individual, and group reflective and active in nature to build an individual manager's confidence and capacity. The situation of each manager is unique based on the interaction of the person, job and organisation. Each of those components have been influenced by the individual manager's situation and it is made up of different variables; therefore generic training and education without any individual tailoring, through analysis, personal support and evaluation, may prove to be a wasteful investment. (Flanagan and Spurgeon, et al 1996). 12
  13. 13. 2.4 The rational of developing effective managers: There are many different reasons that managers need to be developed a list of reasons are as follows: •The introduction of new attitudes and behaviours to promote culture change •The encouragement of more empowerment and innovation •The development the knowledge in order to maximise the use of new technology •The facilitation and the introduction of new working practices (Beardwell et al 2000 pp 416-417). All the above are reasons why an organisation undertakes a management development programme. The NHS is an organisation that needs to develop its managers continuously in order to deliver a service that will cover the diversified needs of its stakeholders. Experiential learning a review of the literature: Experiential Learning What role does your experience play in your learning process? Learning from experience is the process whereby human development occurs. Although experience is essential to learning, it is not enough; one has to do something with it to construct knowledge. The two basic dimensions of the learning process include both understanding and transforming experience. At any given moment, your learning involves one or a combination of these four learning modes. According to Kolb those are Concrete Experience, Active Experimentation, Abstract Conceptualisation. (Kolb 1984) A definition of experiential learning will take place because Kolb’s model in terms of learning style theory is based on the concept of experiential learning. “Experiential learning involves a direct phenomena being studied rather than thinking about the encounter, or only considering the possibility of doing something about it” 13
  14. 14. (Brookfield et al 1983). Experiential learning is education that occurs as a direct participation in the events of life (Houle et al 1980). Experiential learning is actually about learning from primary experience that is learning through sense experiences. (Jarvis et al 1995). According to (Knowles et al 1970) He argued that learn cantered educators pay attention on the importance of experience as one of the five principles of “andragogy” of adult learning. Jack Mezirow and Paulo Freire whose theory of conscientization and praxis, learning through radical action combined with critical reflection, has galvanized emancipator education round the world. The term experiential learning has been often used to distinguish ongoing meaning overlapping from theory and non-directed informal life experiences from the formal education. This is why experiential learning was often understood to be radical, associated with learner empowerment. In direct challenge to disciplinary bodies of theoretical and canonical knowledge, education interest in experiential learning has been championed recognition and valuing and valuing the learner’s personal practical knowledge and informal or incidental experience. (Ravens et all 1999) David Kolb theory of experiential learning: Kolb and Fry's suggested that people develop preferences for different learning styles in just the same way they develop any other sort of style such as management, leadership, and negotiating. David Kolb’s interest lay in exploring the process associated with making sense of concrete experiences and the different styles of learning derived from the work of (Piaget Dewey and Kurt Lewin). (Dewey, J et al 1993), www.infed.org/biblio/b-explrn.htm pages 2-3 14
  15. 15. David A Kolb was a Professor of Organisational Behaviour in the Weathered School of Management. Kolb was initially known for his contribution to thinking around organisational behaviour (Kolb et al 1984). He has a particular interest in the nature of individual and social change, experiential learning, career development and executive and professional education. David A Kolb with Roger and Fry created the famous model out of four elements: Concrete experience, Observation and Reflection, the formation of abstract concepts and testing those in new situations. (Kolb et al 1984 pp 76 – 79) Kolb represented the above elements in the famous experiential learning cycle. (See Kolb experiential learning Cycle) See Appendix Three. Kolb and Fry 1975 argued that the learning cycle can begin at any one of the four points and that it should be approached as a continuous spiral. In some representations of experiential learning these steps are sometimes represented as a circular movement. At the particular instance learning is taking place in a different set of circumstances and the learner is now able to anticipate the possible effects of action. Kolb had the belief that learners must become deeply competent at all stages of the cycle. There has been considerable attention to the issue of matching and mismatching styles with development activities. (Torrington et al 1999) 2.5 Honey and Mumford’s learning styles theory: Honey and Mumford et al 1992 pp 124-125 have modified Kolb's Learning Style Inventory, transforming it into a user-friendly 80 items questionnaire. Kolb and Fry’s suggested that people develop preferences for learning styles in just the same way that they develop any other sort of style such as management, leadership, 15
  16. 16. negotiation. Mumford has tested Kolb Learning style inventory in order to discover his own learning style and he started to include it in courses related to training and management development. Mumford found some problems concerning the inventory itself such as lack if accuracy and the face of validity was not that good. After three years of intensive research experimentation he created an 80 item questionnaire that is presented. (Questionnaire see appendix four) Mumford and Honey learning style theory will be the main theory of the current research. Other theories of management development are also been included in the literature and the reasons of not having been included as the main theories of the research are provided. 2.5.1: The different learning styles of Mumford and Honey learning style theory: Activists learn best when they are actively involved in concrete tasks. Reflectors learn best through reviewing and reflecting upon what has happened and what they have done. Theorists learn best when they can relate new information to concepts of theory. Pragmatists learn best when they see relevance new information and real life issues or problems (Mumford et al 1988:28 124 –125) Honey has done the inventory in order to discover his own learning style and he has started to include it in training courses, he run it as a way of predicting the one that would respond of a way of anticipating learning difficulties. As soon as the theory was brought in problems were found with the inventory itself predictions were not so accurate and the face validity was poor. Honey worked together with Alan Mumford to develop the questionnaire that would be more effective. (Honey and Mumford et al 1988) 16
  17. 17. According to (Honey and Mumford et al 1986), we need to adopt four styles in order to complete any cycle of learning. A weakness is or reluctance to adopt any single style will 'block' our ability to learn effectively. Honey and Mumford learning styles After three years of experimentation the results was an eighty - item questionnaire that takes ten minutes or so to complete and identifies whether someone is an: Activist: learn best by having a go and trying something out without preparing. They are enthusiastic about role-play exercises and keen to take risks in the real environment. Activists learn best when they are actively involved in tasks. (Mumford and Honey et al 1982). They tackle problems by brainstorming. As soon as the excitement from one activity has died down they are busy looking for the next. They are particularly thieved by new experiences but bored by with implementing the longer-term consolidation. (Honey et al 1982) Reflector: Are better at listening and observing. They are effective at reflecting on their own and other experiences and good at analysing what happened and why. Reflectors learn best through reviewing and reflecting upon what has happened and what they have done. (Mumford et al 1982). Their philosophy is to be cautious, to leave no stone unturned "look before you leap" they are thoughtful people who like to consider all possible angles and implications before making a move. (Honey et al 1982) Theorists: strengths lie in building a concept or a theory on the basis of their analysis. They are good at integrating different pieces of information, and building models of the way things operate. They might start reading by choosing a topic. Theorists learn best when they can relate new information to concepts or theory. (Mumford and Honey et al 17
  18. 18. 1982) Theorists tend to be detached analytical and dedicated to rational objectivity rather than anything subjective or ambiguous. Their approaches to problems are consistently logical. This is their mental set and they rigidly reject anything that does not fit with it. (Honey and Honey et al 1982) Pragmatists: They to use what they learn and always work out how they can apply it in real situation. They will plan how to put it into practice. They particular value information/ideas they are given only if they can see how to relate them to practical tasks. Pragmatists learn best When they see relevance between new information and real life issues and problems. (Mumford and Honey et al 1982). Pragmatists are keen on trying out ideas theories and techniques to see if they work in practice. They prefer to get on with things and to act quickly and confidently on ideas that attract them. Their philosophy is "There is always a better way and if it works its good". (Mumford and Honey et al 1982) Each of the above four stages that constitute the learning cycle is important to effective learning, but not many people are strong at each stage and it is helpful to understand where our strengths and weaknesses lie. The rational behind the theory lies in understanding the way that managers learn from experience is paralleled by a change in emphasis in management development from formal training course that allows learning through the job itself, with the required support. (Torington et al 1999). 2.5.2 Strengths of Mumford learning style theory: Kolb experiential learning theory and the evolution of the theory by Mumford has advantages due to the recognition that each individual has different learning experiences. The individual experiences are influenced by a variety of factors such previous roles education and specialisation. 18
