Changing competence requirements in public services: consequences of digitization in general and highly specialized work

The CORPUS project has generated new knowledge on requirements to professional expertise and learning in the primary health services, by conducting close-up studies on how digitalization generates changes in work organization and task distribution, what competencies are needed to cope with and resolve these challenges, and what learning opportunities are afforded in everyday work. The project has examined work and learning in settings where new technologies for service coordination and delivery are recently designed, implemented or reinvented for specific use. We have conducted fieldwork in two cases in the City of Oslo. One case followed the design, development and implementation of ELISE, a digital technology to facilitate information flow and coordination when patients move between units (e.g., from hospital to home care). Special attention was given to how health professionals as users participate in the design process and what this requires in terms of competencies. The other case followed knowledge sharing and collaborative practice development in the services directed towards home-based care, where new care technologies are taken into use in clients’ homes and changes the way health services are provided. In this case, special attention was given to groups of care personnel mandated to facilitate technology integration and adapt the services for these purposes. Our results showed that digitalization processes imply a manifold of new tasks and responsibilities for healthcare workers, which to a limited extent are made explicit. Health professionals who take part in the design of technologies for patient information sharing need to develop an understanding of the larger work system in which tasks and care services are embedded. Moreover, they need to assess and decide on the relevance of different information in different contexts of use. These participants oscillated between different designer roles as explorers, facilitators and negotiators of the emerging design features. Our analyses showed how their emerging responsibilities stretch beyond catering for their own work contexts and imply to design for other work processes and actors in the wider service flow. This work expands their professional expertise as capacities to identifying, delimiting and exploring design problems in a collaborative manner are required. Workers who were given coordinating responsibilities when welfare technologies were taken into use in the care services faced challenges as to navigating relations between different organizational functions, involved actors and organizational layers, and balancing various concerns in short and long perspectives while at the same time aiming at influencing implementation of technologies and development of services. Their tasks and responsibilities in the digitalization processes were to a limited extent formalized or specified. Thus, the crafting of their work role became itself a complex and learning-intensive task. Our analyses showed that this work has a relational character as care workers become and assume responsibilities for redefining and navigating relations to their colleagues, their leaders and clients in the service organization. These forms of ‘meta-work’ are typically not recognized as important work for the digitalization of health care to be realized. Over time, our analyses showed how scaling and connecting multiple technologies in digital infrastructures contribute to increased complexity and require the capacity to handle variation in work practices and meet immediate challenges, while safeguarding future strategic ambitions. Changing personnel also create challenges in securing continuity and leads to repetitive processes to bring new groups of employees on board. Many processes have to be repeated in different work environments to adapt the work organization to more intensified technology use. Results from the project have been disseminated in a final conference that was part of the Research Days 2024, at the national sector conference E-Health in Norway and at international research conferences. The project has also developed a prototype for a competence mapping tool that can support work organizations in mapping competence requirements and learning needs during digitalization processes. The results from the project will be relevant beyond the health sector and be useful for the further development of policies for lifelong learning in working life. For information about publications and other activities, see the project webpage: https://www.uv.uio.no/iped/english/research/projects/nerland-corpus/

Based on the research conducted in CORPUS, and through interaction with partners in the City of Oslo, we have developed a prototype for a competence mapping tool to assist primary care organisations in mapping emerging competences requirements and learning needs during digitization processes. This tool includes models and instructions for facilitators and managers of local competence development. We plan to apply for an innovation grant to further test and develop this tool for use in various work settings. The dissemination of project results include popular science presentations directed towards leaders and policy actors who plan or manage digitalisation processes in the public services. Results are, and will be, presented in teaching in various master-level programmes at UiO and BI directed towards digitalisation, leadership and learning at work. Interest in our results is manifested in the number of participants in our final dissemination conference, in responses to our presentations in the national digital health conference (EHiN), in invitations to present the results for the Norwegian Nurses Association’s annual congress 2025, as well as in continued collaboration with the City of Oslo. Based on these outcomes, we anticipate impact on digitization initiatives in work organisations including the municipality health sector. Our results are also beneficial for the national strategies and agencies supporting digital health and lifelong learning in the era of digital transformation. Moreover, our results lay the ground for further interdisciplinary research on digitalization and learning at work through the way learning at work is related to organisational processes and to the characteristics of different technologies and digitalization initiatives. Currently, the results are planned to inform research initiatives addressing ‘metawork’ and invisible work in digitalized environments; research on organizing for emerging technologies and digital transformation; expanded forms of professionalism in digitalized work; and research on user participation in technology design.

The CORPUS project will develop new and important knowledge on digitization, new skills requirements and learning in working life by conducting close-up studies of how digitization generates changes in work organisation and task distribution, what competences are needed to cope with and resolve these challenges, and what learning opportunities are afforded. Two digitization trends are highlighted: The datafication trend which relates to data-driven development and automation, and the platform trend, which relates to new forms of work coordination and distribution in digital platforms. CORPUS examines work and learning in settings where new technologies for service coordination and delivery are recently designed, implemented or reinvented for specific use. Public health services form the empirical sites. These are heavily exposed to different types of technology change, they employ a major portion of public sector employees with diverse background, and the capacities of work organisations, leaders and employees to use technologies and data in productive ways are critical for the sustainability of the welfare society. The sector offers productive cases for investigating the mundane consequences of digitization and how organisations and individuals master emerging challenges and take advantage of new opportunities for work and learning. CORPUS comprises researchers with expertise in the learning sciences, organisational sociology and computer science. The research work will be organized as a set of case studies in which work practices and learning will be studied by a) examining the 'information ecologies' that make up the work environments, and b) investigate how different groups of employees get access to information, engage in learning-on-the-job, and take advantage of opportunities for future-oriented development. CORPUS collaborates closely with users and stakeholders. The project includes collaboration and comparisons to other Nordic contexts.