The importance of tacit knowledge in practices of care.
Good care grows from caregiver-client trust, not from checklists alone.
01Research in Context
What this study did
Cook (2010) wrote a theory paper about care for people with intellectual disabilities.
The author says the heart of good care is the personal bond between caregiver and client.
Charts and checklists miss the quiet, felt knowledge that lives inside that bond.
What they found
The paper argues that tacit knowledge—what you feel but can’t easily measure—drives quality.
When staff know the person well, they catch small needs before they turn into big problems.
This relationship-first view clashes with rule-heavy, indicator-driven service models.
How this fits with other research
Gaventa (2008) warned that too many compliance rules burn staff out. Cook (2010) deepens the point by showing why rules alone hurt clients: they ignore the quiet knowledge built through trust.
Hamama et al. (2021) extends the idea into research design. They give a person-centered logic model that turns the tacit bond into outcomes you can track without losing the human core.
Together, the three papers form a timeline: first, flag the harm of compliance culture; next, name the missing ingredient—tacit knowledge; finally, offer a tool to measure what matters without squeezing the life out of care.
Why it matters
You can start tomorrow. Ask your direct support staff to share one small thing they notice about a client that no data sheet captures. Write it down and use it to adjust the day’s plan. Over time, these tiny notes build the tacit knowledge Cook (2010) says is the real engine of quality.
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02At a glance
03Original abstract
BACKGROUND: The paper argues that a high quality personal relationship between professionals and clients is a necessary condition of professional knowledge. This epistemological claim is developed against the background of current methods of quality assessment that rely on objectively measurable 'indicators'. METHOD: A philosophical analysis regarding the nature of professional knowledge in the care sector. The analysis proceeds from Michael Polanyi's concept of tacit knowledge to account for the personal dimension of professional expertise in the care sector. RESULTS: Quantitative methods of quality assessment understand 'quality of care' as being independent from the professional who generates it. Consequently, quality assessment as currently practiced necessarily renders the personal dimension of professional knowledge invisible, thereby excluding it from managerial attention and support. To indicate the relevance of Polanyi's concept of tacit knowledge, the paper offers some observations from the practice of care in a group home for people with intellectual disabilities. CONCLUSION: The paper concludes that a high quality relationship between professionals and their clients is crucial for quality of care. This relationship generates the positive interaction that enables professionals to gain adequate insight in the needs of their clients.
Journal of intellectual disability research : JIDR, 2010 · doi:10.1111/j.1365-2788.2009.01235.x