  19. 19. The management team is made up of a variety of individuals that have encountered different roles in their previous time within the directorate. The clinical director, business manager and the nurse manager form the managerial team. The above team is a multidisciplinary team that is formed by many different individuals that have encountered different learning and working experiences. A unified management development programme might not have the best results in terms of individual development because it might be appropriate to the one member of the team but not to the other one. A management development programme that does not achieve equal development opportunities for all the members of the team is not the best strategy of development. The advantage of the theory is that it allows the learner to make sense of his strengths and weaknesses by changing the emphasis in management development from formal training course to offering learning through the job itself. (Torington et al 1999). To make sense of our strengths and weaknesses enables us to choose learning activities that suit our individual style, and also provides us with the opportunity to strengthen a particular weak stage at the learning cycle. Mumford has allowed the above dual approach. The difference with Kolb lies in the fact that learners must become deeply competent at all stages of the cycle. (Torington et al 1999). (Honey and Mumford et al 1986) commented: " Trainers too often assume that learners are empty buckets waiting to by the training method the trainer favours. The fact that the buckets a different sizes and/or leak and/or upside down is conveniently overlooked ". www.massey.ac.nz/kinshuk/thesis/chap5.pdf pp1-2 The other advantage of the theory is the fact that is situated midway between formal planned managerial development processes and informal accidental managerial 19
  20. 20. development activities, "integrated opportunistic management development would enable more effective learning if individuals followed the principles of self-development. (Honey and Mumford et al 1992, 1999) The benefit of becoming an all round learner from experience Knowledge of learning styles can either be used in order to direct learning activities to suit learning styles or to be used as a starting point for self-development. Becoming an all around learner has the advantage of acquiring a broader range of learning skills. (Honey and Mumford et al 1992, 1999) Learning Styles a definition Learning style is a characteristic of the individual not just of the situation. Strategies comprehension learning operation learning is not necessarily styles. Learning styles are the perceptual and cognitive skills and strategies the learner uses in gathering, interprenting and stowing information. Goldstein and Blackman defines learning style as the way that we organise, compare and structure information that we have sensed and attended to before en coding it in our neutral circuits (Langreht et al p p13) (Witkin et al 1977) found there are field independent/global/articulated learners aware of needs, feelings, and attributes) who have a sense of separate identity, who can tolerate longer delays, who gamble, hypothesise, raise critical questions, pursue principles. 20
  21. 21. Consistent individual differences in ways of changing meanings, values, skills, and strategies are defined learning styles (Brundage and MacKeracher 1980) Then there are the field dependent learners, with an operations style, who have a less well developed self-concept, who strive for safety or reduction of uncertainty, who value short cycle activities that yield tangible results, who are closer to the concrete, who see learning as a bit by bit assembly. Field dependent learners like essays, group work and reports, thematic projects, summaries, and creative products. Notably such learners are typically the disadvantaged. (Witkin et al 1977) Individuals do not learn in the same way. They tend to adopt the styles in which they feel most comfortable, to the expense of the styles with which the individual is not comfortable. The benefits of becoming aware of our learning styles are as follows: •Use our learning styles to suit the particular learning that we are undertaking. •Improve our learning in our 'weaker' styles It is important to realise that learning styles are not 'personality traits' and we all adopt different styles in different contexts. However, we usually favour one or two styles above the others. Each of these four stages of the learning cycle is critical to effective learning, but few people are strong at each stage and is helpful to understand where individual strengths and weaknesses lie. An understanding of the way managers learn from experience is paralleled by a change in emphasis in management development from formal training course that has the capacity to offer learning through the job itself, with appropriate support. The remainder of approaches to management development rely heavily on learning from experience. 21
  22. 22. The strength of defining our individual strengths and weaknesses enables us to choose learning activities which suit our style, and also gives us the opportunity to decide to strengthen a particularly weak learning stage of our learning cycle. Honey and Mumford have adapted the above dual approach. (Torrington et al 1995) The benefits to an open system approach: Honey and Mumford are related to an open systems approach to management development: The benefits to an open offers the following benefits to the organisation: •It offers a broader set of strategies, policies and plans are developed that take account the organisation unique situation and its specific requirements concerning managerial skills and knowledge. (Beardwell et al 1999 387-388) •The notion that if you develop the manager you develop the organisation and the opposite. An open system approach view identifies the way that management development contributes to overall organisation effectiveness. (Beardwell et al 1999 387-388) •The open system approach was introduced to make sense of the complexity of the organisational life. Adapting an open systems approach it has the advantage not to look at management development in isolation, management development becomes an integral part of the organisation wider system and its linked to the reality of the managerial work. (Beardwell et al 1999 387-388) 1. By identifying, analysing monitoring and promoting the complex network of influences and patterns of relationships in managerial work, development programmes can become patterns of relationships in managerial work, development programmes can become more adaptable, flexible, responsible and proactive in the face of an organisation change. 22
  23. 23. 2. Viewing management development following an open system approach in terms reveals the full extent of the organisation and is likely to lead to a more detailed and objective assessment of performance and overall effectiveness. 2.6.3 Limitations of Mumford’s and Honey Theory of learning styles: Due to the interconnection between Kolb’s experiential theory and Mumford learning style theory critics concerning Kolb's theory will be related with the limitation of Honey and Mumford's experiential learning theory, because Mumfords and Honey learning style theory is an evolution of Kolb’s theory. Not all writers agree with Kolb's theory. Rogers, for example points out that "learning includes goals, purposes, intentions, choice and decision-making, and it is not at all clear where these elements fit into the learning cycle." (Rogers, 1996, et al pp. 108). Habermas has also proposed that there are at least three kinds of learning and that we have different learning styles for each. (Rogers, et al 1996, p. 110) As for the Inventory, Kolb himself, points out its greatest limitation. The results are based solely on the way learner rate themselves. It does not rate learning style preferences through standards or behaviour, as some other personal style inventories do, and it only gives relative strengths within the individual learner, not in relation to others. In my own case, the results were found dubious. The wording in the questions seemed vague and the results did not with my own view of my preferred learning style. Nonetheless, Kolb's contributions cannot be underestimated. Whatever their limitations, by presenting a model of experience in a scientific form, he has helped move educational thought from the locus of the instructor back to the learner. As many of the major 23
  24. 24. contributors to the field have pointed out, experience has once again become a viable topic of discussion. (Brookfield, 1990) (Cross, et al 1981) (Jarvis et al 1995) (Kemp et al 1996) (Knowles et al 1990) (McKeachie et al 1994) (Peters, et al 1991). The model which dominates experiential learning theory is a four stage learning cycle, of which there are many versions, the one I have found most frequently quoted being that of (Kolb et al 1984). Closely related to these are theories and models of learning styles (Honey and Mumford et al 1982,) (Junch et al 1983 Kolb et al 1984). Both kinds of theory are about learning rather than development. Kolb has himself has paid attention to the fact that his 'learning cycle' model and his 'learning styles' model concern learning rather than development. He has another theory about development, which he calls "the experiential learning theory of development" (Kolb et al 1984: Chapter 6) This theory converts Kolb's learning cycle model by superimposing a three-tier cone on top of the cycle (Kolb, et al 1984). Kolb also clarifies the limitations of his Learning Style Inventory, pointing out that it only represents "elementary learning orientations" which he sees as being in a different dimension to that of development (Kolb et al 1976, 1998). Why is it, then, that courses of personal development, social development, manager development, self-development, organisation development etc. are often based on a learning model? Why is it that development-training brochures generally show just one model - a cyclical learning model? Is there not a development model that would be more suitable? 24
