Can we say everything we know? Clinical judgement and tacit knowledge

The emphasis on EBM, on NICE guidelines and even on principles in medical ethics suggests that where judgements are rational then they can be codified into a rule, guideline or principle. But what of clinical judgement? Is there a place in healthcare for skills which either cannot or cannot easily be put into words? And if there is, are these aspects of our rationality or merely animal skills?

This session starts with an empirical study of the kind of expertise found in anaesthesia and uses that to draw some general lessons on the role of having judgement in healthcare.

Reading:

• • Smith, A., Goodwin, D., Mort, M. and Pope, C. (2003) Expertise in practice: an ethnographic study exploring acquisition and use of knowledge in anaesthesia. British Journal of Anaesthesia, 91, 319-28

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