Journal of

Management Developing elements of a

Development
15,4
learning organization in a
metropolitan ambulance
4
service
Strategy, team development and
continuous improvement
Stuart D. Francis
Waitemata Health Limited, Auckland, New Zealand, and
Peter C. Mazany
University of Auckland, Auckland, New Zealand

Journal of Management
Development, Vol. 15 No. 4, 1996,
pp. 4-19. © MCB University Press,
0262-1711
Introduction
Time-based competition is a reality in the 1990s. Business is operating in a new
environment where the only constant is change. Drucker claims that, for
managers, the “dynamics of knowledge impose one clear imperative: every
organization has to build the management of change into its very structure”[1].
The Japanese have taught Western business a lot about how to run a good
company. Quality of product and of process, and a commitment to proactive
change, are two fundamental examples. Just-in-time, total quality management,
Kanban, quality circles, and statistical quality control are a few more examples.
The Japanese have also demonstrated that managers are not omnipotent nor
omniscient. Workers have just as much responsibility to the organization, its
customers, and their products as do the managers. Participatory-style
management, particularly the use of teams, has proven itself to be a better way
of doing business.
Managers should not scoff at new ways of managing their organizations.
If the ideas will improve what their organization does and how it does it, then
surely they have a responsibility to consider those ideas and to implement
improvements. Organizations which develop focus (systems for continuous
improvement, team development and a more “bottom-up” approach to
management) will prosper in the 1990s. Flexibility and innovation in an
organization’s product or service, and its responsiveness to customers, are
important characteristics for successful competition.
There is a growing requirement for organizations to “learn” in an ever-
changing environment. The need for embracing change, rather than merely
coping with it, is suggested by Sonnenberg and Goldberg[2]. Rather than
reacting, companies must learn to anticipate change. The two authors also
highlight the importance of tapping the potential of all employees, A metropolitan
“encouraging them to be catalysts of change … instead of employing change ambulance
management techniques in response to change … the ability to change must service
become part of every employee’s mindset”[2]. Senge[3] extends this idea by
explaining this as the difference between generative learning, which is about
creating, and adaptive learning, which is about coping. Much of the current
literature on learning organizations emphasizes increased adaptability. 5
As written in Fortune magazine, “the most successful corporation of the 1990s
will be something called a learning organization, a consummately adaptive
enterprise”. Senge contends that adaptiveness is only the first stage in the move
to become a learning organization. He suggests that the human impulse to learn
goes beyond the desire to respond and adapt; rather, we desire to expand our
knowledge and capabilities – to be generative.
Building an environment where learning and education happen as a matter of
course does have the potential to affect the “bottom line”. Fulmer and Graham[4]
quote a study by the University of Michigan and Hay Management Consultants
which found that organizations providing a week or more of educational
opportunities for their employees each year had significantly higher profits
than those companies which chose not to do so. The fact that meeting the
educational needs of experienced managers has the ability to enhance the
reputation of a company as an employer and for managerial excellence, and
affect the bottom line, has led to the growing realization that education is a
strategic weapon for achieving competitive advantage.
The concept of organizational learning was perhaps first coined by Chris
Argyris and Donald Schon in 1976, in the book Organizational Learning[5].
Here, the authors present several ideas for a learning model for an organization.
In a later article, Argyris suggests that the strategy implementation process is
an excellent environment for managerial learning to occur[6]. More recently,
Peter Senge has introduced the concept of a “learning organization” in his work
The Fifth Discipline: The Art and Practice of the Learning Organization[7].
In this work, Senge presents five key disciplines which underpin an organ-
ization’s ability to learn.
This article argues that an organization which has in place a dynamic
strategic planning process, incorporating high levels of employee participation,
a high-performing team-oriented culture, and a participative, empowering
continuous improvement system, has the three major constructs of a learning
organization. Supporting these three systems is leadership which is proactive
and visionary, and learning which is experientially based. Each of these
four components is a proven element of successful business, and, when
combined, they provide the necessary platform on which to build a “learning
organization” (see Figure 1).

