Job rotation in anaesthesiological care is explored in this article. Based on discussions of 'high reliability organizations', and based on current theory in social and organizational psychology, we empirically investigated the impact of job rotation on knowledge management and learning. The study was conducted at the University Hospital of Innsbruck during the job training period of novice nurse anaesthetists. Qualitative interviews were conducted as well as a questionnaire administered. Data were collected between September 2003 and June 2005. Observational and interview data were combined with a questionnaire study to assess transactive memory and cooperation using a mixed-method design. Qualitative data were analyzed using GABEK, a computer-supported content analysis system; quantitative data were analyzed statistically with SPSS. Results indicate that job rotation had both positive and negative effects on knowledge and learning. On the one hand, job rotation can foster flexibility and awareness of a person's own fallibility and lack of knowledge. On the other hand, trust, group cohesion, and social meta-knowledge can be hampered by constant rotation. Consequently, stabilization and change need equal consideration when designing work in high reliability organizations.