Practising Knowing at Work: a case study in healthcare

Abstract

In healthcare today, medical knowledge is still largely viewed by the health sector as an ‘epistemology of possession’; a perspective which gives primacy to knowledge transfer and communication aspects of care. In my view, this perspective underestimates the complexity of the social, material, situated and collective way that doctors and nurses actually work together – and do knowledge – in order to care for their patients . I illustrate this complexity based on data from a large Australian Research Council (ARC) study by closely examining a case study of how a healthcare team cares for a dying 67-year old patient, Joel in an Emergency Room (ER). Drawing on ethnographic and linguistic ethnographic methodologies and data, ‘knowledge’ is proposed, not as ‘possession’, but as an activity, ‘a collective and distributed ‘doing’ situated in time and space, and therefore taking place in [the] work practices [of the ERs nurses and doctors]. Theoretically the paper adopts a ‘practice-based’ analysis of how team knowledge is done in the ER. In adopting this approach the paper challenges conventional views on knowledge, knowledge transfer and communication in healthcare – and more broadly in other organizational contexts – alerting us to new ways of thinking about how team knowledge is done and how organizational learning might be reconceptualized.