Bjørn Erik Mørk

Challenging expertise: On power relations within and across communities of practice in medical innovation

This article addresses the question of how practices perform power effects within and across communities of practice. It does so by drawing on a study of two medical innovation projects leading to radical changes of practice. Situated learning theory has to some degree acknowledged the asymmetry in power between masters and apprentices. Meanwhile, this study suggests that the novelty of new practices may lead to a contestation of the established master-apprentice relationship and even challenge the basis of the community of practice itself. We therefore argue that innovation processes may highlight the political processes and negotiations already at play in communities of practice. Hence, we investigate how communities of practice tried to control the new practices through mobilizing arguments, marginalizing opponents and building alliances. Consequently, the article argues that changing practices may be highly political.

Changing practice through boundary organizing: A case from medical R&D

This article contributes to our understanding of practices in innovating organizations. Previous studies have demonstrated how breakthroughs in knowledge may fail to be translated into practices if they are not aligned with existing practices, or if they cut across established boundaries and power structures. By drawing upon an ethnographic study of a medical R&D department that has been highly successful in developing new medical practices, this article investigates how such challenges can be overcome. To date, much of the literature has focused on coordination across single, well-defined boundaries. We here extend this focus and introduce the notion of ‘boundary organizing’ to analyse highly political and contingent processes of innovation and change within and across different practices. We add to existing literature by highlighting how the handling of multiple boundaries, the indirect effects of boundary work, the negotiation of mutual benefits and interests, and mutual adaptation are key aspects of boundary organizing.

Constructing, enacting and packaging innovations

Purpose – The purpose of this paper is to describe the knowledge generation in a cross‐disciplinary group in Norway that developed a new medical device. The aim is to shed light on how knowledge was generated and how the relationships between different communities of practice were mediated. In particular, the paper seeks to examine how material objects and contextual conditions influenced the innovation process.Design/methodology/approach – In this longitudinal case study an innovation process was followed for five years, and the research material was constructed through extensive observations, interviews and document analysis.Findings – The innovation process exhibited different themes in varying degrees of blend throughout the process. First, the practices of constructing the device and ascertaining technical feasibility are described. Then the enacted nature of the work is outlined; how it was significantly dependent on circumstantial factors, but also strongly shaped by the need to ensure clinical usa...

The Dynamics of Complex Sociomaterial Assemblages

This paper aims to contribute to our understanding of the sociomaterial complexities of information systems. By applying Gilles Deleuze’s process ontology, called Assemblage Theory (AT), as interpreted and presented by Manuel DeLanda, we examine the case of a new high-tech medical procedure called transcatheter aortic valve implantation (TAVI). Complex innovations like TAVI evolve as sociomaterial assemblages whose dynamics are seen as driven by the interaction between various stabilizing and de-stabilizing processes. We argue that AT is a very powerful (process) ontology for researching and theorizing the dynamics of increasingly complex information systems.