Experiential learning
Experiential learning is considered to be the most powerful form of learning,
and is the most effective method for the education of the employees of the
Journal of
Management
Development A learning
organization
15,4 Leadership

Strategy
6
Direction
of growth

Teams CI

Figure 1. Experiential learning

Characteristics of a
learning organization

organization, and of course, the organization itself[8,9]. Schein suggests that the
ability to adapt is tantamount to life-and-death for most organizations: “The
world is changing quickly. In order to survive and grow, organizations must
learn to adapt faster and faster or be weeded out in the economic evolutionary
process”[10]. So, the issue to be addressed here is the way in which experiential
activities offer opportunities for increased learning over traditional teaching
methods. The first observation is that experiential activities combine three
interrelated processes through which managers learn: their cognitions, their
emotions, and their behaviours[8,10]. People learn through their intellect by
thinking about things in different ways. Traditional teaching methods,
including class and lecture-based learning, concentrate on this cognitive
learning. Second, people learn through their emotions. How we feel about
something affects our emotional state, and we remember how something
previously affected us. Finally, people learn by doing this in different ways –
through their actions or behaviour. Many activities may include elements of one
or other of these styles of learning. However, activities which combine all three
styles of learning are the most powerful of learning activities. Experiential
activities such as adventure-based training, outdoor training, interactive
workshops and computer simulation fall into the intersection of the three
areas[8]. These different styles of learning can be incorporated in Kolb’s cycle of
experiential learning (see [9] for further information). In the concrete experience
stage, individuals are primarily doing things: that is, the learning they undergo
is based on their behaviour, and on the emotions that they experience as a result
of that behaviour. When individuals stop doing things, and reflect back on the
activity just completed, the learning styles become more cognitive-based, with
elements of how they felt during the activity (their emotions) still affecting their
cognitions (reflective observation). To be able to generalize their experiences A metropolitan
fully, individuals must then focus their learning solely on their cognitions, ambulance
drawing lessons from how they might have performed in the previous activity, service
and how they might have felt during the activity (abstract conceptualization).
Finally, individuals test the model developed, calling on their cognitive learning
styles to blend with their behavioural styles of learning (active experiment-
ation). Table I and Figure 2 summarize the relationship between the learning 7
stages and the predominant styles in the different stages.

Stage in learning cycle Predominant learning style

Concrete experience Behavioural (B)

Emotional (E)

Reflective observation Emotional (E)

Cognitive (C)

Abstact conceptualization Cognitive (C)

Active experimentation Behavioural (B) Table I.

