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The Use of Narratives in Medical Work: A Field Study of Physician-Patient Consultations

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ECSCW 2011: Proceedings of the 12th European Conference on Computer Supported Cooperative Work, 24-28 September 2011, Aarhus Denmark

Abstract

Medical reasoning involves more than just summarizing clinical data and guidelines. Illness trajectories of chronic patients are often long, complex and full of uncertain information that requires interpretation. Understanding the complex interrelations is an important aspect of medical reasoning that displays narrative rather than scientific characteristics. While the qualities of the medical record as a repository of information or as a coordinative tool are well known, the role it plays in the unfolding of narratives in medical reasoning is less discussed. This paper examines this issue through a case study of patient consultations that take place as part of a distributed treatment of chronic heart patients. We found that the record, even though fragmented and to some extent incomplete, enables the physician to construct an ad hoc narrative. During the actual consultation, physicians and patients unfold a more detailed narrative, which we refer to as the re-emplotted narrative, that includes additional information and entails a collaborative exploration of uncertainties. While this may point to some inadequacies of the medical record as a supportive tool for the process of unfolding narrative, we suggest that is it in fact a crucial component of the medical reasoning activity that must be considered in design of supportive systems.

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Authors and Affiliations

  1. University of Copenhagen, Copenhagen, Denmark

    Troels Mønsted & Jørgen P. Bansler

  2. The Pennsylvania State University, University Park, USA

    Madhu C. Reddy

Authors
  1. Troels Mønsted
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  2. Madhu C. Reddy
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  3. Jørgen P. Bansler
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Corresponding author

Correspondence to Troels Mønsted .

Editor information

Editors and Affiliations

  1. Aabogade 34, Aarhus N., 8200, Denmark

    Susanne Bødker

  2. , Department of Computer Science, Aarhus University, 34 Aabogade, Aarhus, DK- 8200, Denmark

    Niels Olof Bouvin

  3. , Information Systems and New Media, University of Siegen, Hölderlinstr. 3, Siegen, 57068, Germany

    Volker Wulf

  4. Dept. Computer Science &, Information Systems, University of Limerick, Limerick, Ireland

    Luigina Ciolfi

  5. , Information Systems Department, University of Maryland, 1000 Hilltop Circle, Baltimore, 21250, USA

    Wayne Lutters

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Mønsted, T., Reddy, M.C., Bansler, J.P. (2011). The Use of Narratives in Medical Work: A Field Study of Physician-Patient Consultations. In: Bødker, S., Bouvin, N., Wulf, V., Ciolfi, L., Lutters, W. (eds) ECSCW 2011: Proceedings of the 12th European Conference on Computer Supported Cooperative Work, 24-28 September 2011, Aarhus Denmark. Springer, London. https://doi.org/10.1007/978-0-85729-913-0_5

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  • DOI: https://doi.org/10.1007/978-0-85729-913-0_5

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  • Online ISBN: 978-0-85729-913-0

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