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Authority as an interactional achievement: exploring deference to smart devices in hospital-based resuscitation

Authority as an interactional achievement: exploring deference to smart devices in hospital-based resuscitation
Authority as an interactional achievement: exploring deference to smart devices in hospital-based resuscitation
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.
0925-9724
489-525
Patel, Menisha
b35ac672-1dc7-441b-81bc-5613c71672e1
Hartswood, Mark
35951669-a88d-430d-bb5f-cd02ca1c024d
Webb, Helena
d7668489-f6c9-4321-b478-5aa64c19d252
Gobbi, Mary
829a5669-2d52-44ef-be96-bc57bf20bea0
Monger, Eloise
38e8d3f2-e364-4d50-8542-6fc8cf096481
Jirotka, Marina
25d07975-6dc3-4a11-9510-a0d70f90490a
Patel, Menisha
b35ac672-1dc7-441b-81bc-5613c71672e1
Hartswood, Mark
35951669-a88d-430d-bb5f-cd02ca1c024d
Webb, Helena
d7668489-f6c9-4321-b478-5aa64c19d252
Gobbi, Mary
829a5669-2d52-44ef-be96-bc57bf20bea0
Monger, Eloise
38e8d3f2-e364-4d50-8542-6fc8cf096481
Jirotka, Marina
25d07975-6dc3-4a11-9510-a0d70f90490a

Patel, Menisha, Hartswood, Mark, Webb, Helena, Gobbi, Mary, Monger, Eloise and Jirotka, Marina (2017) Authority as an interactional achievement: exploring deference to smart devices in hospital-based resuscitation. Computer Supported Cooperative Work, 26 (4-6), 489-525. (doi:10.1007/s10606-017-9274-0).

Record type: Article

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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Accepted/In Press date: 11 April 2017
e-pub ahead of print date: 28 May 2017
Published date: December 2017

Identifiers

Local EPrints ID: 413745
URI: https://eprints.soton.ac.uk/id/eprint/413745
ISSN: 0925-9724
PURE UUID: 5250cd3c-b779-45cb-b87b-acb382b378e4
ORCID for Eloise Monger: ORCID iD orcid.org/0000-0003-2799-0596

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Date deposited: 04 Sep 2017 16:30
Last modified: 14 Mar 2019 05:51

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