Culture is often seen as the key inhibitor of effective knowledge sharing. A study of companies where sharing knowledge is built into the culture found that they did not change their culture to match their knowledge management initiatives. They adapted their approach to knowledge management to fit their culture. They did this by: linking sharing knowledge to solving practical business problems; tying sharing knowledge to a preexisting core value; introducing knowledge management in a way that matches the organization's style; building on existing networks people use in their daily work; and encouraging peers and supervisors to exert pressure to share.

This article presents how to assess the economic impact of a hospital on a rural community. The economic impact is identified by assessing the direct, induced, and indirect impacts that result because of the presence of a hospital in a rural community. The methodology utilizes survey data and estimation procedures for four rural hospitals. The economic impact estimates are based on microdata. Income multipliers are estimated for each of the rural communities. The research demonstrates that rural hospitals do make significant economic contributions to the communities they serve. Community leaders can use the model presented to evaluate the economic impact of their local hospital.

Purpose -This paper seeks to develop understanding of how competent practitioners develop into experts through learning expert thinking processes and how knowledge management initiatives can be used to structure this development.Design/methodology/approach -A literature review-derived research model underpinned the semi-structured interviews with 21 acknowledged experts from a wide variety of disciplines and sectors. A qualitative exploratory research design was used to study how the experts go about developing other professionals in the field through showing them how they learn themselves and making visible their own thinking processes. The implications for KM programs were developed in conjunction with KM practitioners.Findings -The experts used various methods to make their thinking visible through demonstration of practice and direction of structured learning activities. KM's contribution to this form of expertise development lies in structuring approaches to making work in progress more visible (through technology and process) and through introducing a coaching framework that enables and supports reflection on practice.Research limitations/implications -The specific context of expertise development that has been studied is those situations where generalized principles and explicit knowledge cannot be readily captured in artifacts. Further research is needed to show how this can be combined with other approaches to developing and retaining expertise. Confirmatory research is also needed to refine and further validate the proposed recommendations for KM practice.Practical implications -The paper prepares the ground for integrating an important aspect of expertise development within KM programs.Originality/value -The paper extends KM's contribution to expertise retention and development to include structured support for the development of expert thinking processes.