  25. 25. Would a development model more accurately describe what learner's experience on these courses? Would a development model more accurately describe what clients expect from outdoor management development? Customers and participants are often seeking both learning and development. While experiential learning theories and models help trainers and learners to conceptualise learning, the same theories are not, in my view, well suited for conceptualising development. The major limitation of Mumford's and Honey theory is the limited number of learning styles. The four learning styles is a major limitation. A participant could be represented by another learning style that has not been defined by Mumford and Honey. Another limitation is the time and the resources that, are needed in order to define the learning style of the participants. In large organisations the process has to take time in order to define the learning styles of the managers. The claims made that the four learning styles are extravagant (Jarvis et al 1987 Tennant 1997). According to Tennant M (1997) even though the four learning styles neatly dovetail with the different dimensions of the experiential learning model, this does not necessary validate them. The weakness of Kolb’s model is that he is putting a specific learning style. The weakness there is that experiential learning model does not apply to all situations. The alternatives are information and assimilation. There are also others such as memorization. Those could be appropriate in different situations. www.infed.org pp5 -6 The theory takes little account of the specific cultural conditions (Anderson et al 1988), the inventory has not been used by many different cultural contexts. According to Anderson there is a need to take account of differences in cognitive and communication style that are culturally based. www.infed.org pp 5-6 25
  26. 26. There is weak empirical support; the initial research base was small and there have only been a limited number of studies that have sought to test and explore the model. (Jarvis et 1987 and Tennant et al 1997). The relationship to learning process and knowledge is problematic There is lack of investigating knowledge in any depth. Kolb focus that learning is concerned with the production of knowledge. Knowledge results from the combination of grasping experience and transforming it. (Kolb et al 1984) 2.6.1 The Meta-Cognitive skills This can be thought of as the skill of ‘thinking about thinking’. Adults, in particular, learn best when they have the opportunity of reflecting on their strengths or weaknesses in order to monitor and enhance their learning. Instead of concentrating on what skills to acquire, meta cognition is an attempt to reflect on how to acquire them. The best-known example is the learning style questionnaire by (Honey and Mumford et al 1986). The questionnaire is designed to help us to monitor how well an individual learns by: •Learn by reflecting on experience •Conceptualise what we have learned from this and •Make action plans as a result. The skills required to increase our repertoire of learning styles will be a balance of effective and cognitive skills as originally described by (Bloom et al 1956). Individuals do not learn in the same way. We tend to adopt those styles with which we feel most comfortable. It is important that we become aware of our learning style preferences so that we can: 26
  27. 27. •Use our learning styles to suit the particular learning that we are undertaking. •Improve our learning in our 'weaker' styles. It is important to realise that learning styles are not 'personality traits' and we all adopt different styles in different contexts. However, we usually favour one or two styles above the others. According to (Honey and Mumford et al 1986), we need to adopt four styles in order to complete any cycle of learning (See Kolb’s leaning style). A weakness or reluctance to adopt any single style will 'block' our ability to learn effectively. 2.6.2 The process of learning from experience: Alan Mumford and Honey have developed a simplified version of Kolb's model, which is defined at (See Appendix five). Depending on the learning style preferences managers are likely to take a number of liberties within the process from learning from experience. Some of the better-known ones are as follows: Indulging at stage 1, Limiting at stage 1, Avoiding stage 1, Avoiding stage 2, Limiting stages 2 and 3. (See appendix five) (Honey and Mumford 1984 pp 124-125) The above factors are very useful towards a management development that will have the potential to achieve a better result. The different nature concerning the stages can be the answer to the problems of management development for the Greek NHS trusts. 27
  28. 28. 2.6.4 Theories related to individual learning styles: Introduction: The literature review will focus on other theories related to learning and management development. Reasons that those theories have not been included in the research will be outlined. The reference to the following theories it will contribute to make sense of experiential learning and the theory that is being used by experiential learning. It will also contribute to define similarities and differences of Mumfords and Honey learning style theory with other theories of management development. Learning from experience a review of literature Developments in personal psychology have focused on the individual learning styles. The other developments in personal psychology have been instrumental, and in particular the work of Malcolm Knowles (1985) on "Andragogy" on the principles of adult learning. Carl Rogers (1969) advocating student centre learning as a parallel to his well-known development psychology method, client-centred therapy. Another earlier influence was Ralph Coverdale whose programme of Corverdale Training (Taylor et al 1979) emphasised the need to develop a cycle of preparation, action and review to assist people in learning from experience and practising the skills that are relevant to successful co- operation with others. (Bandura et al 1969) has created the system of social learning advocating learning through observation and imitation. (Rogers et al 1969) argued that in an ever-changing environment, teachers must become "facilitators of learning" setting a climate of trusts, eliciting individual and group aims, providing access to resources, accepting and sharing 28
  29. 29. emotional as well as intellectual contributions and above all accepting their own limitations. Knowles (1989) employed these different sources to create a synthesis of the distinctive principles of adult learning those as follows: The need to know, the learner's self-concept, the role of learner's experiences, readiness to learn, orientation to learning, motivation. Knowles has thus fortuitously managed to pull together the individual qualities that require prior attention before an organisation can induce them to maximise the benefits of their learning style preferences. Alan Mumford openly acknowledges his influence, and so it is possible to see how Honey and Mumford's has created the theory of learning styles. It is a timely synthesis of different stands of thought in addition to the focus upon individual learning styles and the essential features of adult learning. 2.6.5 Knowles theory: (Knowles et al 1985) took a different approach to the definition of experiential learning. He is a proponent of learning autonomy, and described activities, which took place within the concept of experiential learning. He listed what he calls, "participatory experiential techniques": group discussion, cases, simulations, role-plays, and skills practice exercises. He suggested that experiential learning was synonymous with participant and discovery learning Knowles (1989) has employed these different sources in order to create a synthesis of the distinctive principles of adult learning, which are as follows: 29
  30. 30. The need to know, the learner's self-concept, the role learner's experiences, readiness to learn, orientation to learning and finally motivation. With his theory Knowles managed to pull together the individual qualities that require prior attention before an organization can include those individuals in order to maximise the benefits of their learning style preferences. The influence of Knowles is fully acknowledged by Mumford and so it makes it possible to see that the theory of Honey and Mumford concerning the learning styles is a timely synthesis of different thought about individual development. 2.6.6 Other theories related to management development Argiris double loop learning Double-loop learning theory is especially relevant to management education. According to this theory, individuals must learn to discriminate the difference between their perceptions or intentions and reality (espoused theory versus theory-in-use). Such learning takes place primarily through interaction with others. The importance of human interaction in management provides a general framework for many aspects of management education. Coaching and mentoring are commonly used management development techniques that attempt to harness social learning in the workplace (Deegan, et al 1979 Rossett, et al 1990) Theories of adult learning those are Cross, Knowles, and Rogers emphasize the importance of building upon the learner's experience are also very relevant to management education. The experiential theory of Kolb (1984) suggests that the learning cycle consists of four primary stages: concrete experience, reflective observation, abstract conceptualisation, and active experimentation. According to Kolb, individual differences in these stages give rise to learning styles. The theoretical framework of action learning (Revans, et al 1980) has been widely applied to management education. Action learning involves structured projects in 30