Cognitive (C) Learning styles
in the learning cycle

Further
experience

Concrete
experience

B E
Active Reflective
experimentation observation
C

Abstract
conceptualization Figure 2.
Experiential learning
cycle
Journal of Team building
Management In any team-building exercise, individuals should develop into teams better
Development focused on working within the organization. Team development should not
disguise the fact that a team contains individuals – rather, it should highlight
15,4 that it is individualism which provides a team with tremendous amounts of
power. Boss’s[11] argument about the use of teams in health-care institutions
8 is of particular interest here when we are dealing with an ambulance service.
Team-oriented management exploits the traditional autonomous character-
istics of medical professionals’ training and the normal environment of their
work. Specific goals within this are to:
• build trust among individuals and groups throughout the organization,
up and down the hierarchy;
• create an open, problem-solving climate where problems are confronted
and differences clarified, both within groups and between groups, in
contrast to sweeping problems under the rug or smoothing things over;
• locate decision-making and problem-solving responsibilities as close to
information sources and the relevant resources as possible, rather than
in a particular level of the hierarchy;
• increase the sense of ownership of organizational goals and objectives
throughout the membership of the organization;
• move towards more collaboration between interdependent persons and
interdependent groups within the organization;
• increase awareness of group process and its consequences for
performances – that is, to help persons become aware of what is
happening between and to group members while the group is working
on a task.
Team building of middle managers involves a certain amount of empowerment:
enabling them to exert more control over their immediate work environment.
This idea of empowerment is not new to the organization in this study; the role
of station managers has changed remarkably in recent years. The latest
regional chief ambulance officer has accelerated the change in this direction.
Station officers have greater authority with regard to shift changes, goods
purchased, station expenditures and general station management. The next
stage for senior management is to build on that increased responsibility by
allowing station managers to participate in the design of systems to measure
and improve their performance. This is equally as important for their product
responsibilities as it is for their process responsibilities. Not only do they
continue to be responsible for the health-care services that the ambulance
service provides (the product), but also they are becoming increasingly
responsible for how the service provides that health care (the process). As a
result of this shift in work emphasis, their ability to function well as a team
becomes vital, and team development must assume strategic importance.
Forming a team involves more than appointing people to complete a task. Team A metropolitan
members should go through a team-building process to establish good ambulance
relationships, develop a clear and common understanding of the mission, foster service
an understanding of teamwork, provide an opportunity for the team to see itself
in action, and identify behaviours that help and hinder teamwork[12].
As always, an important consideration is that senior management must
support the participants. The participants are thinking creatively about what 9
their jobs are and what they should be. Innovation and creativity are important
outlets for an individual; the prospect of change should be embraced, rather
than treated with suspicion. This applies equally to the organization and to the
individuals within it. Systems for improvement, within service values and
strategy, are important outcomes of developing team management. As senior
officers, their ability to effect change “at the coal face” is very powerful.

Linking to organizational strategy

A key aspect which separates the approach presented in this article from other
experiential frameworks is our focus on driving all experiences to help develop
strategy. Strategy is the key link between theory and practice, and it is what
relates the team to its role within the organization. The focus obtained for a
team through corporate strategy and corporate values means that for an
organization to benefit most from more effective teams, team-building activities
must take the strategy and values of the organization into account. Although
strategy is not driven by teamwork, it is the effectiveness of strategy
formulation and implementation which is affected by poor teamwork. Organiz-
ational strategy is the best vehicle for focusing a group of individuals on a
common goal; a goal which the team participates in defining. Nichol[13]
discusses the strategic planning process and the important role for middle
managers:
The role of the strategist is changing from a strictly planning position to that of a craftsman,
building new or enhanced capabilities to achieve new competitive advantage. To fill this role,
the strategist must first understand the company’s current capabilities, craft a vision of what
those capabilities could be, and then execute that vision. Such a process requires the active
involvement of both middle and senior managers. Each group brings unique advantages to the
table[13].

Stewart and Fondas argue: “Nowadays we hear a lot about the strategic
management of the company but not about the need for individual managers to
think strategically about their jobs”[14]. Nichol also discusses the benefits of
incorporating middle managers in the strategic planning process. Middle
managers have the “detailed knowledge of how the current system operates, as
well as the potential for operating differently in the future”[13]. The importance
of incorporating middle managers in the strategic direction of the firm is also
mentioned by Leibowitz et al.[15]:
Most senior managers believe that human resources are an organization’s greatest asset. From
boardrooms to business schools, they hear about the importance of developing competent and
satisfied employees to improve productivity, profits, and long-term growth. They hear far less
Journal of about the crucial role of managers – the men and women on the corporate front lines, in middle
management, and at the top – in actually translating development from theory into action[15].
Management
Development The strategic planning process allows the opportunity for teams to work
15,4 together on organizational issues. When these are combined with other team
development activities, the team building and strategy development efforts
build on each other. Significant opportunities for the organization are as
10 follows:
• Strategy formulation involves self-analysis. It allows for discussion of the
key “services” or “products” and of the strengths and weaknesses of the
organization’s ability to provide them. It makes those within the
organization question the values, priorities and purpose of the
organization.
• Strategy formulation involves environmental analysis. It helps those
within the organization understand the different environments in which
each key “service” or “product” operates, and the opportunities and
threats apparent.
• Strategy formulation enables teams to develop a team mission to which
all the team is committed. The team is able to focus on what it is there to
do, and how it intends to do it.
• Strategy formulation enables middle managers to establish specific next
steps, the objectives and goals of how their areas of responsibility will
proceed to accomplish their missions.
• Managers are able to determine their requirements for successfully
achieving their missions. This includes the values and characteristics of
staff, an understanding of good leadership, and a commitment to team
development and continuous improvement.
• Managers participate in improved planning, communications and
quality. Analysis of current processes will result in many suggestions for
change. Empowerment of the team for introducing change should be
welcomed, not rebuked. As the team strengthens, the staff working with
it will begin to notice a more consistent commitment to the station and to
improvement in their environment.
Allowing teams to focus on the future of the organization – a desired future
state – effectively ties that person to the team, and to the organization. Someone
who just goes away for a weekend of team building is far less likely to develop
a personal stake in the future of the organization.

