Articulation Work Research Articles

Negotiating Professional Knowledge and Responsibility in Cross-sectoral Telemedicine

In ongoing efforts of rationalization and retrenchment in the Danish health care sector, tasks are increasingly moved from costly specialized hospital departments to the primary health care sec- tor, where less specialized personnel take on these tasks. Telemedicine plays an important role in facilitating local access to specialized competences at central hospitals through ICT systems and establishes new virtual spaces for cross-sectoral cooperation between hospital and municipal health care workers. In an explorative ethnographic study, comprising interviews and participant observation, of telemedicine-based interaction between community nurses and specialized hospi- tal nurses, we show how the ‘tele-ulcer’ system becomes a site for professional development for community nurses, although a hierarchization of professional knowledge also takes place. Further- more, extensive articulation work is necessary to make the tele-ulcer system work.We illuminate how contradictory divisions of responsibility may result from the design of the sociotechnical sys- tem, leaving professionals to deal with risks and insecurity.

Producing Printability: Articulation Work and Alignment in 3D Printing

Three-dimensional printing is widely celebrated as enabling open design and manufacturing practice. With easy-to-use techniques such as automated modeling, fabrication machines ostensibly help designers turn ideas into fully fledged objects. Prior HCI literature focuses on improving printing through optimization and by developing printer and material capabilities. This paper expands such considerations by asking, how do 3D printing practitioners understand and create “printability?” And how might HCI better support the work that holds together printing workflows and changing ecosystems of materials and techniques? We conducted studies in two sites of open design: a technology firm in Silicon Valley, California and a makerspace in Stockholm, Sweden. Deploying workshops and interviews, we examine how practitioners negotiate the print experience, revealing a contingent process held together by trial and error exploration and careful interventions. These insights point to the value of tools and processes to support articulation work, what Strauss and colleagues have called the acts of fitting together people, tasks, and their ordering to accomplish an overarching project. We show that despite the sought-after efficiencies of such manufacturing, 3D printing entails articulation work, particularly acts of alignment, exposing messy modes of production carried out by a varied cast of practitioners, machines, and materials.

Noticing the unnoticed: Lines of work in everyday life information practices

ABSTRACTThis paper challenges the existing dichotomy between “everyday” and “workplace” information practices and uses an expansive understanding of work to make visible the often invisible and unpaid forms of work required to make everyday life possible. After an overview of existing understandings and applications of work within LIS, two studies that take up the information work of caring for a family member living with a chronic illness demonstrate that everyday life information practices transcend domestic and organizational contexts. The unpredictability of a chronic illness leads caregivers to undertake numerous and simultaneous lines of work in their everyday and every night lives, including information, document, affective, avoidance, and articulation work, among others. We argue that using the notion of work is a strategy to acknowledge, name, and count those everyday life information practices that are so commonplace they risk becoming unnoticed.

Transforming Taxonomic Interfaces

If scientific research can be described as "arm's length'' cooperative work, then the sciences engaged in the creation and maintenance of cooperatively built classification systems might be said to require extremely long arms; workers must reach across great distances of time, space and awareness to independently contribute to the creation and maintenance of a conceptual infrastructure. This is particularly the case for the field of biological taxonomy, in which researchers across the globe have, for more than three hundred years, cooperatively developed a massive knowledge organization system describing all life on earth. As taxonomists move from paper-based workflows to born-digital, data-first modes of publishing, new tools and approaches are needed to support their work. In this paper, we present research conducted as part of the "Transforming Taxonomic Interfaces" project aimed at improving interfaces for taxonomic software. We describe biological taxonomy in the context of CSCW, and identify key strategies taxonomists deploy to facilitate loosely coupled cooperative work. We also contribute a discussion of semantic refactoring, a unique kind of "articulation work'' entailed in developing, maintaining, and migrating classification systems. This work has implications for the design and study of knowledge organization systems and infrastructure, classification research, and for the development of general semantic web tools and software as well as those specifically for biological taxonomy.

