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37° Congresso nazionale ANMDO Bologna, 8-10 giugno 2011 Le architetture del sapere Prof. Ferdinando Romano.

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Presentazione sul tema: "37° Congresso nazionale ANMDO Bologna, 8-10 giugno 2011 Le architetture del sapere Prof. Ferdinando Romano."— Transcript della presentazione:

1 37° Congresso nazionale ANMDO Bologna, 8-10 giugno 2011 Le architetture del sapere Prof. Ferdinando Romano

2 Knowledge of the spirit world is to be obtained by divination; information in natural science may be sought by inductive reasoning; the law of universe can be verified by mathematical Calculation Sun Tzu, The art of war

3 Wisdom Implicitly knowing How to Generate Access and Integrate Knowledge Knowledge Validated Platform for Action Information Patterned Data Data Dispersed Elements THE PYRAMID OF KNOWLEDGE

4 Il disordine, il caso, lagitazione, la dispersione, la disorganizzazione stessa (2° principio della termodinamica), sembrano parte integrante dei processi di organizzazione del mondo (Morin E., 1984)

5 Attività 1.Adempimenti DGRC n.596 del 5 agosto Piano di riassetto della rete ospedaliera 3.Piano attuativo 4.Riqualificazione Monitor Knowledge Use Sustain Knowledge Use Evaluate Outcomes Adapt Knowledge to Local Context to Local Context Assess Barriers/ Assess Barriers/ Supports to Supports to Knowledge Use Knowledge Use Select, Tailor, Select, Tailor, Implement Interventions Identify Problem Identify Problem Identify, Review, Identify, Review, Select Knowledge Select Knowledge Product s/Tools Synthesis Knowledg e Inquiry Tailoring Knowledge KNOWLEDGE CREATION Graham et al.: The Journal of Continuing Education in the Health Professions, 2006

6 The knowledge cycle

7 Forms and Stages of Knowledge Production

8 Most people (professionals included) operate most of the time as automatic pilot: spending least amount of reflective thinking time on tasks they spend most of their time doing Kitson, A., Strauss, S.E. (2009) Identifying the knowledge-to-action gaps, Knowledge Translation in Health Care, Wiley-Blackwell

9 The persistent gap between available evidence and current practice in healthcare reinforces the challenge of finding effective solutions. Contributing to this current status have been the complexity of change process, limitations of research on implementation, and slow recognition of the critical role of organizational context Stelter, C.B. et al. (2008) An organizational framework and strategic implementation for system-level change to enhance research-based practice, Implementation Science

10 HaveDont have Know Esplicit Knowledge Knowledge you know you have Knowledge gaps Knowledge you know you dont have Dont know Tacit Knowledge Knowledge you dont know you have Unknown gaps Knowledge you dont know you dont have Knowledge gaps

11 Knowledge transfer and exchange: bringing together researchers and stakeholders and facilitating their interaction Research utilization: moving research findings into action. Implementation Research: the scientific study of methods to promote the systematic uptake of clinical research findings and other evidence-based practices into routine practice and, hence, to improve the quality and effectiveness of health care. Dissemination: the complex process of moving research into practice Knowledge-to-action (KTA) Graham et al. (2006) Lost in Knowledge Translation: Time for a Map? The Journal of Continuing Education in the Health Professions

12 Knowledge as capabilities Underlines the potential of organizational structures and resources to support people in their attempts to use knowledge Knowledge as process Emphasizes flexibility in knowledge use and the need to contextualize knowledge (plausibility, acceptability and feasibility) Knowledge as codification Focuses on the role of codified knowledge to govern health-care organizations Denis, J-L, Lehoux, P (2009), Organizational theory, Knowledge Translation in Health Care

13 Taken together, these three building blocks reflect a constant tension between the search for conformity between research- based evidence and organizational practices and the need for in-situ learning and adaptation in order to bring about quality and performance improvement Denis, J-L, Lehoux, P (2009), Organizational theory, Knowledge Translation in Health Care

14 Explicit (formal) knowledge versus Tacit knowledge

15 HaveDont have Know Esplicit Knowledge Knowledge you know you have Knowledge gaps Knowledge you know you dont have Dont know Tacit Knowledge Knowledge you dont know you have Unknown gaps Knowledge you dont know you dont have Knowledge gaps

16 Tacit knowledge (definition) requires joint, shared activities in order to transmit it Knowledge that is not made explicit because it is highly personal, not easily visible or expressible, and usually requires joint, shared activities in order to transmit it. Examples of tacit knowledge include subjective insights and intuitions.