Methodology
The model described above (Figure 1) for developing a learning organization
was used by the authors to design a workshop for two middle-management
teams of a metropolitan ambulance service in New Zealand. Then the research
measures were used to see whether the framework achieved its objectives[16].
 The steps involved were: A metropolitan
• Initial interviews. Participants were interviewed individually and ambulance
together to develop a rapport with the facilitators. Initial questions were service
answered.
• Half-day in-house session. The outline of the workshop and the required
preparation were explained. A team profile questionnaire, first case 11
study and initial questionnaire were completed.
• Three-day residential workshop. Team and strategy development occurr-
ed. The workshop used indoor and outdoor exercises.
• Half-day in-house workshop. Debriefing and follow-up from the work-
shop were conducted. Team analysis and next steps to developing a
continuous improvement culture were developed, and the second case
study and questionnaire were completed.
A three-day residential workshop is the central component of the team-building
process, and has specific objectives which it sets out to achieve. Important
factors in the success of workshops of this nature include the use of indoor and
outdoor activities; mixing cognitive learning with behavioural and emotional
learning; the use of activity debriefings to improve a participant’s learning
process (abstract conceptualization); and the metaphorical way of dealing with
team relationships. The variety from outdoor applications adds to the generally
enjoyable environment. Challenge and enjoyment are two of the fundamental
components of the facilitation process.
Team building is an investment in the “people” resource of an organization,
and important to any investment decision is an assessment of how effective
outcomes are in relation to money and time spent. The primary motivation
behind this research is that, despite the thousands of dollars organizations pay
to attend experiential team-building exercises, adequate means for measuring
the effectiveness of outdoor training programmes are virtually non-existent.
The few providers of such outdoor programmes who do offer evaluation appear
to be almost entirely dependent on post-event participant questionnaires[19-22].
While this technique does have some merits, more effective techniques must
be sought. An effective tool for measuring teamwork development is the use of
case studies and team questionnaires[23-26], and this technique was one of
several used in the research recorded here.
In this article, the authors present four measurement techniques which
attempt to capture the effectiveness of the outdoor workshop in different ways:
meeting the defined workshop objectives, measuring the change in team
functioning, a participant evaluation questionnaire, and job performance over
time.

