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...

Descripción completa

Detalles Bibliográficos
Autores principales: Hurst, Dominic, Greenhalgh, Trish
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