Philosophies of Knowledge in the Workplace

Knowledge philosophies manifest in a variety of ways and in a variety of business models in the U.S. today. Some business models may lean more towards the rationalism theory of knowledge transfer, while others may lean more towards the empirical model.

Certain business models may require a high tacit transfer of knowledge while other models may require explicit types of knowledge transfer. In this paper, we will be looking at the philosophies of knowledge involved in the healthcare and educational settings. The paper will compare and contrast each modalities philosophy of knowledge and end with a discussion of which approaches can be universally applied verses those, which are more job specific.

Philosophies of Knowledge in the Healthcare Setting

The empiricim theory clearly is the theory favored by healthcare.

Once the healthcare system falters and a patient does not respond favorably to an empirical modality of treatment some healthcare professionals move into the realm of core rationalism.

Core Rationalism believes, “We have knowledge of reality through the non empirical use of reason” In healthcare, there is always a debate between clinicians who are in favor of trying every new modality of treatment and those skeptics who prefer to continue using what has worked in the past with the majority of patients.

Although I do not believe clinicians are as skeptical as Sextus Empiricus, in some cases patients do suffer and die because new and more advanced treatments are withheld. One problem furthering skepticism in healthcare is the fact that using the same modality in different patients will result in different outcomes. Skeptics who play the odds and use the same treatment modality, even in the face of new regimens, base their beliefs on using what works for the majority. This can be very short sighted and life threatening for those patients who do not fit into the normal category. On the other hand, a healthy skepticism belongs in healthcare. Some new treatment modalities may not be as effective as the old may over time. Several years, after initial marketing, may be needed before a new modality faces removal from the marketplace due to developing dangers. Lastly, the method of knowledge transfer utilized in the healthcare settings may actually cause skepticism in this writer’s opinion.

During formal schooling, knowledge transfers through several different methods, which relate to the professional’s area of study and licensing requirements. As part of this formal education, healthcare professionals work and learn together in a group-oriented environment with the free-flow of ideas between student and mentor and student-to-student. This knowledge transfer method breaks down once one begins professional practice as knowledge transfer is relegated to attending continuing education sessions, where very little interaction occurs or one has to rely on representatives from the drug or product companies. As Knowledge Emergence, the most important way to create new knowledge or build on existing knowledge is through interaction. This interaction needs to occur somewhere that allows for the free flow of ideas and creativity. In healthcare, this type of knowledge creation is stifled through a mountain of rules, regulations, policies, and procedures and through the retained vestiges of a old management style, which creates several different power centers in every healthcare environment. Let us look now at the philosophies of knowledge utilized in the educational setting.

Philosophies of Knowledge in the Education Setting

Unlike healthcare, most levels of higher education do not adhere closely to the empiricist model. In lower levels like K-12, instructors do use sensory experience to determine student development. This method is combined with tests to determine mastery of curriculum. Sensory experience can also be used to determine the effectiveness of curriculum. Instructors can judge based on student emotion whether curriculum is too hard or too easy. For example, if students seem frustrated with a particular reading, it may be too advanced. On the other hand, if students quickly finish an exercise, the exercise may not be adequately challenging them. These experiences create knowledge and knowledge creates changes in behavior or curriculum in this case.

For most teachers, reason guides the development of curriculum. Instructors bring past experience and knowledge together to develop learning materials. Past experience derives primarily from concepts learned in school, experience in the field, and translated through relationships.

When three individuals have worked together for a long time, they instinctively know each other’s strengths and weaknesses, under those that could be taken for granted. Consequently, groups form beliefs about what works well and what does not, and this knowledge is over and above the knowledge residing in each individual member.” (Becerra-Fernandez, Gonzalez, Sabherwal, 2004, p. 25)

Nonaka and Nishiguchi (2001) would refer to these relationships as socialization. “In practice, socialization involves capturing knowledge through physical proximity. Experience combined with training and communicated information forms the instructor’s reality in the classroom. For example, experience may tell an instructor that a particular reading may be essential to understand a concept. This reading may be followed up with a writing assignment in order to demonstrate and reinforce knowledge acquisition.

Skepticism is taught extensively at the graduate and doctorate levels of education. Many researcher modeled doctoral programs emphasize the denial of truth when investigating problems. Many university professors are researchers. The scientific process gives researchers a tool for creating arguments that either counter or support current states of knowledge. This model emphasizes that facts can never be found, instead support can be found for ideas. Research professors use the scientific process as a model for their research and understand the importance of denying the truth.