Objectives for the organization

The need for outdoor programmes to have defined objectives has been stated
by many authors; indeed, objectives defined before a programme begins are a
major factor in the success or failure of this type of exercise. The objectives for
Journal of this workshop were developed jointly between the service’s chief ambulance
Management officer and the facilitators in order to ensure that the programme was designed
Development to meet the exact needs (and we hoped some latent needs) of the service. The
objectives underwent several iterations over the months preceding the
15,4
workshop. Of paramount importance was that the objectives be as measurable
as possible, and that they be simple and easy to understand. The five objectives
12 of the workshop were to:
(1) Develop some key components of a strategy for the ambulance service
that has the understanding and commitment of the station management
team, including:
• mission;
• roles;
• critical success factors;
• challenges.
(2) Develop improved understanding of the key services provided by the
ambulance service.
(3) Improve understanding of the principle and implementation of
continuous improvement.
(4) Develop improved teamwork within the station management team in a
variety of decision-making situations.
(5) Have some fun while doing this.
Objective one summarizes the primary documentation outputs of the workshop.
That was, for the teams to design their own mission; to understand their new
roles in a management and continuous improvement context; to develop critical
success factors for station management; and, finally, to understand the
challenges that were facing the service over the next few years and leading into
the next century. The purpose of this objective was to develop the beginning of
an ongoing strategy development process within the ambulance service. The
planned involvement of senior managers, as well as station managers,
encourages open discussion of major strategic options.
The second objective sought primarily to develop a more business-oriented
viewpoint of the services provided by the ambulance service, and to help the
station management teams discover for themselves some of the challenges,
strengths, weaknesses, threats and opportunities of the service. The purpose of
this was two-fold: on the one hand, its analysis supported strategic planning,
while on the other, it helped to develop a greater understanding of management
in a competitive environment.
The third objective sought to develop a knowledge of the basic constructs of
continuous improvement, and to help teams begin planning ways to improve
their station including its product and its process for delivering that product.
This was to start a cultural shift that was necessary to support recent quality A metropolitan
accreditation initiatives of the service. ambulance
Objective four was about the team becoming more aware about its members, service
both how they operate individually and how they operate as a team. Issues of
creativity, lateral thinking, participation, co-operation, competition,
communication and co-ordination are all important facets of team functioning.
Development of the team and of a “learning” environment are the last and final 13
key components of developing a learning organization.
The final objective was aimed at ensuring that we, as the facilitators, as well
as the team, were aware that an important component in any learning
experience is the level of enjoyment experienced. As facilitators for the teams at
the workshop, it was part of our responsibility to try and make the learning fun,
and therefore more effective.
If any team-building activity is to be truly worthwhile, it must ensure that, as
part of its development, systems and structures are put in place so that teams
are able to continue to work in a focused and cohesive manner. This is one of the
most convincing reasons for the importance of driving any team development
from the strategy and values of the sponsoring organization. The team must
understand how it fits into the system, and it must focus on the most important
factors (measurable performance criteria) which are critical to the success of the
organization in the long term. Effective means of communication must also be
developed between rosters and shifts.

Results
The workshop was conducted during July 1993, and since then has been the
basis of three follow-up meetings of the participants. Each month the
participants meet to discuss progress at their stations, identify obstacles to
change and improvement, and to reassess their planning for the future. Below,
each of the four effectiveness-measuring techniques is discussed in turn:
achieving objectives, developing team functioning, participant evaluation and
job performance.

Achieving workshop objectives

Once overall workshop objectives were set it was easy to translate them into
specific measurable outputs. These outputs then served to form the specific
objectives for each session in the workshop. These are depicted in Figures 3 and
4. They are separated into service-oriented (Figure 3) and station-oriented
(Figure 4) outputs, according to the structure of the overall workshop, where the
first day’s work was service-oriented, the second focused on station-
management, and the third on tying together all of the work and establishing
the next steps.
The team output from the workshop – both in terms of the team contract and
of the station strategy – provided a qualitative assessment of the ability of the
group to formulate and plan strategically.
Journal of
Business strategy for
Management
Development [Name of “service”]
15,4 One page for each of: Session

14 1. Industry attractiveness for services S1

2. Strength, weakness, opportunities and threats (SWOT)

analysis for services S1

3. Critical success factors (CSFs) for services S1

Figure 3.
Service-oriented outputs 4. Key challenges for the Auckland Ambulance Service S2

Developing team functioning

In addition to the practical side of actually designing and carrying out team
building, also evaluated was the effectiveness of the intervention on team
functioning. Team case studies, followed immediately by individual
questionnaires before and after the workshop, were used to distinguish team
content (the case-study solution) and team process the questionnaire recording
how the individuals felt during the case study[27-29]. A third station-
management team, commanding the only remaining similar-sized station, was
chosen as a control for the purposes of measuring “team functioning”. The
process questionnaire consisted of 20 questions based around five hypotheses:
H1: The workshop will improve team decision making.
H2: The workshop will help teams to become more participatory.
H3: The workshop will improve team efficiency.
H4: The workshop will improve team communication.
H5: The workshop will improve team experience.

