Rule-Based Learning: Problem Absorption and Knowledge Integration into Clinical Practice Guidelines

Abstract Martin Schulz

This study extends theories of rule-based learning by investigating how imprints of knowledge from diverse sources on a rule interact and affect rule persistence and change. Drawing from organizational learning literature, we propose two mechanisms: problem absorption and knowledge combination. By examining the evolution of Clinical Practice Guidelines – rules that guide the work of health care practitioners – in a Canadian regional health organization, we find the evidence of both mechanisms. Specifically, we show that knowledge imprints originating from a given source can stabilize rules by absorbing problems related to that source and that non-local knowledge integration can have unanticipated outcomes that can be smoothed by integrating local knowledge into the rule.  The implications of the study on theories of organizational learning are discussed.

Abstract Pursey Heugens

This paper examines how organizational politics influence bureaucratic rule change. Through an event history analysis of changes to the organizational rules in the World Heritage Program of the United Nations Educational, Scientific and Cultural Organization (UNESCO) between 1977 and 2004, we test a set of hypotheses predicting that rule changes in bureaucracies will be driven by dominant coalition power processes against a set of competing hypotheses that such changes derive from rational adaptation to technical contingencies. In line with the political perspective, we find that change in World Heritage rules is related to the normative power and cultural heterogeneity of the states represented on the World Heritage Committee in a given year, and that these relationships exist even after controlling for technical factors. These findings contribute to research on the dynamics of organizational rules by suggesting that the composition of the rulemaking body exerts an independent effect on rule change that needs to be explicitly taken into account. Our study also has implications for the analysis of the dysfunctions of bureaucracy, indicating that bureaucratic inertia stems from the heterogeneity of rule makers rather than their overall power positions.