Cargando…
Knowing in general dental practice: Anticipation, constraint, and collective bricolage
RATIONALE, AIMS, AND OBJECTIVES: Much of the literature concerned with health care practice tends to focus on a decision‐making model in which knowledge sits within the minds and bodies of health care workers. Practice theories de‐centre knowledge from human actors, instead situating knowing in the...
Autores principales: | , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2018
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6899494/ https://www.ncbi.nlm.nih.gov/pubmed/30334329 http://dx.doi.org/10.1111/jep.13051 |
_version_ | 1783477142054502400 |
---|---|
author | Hurst, Dominic Greenhalgh, Trish |
author_facet | Hurst, Dominic Greenhalgh, Trish |
author_sort | Hurst, Dominic |
collection | PubMed |
description | RATIONALE, AIMS, AND OBJECTIVES: Much of the literature concerned with health care practice tends to focus on a decision‐making model in which knowledge sits within the minds and bodies of health care workers. Practice theories de‐centre knowledge from human actors, instead situating knowing in the interactions between all human and non‐human actors. The purpose of this study was to explore how practice arises in the moment‐to‐moment interactions between general dental practitioners (GDPs), patients, nurses, and things. METHOD: Eight GDPs in two dental practices, their respective nurses, 23 patients, and material things were video‐recorded as they interacted within clinical encounters. Videos were analysed using a performative approach. Several analytic methods were used: coding of interactions in‐video; pencil drawings with transcripts; and dynamic transcription. These were used pragmatically and in combination. Detailed reflective notes were recorded at all stages of the analysis, and, as new insights developed, theory was sought to help inform these. RESULTS: We theorized that knowing in dental practice arises as actors translate embodied knowing through sayings and doings that anticipate but cannot predict responses, that knowing is constrained by the interactions of the practice but that the interactions at the same time are a collective bricolage—using the actors' respective embodied knowing to generate and solve problems together. CONCLUSION: Practices are ongoing ecological accomplishments to which people and things skilfully contribute through translation of their respective embodied knowing of multiple practices. Based on this, we argue that practices are more likely to improve if people and things embody practices of improvement. |
format | Online Article Text |
id | pubmed-6899494 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-68994942019-12-19 Knowing in general dental practice: Anticipation, constraint, and collective bricolage Hurst, Dominic Greenhalgh, Trish J Eval Clin Pract Original Paper RATIONALE, AIMS, AND OBJECTIVES: Much of the literature concerned with health care practice tends to focus on a decision‐making model in which knowledge sits within the minds and bodies of health care workers. Practice theories de‐centre knowledge from human actors, instead situating knowing in the interactions between all human and non‐human actors. The purpose of this study was to explore how practice arises in the moment‐to‐moment interactions between general dental practitioners (GDPs), patients, nurses, and things. METHOD: Eight GDPs in two dental practices, their respective nurses, 23 patients, and material things were video‐recorded as they interacted within clinical encounters. Videos were analysed using a performative approach. Several analytic methods were used: coding of interactions in‐video; pencil drawings with transcripts; and dynamic transcription. These were used pragmatically and in combination. Detailed reflective notes were recorded at all stages of the analysis, and, as new insights developed, theory was sought to help inform these. RESULTS: We theorized that knowing in dental practice arises as actors translate embodied knowing through sayings and doings that anticipate but cannot predict responses, that knowing is constrained by the interactions of the practice but that the interactions at the same time are a collective bricolage—using the actors' respective embodied knowing to generate and solve problems together. CONCLUSION: Practices are ongoing ecological accomplishments to which people and things skilfully contribute through translation of their respective embodied knowing of multiple practices. Based on this, we argue that practices are more likely to improve if people and things embody practices of improvement. John Wiley and Sons Inc. 2018-10-18 2019-12 /pmc/articles/PMC6899494/ /pubmed/30334329 http://dx.doi.org/10.1111/jep.13051 Text en © 2018 The Authors Journal of Evaluation in Clinical Practice Published by John Wiley & Sons Ltd. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Paper Hurst, Dominic Greenhalgh, Trish Knowing in general dental practice: Anticipation, constraint, and collective bricolage |
title | Knowing in general dental practice: Anticipation, constraint, and collective bricolage |
title_full | Knowing in general dental practice: Anticipation, constraint, and collective bricolage |
title_fullStr | Knowing in general dental practice: Anticipation, constraint, and collective bricolage |
title_full_unstemmed | Knowing in general dental practice: Anticipation, constraint, and collective bricolage |
title_short | Knowing in general dental practice: Anticipation, constraint, and collective bricolage |
title_sort | knowing in general dental practice: anticipation, constraint, and collective bricolage |
topic | Original Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6899494/ https://www.ncbi.nlm.nih.gov/pubmed/30334329 http://dx.doi.org/10.1111/jep.13051 |
work_keys_str_mv | AT hurstdominic knowingingeneraldentalpracticeanticipationconstraintandcollectivebricolage AT greenhalghtrish knowingingeneraldentalpracticeanticipationconstraintandcollectivebricolage |