Learning as strategy dependent

This paper considers the effects of multiple trajectories for learning in the development of new technological competencies. We articulate two distinct dimensions of new technology learning, one that involves becoming more efficient and the other that involves improving the ability to use a new technology to provide unusual or difficult-to-execute services. The former allows a favorable cost picture; the latter serves certain customers that others may not be able to serve. We propose that organizations implementing new technologies will tend to improve along these two trajectories at different rates and that there will be tradeoffs between the two. We investigate these propositions in a data set on hospitals adopting a new technology for cardiac surgery. Data from 679 patients who underwent operations in nine academic and seven community hospitals learning to use the technology between 1996-1998 are used to estimate learning curves for surgical teams along both directions of performance improvement efficiency and difficulty. Results support the existence of two distinct learning curves, support the proposed tradeoff, and show that academic medical centers are more likely to improve operative difficulty quickly while community hospitals are more likely to improve operative efficiency quickly.