Practice as the Site of Knowing: Insights from the Field of Telemedicine

This paper aims to shift the unit of analysis in the study of organisational knowledge from individuals and their actions to practices and their relationships. It introduces the concept of ‘site’ to help advance an understanding of the relationship between practice and knowing. The notion of site supports the intuition that knowing is both sustained in practice and manifests itself through practice. It also evokes the idea of knowledge as being rooted in an extended pattern of interconnected activities that only when taken in its living and pulsating entirety constitutes the site of knowing. In this paper, I review the different ways to conceptualise the relationships between knowing and practice, and I show how the idea of site adds to the existing body of work. Building on the results of a longitudinal study in the field of telemedicine, I then offer suggestions on aspects of practice where knowing manifests itself, and I use the concepts of ‘translation by contact’ and ‘at distance’ to explain how dispersed knowings are woven together and the power effect that can derive from these. I conclude by reflecting on the implications of this radical view and the direction for future research.