Data Bites Man

Malaria surveillance is a practice concerned with collection and analysis of data. This paper presents an ethnographical account of an international team of researchers producing data about malaria in the Zanzibar archipelago. We show that malaria is increasingly constituted by data, and inextricably interwoven with the practices of data workers using ICT tools. Through the practices we document here malaria: 1) becomes a problem to be managed by asymptomatic, as well as symptomatic individuals, 2) increases its geographical incidence through surveillance data and articulation work, and 3) becomes more certain, through coordination mechanisms enabled by ICT. As electronic data, malaria builds and mobilizes diverse human, organizational, and infrastructural worlds around it, who must now be dedicated to its production, management, and care.

Making New Health Services Work: Nurse Leaders as Facilitators of Service Development in Rural Emergency Services.

Nurse leaders in middle management positions in Norway and other Western countries perform additional new tasks due to high demands for quality and efficacy in healthcare services. These nurses are increasingly becoming responsible for service development and innovation in addition to their traditional leadership and management roles. This article analyses two Norwegian nurse leaders efforts in developing an emergency service in rural municipal healthcare. The analysis applies an ethnographic approach to the data collection by combining interviews with the nurse leaders with observations and interviews with six nurses in the emergency service. The primary theoretical concepts used to support the analysis include “organizing work” and “articulation work”. The results show that in the development of an existing emergency room service, the nurse leaders drew upon their experience as clinical nurses and leaders in various middle management positions in rural community healthcare. Due to their local knowledge and experience, the nurses were able to mobilize and facilitate cooperation among relevant actors in the community and negotiate for resources required for emergency medical equipment, professional development, and staffing to perform emergency care within the rural healthcare context. Due to their distinctive professional and organizational competency and experience, the nurse leaders were well equipped to play a key role in developing services. While mobilizing actors and negotiating for resources, the nurses creatively balanced these two aspects of nursing work to develop the service in accordance to their expectation of providing the highest quality of nursing care to their patients. The nurse leaders balanced their professional ambitions for the service with legal directives, economic incentives, and budgets. Throughout the development process, the nurses carefully combined value-based and goal-based management concerns. In contrast, other studies investigating nursing management and leadership have described that these orientations are in opposition to each other. This study shows that nurses leading the processes of change in rural communities manage the change process by combining the professional and organizational domains of the services.

AidAdom: Supporting Inter-Organizational Coordination for Home Help and Healthcare Services Through a Web Platform

PurposeFrom temporary need of help for household chores after a short stay at the hospital to complex healthcare due to chronic conditions, an important number of professional caregivers belonging to different organizations are involved in providing help and healthcare services at home. Despite the well-defined role of each professional, these organizations are complaining of a lack of coordination and visibility of each other work, especially in case of incident. Coordination between organizations appears here as essential but is at the same time the responsibility of all and of no one of the involved professionals. In this context, our research aims at supporting coordination for home care work through the design and implementation of a web platform. MethodsIn order to ground the design of an inter-organizational coordination platform (AidAdom), we first studied the work practices and coordination issues of two help services providers through interviews and observation with different stakeholders (n=11). Then we have conducted a pilot study at three homes (involving from 6 to 17 caregivers) during one month to evaluate the system use in the field as well as to address implementation issues at both technical and social levels. ResultsWe provide an account of inter-organizational coordination in home care and identify issues in terms of limited resources for articulation work and basic coordination information sharing requirements. This analysis supports the features of the AidAdom web platform that enable caregivers to easily register data and messages related to their interventions. The pilot study allowed us to identify deployment issues at regional scale. ConclusionThe AidAdom platform provides a lightweight system which enables organizations to share a minimal set of coordination information. Our future work is oriented toward opening the system to new help and healthcare service professionals and organizations.

Articulation work from the middle—a study of how technicians mediate users and technology

This article studies the work performed by technicians in a large demonstration project, EcoGrid 2.0, in the Danish island Bornholm. Based on observations of household visits conducted by technicians, we demonstrate how these act as ‘middlemen’, mediating and linking together the smart technology of the demonstration and the involved users. Formally, technicians’ work is to keep users online; however, they also perform a number of invisible tasks to keep users engaged and active. Our ethnographic study shows two broad categories of invisible work: first, technicians continually facilitate the willingness of users, recurrently affirming the social contract between users and demonstration project. Second, technicians facilitate the abilities of users by improvising informal training sessions of how to operate the system. These findings are used to discuss the importance of invisible articulation work of technical service workers in large scale real‐world experiments.

Hidden Work and the Challenges of Scalability and Sustainability in Ambulatory Assisted Living

Assisted living technologies may help people live independently while also—potentially—reducing health and care costs. But they are notoriously difficult to implement at scale and many devices are abandoned following initial adoption. We report findings from a study of global positioning system (GPS) tracking devices intended to support the independent living of people with cognitive impairment. Our aims were threefold: to understand (through ethnography) such individuals’ lived experience of GPS tracking; to facilitate (through action research) the customization and adaptation of technologies and care services to provide effective, ongoing support; and to explore the possibilities for a co-production methodology that would enable people with cognitive impairment and their families to work with professionals and technical designers to shape these devices and services to meet their particular needs in a sustainable way. We found that the articulation work needed for maintaining the GPS technology in “working order” was extensive and ongoing. This articulation work does not merely supplement formal procedures, a lot of it is needed to get round them, but it is also often invisible and thus its importance goes largely unrecognized. If GPS technologies are to be implemented at scale and sustainably, methods must be found to capitalize on the skills and tacit knowledge held within the care network (professional and lay) to resolve problems, improve device design, devise new service solutions, and foster organizational learning.

Repetita Iuvant: Exploring and Supporting Redundancy in Hospital Practices

This paper discusses the role of redundancy in hospital work, especially in facilitating the cognitive and coordinative tasks of health practitioners in clinical settings. It also investigates the ways in which health information technology can preserve, support and even enhance this role by being grounded in the observations and analyses that two research groups in Italy and Norway carried out in independent studies. In the present study, this previous research is reassessed and shaped into a unified and coherent design-oriented framework. This framework considers four kinds of data redundancy and outlines their peculiarities and the typical conditions in which they occur. In particular, the paper reports how these kinds of redundancies are exploited in both written artifacts and oral communications and how they affect each other. The paper also reports the impact of redundancies on the articulation work of physicians and nurses by playing either a negative or, more often, a positive role depending on the context. A series of lessons learnt are then proposed for the design of suitable coordination mechanisms that could preserve or even utilize this neglected phenomenon, which is strongly related to the interpretative and coordinative practices that are articulated in the patient’s record.

Collocated Use of Imaging Systems in Coordinated Surgical Practice

In surgery, assemblages of imaging systems need to be managed, interfaced, and coordinated by a collocated team. In this paper, I untangle the different forms of imaging system interaction in this highly specialized multi-device environment (MDE). I show how the different forms of imaging systems affect the work practice by creating a need for additional articulation work. This articulation work is coordinated into the surgical practice on the body by either distributing the work across the team or by requiring a momentary pause of the surgical work for the entire team to attend to the articulation work to be done on or with the images. And we see how distributing the work across the team still requires a reintegration of the knowledge gleaned from the new information into the surgery itself. This presents an expansion of our understanding of how collocated teams function in MDEs that consist of purely shared displays.

Unpacking the Service Triangle: Arranging Power Relations Between Frontline Occupations

Service work scholarship has insufficiently acknowledged the diversity of interactive frontline occupational categories within organizations. Nor has it paid enough attention to how frontline workers act collectively to deal with the structural contradictions in the service labor process to actually produce a service. This article studies both these questions using Anselm Strauss’ conceptual framework, articulation work. Based on in-depth qualitative research in a major French bank, this article highlights the power relations between two distinct groups of frontline employees responsible for managing customer complaints. It shows how these groups arrange temporary solutions to the structural tensions underpinning their activities. In doing so, this article makes two contributions to service work theory. First, it provides a more detailed picture of the service triangle which is enlarged by these arrangements between different groups of frontline workers. Second, it shows how lateral relations between frontline workers can contribute to the making of a “fragile service social order.”

