Experimental reality: principles for the design of augmented environments

The Laboratory of Design for Cognition at EDF R&D (LDC) is a living laboratory which we created in order to develop AE for collaborative work, more specifically “cognitive work” (white collars, engineers, office workers). It is a corporate laboratory in a large industry, where natural activity of real users is observed in a continuous manner in various spaces (project space, meeting room, lounge, etc.) The RAO room, an augmented meeting room, is used daily for “normal” meetings; it is also the “mother room” of all augmented meeting rooms in the company; where new systems, services and devices are tested. The LDC has gathered a unique set of data on the use of AE, and developed various observation and design techniques, described in this chapter. LDC uses novel techniques of digital ethnography, some of which were invented there (SubCam, offsat) some of which were developed elsewhere and adapted (360° video, WebDiver, etc.) At LDC have also been developed some new theories to explain behavior and guide innovation: cognitive attractors, experimental reality, and the triple-determination framework. Published as Chapter 5 in In S. Lahlou (ed.) Designing User Friendly Augmented Work Environments. From Meeting Rooms to Digital Collaborative Spaces. London: Springer, Computer Supported Cooperative Work Series, 200

Representation, interaction and interpretation : Making sense of the context in clinical reasoning

Background All thinking occurs in some sort of context, rendering the relation between context and clinical reasoning a matter of significant interest. Context, however, has a notoriously vague and contested meaning. A profound disagreement exists between different research traditions studying clinical reasoning in how context is understood. However, empirical evidence examining the impact (or not) of context on clinical reasoning cannot be interpreted without reference to the meaning ascribed to context. Such meaning is invariably determined by assumptions concerning the nature of knowledge and knowing. The epistemology of clinical reasoning determines in essence how context is conceptualised. Aims Our intention is to provide a sound epistemological framework of clinical reasoning that puts context into perspective and demonstrates how context is understood and researched in relation to clinical reasoning. Discussion We identify three main epistemological dimensions of clinical reasoning research, each of them corresponding to fundamental patterns of knowing: the representational dimension views clinical reasoning as an act of categorisation, the interactional dimension as a cognitive state emergent from the interactions in a system, while the interpretative dimension as an act of intersubjectivity and socialisation. We discuss the main theories of clinical reasoning under each dimension and consider how the implicit epistemological assumptions of these theories determine the way context is conceptualised. These different conceptualisations of context carry important implications for the phenomenon of context specificity and for learning of clinical reasoning. Conclusion The study of context may be viewed as the study of the epistemology of clinical reasoning. Making sense of ‘what is going on with this patient’ necessitates reading the context in which the encounter is unfolding and deliberating a path of response justified in that specific context. Mastery of the context in this respect becomes a core activity of medical practice