Towards Understanding Workplace Learning Through Theorising Practice: At Work in Hospital Emergency Departments

Chapter
Part of the Professional and Practice-based Learning book series (PPBL, volume 8)

Abstract

Focusing on the experiences of one 95-year-old patient, Jane Edna, this chapter uses a practice theory approach to investigate in situ ‘knowing-in-practice’ (Gherardi, Situated knowledge and situated action: what do practice-based studies promise? In Barry D, Hansen H (eds) The Sage handbook of new approaches in management and organization. Sage, Los Angeles, pp 516–525, 370, 2009b) in emergency health care. In particular, we discuss relationships between work, knowledge/knowing and learning through an examination of professional and interprofessional ‘doings and sayings’ (Schatzki, Organ Stud 27(12):1863–1873, 2006) by clinicians around the bedside of Jane Edna, who spends over 11 h in a busy Australian hospital emergency department (ED). We present and explore some of the ethnographic and spoken interactional data recorded between Jane Edna and her team of clinicians.

We are primarily concerned with the practices and the potential for learning practices that the ED affords the junior doctor who directs Jane Edna’s care. The junior doctor’s ‘doings’, ‘sayings’ and ‘beings’ concentrate on applying biomedical scientific knowledge – practising medicine learned in vacuo – privileged within the institutional order (Sarangi and Roberts (eds), Talk, work and institutional order: discourse in medical, mediation and management settings. Mouton de Gruyter, Berlin/New York, 1999) of the ED. We consider the interplay and consequences of differentially valued epistemologies (Cook and Brown, Organ Sci 10(4):381–400, 1999), in particular, the dominance of ‘organisational knowledge’ (knowledge possessed by individuals – here, high-status doctors). We discuss how ‘organisational knowing’ (the collective working/knowing of all the participants who care for Jane Edna including Jane Edna herself) and ‘knowing-in-practice’ (Gherardi, Learn Organ 16(5):352–359, 2009a) could be more explicitly foregrounded to help create the team-based models of care that are enshrined in twenty-first-century hospital policies.

The chapter concludes with some implications for understanding practice and learning practice in organisations as doing knowledge together where knowledge is emergent and co-constructed in situ through language, actions, relationships and material arrangements.

Keywords

Emergency Department Clinical Team Junior Doctor Organisational Knowledge Workplace Learning 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

References

  1. Antonacopoulou, E. (2009). Impact and scholarship: Unlearning and practising to co-create actionable. Management Learning, 40(4), 421–430.CrossRefGoogle Scholar
  2. Australasian College of Emergency Medicine. (2004). Access block and overcrowding in emergency departments. West Melbourne: Australasian College of Emergency Medicine.Google Scholar
  3. Cook, J., & Brown, S. (1999). Bridging epistemologies: The generative dance between organizational knowledge and organizational knowing. Organization Science, 10(4), 381–400.CrossRefGoogle Scholar
  4. Engestrom, Y. (2008). From teams to knots: Activity-theoretical studies of collaboration and learning at work. New York: Cambridge University Press.CrossRefGoogle Scholar
  5. Gergen, K. J. (1985). The social constructionist movement in modern psychology. American Psychologist, 40(3), 266–275.CrossRefGoogle Scholar
  6. Gherardi, S. (2000). Practice-based theorizing on learning and knowing in organizations. Organization, 7(2), 211–223.CrossRefGoogle Scholar
  7. Gherardi, S. (2008). Situated knowledge and situated action: What do practice-based studies promise? In D. Barry & H. Hansen (Eds.), The Sage handbook of new approaches in management and organization (pp. 516–525). Los Angeles: Sage.Google Scholar
  8. Gherardi, S. (2009). Knowing and learning in practice-based studies: An introduction. The Learning Organization, 16(5), 352–359.CrossRefGoogle Scholar
  9. Green, B. (2009). Introduction: Understanding and researching professional practice. In B. Green (Ed.), Understanding and researching professional practice. Amsterdam: Sense Publishers.Google Scholar
  10. Hak, T. (1999). “Text” and “con-text”: Talk bias in studies of health care work. In S. Sarangi & C. Roberts (Eds.), Talk, work and institutional order (pp. 427–451). New York: Mouton de Gruyter.CrossRefGoogle Scholar
  11. Hobbs, P. (2007). The communicative functions of the hospital medical chart. In R. Iedema (Ed.), The discourse of hospital communication: Tracing complexities in contemporary health care organizations. Houndmills: Palgrave Macmillan.Google Scholar
  12. Johnsson, M., & Boud, D. (2010). Towards an emerging view of learning work. International Journal of Lifelong Education, 29(3), 359–372.CrossRefGoogle Scholar
  13. Liaschenko, J., & Fisher, A. (1999). Theorizing the knowledge that nurses use in the conduct of their work. Scholarly Inquiry for Nursing Practice: An International Journal, 13(1), 29–41.Google Scholar
  14. Lingard, L., Reznick, R., Espin, S., Regehr, G., & DeVito, I. (2002). Team communications in the operating room: Talk patterns, sites of tension, and implications for novices. Academic Medicine, 77(3), 232–237.CrossRefGoogle Scholar
  15. Macpherson, A., Elliot, D., & Antonacopoulou, E. (2010). The impact of learning on policy development in response to crisis. Paper presented to the Organization Learning Knowledge Capabilities, Boston.Google Scholar
  16. Matthews, L. R., Pockett, R. B., Nisbet, G., Thisthlethwaite, J. E., Dunston, R., Lee, A., & White, J. F. (2011). Building capacity in Australian interprofessional health education: Perspectives from key health and higher education stakeholders. Australian Health Review, 35, 136–140.Google Scholar
  17. Neal, D. M., & McKenzie, P. J. (2010). Putting the pieces together: Endometriosis blogs, cognitive authority, and collaborative information behaviour. Unpublished, Faculty of Information and Media Studies, UWO, London, ON.Google Scholar
  18. Reddy, M. C., & Spence, P. R. (2008). Collaborative information seeking: A field study of a multidisciplinary patient care team. Information Processing and Management, 44(1), 242–255.CrossRefGoogle Scholar
  19. Risser, D. T., Rice, M. M., Salisbury, M. L., Simon, R., Jay, G. D., & Berns, S. D. (1999). The potential for improved teamwork to reduce medical errors in the emergency department. Annals of Emergency Medicine, 34(3), 373–383.CrossRefGoogle Scholar
  20. Sarangi, S., & Roberts, C. (Eds.). (1999). Talk, work and institutional order: Discourse in medical, mediation and management settings. Berlin/New York: Mouton de Gruyter.Google Scholar
  21. Schatzki, T. R. (2002). The site of the social: A philosophical account of the constitution of social life and change. University Park: Pennsylvania State University Press.Google Scholar
  22. Schatzki, T. R. (2005). The sites of organizations. Organization Studies, 26, 465–484.CrossRefGoogle Scholar
  23. Schatzki, T. R. (2006). On organizations as they happen. Organization Studies, 27(12), 1863–1873.CrossRefGoogle Scholar
  24. Stein-Parbury, J., & Liaschenko, J. (2007). Understanding collaboration between nurses and physicians as knowledge at work. American Journal of Critical Care, 16(5), 440–447.Google Scholar

Copyright information

© Springer Science+Business Media Dordrecht 2012

Authors and Affiliations

  1. 1.Faculty of Arts & Social SciencesUniversity of Technology, SydneySydneyAustralia

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