Doctors' perspectives on their innovations in daily practice: implications for knowledge building in health care.

CONTEXT: When individuals adapt their practice in order to solve novel or unexpected problems of practice, they are creating new knowledge. This form of innovation development is understood as a core competency of adaptive expertise and the basis for knowledge building community practice. However, little is known about the ways in which this knowledge, produced through daily, innovative problem solving, is developed, identified and shared by health care professionals.
METHODS: Following this line of inquiry, we conducted semi-structured interviews with a saturation sample of 15 clinical faculty staff at the University of Toronto.
RESULTS: A grounded theory analysis of the results showed that our participants held the view that innovation was focused on outcomes, developed through research practice and diffused for adoption in the broader community. As a result, their own individual improvements to daily practice were excluded from this view of innovation. Furthermore, their perceptions of innovation limited participants' engagement in the sort of collaborative process that is central to the practice of knowledge-building communities.
CONCLUSIONS: This research demonstrated that thinking about innovation and innovative practice must be changed in order to foster the development of knowledge-building communities in medicine.