Theorizing Team Process Through Cultural–Historical Activity Theory (CHAT): Networking and Knotworking

Abstract

Cultural–historical activity theory (CHAT) is one of a group of social learning theories that has powerful explanatory power for work-based learning in medicine. Team communication can be explored fruitfully through CHAT, particularly to explore how differing aims between team members with differing roles can create tension within a team that can be both constructive and destructive. How might team members with different objectives align activities? Activity systems are inherently dynamic, unstable, and constantly seek expansion. Team members must be reflexive about such dynamics in order to manage the activity system as it progressively expands its knowledge and horizons.Importantly, CHAT explores how ‘boundary crossing’ occurs between teams—which can be helpful in coordinating multiple team care around patients. Where multiple team activity has been explored through classical networking theory, CHAT suggests a ‘knotworking’ theory for the liquid age of ad hoc teams with changing membership, in which communications are temporary but meaningful. While networking approaches seek to manage and reduce complexity, knotworking approaches see complexity as a resource rather than a hindrance.KeywordsSocial CapitalClinical TeamMoral CourageTeam PracticeMedical Education ResearchThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.