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Cited by 82Innovative Education and Learning PracticesAdult and Continuing Education TopicsInnovative Teaching and Learning Methods

Expertise in Transition: Expansive Learning in Medical Work

Engeström, Yrjö·2018·Cambridge University Press eBooks
DOI 10.1017/9781139023009
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Abstract

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.

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  • An example of knotworking is the collaborative development and implementation of a care agreement containing all relevant information about the patient's care in different units.

    “An example of knotworking is the collaborative development and implementation of an instrument called care agreement that contained all relevant information about the patient's care in different units (Engeström 2018).”

    From Using activity theory to transform medical work and learning (2021) · cites this paper as Engeström 2018

  • One major challenge in medical work today is fragmentation of care, or fragmentation of the object, especially salient in care of patients with multiple chronic conditions.

    “One of the major challenges in medical work today is the fragmentation of care, or in activity-theoretical terms, the fragmentation of the object, especially salient in the care of patients with multiple chronic conditions (Kerosuo and Engeström 2003;Engeström 2018;Meijer et al. 2020, in press).”

    From Using activity theory to transform medical work and learning (2021) · cites this paper as Engeström 2018

  • A Finnish study on development of a negotiated way between primary health care and specialized hospital care in Helsinki provides a rich description of a successful implementation of Change Laboratory in healthcare settings.

    “A Finnish study on the development of a negotiated way of working between primary health care and specialized hospital care in Helsinki (Engeström et al. 2003;Engeström 2018) provides a rich description of a successful implementation of Change Laboratory in healthcare settings.”

    From Using activity theory to transform medical work and learning (2021) · cites this paper as Engeström 2018

  • Change Laboratory interventions have been carried out and reported in various medical settings in Finland, Denmark, Brazil, and the United Kingdom.

    “Change Laboratory interventions have been carried out and reported in various medical settings in Finland (Engeström 2018), Denmark (Skipper et al. 2016), Brazil (Vilela et al. 2020;Grilo Diniz et al. 2020, in press) and the United Kingdom (Reid et al. 2015;Morris et al. 2020, in press).”

    From Using activity theory to transform medical work and learning (2021) · cites this paper as Engeström 2018

  • Studies on multimorbidity and fragmentation of care call for medical education to provide continuity, coordination, and collaboration across healthcare units and with patients.

    “Studies on multimorbidity and fragmentation of care call for medical education to adopt an approach that provides patients with continuity, coordination and collaboration across healthcare units and with patients under their care (Barnet et al. 2012;Braithwaite 2018;Engeström 2018).”

    From Using activity theory to transform medical work and learning (2021) · cites this paper as Engeström 2018

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Authors
Engeström, Y.
Affiliations
University of Helsinki (FI)
Corresponding author
Engeström, Yrjö
ORCID
Engeström, Yrjö
Venue
Cambridge University Press eBooks
Publisher
Cambridge University Press
Published
2018-07-27
DOI
10.1017/9781139023009
OpenAlex
W4240380228
Cited by
82
References
0
Citations by year
2026: 7 · 2025: 9 · 2024: 11 · 2023: 12 · 2022: 14 · 2021: 8 · 2020: 17 · 2019: 3 · 2018: 1
FWCI
8.80
Type
book
Language
en
Open access
closed
Locations
Cambridge University Press eBooks (publishedVersion)
Topics
  • Social Sciences › Human Factors and Ergonomics › Innovative Education and Learning Practices
  • Social Sciences › Education › Adult and Continuing Education Topics
  • Social Sciences › Psychology › Developmental and Educational Psychology › Innovative Teaching and Learning Methods
Keywords
expertise, collective expertise, expansive learning, activity theory, organizational change, complex tasks

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