The use of tacit and explicit knowledge in public health: a qualitative study

Implementation Science

Nancy Edwards³  Shannon Sibbald¹  Michael Rouse⁴  Maureen Dobbins²  Debbie Rudman¹  Anita Kothari¹ 

[1] Faculty of Health Sciences, The University of Western Ontario, Richmond Street, London, Canada;School of Nursing, McMaster University, Main Street West, Hamilton, Canada;Faculty of Health Sciences and Faculty of Medicine, University of Ottawa, Laurier Avenue East, Ottawa, Canada;Richard Ivey School of Business, The University of Western Ontario, Richmond Street, London, Canada

关键词: Program planning;    Public health;    Narrative inquiry;    Tacit knowledge;    Knowledge translation;   

Others  :  1146998
DOI  :  10.1186/1748-5908-7-20

 received in 2011-06-07, accepted in 2012-03-20,  发布年份 2012

【 摘 要 】

Background

Planning a public health initiative is both a science and an art. Public health practitioners work in a complex, often time-constrained environment, where formal research literature can be unavailable or uncertain. Consequently, public health practitioners often draw upon other forms of knowledge.

Methods

Through use of one-on-one interviews and focus groups, we aimed to gain a better understanding of how tacit knowledge is used to inform program initiatives in public health. This study was designed as a narrative inquiry, which is based on the assumption that we make sense of the world by telling stories. Four public health units were purposively selected for maximum variation, based on geography and academic affiliation.

Results

Analysis revealed different ways in which tacit knowledge was used to plan the public health program or initiative, including discovering the opportunity, bringing a team together, and working out program details (such as partnering, funding).

Conclusions

The findings of this study demonstrate that tacit knowledge is drawn upon, and embedded within, various stages of the process of program planning in public health. The results will be useful in guiding the development of future knowledge translation strategies for public health organizations and decision makers.