Business strategy for

[Name of “station”]

One page for each of: Session

1. Team mission S7

2. Systems of CSFs for stations and portfolios –

station, stores, vehicles, volunteers and training S4

3. Understanding of leadership role S5

Figure 4.
Station-oriented outputs 4. Understanding of team values S3
Analysis found that the workshop positively influenced most characteristics of A metropolitan
how the workshop teams worked together: ambulance
• Team decision making improved over the workshop. It became more service
consensus-oriented ( p = 0.011), with some evidence that the teams
became more satisfied with team progress (p = 0.139).
• The teams became more participatory in nature during the workshop. 15
Members felt more actively involved in the task (p = 0.030), and there
was some weaker evidence that there was less alienation of individuals
(p = 0.173).
• The workshop positively affected the level of communication within the
teams. Team members were more able to give information to other team
members ( p = 0.046), and increased their overall rating of team
communication (p = 0.002). There was also evidence to suggest that rank
had less influence on idea sharing after the workshop ( p = 0.132) and
that the teams became more receptive to ideas generated by members
(p = 0.134).
• The workshop significantly improved the team experience of team
members. The teams felt that overall they worked better together ( p =
0.008), and that they became more committed to team solutions and
assumptions (p = 0.065). Team enjoyment also improved over the course
of the workshop (p = 0.091).
The single exception was team efficiency, where participants felt on both
occasions that their planning had been adequate, the issues discussed relevant,
time had been used efficiently, and that the output was entirely satisfactory.
A significant point was that the effects of the workshop were evident over a
period of almost four weeks. Initial post-workshop euphoria had subsided, and
since the second case study was the first event of the follow-up workshop, the
participants had not at that stage had the opportunity to rekindle that
excitement fully. Since team members were better able to identify improved
ways of operating as a team, the workshop has achieved not only the
beginnings of a developed organizational strategy, but a more enjoyable and
effective team spirit.
The control team for the experiment showed no results beyond what we may
expect due to random causes[30].

Participant evaluation
The third component of measurement is the questionnaires completed by the
participants, which encompass all facets of the activity from the preliminary
briefing to the follow-up session, the presentation of workshop staff, and the
nature of the accommodation. These data are critical for the design
considerations for future workshops, as well as for a complete evaluation of this
activity. Space was provided at the end of each topic for the participants to
make additional comments. The participant questionnaire is important from
Journal of the perspective of practising continuous improvement. Continuous quality
Management improvement is a major component of successful business.
Development Analysis of the participant questionnaires revealed an overall satisfaction
with every facet of the workshop and associated activities. Averaging the
15,4 responses to all 64 questions yielded an overall satisfaction of 6.00 (on a Likert
1-7 scale). This translates to an average rating of 85.7 per cent across all
16 questions – including sessions, physical challenge, food, accommodation and
all briefings! The four questions about the overall experience by themselves
averaged 6.44 (92 per cent). Perhaps most significantly, the comments about
each topic offer very constructive feedback, including suggestions about future
similar exercises.

Job performance
The fourth and final measurement tool is the longitudinal measure of whether
team job performance improved relative to teams which did not participate in
the programme. Of the two station-management teams which took part, one
still has its original members and has developed very well. The chief ambulance
officer describes it as the best functioning team in Auckland and one that has
developed a reputation for having a team approach and high staff involvement.
The officer in charge of the service’s continuous improvement system feels that
improvement suggestions from the station have been given more thought and
discussion than have those from other stations. The station’s senior officer tells
of other stations requesting information and assistance so that their stations
may also improve. The second station has lost a member of its management
team, and has had, for varying reasons, a particularly high level of staff
movement. Combined with greater workloads, the team has found it difficult to
pass on its learning or to engender motivation for change. Improvements are
not as obvious here as they are at the first station. This station’s senior officer
feels frustrated in his efforts, and does not have such strong support from his
other station managers.

