Knowledge transformation between practice-based communities is reported through a 2-year longitudinal case study. The company, PresMed, was transformed from a moribund and divided organization to one where different practice-based communities engaged in collective learning. However, the transformation involved conflict, politics and power to overcome the influence of localized and embedded knowledge. The nature of practice-based learning means investment in past activities and different organizational communities create tensions. It is suggested that mediating artefacts, or boundary objects, provide an opportunity to develop new shared conceptions of activity and new modes of action. However, at the heart of this transformation, communication, politics and power are central to pragmatic engagement in new practices. Thus, it is the social activities and the political will and skill to influence, cajole and institutionalize systemic changes and not the artefacts or objects per se that are at the heart of knowledge transformation.
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