Expertise in Transition

Yrjö Engeström is Professor Emeritus of Communication at the University of California, San Diego and Professor Emeritus of Adult Education at the University of Helsinki, Finland, where he is also Director of the Center for Research on Activity, Development, and Learning (CRADLE). In his work, Engeström applies and develops cultural-historical activity theory as a framework for the study of transformations in educational settings, work environments, and communities. He has carried out interventionist research in health care settings for over thirty years. He is known for his theory of expansive learning and for the methodology of formative interventions, including the Change Laboratory method. Engeström's most recent books are From Teams to Knots: Activity-Theoretical Studies of Collaboration and Learning at Work (Cambridge, 2008), Learning by Expanding: An Activity-Theoretical Approach to Developmental Research (Cambridge, Second Edition, 2015), and Studies in Expansive Learning: Learning What Is Not Yet There (Cambridge, 2016).

'This is simply the best book that I have read on medical education … Engeström's thinking … is far ahead of that of anybody else whom I know in the field of clinical education, and we should be grateful for his cumulative insights, theorising, and modelling. They provide extraordinarily rich templates for anybody pursuing innovative, applied clinical education research. … It should be standard reading across medical schools and postgraduate medical centres.' Alan Bleakley, Mind, Culture, and Activity

• Part I. The Theoretical Landscape: 1. Toward a new framework for understanding expertise; Part II. Expertise as Objected-Oriented Activity: 2. Constructing the object in the work activity of primary care physicians; 3. Objects and contradictions as drivers of expert work; 4. Spatial and temporal expansion of the object; Part III. Expertise as Knotworking: 5. The emergence of knotworking in medicine; 6. Knotworking as expansive decision making; 7. Knotworking as history making; Part IV. Expertise as Expansive Learning: 8. Expansive visibilization of medical work; 9. Expansive learning in a hospital; 10. The horizontal dimension of expansive learning; Part V. Toward Collaborative and Transformative Expertise: 11. From stabilization knowledge to possibility knowledge; 12. Expertise in transition.