“MacGyver-Meets-Dr. Ruth”: Science Journalism and the Material Positioning of Dr. Carla Pugh

This article examines the rhetorical consequences of foregrounding female scientists\u27 materials through an analysis of seven news articles on Dr. Carla Pugh, a surgeon who designs medical patient simulators. Journalists foreground Pugh\u27s materials by positioning her as both “MacGyver,” creatively assembling simulators from everyday objects, and “Dr. Ruth,” willingly discussing intimate parts. These positions avoid focusing on Pugh\u27s personal life or body but still ultimately gender her and her work. The MacGyver position associates Pugh with gendered activities, objects, and spaces while undermining her affiliation with the technical aspects of design. Meanwhile, the Dr. Ruth position implies Pugh\u27s knowledge comes from inherent bodily expertise, making certain scientific fields appear more natural for women

Simulation Genres and Student Uptake: The Patient Health Record in Clinical Nursing Simulations

Drawing on fieldwork, this article examines nursing students’ design and use of a patient health record during clinical simulations, where small teams of students provide nursing care for a robotic patient. The student-designed patient health record provides a compelling example of how simulation genres can both authentically coordinate action within a classroom simulation and support professional genre uptake. First, the range of rhetorical choices available to students in designing their simulation health records are discussed. Then, the article draws on an extended example of how student uptake of the patient health record within a clinical simulation emphasized its intertextual relationship to other genres, its role mediating social interactions with the patient and other providers, and its coordination of embodied actions. Connections to students’ experiences with professional genres are addressed throughout. The article concludes by considering initial implications of this research for disciplinary and professional writing courses

Materialising Materiality

This paper examines the recent claim that “technologies remain largely understudied in organizational research”. The core contention is that the materiality of the IT artefact has been ignored, thus contributing to an impoverished understanding of the relationship between technology, people and organisation. While accepting much of the criticism directed towards the “isolation of technology”, this paper sets out to develop a basis from which the concept of materiality may be fruitfully developed by outlining a structure of mediation based on the work of Don Ihde and Peter-Paul Verbeek. In discussing the role of mediation, the paper claims that much of the literature on Clinical Information Systems has failed to address the ‘substitution of bodies’ and the ‘de-centred patient’, thus providing a fertile environment for a promising research agenda in Information Systems Materiality

Health Information Systems Affordances: How the Materiality of Information Technology Enables and Constrains the Work Practices of Clinicians

The IT artifact is at the core of the information systems (IS) discipline and yet most IS research does not directly theorize the IT artifact or its nomological network (Benbasat and Zmud 2003; Orlikowski and Iacono 2001). This research seeks to answer a repeated call for more direct engagement with the IT artifact and its nomological net with affordance theory adopted as the basis for this theoretical work. An exploratory case study was conducted to answer the research question, how do the material properties of health information systems enable and constrain the work practices of clinicians? The study was conducted at a large urban acute care hospital in the Midwestern United States with registered nurses working on inpatient care units as the clinicians of interest. Through interviews with nurses and other clinical stakeholders and the observation of nurse’s work practices on three patient care units in the hospital, theoretical insights were developed on the nature of affordances for information systems research. IS affordances are defined in this study as relationships between abilities of an individual and features of an information systems within the context of the environment in which they function. The concepts of an affordance range and an affordance threshold are proposed as theoretical constructs in the nomological network of affordances that help to explain the use of information systems as a function of the difficulty of acting on IS affordances. The relationship between affordances and constraints is theorized and linked to the affordance range and threshold with the assertion that constraints are closely associated with the difficulties experienced by users in acting on IS affordances. The challenge of studying IS affordances in all their complexity is discussed with the suggestion that researchers take the user’s perspective of affordances to alleviate the need for repeated decomposition. Finally, the role of information systems in facilitating social interaction is emphasized through the concept of affordances for sociality. The contribution of this research to the IS field is a more nuanced understanding of the nature of the IT artifact and its relationship to the users of that technology

