Doctor of Philosophy, The Ohio State University, 1968, Graduate School

Committee: Not Provided (Other) Subjects: Health Sciences

Ph.D., Antioch University, 2015, Leadership and Change

Transformation of health care systems will be grounded in new professional relations and collective, cross-disciplinary actions to impact care delivery. Organizing such relations and actions involves practical inquiry rather than applying professional knowledge. This dissertation presents an exploratory, performative study of the initial organizing of the Health Systems Innovation and Research (HSIR) Program in Health Sciences at the University of Utah. The HSIR program was conceived principally to catalyze cross-disciplinary innovation and health services research and enhance care delivery changes by documenting care improvements and publishing research. This study includes a composite narrative of the organizing and practical inquiry work of HSIR organizers, which highlights many questions, issues, possibilities, and priority shifts that would likely face those who would seek to transform care delivery and the cultures of academic medicine. The study identifies improvement, integration, and transformative strategies as pathways to effect change in health systems. The study includes a narrative-based analysis of cultural, dynamic, and narrative resources to enhance understanding of the HSIR story and the implications of cultural and dynamic influences for the Program's future and health systems transformation. This analysis emphasizes the cultural and dynamic influences of academic and clinical departments and other sources of dynamic influence that were operating to hinder or facilitate the larger objectives of HSIR organizers. The study also explores the significance of collective practical inquiry, exploratory inquiry, and culture change to the practice and theory of leadership and change. The HSIR study was conducted using a practice study methodology developed from practice and narrative theories, with contributions from complexity, process, learning, organizing, social construction, and relational theories and empirical studies of professionals undergoing cha (open full item for complete abstract)

Committee: Alan Guskin Ph.D. (Committee Chair); Laura Roberts Ph.D. (Committee Member); Jon Wergin Ph.D. (Committee Member); William Plater Ph.D. (Other) Subjects: Health Care Management; Organization Theory; Organizational Behavior; Social Research

Doctor of Philosophy, Case Western Reserve University, 1991, Organizational Behavior

As managed health care increases in appeal, including the positive implications for family practice, the need for the effective career development of family physicians becomes more apparent. This dissertation employs experiential learning theory to explore factors that impact the career development of faculty of family medicine. Four hypotheses are tested regarding learning styles. The Executive Skills Profile (ESP) – an assessment instrument based on experiential learning theory – is used to explore organizational culture, organizational strengths, and organizational developmental needs. A major focus is the usefulness of the ESP for purposes of this study. The thirty-one tenured and non-tenured faculty of family medicine at a major urban university voluntarily participated in this research. The Learning Style Inventory (LSI) and the ESP were administered. The LSI identified subjects' preferred approach to learning and the ESP measured their perception of their job demands, personal skills, and developmental needs. Subjects also responded to questions designed to capture their thoughts regarding their career development. Findings support three hypotheses that predicted a population of family medicine academics who are strongly accommodator and assimilator in learning style and who are weakest in the converger learning style. Findings of a fourth hypothesis are mixed. As expected, female faculty of family medicine favor concrete experience over abstract conceptualization; however, male faculty are equivocal with respect to these two learning modes. Further observations indicate that contrary to predictions of experiential learning theory, one-third of the population seem to have a simultaneous concrete and abstract learning orientation, i.e., a “mixed” learning style. The results of ESP suggest an alignment of individual and organization. The people oriented learning styles are matched by organizational culture, organizational strengths, and organizational developme (open full item for complete abstract)

Committee: David Kolb (Advisor) Subjects: