Exploring varieties of knowledge in safe work practices - an ethnographic study of surgical teams

We address this concern by exploring the varieties in which knowledge is expressed during interdisciplinary surgical operations. Specifically, the study was conducted in a surgical section of a Norwegian regional general hospital, between January and April of 2010, by means of an ethnographic design combining detailed non-participant observations, conversations and semi-structured interviews.Based on an analysis of the gathered data, we identify three particular themes in how knowledge is expressed by operating room personnel: (i) the ability and variety individuals demonstrate in handling multiple sources of information, before reaching a particular decision, (ii) the variety of ways awareness or anticipation of future events is expressed, and (iii) the different ways sudden and unexpected situations are handled by the individual team members.We conclude that these facets of knowledge bring different insights into how safe work practices are achieved at an individual and team level in surgical operations, thus adding to the existing understanding of the nature of knowledge in safe work practices in surgical operations. Future research should focus on exploring and documenting the relationships between various elements of knowledge and safe work practices, in different surgical settings and countries.Traditionally, the process of ensuring clinical competency have been subjected to what Sch？n [1] terms a "technical rationality", that is a state of mind or mental model of problem solving using established scientific theories and techniques. However, health care literature in recent years have also looked to specific safety principles used in high reliability sectors [2-5], and recognized that the individual technical skills are only one part of the total skill repertoire applied by individuals as part of a team. Despite this, the dominance of the technical rationality seems to prevail, much of which can be attributed to weaknesses in the identification, understanding