The impact of using computer decision-support software in primary care nurse-led telephone triage:Interactional dilemmas and conversational consequences

Telephone triage represents one strategy to manage demand for face-to-face GP appointments in primary care. Although computer decision-support software (CDSS) is increasingly used by nurses to triage patients, little is understood about how interaction is organized in this setting. Specifically any interactional dilemmas this computer-mediated setting invokes; and how these may be consequential for communication with patients. Using conversation analytic methods we undertook a multi-modal analysis of 22 audio-recorded telephone triage nurse-caller interactions from one GP practice in England, including 10 video-recordings of nurses' use of CDSS during triage. We draw on Goffman's theoretical notion of participation frameworks to make sense of these interactions, presenting 'telling cases' of interactional dilemmas nurses faced in meeting patient's needs and accurately documenting the patient's condition within the CDSS. Our findings highlight troubles in the 'interactional workability' of telephone triage exposing difficulties faced in aligning the proximal and wider distal context that structures CDSS-mediated interactions. Patients present with diverse symptoms, understanding of triage consultations, and communication skills which nurses need to negotiate turn-by-turn with CDSS requirements. Nurses therefore need to have sophisticated communication, technological and clinical skills to ensure patients' presenting problems are accurately captured within the CDSS to determine safe triage outcomes. Dilemmas around how nurses manage and record information, and the issues of professional accountability that may ensue, raise questions about the impact of CDSS and its use in supporting nurses to deliver safe and effective patient care

Qualitative Research: Methods and Methodology

This entry provides an overview of qualitative LGBTQ research. It begins by mapping out the qualities and character of studies that use this approach with particular attention to psycho-social research. It then highlights how reflexivity, the iterative process of self-identity making, has informed qualitative research, influencing both understandings of sexualities and also the underlying methodologies and research methods used. Finally, it considers how “the everyday” and a practices approach have generated significant insight on the materialities (lived experiences) and emotionality in qualitative research on LGBTQ lives

How could discourse theories of identity formation critically engage patient-centred care in older adults?

Purpose – The purpose of this paper is to explore how discourse theories can contribute to the concept of identity formation within a patient- or person-centred care (PCC) orientation, to enable more critical engagement with PCC in older people. Design / methodology / approach – Conceptual paper Findings – This paper concludes that the discourse literature has important insights for understanding identity formation in older people as operationalized in the context of PCC in three particular ways: 1) Accounting for multiplicity in patients’ identity 2) Exploring ‘the devolution of responsibility’ to address shifts in performing identities in clinical encounters 3) Attending to a ‘crisis of positioning’ to engage empowerment discourse within a PCC philosophy Originality/value – Whilst a notion of patient identity is at the heart of PCC, the concept remains inconsistent and underdeveloped. This is particularly problematic for the quality of care in older adults, as PCC has become increasingly synonymous with care of older people. Discourse theories of identity formation can be used to critically engage with identity within the context of PCC, so as to develop more nuanced understandings of ‘the person’ or ‘the patient’, with the potential to improve research into care for aging and older adults

Situated and distributed cognition in artifact negotiation and trade-specific skills: A cognitive ethnography of Kashmiri carpet weaving practice

This article describes various ways actors in Kashmiri carpet weaving practice deploy a range of artifacts, from symbolic, to material, to hybrid, in order to achieve diverse cognitive accomplishments in their particular task domains: information representation, inter and intra-domain communication, distribution of cognitive labor across people and time, coordination of team activities, and carrying of cultural heritage. In this repertoire, some artifacts position themselves as naïve tools in the actors’ environment to the point of being ignored; however, their usage-in-context unfolds their cognitive involvement in the tasks. These usages-in-context are shown through artifact analysis of their routine, improvised, and opportunistic uses, where cognitive artifacts like talim—the central artifact of this practice—are shown to play not only multifunctional roles beyond representation, but are also complemented by trade-specific skills bearing strong cognitive implications in a task