【 授权许可】

   
2012 Kothari et al; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

【 参考文献 】

• [1]Kiefer L, Frank J, Di Ruggiero E, Dobbins M, Manuel D, Gully PR, Mowat D: Fostering evidence-based decision-making in Canada: Examining the need for a Canadian population and public health evidence centre and research network. Can J Public Health 2005, 96(3):I1-I19.
• [2]Mitton C, Adair CE, McKenzie E, Patten SB, Waye B: Knowledge transfer and exchange: Review and synthesis of the literature. Milbank Q 2007, 85(4):729-768.
• [3]Duguid P: 'The art of knowing': Social and tacit dimensions of knowledge and the limits of the community of practice. Inform Soc 2005, 21(2):109-118.
• [4]Landry R, Amara N, Pablos-Mendes A, Shademani R, Gold I: The knowledge-value chain: A conceptual framework for knowledge translation in health. B World Health Organ 2006, 84(8):597-602.
• [5]Connell NAD, Klein JH, Powell PL: It's tacit knowledge but not as we know it: Redirecting the search for knowledge. J Oper Res Soc 2003, 54(2):140-152.
• [6]Gabbay J, le May A: Evidence based guidelines or collectively constructed 'mindlines?' ethnographic study of knowledge management in primary care. BMJ 2004, 329(7473):1013-1018.
• [7]Patel V, Arocha J, Kaufman D: Expertise and tacit knowledge in medicine. In Tacit knowledge in professional practice: Researcher and practitioner perspectives. Edited by Sternberg RJ, Horvath JA. Mahwah: Lawrence Erlbaum Associates; 1999:75-101.
• [8]Smith A, Goodwin D, Mort M, Pope C: Expertise in practice: An ethnographic study exploring acquisition and use of knowledge in anaesthesia. Brit J Anaesth 2003, 91(3):319-328.
• [9]Leonard N, Insch GS: Tacit knowledge in academia: A proposed model and measurement scale. J Psych 2005, 139(6):495-512.
• [10]Polanyi M: The tacit dimension. Gloucester, MA: Peter Smith; 1966:4. Polanyi M, 1966. The tacit dimension. Peter Smith, Gloucester, MA, pp. 4
• [11]Ambrosini V, Bowman C: Tacit knowledge: Some suggestions for operationalization. J Manage Stud 2001, 38(6):811-829.
• [12]Becker MC: Organizational routines: A review of the literature. Ind Corp Change 2004, 13(4):643-678.
• [13]Jasimuddin SM, Klein JH, Connell C: The paradox of using tacit and explicit knowledge. Manage Dec 2005, 43(1):102-112.
• [14]Nonaka I: A dynamic theory of organizational knowledge creation. Organ Sci 1994, 5(1):14-37.
• [15]McAdam R, Mason B, McCrory J: Exploring the dichotomies within the tacit knowledge literature: towards a process of tacit knowing in organizations. J Knowledge Manage 2007, 11(2):43-59. p.46
• [16]Stein EW: Organizational memory: Review of concepts and recommendations for management. Int J Inform Manage 1995, 15(1):17-32.
• [17]Orlikowski WJ: Knowing in practice: Enacting a collective capability in distributed organizing. Organ Sci 2002, 13(3):249-273.
• [18]Nonaka I, Toyama R: A firm as a dialectical being: Towards a dynamic theory of a firm. Ind Corp Change 2002, 11(5):995-1009.
• [19]Estabrooks CA, Rutakumwa W, O'Leary KA, Profetto-McGrath J, Milner M, Levers MJ, Scott-Findlay S: Sources of practice knowledge among nurses. Qual Health Res 2005, 15(4):460-476.
• [20]Carper B: Fundamental patterns of knowing in nursing. Adv Nurs Sci 1978, 1(1):13-24.
• [21]Rycroft-Malone J, Seers K, Titchen A, Harvey G, Kitson A, McCormack B: What counts as evidence in evidence-based practice? J Adv Nurs 2004, 47(1):81-90.
• [22]Brownson RC, Fielding JE, Maylahn CM: Evidence-based public health: A fundamental concept for public health practice. Annu Rev Public Health 2009, 30:175-201.
• [23]The Health Communication Unit at the Centre for Health Promotion, University of Toronto: Introduction to Health Promotion Program Planning. Toronto. 2001.
• [24]Government of Ontario: Guide to Strategic and Program Planning. Ontario. 2005.
• [25]Region of Waterloo Public Health: Evidence and Practice-based planning framework with a focus on health inequities: Based on the new Ontario Public Health Standards and the Population Health Assessment and Surveillance Protocol. Waterloo. 2009.
• [26]National Public Health Partnership: Planning Framework for Public Health Practice. Melbourne. 2000.
• [27]National Association of County & City Health Officials: MAPP Framework. [http://www.naccho.org/topics/infrastructure/mapp/framework/] webcite
• [28]Metropolitan Toronto District Health Council: A Guide to Needs/Impact-Based Planning, Final Report of the Needs/Impact Based Planning Committee to the Ministry of Health, Community Health Division. Toronto. 1996.
• [29]Intervention Mapping: The Protocol. [http://interventionmapping.com/?q=node/1711] webcite
• [30]Green LW, Kreuter MW: Health Promotion Planning: An Educational and Ecological Approach. 4th edition. New York: McGraw-Hill; 2004.
• [31]The Health Communication Unit at the Centre for Health Promotion, University of Toronto: Logic Models Workbook. Toronto. 2001.