17 Tacit knowledge (implications) With tacit knowledge, people are not often aware of the knowledge they possess or how it can be valuable to others. With tacit knowledge, people are not often aware of the knowledge they possess or how it can be valuable to others. Effective transfer of tacit knowledge generally requires extensive personal contact and trust. Effective transfer of tacit knowledge generally requires extensive personal contact and trust.

18 In any organization the goal is to create a hybrid design for its knowledge management practice that synthesizes the right combination and balance of the tacit and explicit knowledge management approaches.

19 The half-life of knowledge is decreasing The half-life of knowledge can be interpreted as the time-scale in which knowledge is replaced by new knowledge. The half-life of ICT knowledge is already considered to be less than nine months. In medicine the half life of knowledge is 3-4 years.

20 Does the workforce generalise or specialise? European Commission, Changing professions in 2015 and beyond, 2006

21 Currently, the professional faces the increased dynamics of knowledge. The supervisor cannot reasonably be expected to be up to date and be able to understand everything, when the knowledge that they use changes. As the half-life of knowledge decreases this gap will increase ever further. To remedy this effect, it will be important that the supervisors become generalists when they climb up the ranks. European Commission, Changing professions in 2015 and beyond, 2006

22 Currently, a surgeon who has climbed up the ranks supervises a set of surgeons. He can therefore easily switch between the surgeons he supervises. In the future this will no longer be the case. The doctors he supervises become more specialised. Their expertise focuses on one area. Consequently not only does the knowledge gap between the various doctors increase, also the gap of knowledge will increase between the supervisor and his employees. A change of skills of the doctors is therefore essential. European Commission, Changing professions in 2015 and beyond, 2006

23 The increased knowledge gap between the various experts and their supervisors will necessitate a change of skills. In the future the supervisor will have to be able to bridge the knowledge gap between the doctors and him. Unless the skills of the supervisor change, these gaps cannot be bridged. European Commission, Changing professions in 2015 and beyond, 2006

24 As knowledge becomes more dynamic and the amount of information is rising, professionals in the health care sector will face a choice. They can either generalise or specialise. European Commission, Changing professions in 2015 and beyond, 2006

25 HaveDont have Know Esplicit Knowledge Knowledge you know you have Knowledge gaps Knowledge you know you dont have Dont know Tacit Knowledge Knowledge you dont know you have Unknown gaps Knowledge you dont know you dont have Knowledge gaps

26 Dalla conoscenza alla competenza

27 Quando possiamo dire che il soggetto possiede effettivamente una competenza? modello mentale Una competenza è sempre associata alla presenza nel soggetto di uno specifico modello mentale relativo a quel dato dominio. Un modello mentale è la "teoria" che guida il soggetto nelle decisioni e nelle scelte che egli compie quando si trova ad agire nel mondo. R. Trinchero in Le risorse culturali della rete, Milano, Franco Angeli, 2003

28 I soggetti che sono in grado di ristrutturare rapidamente ed efficacemente i propri modelli mentali, e che sono aperti alla sperimentazione e accettazione di modelli mentali alternativi in risposta agli stimoli che provengono dall'esterno, sono quelli che riescono meglio ad adattarsi all'ambiente, dato che sono in grado affrontare situazioni nuove, impreviste e complesse con decisioni maggiormente efficaci ed efficienti (teoria della flessibilità cognitiva) R. Trinchero in Le risorse culturali della rete, Milano, Franco Angeli, 2003

29 Nella competenza non rientra quindi solo la padronanza di un modello mentale adeguato ma anche la sua capacità di ristrutturazione in relazione agli eventi contingenti. Questo è uno degli elementi che contraddistingue il comportamento comunemente definito intelligente: il fatto di non rimanere fermi ad oltranza sulle proprie posizioni ma di sintonizzarsi di volta in volta sulla specifica situazione. R. Trinchero in Le risorse culturali della rete, Milano, Franco Angeli, 2003

30 Dilberts theorem on salary (by Scott Adams) Enunciato : Ingegneri e scienziati non guadagneranno mai quanto i commercianti e gli uomini daffari Dimostrazione Postulato 1: il Sapere è Potere (Sapere = Potenza) Postulato 2: il Tempo è Denaro (Tempo = Denaro) In fisica: Potenza = Lavoro/Tempo Sostituendo abbiamo: Sapere = Lavoro/Denaro Quindi Denaro = Lavoro / Sapere Quando il Sapere tende a zero, il Denaro tende a infinito, indipendentemente dal lavoro svolto. Conclusion: The Less you Know, the More you Make.


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