How Do We Know?

I was in Edmonton yesterday, having been invited to give the keynote address to the biennial conference of SEARCH Canada.

SEARCH Canada is a not-for-profit, member-funded organization that helps health organizations create, choose and use research evidence in innovative practice settings to enhance decision-making capacity. SEARCH Canada facilitates partnerships with academic institutions to advance applied learning and research. SEARCH invests in the health system by supporting faculty and health professionals, and a knowledge infrastructure. System engagement at the academic, health service, and government levels – organizations and individuals – has also created a strong SEARCH network. SEARCH Canada and its programs are funded by its founding member organizations: the Alberta Heritage Foundation for Medical Research (AHFMR), Alberta’s nine health regions, and the University of Calgary.

I was asked specifically to address the idea that our current conception of evidence-based research is limited in its scope of what can be discovered. To that end, I created a talk entitled, How Do We Know: The changing culture of knowledge. In it, I ask what the audience thought are some interesting questions:

How did we as a culture come to decide that certain things are to be considered as knowledge and others are not? How did those that decide such things acquire that very privileged position of knowledge authority? The fact of the matter is that our dominant knowledge paradigm has existed for a very long time – since the 17th century. But the world has changed considerably since then, so I’d like to suggest to you this morning that perhaps it is time to consider some changes to what we consider as knowledge, and who gets to decide, in a way that is consistent with today’s reality.

I briefly trace the history of knowledge and knowledge authority (from "Johnny and Janey"), and suggest that the the contextual foundation upon which evidence-based research is currently constructed - positivism - is a 17th century worldview, that is, a mechanistic world that functions according to deterministic causality, in which both human systems and inanimate, non-sentient, physical systems behave in precisely the same ways. In contrast, if the objective of research is to discover what exists in the world and to make sense of what happens, it is crucial that the contextual framing of that research is consistent with the contextual framing of the world, and that means the application of principles of complexity. I go on to demonstrate how constructivist (and even critical) research approaches are more appropriate, and more consistent with the reality of a UCaPP world.

Based on the wonderful feedback I received during the conference, the keynote seemed to be very well accepted and appreciated by a group of people who have all been well trained in the positivist, evidence-based paradigm. Many thanks to SEARCH Canada for the invitation, and for their open-mindedness and willingness to truly search for knowledge.

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