When trustworthiness matters: how trust influences knowledge-production and knowledge-sharing in a surgical...

Transferring clinical knowledge and bringing various representations of clinical knowledge together is crucial as support for clinical decision-making. While previous scholarship has elaborated patients' trust of healthcare providers as well as the healthcare system, this article emphasizes trust as a catalyst for clinical knowledge production. Using an observational study of a surgical department at a large Norwegian hospital, the article focuses on knowledge transfer between surgeons in a surgical department. The surgeons' confidence to initiate knowledge requests and the perceived trustworthiness of knowledge by colleagues is significant. There is a distinct underuse of medical patient records, both paper-based and electronic, which results in an oral transferring and sharing of clinical knowledge. Significantly this oral knowledge-transfer is dynamic and effective, meeting demands for timely patient information. By studying knowledge-intensive work very closely from a perspective that suggests that knowledge is local and developed through trust and dependence, this study identifies how work practices have developed to be effective with little support of formal information systems.