• [32]Edwards RW, Jumper-Thurman P, Plested BA, Oetting ER, Swanson L: Community readiness: Research to practice. J Community Psychol 2000, 28(3):291-307.
• [33]Health System Intelligence Project: The Health Planner's Toolkit: Module 3 Evidence-based Planning. Ontario. 2006.
• [34]Greenhalgh J, Flynn R, Long AF, Tyson S: Tacit and encoded knowledge in the use of standardised outcome measures in multidisciplinary team decision making: A case study of in-patient neurorehabilitation. Soc Sci Med 2008, 67(1):183-194.
• [35]Smith A, Goodwin D, Mort M, Pope C: Expertise in practice: An ethnographic study exploring acquisition and use of knowledge in anaesthesia. Brit J Anaesth 2003, 91(3):319-328.
• [36]Herbig B, Büssing A, Ewert T: The role of tacit knowledge in the work context of nursing. J Adv Nurs 2001, 34(5):687-695.
• [37]Yoshioka-Maeda K, Murashima S, Asahara K: Tacit knowledge of public health nurses in identifying community health problems and need for new services: A case study. Int J Nurs Stud 2006, 43(7):819-826.
• [38]Thornton T: Tacit knowledge as the unifying factor in evidence based medicine and clinical judgement. Philos Ethics Humanit Med 2006, 1:2-11. BioMed Central Full Text
• [39]Friedman LH, Bernell SL: The importance of team level tacit knowledge and related characteristics of high-performing health care teams. Health Care Manage Rev 2006, 31(3):223-230.
• [40]Pavitt K: Key characteristics of the large innovating firm. British J Manage 1991, 2:41-50.
• [41]Sobol MG, Lei D: Environment, manufacturing technology and embedded knowledge. Int J Hum Factor in Manage 1994, 4(2):167-189.
• [42]Sternberg RJ, Wagner RK (Eds): Practical intelligence: Nature and origins of competence in the everyday world. New York: Cambridge University Press; 1986.
• [43]Nonaka I: The knowledge-creating company. Harvard Bus Rev 1991, 69(6):96-104.
• [44]Klein GA, Calderwood R, MacGregor D: Critical decision method for eliciting knowledge. IEEE Trans Syst Man Cybern 1989, 19(3):462-472.
• [45]Taylor H: A critical decision interview approach to capturing tacit knowledge: principles and application. Int J Knowledge Manage 2005, 1(3):25-39.
• [46]Abidi SSR, Cheah Y, Curran J: A Knowledge Creation Info-Structure to Acquire and Crystallize the Tacit Knowledge of Health-Care Experts. IEEE Trans Inf Technol Biomed 2005, 9(2):193-204.
• [47]Richards D, Busch P: Acquiring and applying contextualised tacit knowledge. J Inf Knowledge Manage 2003, 2(2):179-190.
• [48]Zappavigna M, Patrick J: Eliciting tacit knowledge about requirement analysis with a Grammar-targeted Interview Method (GIM). Eur J Inform Syst 2010, 19:49-59.
• [49]Colombo M: Reflexivity and narratives in action research: A discursive approach. Forum Qual Sozialforschung/Forum Qual Soc Res 2003, 4(2):9.
• [50]Mishler EG: Models of narrative analysis: A typology. J Narrat Life Hist 1995, 5(2):87-123.
• [51]Parse RR: Qualitative inquiry: The path of sciencing. Mississauga: Jones and Bartlett Publishers Canada; 2001.
• [52]Riessman C, Quinney L: Narrative in social work. Qual Soc Work 2005, 4(4):391-412.
• [53]Statistics Canada: [http://www40.statcan.gc.ca/l01/cst01/demo31a-eng.htm] webcitePopulation by sex and age group, by province and territory. 2010.
• [54]Ontario Ministry of Finance: Public health program - vote 1406. [http://www.fin.gov.on.ca/en/budget/estimates/2010-11/volume1/] webciteExpenditure estimates of the province of Ontario for the fiscal year ending march 31, 2011. Ontario 2010.
• [55]Bruner J: The narrative construction of reality. Crit Inquiry 1991, 18(1):1-21.
• [56]Wengraf T: Qualitative research interviewing: Biographic narrative and semi-structured methods. Thousand Oaks: Sage Publications; 2001.
• [57]Fraser H: Doing narrative research: Analyzing personal stories line-by-line. London: Sage Publications; 2004.
• [58]Rice P, Ezzy D: Qualitative research methods: A health focus. Melbourne: Oxford University Press; 1999.
• [59]Aita V, McIlvan H, Susman J, Crabtree B: Using metaphor as a qualitative analytic approach to understand complexity in primary care research. Qual Health Res 2003, 13(10):1419-1431.
• [60]Steger T: The stories metaphors tell: Metaphors as a tool to decipher tacit aspects of narratives. Field Methods 2007, 19(1):3-23.
• [61]Krueger RA: Focus groups: A practical guide for applied research. 2nd edition. Thousand Oaks, CA: SAGE Publications; 1994.
• [62]Patton M: Qualitative Research and Evaluation Methods. Thousand Oaks, CA: Sage Publications; 2002.
• [63]Upshur REG, VanDenKerkhof EG, Goel V: Meaning and measurement: An inclusive model of evidence in health care. J Eval Clin Pract 2001, 7(2):91-96.
• [64]Haynes RB, Devereaux P, Guyatt GH: Physicians' and patients' choices in evidence based practice: Evidence does not make decisions, people do. BMJ 2002, 324(7350):1350.
• [65]Chen HT: The bottom-up approach to integrative validity: A new perspective for program evaluation. Eval Program Plann 2010, 33(3):205-214.