Conclusions and further research

A new model for developing a learning organization
To become a learning organization, an organization must develop a wide range
of knowledge, skills and characteristics; however, the beginning step is to
develop the necessary structures to assist those within the organization, as well
as the organization itself, to learn and to change. A dynamic strategic planning
process, an empowered team-oriented environment and a continuous
improvement culture when combined with proactive visionary leadership and a
commitment to experiential learning, are fundamental structures on which to
build a learning organization.

Four evaluation techniques for experiential workshops

This article also presented an overview of the design and evaluation of an
experiential management development technique which is becoming
increasingly popular in the 1990s. This technique had definite objectives A metropolitan
relating to the development of learning organization systems, and also had ambulance
multiple measures for evaluating effectiveness. Four measurement techniques service
which sought to capture in different ways the effectiveness of the outdoor
workshop were described: meeting defined workshop objectives, measuring
change in team functioning, participant evaluation, and job performance.
The workshop: 17
(1) Achieved all objectives.
(2) Had a significant positive effect on the ability of the team to function
together and, specifically, improved:
• decision making;
• communication;
• participation; and
• team experience.
(3) Received positive and constructive evaluations.
(4) Significantly improved job performance at one of the two stations.

A case study of team and strategy development for health-care managers

Strategic planning is a fundamental component of success; the analysis of one’s
present circumstances and the determination of a future vision are very
important steps in the evaluation of organizational performance. Without a
future vision, a goal towards which to focus energy, organizations exist without
a clear purpose against which they can evaluate their performance. This article
presents a method of developing strategy, of engendering enthusiasm and
commitment to it, and of measuring steps in the implementation of it. Also
presented is a case study for team development in a health-care environment.
Team building in health care has been developed in many hospital-based
settings. However, this article is among the first scholarly writings to develop
teamwork with a pre-hospital emergency service. If teamwork does not function
in the stressful environment of pre-hospital emergency care then, clearly, lives
are at risk. The case study presents an effective method for improving the
ability of ambulance-service middle managers to function as a team and for
enabling these managers to develop their stations so as to provide improved
service.
Notes and references
1. Drucker, P.F., “The new society of organizations”, Harvard Business Review, September-
October 1992.
2. Sonnenberg, F. and Goldberg, B., “It’s a great idea, but…”, Training and Development
Journal, March 1992, pp. 65-68.
3. Senge, P.M., “The leader’s new work: building learning organizations”, Sloan Management
Review, Fall 1990, pp. 7-23.
Journal of 4. Fulmer, R.M. and Graham, K.R., “A new era of management education”, Journal of
Management Development, Vol. 12 No. 3, 1993, pp. 30-8.
Management 5. Argyris, C. and Schon, D., Organizational Learning, Addison-Wesley, Reading, MA, 1976.
Development 6. Argyris, C., “Strategy implementation: an experience in learning”, Organizational
15,4 Dynamics, Vol. 18 No. 2, 1989, pp. 5-15.
7 Senge, P.M., The Fifth Discipline – The Art and Practice of the Learning Organization,
18 Doubleday, New York, NY, 1990.
8. Mullen, T.P., “Integrating self-directed teams into the management development
curriculum”, Journal of Management Development, Vol. 11 No. 5, 1992, pp. 43-54.
9. White, J.A., “Applying an experiential learning styles framework to management and
professional development”, Journal of Management Development, Vol. 11 No. 5, 1992,
pp. 55-64.
10. Schein, E.H., “How can organizations learn faster? The challenge of entering the green
room”, Sloan Management Review, Winter 1993, pp. 85-92.
11. Boss, W., “Team building in health care”, Journal of Management Develoment, Vol. 10
