Abstract
Over the years, healthcare has been an important domain for CSCW research. One significant theme carried through this body of work concerns how hospital workers coordinate their work both spatially and temporally. Much has been made of the coordinative roles played by the natural rhythms present in hospital life, and by webs of mundane artefacts such as whiteboards, post-it notes and medical records. This paper draws upon the coordinating role of rhythms and artefacts to explore the nested rhythms of the Cardio-Pulmonary Resuscitation (CPR) protocol conducted to restore the proper heart rhythm in a patient who has suffered a cardiac arrest. We are interested in how the teams delivering CPR use various ‘smart’ assistive devices. The devices contain encoded versions of the CPR protocol and are able to sense (in a limited way) the situation in order to give instructions or feedback to the team. Using an approach informed by ethnomethodology and conversation analysis (EM/CA) we analysed video of trainee nurses using these devices as they delivered CPR in dramatized training scenarios. This analysis helped us to understand concepts such as autonomy and authority as interactional accomplishments, thus filling a gap in CSCW literature, which often glosses over how authority is formed and how it is exercised in medical teams. It also helps us consider how to respond to devices that are becoming more active in that they are being increasingly imbued with the ability to sense, discriminate and direct activity in medical settings.
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Notes
A bracketed utterance indicates that it was not fully clear what was being said at that moment, and instead there is an interpretation of what is likely to have been said given available audible data. Where an utterance is entirely inaudible, brackets will enclose no text at all, and instead mark that the occurrence of the utterance rather than details of what that utterance was or an interpretation of this.
the ‘=’ symbol marks a very rapid transition from one utterance to the next.
There is an ever-present tension and trade-off between the ‘purity’ of the CPR protocol and the practicalities of its application (Timmermans 2010).
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Acknowledgements
This work was supported in part by EU FP7 FET SmartSociety project (http://www.smart-society-project.eu/) under the Grant agreement n.600854. It was also supported by the CLEAR (Comparison of Learning Event and Actual Resuscitation) project which was funded by a small grant from the Web Science Institute (University of Southampton) Stimulus Fund in Sept 2014.
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Patel, M., Hartswood, M., Webb, H. et al. Authority as an Interactional Achievement: Exploring Deference to Smart Devices in Hospital-Based Resuscitation. Comput Supported Coop Work 26, 489–525 (2017). https://doi.org/10.1007/s10606-017-9274-0
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DOI: https://doi.org/10.1007/s10606-017-9274-0