The impact of sensemaking on knowledge transfer: a qualitative analysis of junior doctors’ clinical handover

Abstract

This study investigates the impact of sensemaking upon domain-specific knowledge transfer amongst professionals. The research context is the late afternoon clinical handover between junior doctors finishing their day duty shift and those coming on duty. Those taking part in this handover are all within their first year of clinical practice with no senior medical staff or other health professionals present. A qualitative methodology is employed involving semi-structured interviews, observation and recording of handovers, and observation of those taking over from their day shift colleagues as they go about their work during the evenings. Two groups of junior doctors are observed, each group developing its own individual handover style. One group creates a narratively oriented forum at which knowledge is shared, while the other takes a more instructive approach, in which information or explicit knowledge is transferred. The way in which the junior doctors make sense of the role and purpose of the handover at that time of day is seen to guide the development of handover style. This in turn impacts upon the knowledge that is transferred or shared between them, and also upon how those coming on duty conduct their work during the evening. Identity construction, the central theme in social-constructionist sensemaking theory, is seen to play a significant role in the development of group cohesion, which influences the junior doctors’ understanding of the handover in terms of both purpose and content. Identity is also influential in the processes involved when sensemaking reaches an inadequate conclusion but is maintained, regardless of additional conflicting data. The research contributes to current knowledge of these processes. The sensemaking activities involved in intentional, deliberate efforts by individuals to understand what is happening were identified at group level, suggesting that the analytical structure used might be applied more widely in the investigation of group situations, rather than individual sensemaking events. The junior doctors work together for six months before separating to go to different posts; they do not continue as a team. The research therefore has applicability to team and project work, especially in which there is no continuity of group membership

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ORCID for J.H. Klein: orcid.org/0000-0002-5495-8738

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