  31. 31. organizations rather than traditional classroom instruction. The key elements of action learning are: Commitment to learning, social interaction, action plans, and assessing the results of actions. 2.6.7 Pedler Boydell and Burgoyne theory of the learning organisation: According to Pedler et al (1988) a learning organisation is one which: •It has a climate in which individual members are encouraged to learn and to develop their full potential. •Extends this learning culture to include customers, suppliers and other significant stakeholders. •Makes human resource development strategy central to business policy. •It is in a continuous process of organisational transformation. Pedler, Boydell and Burgoyne (1989) have defined current interest in the idea of a learning organisation that capitalises on the poor organisation performance. Both Pedler and Boydell mention the history of training and development in organisations in terms of critical problems and solutions. They have given the following definition concerning the reason behind poor organisation performance leading to the concept of the learning organisation. "Sluggishness an excess of Bureaucracy and over-control, of organisations as straitjackets frustrating the self development efforts of individual members and failing to capitalise upon their potential". Burgoyne (1995) refers to an appropriate learning culture as an attribute of a learning organisation. He defines it as a culture, which supports shared learning from experience. 31
  32. 32. Habit formation and learning is adaptive to organisation learning and creative proactive learning. As (Boyell and Pedler 1981) remark: "Any effective system for management development must increase the manager's capacity and willingness to take control over and responsibility for events, and participating for themselves in their own learning" 2.6.8 Kohler theory: (Kohler et al and Jackson et al 1991) see discovery learning as reflecting the way in which we learn to recognise and define problems, experiment to find solutions, whether by trial and error, by deductive reasoning, by seeking information or help, or by a combination of all three. A wide variety of learning methods have evolved, which have come to be known as experiential learning methods, all of which focus on the learner being offered an experience, followed by reflection and making sense of that experience, following the Kolb cycle described earlier. Of particular interest are structured group activities and role-plays. The idea of these activities is that the group undertakes an experience, after which they discuss their thoughts and feelings about the experience, and apply the new learning to the real or clinical situation. 2.6.9 Burnard theory: (Burnard et al 1990) Stated that the advantage of this approach includes the sharing of a common experience, the generation of a wide range of possible solutions to practical problems, and the realisation of both the personal and the common nature of group experiences. 32
  33. 33. Role-plays involve the setting up of an imagined and possible situation, and learning from the drama. More specifically, the cycle indicates that, after a role-play, a period of reflection is necessary, followed by feedback from other participants in order that new learning can be absorbed from the drama. 2.6.10 Skinner theory: (Skinner et al 1995) The theory is that receiving a reward, such as being told that they have answered correctly, or done well, gives positive reinforcement to the participants' response, and so motivates them to extend their learning. A particularly relevant development of reinforcement theory is the work of (Seligman et al 1990). From his experiments he concludes that, just as subjects can learn to perform certain behaviour for some kind of reward, they can also learn that certain situations are "uncontrollable", i.e. that no behaviour they can display will produce any result. He claims that just as organisms can learn by positive reinforcement, when they are exposed to uncontrollable events, they can learn that responding is futile. This learning undermines motivation to respond and persists even when events actually become controllable. Building on the philosophy of experiential learning is detailed literature focusing on the role of the trainer. This is to be addressed in two ways: the trainers' role in the organisation; and specifically in the training session itself. 2.6.12 Senge theory: According to Senge (1990), systems thinking - his fifth discipline - are essentially for the development of the effective organisation - the learning organisation: 33
  34. 34. At the heart of a learning organisation is a shift of mind - from seeing ourselves as separate from the world to connected to the world, from seeing problems as caused by someone or something out there to seeing how our actions create the problems we experience. A learning organisation is a place where people are continually discovering how they create their reality and how they change it. The rationale behind Senge’s theory is the learning organisation that is described in terms of disciplines. His philosophy behind incorporating these disciplines lies in understanding the way in which organisations are a product of how people think and interact. Organisation cannot change unless people can change their basic process of thinking and interacting. 2.6.13 Double loop learning: Double loop theory is based upon a "theory of action" perspective outlined by Argyris & Schon (1974). This perspective examines reality from the point of view of human beings as actors. Changes in values, behaviour, leadership, and helping others, are all part of, and informed by, the actors' theory of action. An important aspect of the theory is the distinction between an individual's espoused theory and their "theory-in-use" (what they actually do); bringing these two into congruence is a primary concern of double loop learning. Typically, interaction with others is necessary to identify the conflict. Argiris (1976) proposes double loop learning theory, which pertains to learning to change underlying values and assumptions. The focus of the theory is on solving problems that are complex and ill structured and which change as problem-solving advances. Double loop theory is based on the theory of action perspective outlined by Argiris and Schon (1974). This perspective examines reality from the point of view of human being as actors. 34
  35. 35. Double-loop learning theory of Argiris (1976) is especially relevant to management education, according to this theory, individuals must learn to distinguish the difference between their perceptions or intentions and reality (espoused theory versus theory-in- use). Such learning takes place primarily through interaction with others. 2.7 The reasons that the above theories have not been considered in the current research: 2.7.1 Pedler and Burgoyne is based on the concept that the learning organisation is to promote learning and development. Learning and development can be the solution towards the problems that are encountered in the organisation. Burgoyne (1995) refers to an appropriate learning culture as an attribute of a learning organisation. He defines it as a culture, which supports shared learning from experience. The concept of Pedler that learning and development have to be supported by the organisation that could be more feasible in a small organisation. A shared culture is difficult to be created in case of having a non-homogeneous team of individuals. Handy (1995) describes some of their common qualities. They work primarily as individuals and do not see themselves as needing to be managed. Management actions are labelled managerialism, which is insidious, over-bureaucratic and generally undesirable. The 35
  36. 36. problem with the term professional is that it quite often appears in phrases like "I don’t need training, I’m a professional". The implication is that once professionally qualified, no further learning is required. Managerialism threatens individual freedom, but the obverse of freedom of choice is taking responsibility for one’s actions. The problem with the learning organisation, as we perceive it, is that too few people are taking their share of responsibility for the situation they find themselves in and one way of avoiding responsibility is to see yourself as a powerless victim of imposed change. "Sluggishness an excess of Bureaucracy and over-control, of organisations as straitjackets frustrating the self development efforts of individual members and failing to capitalise upon their potential". Burgoyne (1995) refers to an appropriate to an appropriate learning culture as an attribute of a learning organisation. He defines it as a culture, which supports shared learning from experience. Such learning is adaptive to organisation learning and creative proactive learning. Often the creation of a common culture is difficult because of having conflicts of interest. Other critiques on the learning Organisation: In theory, the learning organization concept is appealing. However, according to Watkins and Marsick et al (1993), "Everyone is talking about it but few are living it" (p. 3). We "know a lot about learning-organization theory, but far less about how to apply it" 36
  37. 37. (Calvert et al. 1994, p. 40). Nevertheless, examples can be found of LO principles in practice in the workplace and in schools. Johnsonville Foods in Sheboygan, Wisconsin, appears to have been an LO long before the label was coined. In the early 1980s, the sausage manufacturer implemented several programs based on the notion of using the business to build great people; that way, the organization cannot help but succeed (Watkins and Marsick et al 1993) 2.7.1 Skinners theory it seems to be to simplistic for the complex issue of management development of the public sector. Rewards could have an effect to change behaviour but it could be that feasible at the managerial environment of the NHS directorate. 2.7.2 Burnard theory is related to the importance of experience and the reflection upon experience. It relates to Kolb experiential learning that defines the importance of learning from experience. Therefore there is a direct relation between the two theories the difference being the sharing of a common experience. 2.7.4 Kohler theory: (Kohler et al and Jackson et al) see discovery learning as reflecting the way in which we learn to recognise and define problems, experiment to find solutions, whether by trial and error, by deductive reasoning, by seeking information or help, or by a combination of all three. Kohler defines also the importance of the reflection of experience on the way that we learn in the definition of problems. 37
