Challenging the belief in simple solutions: The need for epistemic practices in professional work.

CONTEXT As a contribution to the State of the Science issue on' The problem with solutions', this paper discusses how technology-mediated and assumedly simple and straight-forward solutions to professional problems in fact require extensive work from professionals in order for them to make sense of, adapt and employ generalized tools and procedures to their local practice. THEORETICAL PERSPECTIVE The authors introduce a perspective on epistemic practices in professional work and learning to conceptualize and discuss the diversity of knowledge-related actions that are needed to perform professional services. They discuss how the growing number and diversity of knowledge-generating actors that aspire to inform professional practice create 'multi-charged' work settings, imbued with multiple objectives and purposes. This development presents new epistemic challenges to professionals, which require extended capacities for knowledge work. SUMMARY The authors give examples from empirical studies conducted in Nordic health care settings, which relate to nurses' engagement with repositories of clinical procedures and to the development of new medical technologies for clinical use. They show how work performance in both cases depends on a range of epistemic practices - that is, collective ways of exploring, assessing, critically examining and justifying knowledge claims - which are needed to put the general tools and technologies to work in the local environment. This forms a core dynamic in practitioners' work-based learning, as it moves between what is known and what remains to explore or improve. CONCLUSIONS The paper argues that the widespread belief in simple or versatile solutions is challenged by research that reveals the diversity of knowledge practices needed to perform professional services. The paper suggests professional communities pay more attention to epistemic practices as means to handle complexity. Intriguing questions are raised, and implications for medical education are discussed.