Computer Supported Cooperative Work (CSCW)

, Volume 15, Issue 5–6, pp 501–535 | Cite as

Multidisciplinary Medical Team Meetings: An Analysis of Collaborative Working with Special Attention to Timing and Teleconferencing

  • Bridget KaneEmail author
  • Saturnino Luz


In this paper we describe the process of a multi-disciplinary medical team meeting (MDTM), its functions and operation in colocated and teleconference discussions. Our goal is to identify the elements and mechanics of operation that enhance or threaten the dependability of the MDTM as a “system” and propose technologies and measures to make this system more reliable. In particular, we assess the effect of adding teleconferencing to the MDTM, and identify strengths and vulnerabilities introduced into the system by the addition of teleconferencing technology. We show that, with respect to the system’s external task environment, rhythms of execution of pre-meeting and post-meeting activities are critical for MDTM success and that the extension of the MDTM to wider geographic locations with teleconferencing might disrupt such rhythms thereby posing potential threats to dependability. On the other hand, an analysis of vocalisation patterns demonstrates that despite difficulties related to coordination and awareness in video-mediated communication (evidenced by increased time spent in case discussion, longer turns, decreased turn frequency and near lack of informal exchanges) the overall case discussion structure is unaffected by the addition of teleconferencing technology into proceedings.


ethnography healthcare interaction analysis multidisciplinary medical team meetings teleconference 



Our thanks to Dr. Finbarr O’Connell and all the members of the multidisciplinary team at the respiratory MDTM in St James’s Hospital, Dublin, for their cooperation in this on-going study. We also thank Dr. D. S. O’Briain, and all of the staff in pathology. We also thank the staff at the Academic Unit of Clinical and Molecular Oncology, Trinity College Dublin. This research is supported by funding from the Irish Research Council for the Humanities and Social Sciences.


