Knowing and learning in clinical contexts

The paper discusses a specific methodology to detect and to analyze professional practices as a way to sustain organizational reflection and change. Based on an intervention conducted in a health district in Northern Italy, the work shows the use of a projective interview technique, the “interview to the double”, for the search of meaning around the practices in place and the possibility to rethink them. Opportunities and critical aspects of this tool in articulating and representing practice are presented, together with its potential in developing hypothesis for organizational change, and the process that, stemming from it, was developed in the specific context. The action-research intervention described is based on a psycho-sociological approach where narrative and ethnographic tools sustain the joint-work of researchers and organizational actors. Other than the interview to the double”, the project utilized a group of coretools like mapping exercises, ethnographic and narrative forms, group action plans and evaluative methodologies. The study is based on a qualitative analysis, with the assumption that a specific context can only be studied by going in depth into it and by getting close to how people know, practice and learn in it. The paper shows the use of the “interview to the double” as a way for situated learning and as a possibility for involving people in inquiry processes around their daily sequences of activities. The tool provides the organizational actors with the possibility to share languages, evaluative criteria and meanings that are often implicit or taken-for-granted. This methodology also gives the opportunity to detect critical issues on which it is possible to undertake transformative actions, and through which it is possible to refine professional identities and practices. The approach and the tools utilized show the richness of the tacit and situated knowledge detected and its potentiality when used for reflexivity and transformational actions in organization. The article argues that the ideas of shaping and sharing knowledge are strong and useful when accompanied by an approach close to people that allow them to reflect on the meaning of that knowledge and on the possibility to challenge it.