Developing the Ethnographic Study

Abstract

This chapter opens with an auto-ethnography and goes on to establish the methodology that was used in this research. Institutional ethnography (IE) was developed by feminist sociologist Dorothy Smith. Smith refers to this approach as a method of inquiry that uses people’s everyday experiences as the starting point for an exploration of the often-invisible social relations underpinning or organizing their experiences. It is a sociological approach based on her understandings of the social organization of knowledge as well as the understandings of other IE practitioners (Campbell and Manicom, Knowledge, experience, and ruling relations: Studies in the social organization of knowledge. Toronto, ON; Buffalo; London: University of Toronto Press, 1995). The central premise of IE is that we live in a text-mediated world in which relations of ruling are accomplished through texts that coordinate our activities with those of others, although this is rarely visible to us from our particular standpoints. Understanding the social world requires taking up a specific position as a starting point from which to begin to explore how things are put together the way that they are. In this sense, IE is sampling an institutional process rather than a population and provides an alternative to the highly abstract and theoretical accounts of the world often provided through mainstream sociology (Smith, Institutional ethnography: A sociology for people. Toronto, ON: AltaMira Press, 2005). The standpoint I take up here is that of physicians working in cities and smaller communities and who are involved in delivering thrombolytic therapy (rt-PA) for acute stroke. However, while I begin from their perspective, physicians are not the objects of my investigation. Locating an institutional standpoint within the experiences of physicians as a framework of relevance allows me to direct my gaze to how things are organized in such a way as to standardize a textually established best practice that must be enacted across multiple locations. These Ontario locations differ widely in the social organizational conditions under which best practice can be delivered and hence in the empirical practicalities of treating stroke cases using rt-PA.