  1. AJCC. (1992): Manual for Cancer Staging. American Joint Committee on Cancer, 4th edn.Google Scholar
  2. Michael Alberts, W., G. Bepler, T. Hazelton, J.C. Ruckdeschel and J.H. Williams (2003): Practice Organization. Chest 123(1 Supplement), 332S–337SGoogle Scholar
  3. Arnaudova A., Jakubowski E. (2005) Eigth Futures Forum on governance of patient safety. WHO, Copenhagen, DenmarkGoogle Scholar
  4. Aviužienis A., Laprie J.C., Randell B., Landwehr C. (2004) Basic Concepts and Taxonomy of Dependable and Secure Computing. IEEE Transactions on Dependable and Secure Computing 1:11–33CrossRefGoogle Scholar
  5. Bannon, L. and S. Bødker (1997): Constructing Common Information Spaces. In: Proceedings of the Fifth European Conference on Computer-Supported Cooperative Work, pp. 81–96Google Scholar
  6. Bly S. (2003) Talking about Talking about Things. Human-Computer Interaction 18:181–191CrossRefGoogle Scholar
  7. Bossen, C. (2002): The Parameters of Common Information Spaces: The Heterogeneity of Cooperative Work at a Hospital Ward. Proceedings of the CSCW ’02Google Scholar
  8. Calman K., Hine D. (1995) A Policy Framework for Commissioning Cancer Services. Department of Health, Welsh OfficeGoogle Scholar
  9. Cohen, K.M. (1982): Speaker Interaction: Video Teleconferences versus Face-to-Face Meetings. In: Proceedings of Teleconferencing and Electronic CommunicationsGoogle Scholar
  10. Crabtree A. (2003) Designing Collaborative Systems A Practical Guide to Ethnography. Springer, VerlagGoogle Scholar
  11. Dabbs J.J., Ruback R. (1987) Dimensions of Group Process: Amount and Structure of Vocal Interaction. Advances in Experimental Social Psychology 20:123–169CrossRefGoogle Scholar
  12. Dourish, P. (2004) What We Talk about When we Talk about Context. Pers Ubiquit Comput (8):19–30CrossRefGoogle Scholar
  13. Elan. Elan-eucido Linguistic Annotator. Max-Planck-Institute for Psycholinguistics,, March 2005.
  14. Finn, K.E., A.J. Sellen and S.B. Wilbur (1997): Video-Mediated Communication. Lawrence Erlbaum Associates, Inc.Google Scholar
  15. Goodwin C. (1994) Professional Vision. American Anthropologist 96(3):606–633CrossRefGoogle Scholar
  16. Hackman, R.J. (1980): Work Redesign. Addison WesleyGoogle Scholar
  17. Hardstone, G., M. Hartswood, R. Proctor, R. Slack and A. Voss (2004): Supporting Informality: Team Working and Integrated Care Records. In: CSCW ChicagoGoogle Scholar
  18. Harper R.H.R. (2000) The Organization in Ethnography. Computer Supported Cooperative Work (CSCW), 9:239–264CrossRefGoogle Scholar
  19. Hartswood M., Proctor R., Rouncefield M., Slack R. (2003) Making a case in Medical Work: Implications for the Electronic Patient Record. Computer Supported Cooperative Work, 12:241–266CrossRefGoogle Scholar
  20. Hollywood D.P. (2003) The Development of Radiation Oncology services in Ireland. Department of Health and Children. The Stationary Office, DublinGoogle Scholar
  21. Housley W. (2000) Category work and knowledgeability within multidisciplinary team meetings. Text and Talk, 20(1):83–108Google Scholar
  22. Howell, W.C. (1991): Handbook of Industrial and Organizational Psychology, Vol 2 Chapt. Human Factors in the Workplace, Consulting Psychologists PressGoogle Scholar
  23. Jaffe, J. and S. Feldstein (1970): Rhythms of Dialogue. Academic PressGoogle Scholar
  24. Jordan B., Henderson A. (1995) Interaction Analysis: Foundations and Practice. The Journal of the Learning Sciences 4(1):39–103CrossRefGoogle Scholar
  25. Kane, B. and S. Luz (2006): Probing the Use and Value of Video for Multi-Disciplinary Medical Teams in Teleconference. In: Proceedings of the 19th IEEE International Symposium on Computer-Based Medical SystemsGoogle Scholar
  26. Kane, B., S. Luz, G. Menezes, and D.P. Hollywood (2005): Enabling Change in Healthcare Structures through Teleconferencing. In: Proceedings of the 18th IEEE International Symposium on Computer-Based Medical Systems, pp. 76–81, IEEE Computer Society, 2005. doi: Scholar
  27. Kempner K.M., Chow D., Choyke P., Cox J.R., Elson J.E., Johnson C.A., Okunieff P., Ostrow H., Pfeifer J.C., Martino R.L. (1997) The Development of an ATM-based Radiology Consultation workstation for Radiotherapy Treatment Planning. Medical Imaging 1997 Image Display, 3031:550–511Google Scholar
  28. Masoodian M., Apperley M., Frederickson L. (1995) Video Support for Shared Work-Space Interaction: An Empirical Study. Interacting with Computers 7(3):237–253CrossRefGoogle Scholar
  29. McAleer J., O’Loan D., Hollywood D. (2001) Broadcast Quality Teleconferencing for Oncology. Oncologist 6 (5):459–462CrossRefGoogle Scholar
  30. McGrath, J.E. (1988): The Social Psychology of Time. Sage PublicationsGoogle Scholar
  31. NCCAC. (2005): The Diagnosis and Treatment of Lung Cancer. National Institute for Clinical Excellence (NICE)Google Scholar
  32. O’Conaill B., Whittaker S., Wilbur S. (1993) Conversations Over Video Conferences: An Evaluation of the Spoken Aspects of Video-Mediated Communication. Human-Computer Interaction 8(4):389–428CrossRefGoogle Scholar
  33. O’Connell F. (2004): Guidelines for the Clinical Management of Lung Cancer. Irish Medical Journal, vol. 97, no. 2 (Supplement)Google Scholar
  34. Olson, J. S., G.M. Olson and D. Meader (2000): Distance Matters. In: K.E. Finn, A.J. Sellen and S.B. Wilbur (eds.): Video-Mediated Communication. ACM Press, Chapt. Face-to-Face Group Work compared to Remote Group Work with and without Video.Google Scholar
  35. Øvretveit, J. (1999): Integrated Quality Development for Public Healthcare. Norwegian Medical Association.Google Scholar
  36. Øvretveit J. (2000) System negligence is at the root of medical error. International Journal of Health Care Quality Assurance, 13(3):103–105CrossRefGoogle Scholar
  37. Paterno F. (1999) Model-Based Design and Evaluation of Interactive Applications. Applied Computing, Springer VerlagGoogle Scholar
  38. Pinelle D., Gutwin C., Greenberg S. (2003) Task Analysis for Groupware Usability Evaluation: Modeling Shared-Workspace Tasks with the Mechanics of Collaboration. ACM Transactions on Compututer-Human Interaction 10(4): 281–311CrossRefGoogle Scholar
  39. Reddy, M. and P. Dourish (2002): A Finger on the Pulse: Temporal Rhythms and Information Seeking in Medical Work. CSCW ’02 pp. 344–353Google Scholar
  40. Sacks H., Schegloff E.A., Jefferson G. (1974) A simplest systematics for the organization of turn taking in conversation. Language, 50(4):696–735CrossRefGoogle Scholar
  41. Schmidt K., Bannon L. (1992) Taking CSCW Seriously: Supporting Articulation Work. Computer Supported Cooperative Work 1(1/2): 7–40CrossRefGoogle Scholar
  42. Sellen, A. J. (1992): Speech Patterns in Video-mediated Conversations. In: ACM (ed.): Proceedings of the Computer Human Interactions (CHI) ’92Google Scholar
  43. Shannon C.E., Weaver W. (1949). The Mathematical Theory of Communication. University of Illinois Press, Urbana IlGoogle Scholar
  44. Star S.L., Griesemer J.R. (1989) Institutional Ecology, Translations and Boundary Objects: Amateurs and Professionals in Berkeley’s Museum of Vertebrate Zoology, 1907–1939. Social Studies of Science 19:387–420CrossRefGoogle Scholar
  45. Symon G., Long K., Ellis J. (1996) The Coordination of Work Activities: Cooperation and Conflict in a Hospital Context. Computer Supported Cooperative Work (CSCW), 5(1):1–31CrossRefGoogle Scholar
  46. van der Veer G., Lenting B., Bergevoet B. (1996) GTA: Groupware Task Analysis – Modeling Complexity. Acta Psychologica 91:297–322CrossRefGoogle Scholar
  47. Whittaker S. (2003) Things to talk about when talking about things. Human-Computer Interaction 18:149–170CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media B.V. 2006

Authors and Affiliations

  1. 1.Department of Computer ScienceTrinity College DublinDublin 2Ireland

Personalised recommendations