Abstract
To understand how video telephone technology could support consultations between pathologists and surgeons, this study looked at what constitutes ‘work’ in clinical consultations. Using several methods (participant observation, video and interviews), we found pathologists and surgeons both share and do not share similar understandings of what a consultation is, what one should achieve in a consultation, and what in fact constitutes a ‘successful’ consultation. Furthermore, the same objects of consultation (the products of ‘offstage’ work) can be used and defined quite differently depending on how a consultation is framed. Differences and disjunctions like these have to be better understood if computer-supported cooperative healthcare work (CSCHW) applications are to be adopted and accepted.
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References
Bartley, M. (1990) Do we need a strong programme in medical sociology?Sociol. of Health & Illness,12, 371–390.
Conklin, J. (1987) Hypertext: an introduction and survey.IEEE Computer.,20, 17–41.
Forsythe, D. andBuchanan, B. G. (1991) Broadening our approach to evaluating medical information systems. Proc. 15th Symp. on Computer Applications in Medical Care (SCAMC '91),Clayton, P. D. (Ed.), McGraw-Hill, New York, 8–12.
Garfinkel, H. (1967) What is ethnomethodology? InStudies of ethnomethodology. Prentice-Hall, Englewood Cliffs, New Jersey, 1–37.
Gooding, D. (1990)Experiment and the making of meaning. Kluwer, Dordrecht.
Graves, W. andNyce, J. M. (1992) Normative models and situated practice in medicine: towards more adequate system design and development.Inform. & Decis. Technol.,18, 143–149.
Henderson, K. (1991) Flexible sketches and inflexible data bases: visual communication, conscriptive devices and boundary objects in design engineering,Sci., Tech., & Human Values,16, 448–473.
Johansen, R. (1988)Groupware: computer support for business teams. Free Press, New York.
Knorr-Cetina, K. D. (1981)The manufacture of knowledge. Pergamon, New York.
Latour, B. andWoolgar, S. (1979)Laboratory life: the social construction of facts. Sage, Beverley Hills, California.
Lee, F. D. (1989) External quality assessment in histopathology: an overview.J. Clin. Pathol.,42, 1009–1011.
Lilleyman, J. S. (1990) Royal College of Pathologist's United Kingdom pilot study of laboratory accreditation. ——Ibid.,43, 89–91.
Lindblom, C. E. (1959) The science of muddling through.Publ. Admin. Rev.,19, entire Spring issue.
Lynch, M. (1985)Art and artifact in laboratory science, Routledge & Kegan Paul London.
Mercurio, P., Elvins, T., Young, S., Cohen, P., Fall, K. andEllisman, M. (1992) The distributed laboratory: an interactive visualization environment for electron microscopy and 3D imaging.Comm. ACM,35, 54–63.
Nardi, B. A. andMiller, J. R. (1991) Twinkling lights and nested loops: distributed problem solving and spreadsheet development.Int. J. Man-Machine Stud.,34, 161–184.
Nordrum, I., Engum, B., Rinde, E., Finseth, A., Ericsson, H., Kearney, M., Stalsberg, H. andEide, T. J. (1991) Remote frozen section service: a telepathology project in Northern Norway.Human Pathol.,22, 514–518.
Nyce, J. M. andGraves, W. (1990) The construction of knowledge in neurology: implications for hypermedia system development.Artif. Intell. in Med.,2, 315–322.
Pedler, S. J. andBint, A. J. (1991) Survey of users' attitudes to their local microbiology laboratory.J. Clin. Pathol.,44, 6–9.
Ramsay, A. D. (1991) Locally organised medical audit in histopathology. ——Ibid.,44, 353–357.
Star, S. L. (1983) Simplification in scientific work: an example from neuroscience research.Soc. Stud. of Sci.,13, 205–228.
Star, S. L. (1989) The structure of ill-structured solutions: heterogeneous problem-solving, boundary objects and distributed artificial intelligence. InDistributed artificial intelligence 2.Huhns, M. andGasser, L. (Eds.) Morgan Kaufman, San Mateo, California 37–54.
Timpka, T. (1989) Introducing hypertext in primary health care: a study of the feasibility of decision support for practitioners.Comput. Meth. & Programs in Biomed.,29, 1–13.
Timpka, T., Hedblom, P. andHolmgren, H. (1991) Action design: using an object-oriented environment for group process development of medical software. InSoftware engineering in medical informatics.Timmers, T. (Ed.), Elsevier, Amsterdam, 151–165.
Timpka, T. andNyce, J. M. (1992) Towards pragmatics for medical hypermedia systems. Proc. 7th Conf. on Med. Informatics (MEDINFO '92).Lun, K. C. et al. (Eds.) North-Holland, Amsterdam, 1254–1260.
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Nyce, J.M., Timpka, T. Work, knowledge and argument in specialist consultations: Incorporating tacit knowledge into system design and development. Med. Biol. Eng. Comput. 31, HTA16–HTA19 (1993). https://doi.org/10.1007/BF02446887
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DOI: https://doi.org/10.1007/BF02446887