Exploring Knowledge-practice Networks in U.S. Academic Health Centers

Regina G Russell, Tennessee State University


Knowledge-practices are the various, recurring ways that we build our individual and shared knowledge. Knowledge-practice networks (KPN) shape opportunities for development, receptivity to innovation and ultimately, outcomes. This dissertation extends thinking about connectivity in learning and investigates the impact of scientific knowledge-practice networks across U.S. Academic Health Centers. Kai Hakkarainen outlined the ways that knowledge-building practices are embedded in network structures. Network characteristics are theorized to impact learning outcomes and organizational innovations. Continuous learning is foundational to ongoing practice in professional and public service communities. Therefore, understanding the intersection of learning and organizing is key to effective public administration. The theoretical implications of KPN are explored in Chapter 2: “Knowledge-Practice Networks: Complex Systems at the Intersection of Learning and Organizing.” Theories of learning and organizing are reviewed and aligned through a complex systems lens. KPN connections are theorized to exist along three dimensions: directedness (self or other-), formality (formal or informal), and idea domain. Understanding connectedness in ongoing knowledge-building activities is critical to understanding system function and outcomes. Chapter 3, “Academic Research and Hospital Outcomes at Academic Health Centers,” uses the theory of knowledge-practice networks advanced in Chapter 2 to hypothesize relationships between research and outcomes in organizations. Academic Health Centers (AHCs) were used as the organizational field to test whether there is a measurable relationship between research output and patient care outcomes. Hypotheses were confirmed: 1) AHCs with more publications in cardiac and cardiovascular related areas have lower 30-day mortality in cardiac-related patient care and 2) AHCs with more publications in management have lower rates of hospital-acquired conditions. Structural features of the hospitals were also important and overall research productivity is likely to contribute to organizational outcomes. Chapter 4, “The Impact of Clinical Translational Science Awards on the Research Output of U.S. Academic Health Centers,” extends thinking about knowledge-practice networks to include Burt’s theory of structural holes. Research output from the Web of Science citation database is captured five years prior to large federal scientific awards and a decade later. Differences between funded and non-funded institutions are apparent prior to the awards. Research output increased substantially over time, but the distribution of output across research areas is relatively stable. Historical structural features support KPN in organizations and funding initiatives are likely to operate within these existing structures. Organizations can identify structural holes in ongoing knowledge-practices and develop deliberate bridging strategies.

Subject Area

Public administration|Organization Theory|Educational sociology

Recommended Citation

Regina G Russell, "Exploring Knowledge-practice Networks in U.S. Academic Health Centers" (2019). ETD Collection for Tennessee State University. Paper AAI22622080.