Expertise in Transition
Expansive Learning in Medical Work

Expertise is recast as fluid collaboration on complex tasks that requires envisioning the future and mastering change.

Yrjö Engeström (Author)

9780521407854, Cambridge University Press

Paperback, published 2 August 2018

290 pages, 46 b/w illus. 5 tables
22.8 x 15.3 x 1.6 cm, 0.44 kg

'This is simply the best book that I have read on medical education … Engeström's thinking … is far ahead of that of anybody else whom I know in the field of clinical education, and we should be grateful for his cumulative insights, theorising, and modelling. They provide extraordinarily rich templates for anybody pursuing innovative, applied clinical education research. … It should be standard reading across medical schools and postgraduate medical centres.' Alan Bleakley, Mind, Culture, and Activity

This book challenges standard notions of expertise. In today's world, truly effective expertise is built on fluid collaboration between practitioners from multiple backgrounds. Such collaborative expertise must also be transformative, must be able to tackle emerging new problems and changes in its organizational framework. Engeström argues that the transition toward collaborative and transformative expertise is based on three pillars: expertise needs to be understood and cultivated as a collective activity; expertise needs to be built on flexible knot-working among diverse practitioners; and expertise needs to be fostered as the expansive learning of models and patterns of activity that are in progress. In this book, Engeström recasts expertise as fluid collaboration on complex tasks that requires envisioning the future and mastering change.

Part I. The Theoretical Landscape: 1. Toward a new framework for understanding expertise
Part II. Expertise as Objected-Oriented Activity: 2. Constructing the object in the work activity of primary care physicians
3. Objects and contradictions as drivers of expert work
4. Spatial and temporal expansion of the object
Part III. Expertise as Knotworking: 5. The emergence of knotworking in medicine
6. Knotworking as expansive decision making
7. Knotworking as history making
Part IV. Expertise as Expansive Learning: 8. Expansive visibilization of medical work
9. Expansive learning in a hospital
10. The horizontal dimension of expansive learning
Part V. Toward Collaborative and Transformative Expertise: 11. From stabilization knowledge to possibility knowledge
12. Expertise in transition.

Subject Areas: Medical sociology [MBS], Occupational & industrial psychology [JMJ], Humanistic psychology [JMAN], Psychology [JM], Sociology: work & labour [JHBL]