  38. 38. 2.7.5 Senge theory: Senge in his theory believes that organisation is a product of how individuals think. There is a relation with Mumford’s learning style theory that examines individual learning styles which consequently reflect the way individuals think towards problems. He believes that organisations can change unless they change the way that organisations interact. Mumford with the questionnaire examines the learning styles of the individual managers. Therefore there is a correlation between Mumford and Senge. There are certain critics concerning Senge’s theory as follows: When making judgements about Peter Senge’s work, and the ideas he promotes, we need to place his contribution in context. His is not meant to be a definitive addition to the’Academic, literature of organizational learning. Peter Senge writes for practicing and aspiring managers and leaders. The concern is to identify how interventions can be made to turn organizations into ‘learning organizations’. Much of his, and similar theorists’ efforts, have been ‘devoted to identifying templates, which real organizations could attempt to emulate’ (Easterby-Smith and Araujo 1999: 2). One of the biggest problems with Peter Senge’s approach has nothing to do with the theory, it’s rightness, nor the way it is presented. The issue here is that the people to whom it is addressed do not have the disposition or theoretical tools to follow it through. One clue lies in his choice of ‘disciplines’ to describe the core of his approach. As we saw a discipline is a series of principles and practices that we study, master and integrate into our lives. In other words, the approach entails significant effort on the part of the practitioner. It also entails developing quite complicated mental models, and being able to apply and adapt these to different situations - often on the hoof. Classically, the approach involves a shift from product to process. Leadbeater C et al (2000). 38
  39. 39. 2.7.6 Double loop learning: By defining the above theories there is a direct relation with Mumford’s learning styles theories. For example Argiris double loop learning is direct related to Mumford’s learning style. Single loop learning is related to the two first steps of the cycle, the first two stages of the learning style and the double loop is related to the other two learning styles of the cycle. 2.8 Managing clinical teams: A definition of clinical management will take place. Clinical management involves the identification of a range of financial and other resources available to provide patient care and the assurance that these resources are utilised to the greatest effect, for the benefit of the individual patient and groups of patients (Harrwood and Boufford et al 1993). 2.8.1 The clinical management team: A definition concerning the individuals that are involved in the management of the clinical teams will be useful in order to define the issues that managers need to face. The management team includes a clinical director, a business manager and a professional manager, for example a nurse or technical manager. As it can be seen the management team is a multidisciplinary team. The individuals that constitute the team come from different professional backgrounds. It means that the team has encountered different experiences shaped during their professional career. It is very important to define the team, and the way the team will be developed, and the role of each individual member of the team. 39
  40. 40. 2.9 The contribution of Mintzeberg concerning managers 2.9.1 Mintzberg framework: According to Mitzeberg classic research concerning management he defines ten roles form managers. According to Mitzberg managers are under constant to acquire and disseminate information, in order to develop strategies without the essential time for analysis, in order to influence the behaviour of others without being autocratic to external initiatives. (Tony White et al 1993) (Mintzberg framework See appendix six) Discussion from the literature review: At the literature review Kolb experiential theory was first presented because the above theory is the main theory of the research and is an evolution of Honey and Mumford’s learning style theory. The particular theory has the potential to contribute towards an effective management development of the clinicians and non-clinicians that are involved in the management of the Greek NHS trusts. The process of learning from experience has the potential to solve the problem of learning and management development for the individuals that are involved in the management of the Greek NHS trusts. The findings from the literature concerning the theory are as follows: Mumford’s learning style theory can be the answer towards an effective management development for the Greek NHS trusts. Knowledge of the learning styles can contribute to suit learning activities to suit the learning styles due to the fact that Individuals have different learning styles, which indicate preference for particular learning experiences. A validation of the learning styles will be defined at the primary research through the questionnaire research. 40
  41. 41. The theory allows managers to take some liberties within the process of learning from experience according to their particular learning style and the theory realizes, that there is scarcely an individual who can adapt to all the stages, respectively. Mumford and Kolb experiential learning theory has advantages due to the fact that each individual has different learning experiences. The individual experiences are influenced from a variety of factors such as previous roles education and specialization. The management team is made up of a variety of individuals who have encountered different roles in their previous time within the directorate. The clinical and non-clinical director has been chosen in the primary research because they constitute the management team in the Greek NHS trusts. The particular method of management development has considerable advantages in relation to other methods because it considers the needs and the learning style of the individuals. A definition of the learning styles will contribute to dovetail learning activities to suit learning style and the other hand to encourage the participants of a management development to develop the weak learning styles. The other major advantage of experiential learning is the advantage of becoming all round learners from life’s events and, in case of being a trainee it is possible to become a more effective trainer by helping more trainees. In organization let management development programs the participants receive ready knowledge but in management more efficient learning takes place by doing, watching and listening to others and try things on our own. The above sparks interest and generates our motivation to self-discover. The above process is a part of experiential learning. 41
  42. 42. Honey and Mumford (1982) have built a typology of learning styles around this sequence, (Activist, Reflector, Theorist, Pragmatist) The advantage of experimental learning is the need for adjustment between learner and teacher, learning styles. Sometimes their preferences are antagonistic, complementary, or collusive. Neglecting some stages can cause problems concerning effective development and that can be a major obstacle to learning. David Kolb (1984) wrote that learners have immediate concrete experiences that allow us to reflect on new experience from different perspectives. From these reflective observations, we engage in abstract conceptualisation, creating generalizations or principles that integrate our observations into sound theories. Finally, we use these generalizations or theories as guides to further action. Active experimentation allows us to test what we learn in new and more complex situations. The result is another concrete experience, but this time at a more complex level. To be effective learners we must (1) perceive information, (2) reflect on how it will impact some aspect of our life, (3) compare how it fits into our own experiences, and (4) think about how this information offers new ways for us to act. Learning requires more than seeing, hearing, moving, or touching to learn. We integrate what we sense and think with what we feel and how we behave. According to Kolb (1975) the individual can begin at any one of the four points of the learning cycle, which has to be approached as a continuous spiral. Therefore management development is a continuous process that involves all the stages of the learning cycle. The learning process can begin with a person carrying out a particular action and then seeing the effect of the action at a particular situation. The second step facilitates the individual to understand the effects in a particular instance so when the same action is taken in similat circumstances it will be possible to see, what will follow from that particular action. 42
