Delivering the script: The educational activities of medical device industry representatives as a knowledge management strategy

Representatives of the medical device industry are routinely present in hospitals to provide education and support related to their products which, collectively, represent a company's knowledge management strategy. Between 2021 and 2022, I undertook an interpretive, phenomenological qualitative study at a large, urban, academic medical centre in Canada to examine industry's role in practice-based education. I conducted interviews (n = 23) and focus groups (N = 2) with 36 participants working across departments in roles spanning the point-of-care to executive leadership. Drawing on social studies of the co-construction of users and technologies, I examine the implications of involving commercial interests in the acquisition, circulation, and deployment of knowledge needed to practice in concert with medical technologies. Participants described manufacturers as the source of knowledge needed to use and maintain medical products and equipment and technology transfer occurred through in-services, product samples, and trial periods. However, the circulation of knowledge did not always happen freely: industry sought to maintain its position as a key intermediary in these technology transfers by controlling the flow of knowledge needed to practice in concert with technology. Instances of breakdown in access to knowledge meant that commercial interests became apparent to end-users as they conflicted with existing norms, processes, and clinical goals. Analysis of educational activities involving medical device industry representatives provides insight into the industry's strategic knowledge management, but also analysis of new forms of power and resistance to commercial goals that originate in practice and among proximate gatekeepers for technologies to practice settings.