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

Abstract

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.