Using concept mapping to locate the tacit dimension of clinical expertise: towards a theoretical framework to support critical reflection on teaching

The tacit dimension of expertise is given considerable prominence in the literature on clinical education. However, the concept of knowing more than you can tell is one that cannot be used explicitly to support student learning. In this paper, the authors contend that much professional knowledge that has been described as tacit can be surfaced for examination through application of concept mapping techniques. This allows the articulation of expert practice in a way that can be modelled for students. It also provides a new model of expertise that is based on connections between chains of practice (characterized by sequences of observable actions) and the underlying network of understanding from which they are extracted. These connections, often overlooked and automated in daily practice, represent the location of the tacit dimension. Localizing the tacit dimension in this way allows the teacher and student to focus on the connections of tacit knowledge with formal knowledge and with practice in such a way that intuitive actions can be verified and connected to underlying knowledge frameworks. The act of concept mapping also slows reflection on actions that are normally automated and often overlooked. The resulting model includes an additional dimension that is missing from the traditional stage models of expertise. As such, it provides a conceptual framework upon which it would be possible to develop protocols to support the continuing development of clinical teachers through peer observation and/or guided self-reflection.