  43. 43. Reflecting on our experiences is very important in order to become better managers. Managers are involved in taking decisions and choosing from alternative action. Special in the NHS, which is a service whose demands are changing continuously. The development of managers who can decide and understand the effects of their actions is very important. The need for adjustment between the learner and the teacher has a considerable advantage towards a successful management development. Often the relation between the trainer and the trainee are antagonistic, and often collusive if they tend to follow the same stages of the cycle. A definition of experiential learning will take place because Kolb’s model in terms of learning style theory is based on the concept of experiential learning. “Experiential learning involves a direct phenomena being studied rather than thinking about the encounter, or only considering the possibility of doing something about it” (Brookfield et al 1983). Experiential learning is education that occurs as a direct participation in the events of life (Houle et al 1980). Experiential learning is actually about learning from primary experience that is learning through sense experiences. (Jarvis et al 1995) All the relevant literature concerning experiential learning the factors that affect management development has been presented. What role does your experience play in your learning process? Learning from experience is the process whereby human development occurs. The importance of modifying the experiences that the individual has acquired in order to change the individual learning style preferences is the main strength of experiential learning. Although experience is essential to learning, it is not enough; one has to do something with it to construct knowledge. The two basic dimensions of the learning process include both understanding and transforming experience. At any given moment, your learning involves one or a combination of these four learning modes. According to Kolb those are Concrete Experience, Active Experimentation, and Abstract Conceptualisation. 43
  44. 44. Other theories related to experiential learning have also been presented in the literature as well as the reasons why those theories have been rejected as the main theory of the research. The importance of management development within the context of management development will be presented. Experiential learning provides an alternative to other methods of management development. The fact that management development has to be able to define the way that individuals learn and develop is very important. It has a fundamental difference to other methods of management development that consider each individual as receiving fixed knowledge. 44
  45. 45. Chapter 3 Methodology: 3.1 Introduction: The scope of the primary research is to find, the learning styles of the clinical directors that are involved in the management of the Greek NHS trusts. The primary research is based on Mumford's learning style questionnaire. The main groups, are considered, in the primary research are the clinicians that possess a speciality, the pathologists and the nurses all those groups are involved in the management of the Greek NHS trusts. All the above groups have acquired different professional and training experiences. A validity of the Kolb study will take place by distributing the questionnaires to the above groups at the Greek NHS trusts. According to Kolb (1985) individuals that receive different learning experiences have developed different learning style preferences. The main purpose of the research is to define the learning styles of the clinicians within the directorate. The results from the questionnaire will be distributed to various clinicians involved in the management of the directorate. The results will be analysed separately according to the following three different categories the clinicians that have a speciality such as radiology, pedagogy the pathologists and finally nurses. Pathologists and nurses have been chosen as two different categories due to the large number of pathologists and nurses that are involved in management. The results from the questionnaire will be analysed according to the speciality education and years in service of each individual participant. Particular attention will focus on the outcome and the diversity of the results from the questionnaires according to the clinician medical role. 45
  46. 46. A large diversification concerning the results will define that previous education and specialisation has influenced the learning style of the individual clinician that is involved in management. In this case a management development policy will start by the learning style of the individual and try to move the individual by reinforcing his other styles and should have positive results. The research will provide useful information to trainers because it compares the learning style of the trainer and the trainee. It can also shift resources towards developing weaker learning styles. The results will verify the extent that there are differences between the two managerial groups. The rationale of Mumford’s learning style theory will be followed in order to contribute to develop our conclusions concerning the management development strategy within the directorate. 3.2.1 The application of the theory: As mentioned above the theory that the primary research will be based is Mumfords learning style theory. The use of the theory through the questionnaire survey is based on Mumfords learning style questionnaire that is an evolution of Kolb's experiential learning theory. The questionnaire will define the learning styles of the individual that completes the questionnaire, and the results will be gathered and analysed according to the speciality and the learning experience of the individual clinician that fills in the questionnaire. 46
  47. 47. The use of Mumford’s Learning style questionnaire will define the learning styles of the three groups, of clinicians (those that have the following specialities genecology, radiology, bio pathology, orthodoxy, pediatrian, cardiologists, pathologists and nurses). The pathologists and the nurses have been considered as different groups due to the fact of a receiving a more general education to the other clinicians that have a speciality. The learning style questionnaire is based on the theory of Mumfords and Honey, which has four styles the -Theorists, Activists, Reflector, and Pragmatist. The application of the theory takes place by the use of Honey and Mumfords questionnaire for the particular research. Honey and Mumford questionnaires have been distributed to various clinicians involved in management. The answers from the questionnaires will define the learning styles of the clinicians and the implications of those styles will be defined. The validation of the theory will prove that clinicians from different professional and educational domains encounter different learning styles. The questionnaire will contribute to define the learning styles of the clinicians who have encountered different professional and education experiences. The results of the questionnaire will prove the validity of the hypothesis. It will also provide useful information to future management development programmes. It will also be the starting where the implications of the different learning styles will be studied in detail. Further application of the theory of learning styles can take place in future management development programmes. It will contribute to the formation of management development programmes within the context of the Greek NHS trusts. The learning style questionnaire will be the tool of defining the learning style of potential candidates in management development programmes. The successful definition of the learning style will help to dovetail the learning activities to suit learning styles or be used as a starting point for self-development. 47
  48. 48. Considering and applying Mumford’s learning style theory of the clinician to a management development programme should be beneficial. It will be beneficial because the management development programme will consider the learning styles of the individual clinicians and the extent that a management development process has to start by the learning style of the individual manager. The measurement of the learning styles of the managers it will allow the comparison of learning styles of the two managerial groups of the directorate. Kolb and Fry's Learning Style Inventory is based on the rationale that people develop preferences for different learning styles in just the same way that they develop any other sort of style such as management and negotiating. (Mumford et al 1986). "Honey stated the following:" “Naturally Kolb’s learning style inventory in order to discover my own learning style and started to include it on training courses I ran as a way of predicting who would respond in what sort of way and so anticipating learning difficulties. Unfortunately, whilst I bought the theory, I found some problems with the inventory itself the problem was that the predictions were not as accurate as I wished and the face validity was poor. Accordingly, together with Alan Mumford I started to develop a questionnaire that would a better job. After three years of intensive experimentation the result was an eighty-item and defines whether someone is an activist a Reflector, a theorist and a pragmatist”. (Mumford et al 1986 124 –125) Honey and Mumford (1992, 1996) have modified Kolb's learning style Inventory, transforming it into user-friendly 80-item learning style questionnaire. In turn, Kolb's four stages of Concrete experience, reflective observation, abstract conceptualisation, and active experimentation became four learning styles: the activist, reflector, theorist, and pragmatist respectively. This has become the best-known tool for classifying different learning styles and linking them to the type of learning activities, which each type enjoys 48
  49. 49. or dislikes. It provided the basis for Mumford's idea of using learning opportunities to develop personal effectiveness. Mumford claimed that situated midway between formal planed managerial development process and informal accidental management development activities, integrated opportunistic management development' would enable more effective learning if individuals followed the principles of self-development. Mumford (1992) pp 144-145 Thus Honey and Mumford (1992) pp144-145 took the view that every managerial event and personal experience could be of benefit, if the main principles of the learning cycle are followed namely: •Overview •Conclude •Plan •Act again •Review •Plan Mumford’s learning style theory is an evolution of Kolb's learning style theory. The strength of the theory lies on the dynamic, notion of the process of learning that is represented by the cycle of learning. Recognising that learning has many different identifiable faces. The different faces of learning makes Kolb's learning theory a theory that recognises the individual learning style. The other significance of the theory is the fact that it draws attention of learning through action and reflection, as well as through the traditional channels of teaching, learning. The theory recognizes that the participant may prefer different learning styles the definition of those styles in the context of a management development programme would have beneficial results because it complies more with the participant individual learning style. 49
