What is knowledge work?
Knowledge work is about managing complex problems. A problem is ‘complex’ when there are multiple different ways we can - and indeed need to - look at that problem. Things get even harder when these different perspectives contradict each other. A complex problem will have multiple possible outcomes. The distinct skill of the knowledge worker is to create understanding when dealing with complex problems.
Creating understanding needs 3 elements: critical creative Exploration of a problem, to construct an Explanation that guides action, and Evaluation to determine the value and impact of this.
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The knowledge work of daily practice is complex and hard. So how do we make it manageable in the challenges of everyday practice?
Gabbay and le May’s work has helped us understand how GPs already do this work – by creating mindlines in practice, to help with the challenge of daily knowledge work(1). We can think of mindlines as flexible ‘guidelines in the head’. They incorporate knowledge that we gain through our experiences which we may not be aware of (tacit knowledge)(2), as well as formal training, research evidence, guidelines, stories and narratives and the social and cultural context that we practice in. We create mindlines by interacting with other clinicians, patients and our teams. They are a form of ‘practice-based evidence’ – knowledge created in-practice-in-context.
When a patients’ symptoms don’t fit the guidelines we are asked to work within, mindlines can help us negotiate complexity.
1. Gabbay J, le May A (2004) Evidence based guidelines or collectively constructed ‘mindlines’? Ethnographic study of knowledge management in primary care. BMJ 329(7473):1249–1252.
2. Ray, T. (2009). Rethinking Polanyi’s Concept of Tacit Knowledge: From Personal Knowing to Imagined Institutions. Minerva, 47(1), 75–92. https://doi.org/10.1007/s11024-009-9119-1