No. 4, 1991, pp. 38-44.
12. Brooks, I., “Teamwork: how to improve your game”, Management, December 1991, pp. 124-
127.
13. Nichol, R.L., “Get middle managers involved in the planning process”, Journal of Business
Strategy, 1992, pp. 26-32.
14. Stewart, R. and Fondas, N., “How managers can think strategically about their jobs”,
Journal of Management Development, Vol. 11 No. 2, 1992, pp. 10-17.
15. Leibowitz, Z.B., Shore, J.E. and Schuman, G.M., “Managers can be developers too”,
Training and Development, March 1992, pp. 46-62.
16. The framework presented here is similar to that used in several courses organized by the
University of Auckland School of Commerce and the Graduate School of Business, as well
as to that suggested by Buller et al.[17] and Brauchle and Wright[18]. It is, and continues
to be, supported by ongoing research in the department of management science and
information systems at the University of Auckland, which evaluates its performance with
undergraduate and MBA courses and through working with organizations.
17. Buller, P., Cragun, J. and McEvoy, G., “Getting the most out of outdoor training”, Training
and Development Journal, March 1991, pp. 58-61.
18. Brauchle, P.E. and Wright, D.W., “Training work teams”, Training and Development,
March 1993, pp. 65-8.
19. Wagner, R., Baldwin, T. and Roland, C., “Outdoor training: revolution or fad?”, Training
and Development Journal, March 1991, pp. 50-65.
20. Mazany, P., Francis, S. and Sumich, P., “Evaluating the effectiveness of an outdoor
workshop for team building in a MBA programme”, Journal of Management Development,
Vol. 14 No. 3, 1995, pp. 50-68.
21. A thesis by Francis[22] also expands on the deficiency of effectiveness measurements for
management development workshops.
22. Francis, S., “Developing a learning organization at the Auckland Ambulance Service”, M.
Com. Thesis, University of Auckland, Auckland, 1993.
23. Schweiger et al.[24,25] use a similar framework. Fulmer[26] uses case studies but no formal
measurement for effectiveness.
24. Scheweiger, D., Sandberg, W. and Ragan, J.W., “Group approaches for improving strategic
decision making: a comparative analysis of dialectical inquiry, devil’s advocacy, and
consensus”, Academy of Management Journal, Vol. 29 No. 1, 1986, pp. 51-71.
 25. Scheweiger, D., Sandberg, W. and Rechner, P., “Experiential effects of dialectical inquiry, A metropolitan
devil’s advocacy, and consensus approaches to strategic decision making”, Academy of
Management Journal, Vol. 32 No. 4, 1989, pp. 745-72. ambulance
26. Fulmer, W.E., “Using cases in management developing programmes”, Journal of service
Management Development, Vol. 11 No. 3, 1992, pp. 33-7.
27. This continues the authors’ previous work[20,28]. The use of case studies to measure team
functioning is also used by Scheweiger et al. Scheweiger et al.[24,25] and Bettenhausen[29],
who also examine similar dimensions of team functioning. Mullen[8] also distinguishes 19
between process and content measures.
28. Mazany, P., Francis, S. and Sumich, P., “Evaluating the effectiveness of an experiential
‘hybrid’ workshop: strategy development and team building in a manufacturing
organization”, Journal of Management Development, Vol. 14 No. 1, 1995, pp. 40-52.
29. Bettenhausen, K.L., “Five years of groups research: what we have learned and what needs
to be addressed”, Journal of Management, Vol. 17 No. 2, 1991, pp. 345-81.
30. For detailed results, refer to Francis’s thesis[22].

Further reading
Argyris, C., “Teaching smart people how to learn”, Harvard Business Review, May-June, 1991, pp.
99-109.
Dobbs, J.H., “The empowerment environment”, Training and Development, February 1993, pp. 55-
7.
Hamilton, R.T., Dakin, S.R., and Loney, R.P., “Perspectives on management development in New
Zealand companies”, Journal of Management Development, Vol. 11 No. 7, 1991, pp. 30-6.
Sonnenberg, F., and Goldberg, B., “Encouraging employee-led change through constructive
learning processes”, Journal of Business Strategy, Vol. 13 No. 6, November/December 1992,
pp. 53-7.
Stata, R., “Organizational learning – the key to management innovation”, Sloan Management
Review, Spring 1989, pp. 63-74.
Stumpf, S.A. and Mullen, T.P., “Strategic leadership: concepts, skills, style and process”, Journal
of Management Development, Vol. 10 No. 1, 1991.