  50. 50. Recognising that the individual may prefer different phases of the learning cycle that fit with his/her individual learning style has the potential to create learning that would be more effective. The advantage of the questionnaire is that it can be sent to many different individuals across the different NHS trusts. That is very suitable for that particular research because there is a need for a broad view in terms of the numbers of the individual managers and clinicians. An interview approach would provide us with limited results concerning the learning styles of the clinicians of the Greek NHS trusts. The other strength of the questionnaire is that, it is directly related to the Mumford learning style theory. Mumford's and Honey questionnaire has been tested of its reliability. Other approaches that have been considered Qualitative research has been considered but was not suitable for the current research due to its limitations to create the big picture for the clinicians that are involved in the management of the Greek NHS trusts. Three, or four interviews cannot represent the attitude of all the clinicians towards management development. Interviews will provide a limited picture concerning the learning style of the clinicians. The other weakness of qualitative research is that it is very difficult to come into comparisons by interviewing two three individuals. 50
  51. 51. 3.3.1 The samples of the questionnaire The samples that will be considered are those of clinicians involved in the management of the Greek NHS trusts. The research will be divided into three samples, the clinicians with a speciality, the pathologists, and finally the nurses. Due to the large number of pathologists and nurses that are involved in the management of the Greek NHS trusts those two groups of clinicians will be considered separately in the research. The separation into three samples it will contribute to come into comparisons. The questionnaires will be dispatched to the different Greek NHS trusts. The NHS trusts that the questionnaire has been posted are the NHS trusts of Athens Thessalonica, Iraklion, and Chania of Crete. Clinical directors from different specialities have been chosen. The sample has validity because all three groups of clinicians are involved in the management of the Greek NHS trusts. Questionnaires will be sent both to clinical directors and non - clinical managers. The samples will be analysed according to the speciality and the years in service. The answers from the questionnaires will define the diversity of the learning styles according to previous workings and education experiences that the individual has been encountered 3.3.2 A definition of the instrument questionnaire and how many will be sent out. The questionnaire is based on Mumford’s learning style questionnaire that is an adaptation of Kolb’s theoretical work. The questionnaire consists of 80 questions which defines the extent that an individual is either an Activist, Reflector Theorists or a Pragmatist. Fifty questionnaires have been sent out. A copy of the questionnaire is being shown in appendix one. The individual ticks a question or rejects it by an X (for each 51
  52. 52. ticked question there is point). Twenty questions have been allocated for each learning style. The maximum points that can be allocated for one of the four learning styles are twenty. An analysis of the results concerning the questionnaires is allocated at the (appendix seven) 3.3.3 The instrument strengths and weaknesses Mumford’s and Honey learning style theory is an evolution of Kolb’s experiential learning. The strengths of Kolb’s learning style inventory, will be found in the introduction. Second, the self-image description format was chosen for the inventory, since the notion of possibly processing structure relies heavily on conscious choice and decision. Self-image descriptions would be more powerful determinants of behavioural choices and decisions than the performance tests. Another important factor is that the inventory was constructed with the hope that it will validate the measures of the learning styles in predicting behaviour in a way that is consistent with the theory of experimental learning. The LSI measures a person's relative emphasis on each of the four modes of the learning process plus two-combination scores that indicate the extent to which the person emphasises action over reflection. The importance of the learning style inventory is that it defines the particular learning style of the individual. Measuring and defining the way that individuals learn is very important for the success of a management development programme. The direct relation of the learning style inventories with Kolb learning style is very useful because the findings from the test are directly related to the Kolb’s learning cycle. 52
  53. 53. Different patterns of learning style define the way that the individuals react to different problems at the directorate. Individuals at the directorate have different perspectives to the different problems. Defining the individual thinking towards different problems has the advantage of being able to start the development process with the support of the individual learning style. The particular learning style is very useful due to the diversity of the problems that individuals face in management. Learning in action is very useful because it involves an approach that starts with the individual learning style. Learning style defines the personality of the individual the way that he/she reacts to certain problems and circumstances. 3.3.4.1 The advantage of the instrument: The instrument strengths are that it is a widely tested questionnaire adapted by Honey and Mumford (1986). The questionnaire contains 80 questions, which test the learning styles of the individual that completes it. It directly relates to Kolb's learning cycle theory that is used to define the learning styles of the clinical directors and the managers. For purpose of the research the advantages of the qualitative study seem to outperform its disadvantages. The quantitative research is suitable in exploring a number of issues in the present research. It focuses on the management development of the clinicians that are involved in the management of the directorate. The focus of the investigation is on Mumford’s learning style theory. In this case the issues being investigated are the four learning styles of Mumford’s learning style theory, the Activist, Reflector, Theorist, and Pragmatist. The learning style questionnaire has been used successfully in many different countries due to the validity of the instrument. This resulted in, an improved learning process by altering the course structure slightly for individuals according to their learning preference. 53
  54. 54. Mumford’s and Honey questionnaire is being used in order to define the learning styles of the clinicians. In order to understand the implication of the learning styles on the management development it is necessary to define them and furthermore to use the questionnaire and observe in praxis the different learning style preferences among the clinicians. The definition of Mumford’s and Honey learning styles has been given in the literature. The next stages is sending the questionnaires to the different clinicians and observing the differences concerning their individual learning style. The results will define the existence of the learning styles within the different groups of clinicians involved in the management of the Greek NHS. Honey and Mumford’s questionnaire is the tool of defining the learning styles of the clinicians. The overall implication of the learning styles towards management development is that management development is being influenced by the existence of different learning styles. A team of individuals possessing different learning styles has developed different perceptual and cognitive skills and strategies that the learner uses in gathering and interpreting and starting similar information, which has the potential to be interpreted differently, according to the individuals personal learning style. Honey and Mumford’s learning style questionnaire contributes to learning in the Greek NHS trusts, because the participants that fill the questionnaire find out about themselves. The self-awareness of the participants is being raised through this method and behaviour changes are more likely to take place following the questionnaire. Participants trusted the data more because they filled them out themselves. They identified their own learning style of leadership. Therefore power and responsibility of change and personal growth lie within the participants 54
  55. 55. The other advantage of the instrument is the potential of creating a wider view due to the opportunity of accessing a number of different individuals. On the other hand an interview has a limited potential to access more than one individual. (Jankowicz et al 1995 pp 223) The advantage of the fully structured techniques is that it allows you to standardize the questionnaire to such an extent that a more numerate, statistically based analysis is possible, and permits you to test the hypothesis more explicitly, always assuming that the situation permits. The other advantage of the fully structures techniques it permits access to more responders, and can provide greater feelings of anonymity, may require less skills and sensitivity to administer, and allows your responders more time to think about his or her responses than any of the semi structured techniques. (Jankowicz et al 1995 pp 223) 3.3.4.2The disadvantage of the instrument: The weakness of the instrument is that it contains many questions that might confuse the user and lose focus. The other factor is the extent that the persons that fill the questionnaire are honest enough to fill it, in properly. The other weakness of the theory is, that the four learning styles could be restricted in order to define adequately the learning style of the individual. The other weakness of the instrument is the lack of open- ended questions. It can be considered fixed in terms of its structure. It does not provide the on time response that is provided by the qualitative research. The disadvantage of the quantitative method is that the depth of the research has already been decided. The answer to the learning style questionnaire provides the participants with four choices that derive from the learning style theory. The limitation at this stage is that the participants are presented with limited choices, and this limitation leads to restricting the chance for the participants to be able to take the issues under consideration deeper than I decided to. 55
