Knowing--in medicine.

摘要: In this paper we argue that knowledge in health care is a multidimensional dynamic construct, contrast to the prevailing idea of being an objective state. Polanyi demonstrated personal, discovered, and has explicit tacit dimensions. Complex adaptive systems science views simultaneously as thing flow, constructed well constant flux. The Cynefin framework one model help our understanding personal construct achieved through sense making. Specific aspects temporarily reside either four domains – known, knowable, complex or chaotic, but new can only be created by challenging known moving it looping other domains. Medical implicit with certain already easily transferable, others are not yet fully must still learned. At same time predominantly concerned content, whereas deal context. Though clinical may operate predominately domain, also will some others. Medical inherently uncertain, require context-driven flexible approach discovery application, practice service planning.