Contemporary ecologies of expert knowledge: classic and novel conundrums across professional boundaries in the NHS

Classic studies in the Sociology of the Professions have explored knowledge barriers across traditional forms of professionalism, quintessentially represented by medical doctors, lawyers, and university professors. Thus, the impact of distinctive professional identities and communal boundaries on processes of knowledge sharing have been well documented. More recently, however, many scholars have suggested that those classical analyses need to be revisited and reassessed (see for e.g. the recent call for papers of Teelken and colleagues at EGOS 2011, cf. also Evetts, 2006; Noordegraaf, 2007) in the light of three contemporary trends: a changing context of professional practice, the associated erosion of classic forms of professionalism, and the emergence of new forms.While classical studies have laid the foundation of our understanding of the conditions that render knowledge sharing across more established forms of professionalism problematic, the processes and potential barriers across more novel and hybrid forms are less clear (cf. Noordegraaf, 2007). In order to address this gap, this thesis presents a comparative investigation of expert knowledgesharing across professional boundaries in four cross-occupational teams in the English National Health Service; two of them primarily composed of established professionals and two of hybrid professionals. By analysing these two types of cross-occupational teams, this thesis’ contribution is the identification of a different configuration of knowledge barriers affecting the sharing of knowledge within the two forms of professionalism.These findings further highlight the existence of two very different ecologies of (inter) professional knowledge within established and hybrid forms of professionalism. First, distinctive knowledge bases underlie professional practice and interaction in established and hybrid forms of professionalism. For established forms knowledge is more substantive and disciplinary based, whereas for hybrid forms it is general and situated, and characterized by a syncretic use of different disciplines, theories, and information. Second, the types of indeterminacies that permeate the two types of ecologies also vary. While the more established forms of professionalism face higher levels of ambiguity (semantic indeterminacy), the more transient and hybrid forms of professionalism face higher levels of uncertainty (de re indeterminacy). Finally, the nature of professional boundaries is different between these two types. While in established forms of professionalism boundaries are relatively well defined, and hence recognizable; in hybrids forms they are vague and transient.This thesis is not currently available via ORA