  56. 56. 3.4.1 Analysis of the questionnaire The results will be analysed as follows: The questionnaire received will be separated into three groups: the clinicians that have a speciality for example radiology, pedagogy. The other group is the pathologists and finally the nurses. The results of each questionnaire will be analysed graphically so the differences of each answer can be readily identified. Particular focus in the analysis has been given on the three different groups of clinicians because these groups are participating in the management of the Greek NHS trusts. The results from the questionnaire will be analysed separately according to the three groups that participate in the questionnaire. The above separation will help to make comparisons concerning the similarities and the differences concerning the results of the three groups. It will also contribute to defining the influence of individual professional and educational experiences on the learning style of the individual that filling in the questionnaire. All the above parameters have been considered in analysing the questionnaires because there are potential factors that might influence the individual learning style. It will also define the extent that individuals with different learning and professional experiences have created a different learning style. At the analysis stage excel will be used in order to analyse each questionnaire separately. With the contribution of excel, graphs will be generated in order to make comparisons and help towards defining the big picture of the primary research. The questionnaires will define the extent that clinicians with different professional and training experiences have created a different learning style. The answer will provide validity to Mumfords learning styles theory. 56
  57. 57. 3.5 The questionnaires turnaround The number of questionnaires that we received is 27 out of 40 that was a very positive response due to the usual low responds that taking place Limitations Due to the large number of the NHS trusts it will be impossible to have a perfect idea concerning the learning style's of all the clinical directors that work for the Greek NHS trusts. An uncontrollable factor that has the potential to become a limitation is the honesty of the responders. The other limitation concerns Mumford’s learning style theory the four learning styles seem to be a limitation because they cannot adequately represent every responder. There should be more than four learning styles. 57
  58. 58. Chapter 4 Analysis and findings of the questionnaire 4.1 Introduction The questionnaire has been posted to the following groups of clinicians involved in management within the Greek NHS trusts. The clinicians that are involved in the research are specialised in the following areas: Genecology, Radiology, Bio pathology, Orthopaedic, Pediatrian, General medicine, Cardiologists, Pathologists and Nurses. A separation into three groups has taken place in order to make comparisons concerning the results of Mumford’s and Honey questionnaire. Another factor that has contributed to the above separation is due to the large number of pathologists and nurses that are involved in the management of the Greek NHS trusts. The results will be analysed and compared in order to define the similarities and the differences between the results of the three groups of clinician. In the appendices the result of each questionnaire are both numerically and graphically represented with a pie graph. Honey and Mumfords questionnaire will define the diversity of learning styles between different groups of clinicians in case of big differences concerning the results of the questionnaire there will be big differences concerning the perceptual and cognitive skills and strategies the learner uses in gathering and interpreting and stowing information that will have a major implication for a management development programme, due to the big differences that the members of the clinical team organise experiences into meanings, values, skills and strategies. In that case it will be a major implication concerning the existence of learning styles, in the context of management development. 4.2.1 Analysis of the results 58
  59. 59. There is a separate reference and interpretation for each individual group, concerning the results of the questionnaire. The clinicians that have a speciality, the pathologists and the nurses at appendix 7 the results of each clinician are included. The results are also related to previous research that has taken place in order to define the learning style of medical students and the choice medical students speciality. The results are analysed according to the structure of Mumford’s and Honey questionnaire. In total there are 80 questions, the questions being divided into four different learning styles according to Mumford’s and Honey learning style theory. There is a focus on the four learning styles the Activists the Reflectors the Pragmatists and the Theorists. The questionnaire has a total of eighty questions. Each preferred question counts one point, a maximum of 20 points is being allocated at each learning style, which is a combination of the 80 questions of Mumford’s and Honeys questionnaire. The questions that are allocated to each learning style are indicated in the numerical analysis of the results. (Numerical analysis concerning the results of each questionnaire see appendix 7) 4.2.1.1 The medical Specialities The following medical specialities have been considered in that particular group genecology, radiology, bio pathology, orthopaedic, pediatrian, general medicine, and cardiologists. The results of the questionnaire indicate, low indices in the activists learning style with the lowest answer concerning the activist column being 8 points out of 20. The reflector and the activists learning style have higher numbers that varies from 13 to 17 points, only one questionnaire has a high reflector with 20 points, and the theorists of 17 points but on the other hand there are average points that lie between 8-10 concerning the pragmatist column. 59
  60. 60. In general the highest marks have been allocated to the reflectors and the theorists columns most of the answers are allocated just above the average concerning those two learning styles. The low results concerning the activists column is remarkable, there is a partly correlation to the research of Mark Plovnick that investigates the relation between the learning style and the senior medical students choice of Speciality that has been used by Kolb as a reference according to his research students with a convergent learning style choose medical specialities. The results of Mark Plovinck concerns medical students that do not possess any work experience its only being used as a mean of comparison concerning the results of the questionnaire. (See appendix 8 The diagram of Mark Plovnick) Plovnick has allocated those that possess a medical speciality high at the convergent learning style. Most points have been indicated to the to the reflector and theorists column with the reflector column gaining below average marks, there is a shift towards the assimilator knowledge The average points, concerning the reflector and the theorist’s columns and the below average for the pragmatists. 4.2.1.2 The results concerning the Pathologists The participants that have taken part in the questionnaire have the following results: The most remarkable is the considerably high result concerning both the reflector and the theorist’s column. In many cases the reflector and the theorist column reaches the maximum points of twenty. The pragmatist’s column is below average and the activists below average. The high results concerning the reflector and the theorists learning style suggest a strong preference towards assimilative knowledge, which indicated a strong preference for thinking and organising information and building conceptual models. 60
  61. 61. There is a direct correlation with the research of Mark Plovnick concerning the relation between the learning styles and the choice of speciality. Plovnick research and the results of the questionnaire are very identical. Pathologists have a strong preference for assimilative knowledge, which is proved by Mumford’s and Honey questionnaire. 4.2.1.3 The results concerning the Nursing participants On the other hand the results concerning nursing are very different, to the ones of pathology, there are higher results concerning activists in relation to the two previous groups. In many cases equal points have been distributed to all the learning styles. The way that those results have been distributed indicates a preference between accommodator and divergent due to the similarity of the results to all the four columns. According to Mark Plovnick those that choose to follow career in nursing lie in the border between accommodator and diverger due to the equality concerning the points concerning the theorists the reflectors and the theorists there is a correlation with Mark Plovnick research concerning learning styles. The nature of nursing encourages a more activist learning therefore there is a higher mark for the activist learning style in relation to the other learning styles. 4.2.2 Discussions concerning the results of the questionnaires By analysing the results of Honey and Mumford’s questionnaire considerable differences have been defined concerning the answers to the questionnaire. Therefore the questionnaire can be a useful tool of understanding the implications of learning styles in the context of a management development programme. By analysing the results of the questionnaire there have been considerable differences in the learning styles of the participants. 61

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