Knowing how to know: questioning ‘knowledge transfer’ as a model for knowing and learning in health

Abstract

Many healthy human experiences and practices have become medicalized and professionalized within health during the past century. In the example used in this article, the legitimation of formal, ‘evidence-based’ scientific knowledge about parenting within nursing and midwifery can have the effect of replacing and discrediting embodied, informal and culturally located ways of knowing and learning. At the same time, recent developments within health policy increasingly focus on the need for active engagement by members of the community in the production and maintenance of their own health. This is often promoted in terms of partnership between ‘consumers’ of health services and ‘providers’. The dominant metaphor of ‘knowledge transfer’, however, produces a prescriptive text that assumes a unidirectional movement from expert professional knowledge providers towards the consumers of that knowledge. This article addresses this problematic by discussing a case study of one woman learning to breastfeed her first baby. It examines, through discursive analysis, the complex and contradictory dynamics of her knowing and learning, situated in relation to formal knowledge about breastfeeding, in order to explore and elaborate an argument for more complex ‘cultural and relational’ understandings of knowing and learning than that offered by the ‘knowledge transfer’ metaphor.

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