Understanding, navigating and communicating knowledge: Issues and challenges

This paper presents a psychological perspective on key issues related to me dical vocabularies, There have been rapid advances in the development of co mputer technology underlying medical information systems. However, in keepi ng with technological progress, we must also take into account advances in our understanding of human behaviour and learn from failures in human perfo rmance. A central issue examined in this paper is the extent to which we ca n develop generic vocabularies that are also flexible and adaptable to spec ific situations. Empirical research indicates that variability in human per formance is much greater than what current medical classifications take int o account. A related challenge is that of how to best develop vocabularies that meet the needs of users. Based on theoretical perspectives and researc h emerging from the domain of cognitive psychology, we suggest that an unde rstanding of the cognitive mechanisms underlying the comprehension and appl ication of terminology is required. It is argued that rather than beginning with highly specified terminologies, i.e, the normative approach, we might instead begin by examining the natural context of how health care workers acquire, understand and negotiate knowledge in practice.