Similar to healthcare, educators, especially researchers share findings with the rest of the community through publications, which include specialized journals, popular press articles, and books. Information is also spread during conferences and classroom instruction. In this respect, professors do not see themselves as much a part of an institution as part of a specific field like cognitive psychology. Instead their respective organization is viewed more as a location or ba. Important research findings translate to university notoriety, which facilitates the recruitment of talented learners.

Knowledge in Healthcare verses Education

Knowledge acquisition changes in education depending on the level that you are investigating. For example, K-12 teachers are more likely to apply reason when instructing than hard research findings. The same is true for Healthcare. Some healthcare workers are trained as researchers; especially those working in the education field, while others, like medical doctors, are trained to diagnose problems using reason and empirical evidence. Unfortunately, malpractice lawsuits, and current payment structures, have taken a major toll in healthcare and thus most healthcare professionals today must rely on empirical evidence to determine treatment modalities. Documentation supporting the treatment choices becomes essential in the event of a lawsuit, thus empirical evidence is now more important than reason when deciding on a treatment. In addition to the effects of malpractice, current payment strategies by such payors as Medicare, Medicaid and many insurance companies, stress the importance of empirically tested treatment modalities and predetermined treatment pathways. These empirically tested treatment modalities, and predetermined treatment pathways, are commonly referred to as cookbook medicine by some healthcare professionals. This myopic focus on malpractice, coupled with current payment strategies, affects the universal method of knowledge acquisition in healthcare.

In healthcare today practitioner knowledge is universally acquired and transferred by the use of empirical data. This empirical data is disseminated in medical journals, continuing education programs, professional conventions and sales representatives. Tacit types of knowledge in certain areas of healthcare is initially acquired by peer training. This peer training runs the gamete from surgical training to the taking of blood pressures by nurses. Once the basic tacit skills are acquired, further knowledge acquisition in these areas also occurs through the use of empirical data. This reliance on empirical data, predetermined treatment pathways and specific treatment modalites does not allow for the creation of knowledge through social interactions nor empowerment of these knowledge workers in healthcare.

As noted by Pontecorvo, C. (1993), social interactions are essential if one wishes to create new knowledge or build on existing knowledge. A research study by P. Jackson (2003) also notes the importance of knowledge workers empowerment in the creation of knowledge and even the management guru, Peter Drucker (1999) notes the importance of restructuring work environments to include knowledge worker empowerment and social interactions if one wishes to create new knowledge. What does this mean to healthcare? Currently healthcare and its knowledge workers do not feel empowered, they are not challenged to create new knowledge and thus the healthcare field is not experiencing any leaps in clinical innovations. In addition, healthcare is losing its best and brightest to other fields of work, which allow for more personal satisfaction.

K-12 teachers and many drug researchers do not use the same cross-organizational communication that is common among medical doctors and research faculty. Instead, these groups communicate more extensively within their organizations. Drug researchers may even be forbidden to share findings with external groups or individuals.

Healthcare workers are primarily trained as practitioners, while most professors are trained as researchers. However, both see themselves as part of a greater community (respective field) than part of any particular organization. Their work focuses on the progress of society rather than any particular organization. This researcher versus practitioner model translates into a difference between how knowledge is acquired. Many practitioners are not trained as researchers and as a result do not have the skeptical skills needed to investigate problems and separate empirical argument findings and reason from grounded knowledge.

Conclusion

In conclusion, healthcare and education use very different techniques for acquiring knowledge. On the other hand they share very similar perspectives. Both see their position as a tool to benefit the community as a whole. This perspective translates into extensive and formal communication across organizations rather than the traditional business model that pits organizations against each other. For several different reasons, healthcare has moved into the empiricism theory of knowledge acquisition, almost exclusively, and this is stifling new innovations. Although empirical data is important, these writers believe healthcare would benefit by incorporating Nanaka & Nishiguchi (2001) views regarding knowledge creation into the healthcare field.

Becerra-Fernandez, I., Gonzalez, A., & Sabherwal, R. (2004). Knowledge management: Challenges, solutions, and technologies. Upper Saddle River: Pearson.

Drucker, P. (1999). Knowledge-worker productivity: The biggest challenge. California Management Review 41 (2) 79-85. Retrieved June 28, 2005, from Apollo Library EBSCO dababase

Jackson, P. (2003). The effect of empowerment on job knowledge: An empirical test involving operators of complex technology. Journal of Occupational and Organizational Psychology March 2003. Retrieved July 29, 2005, from http://www.highbeamresearch.com