Strategy and virtue: Developing strategy-as-practice through virtue ethics

Strategy-as-practice research has usefully built on earlier strategy process research by taking into account the social embeddedness of strategy making. While such an approach has generated valuable insights, it has curiously left unexplored the moral dimension of practice. In this article, we show how the potential of strategy-as-practice research may be more fully realized if the moral dimension of practice is conceptualized through virtue ethics (especially MacIntyre’s version). Specifically, we first reconceptualize, through virtue ethics, the three main concepts of strategy-as-practice—practice, praxis, and practitioners—underscoring the inherently moral constitution of actions undertaken in strategy-related work. Moreover, we suggest that strategic management is viewed as a particular kind of practice (what we call “competitive institutional practice”), charged with “values articulation work” and “balancing work.” While the former articulates a good purpose for the organization, the latter seeks to care for both excellence and success through balancing “capabilities development work” with “differentiation work.” Illustrations are provided to support this argument, and several suggestions for further research are offered.

Visible persons, invisible work?

Visible persons, invisible work? Exploring articulation work in the implementation of person-centred care on a hospital wardRecently, many initiatives promoting a holistic view of the patient have been developed. In the last 20 years, different models and frameworks have been advanced to operationalize these different forms of holistic care. This article focuses on one specific case of holistic person-centred care, using the sociological theories of articulation work and invisible work to investigate the efforts involved in sustaining its realization. The article builds on a small ethnographic study conducted at a ward in a Swedish hospital implementing person-centred care. Following a nurse, and her patient, through a ‘person-centred’ admission process and its subsequent procedures, it is argued that person-centred care depends on nurses performing many new tasks which are rarely recognized and appreciated. Secondly, it is argued that nurses are continually asked to do what Anselm Strauss defined as articulation work, coordinating between these different new tasks and established duties. Thirdly, the article discusses the tensions arising when implementing a formalized model of care, which builds on a critique of standardization and objectification, and the work that is excluded and invisible in such routinized operationalization. Finally, it is concluded that while the successful implementation of person-centred care is often argued to rely on the willingness of nurses to surrender old habits, it seems rather to hinge on the skilled inventiveness of these nurses and their ability to overcome the practical difficulties they encounter.

Becoming a Good Homecare Practitioner: Integrating Many Kinds of Work

The paper reports from a homecare fieldwork and discusses the various types of work carried out by homecare workers. We describe formal guidelines for quality in homecare services as a background for looking deeper into the homecare practices and using them as a basis for discussing what high quality homecare is. We have identified seven types of homecare work needed in homecare: illness work, everyday life work, life-changing work, relation work, discretion work, information work and articulation work and we discuss quality in each of these as well as in the homecare as a whole. We exemplify how the quality criteria can be achieved in practice.

Orientación estudiantil y desempeño académico en ingeniería

This paper presents the results of the joint work between the Orientation and Consultation Space (Espacio de Orientacion y Consulta, EOC) and the Teaching Unit of the Faculty of Engineering on the monitoring and analysis of the impact of the EOC actions in the period 2015-2016. The analysis, which articulates qualitative and quantitative data, focuses on the link between individual orientation interviews aimed at first year math students and their subsequent academic performance. The first results indicate that the orientation activities directed to the organization and planning of the study can positively influence in the improvement of the performance and advancement of the students. There are statistically significant differences for the approval and exemption of Calculus 1, critical course at the beginning of engineering careers, in favor of those who transit through the EOC. From the work of articulation, it is expected to have more and better elements for decision making at institutional level that allow to promote actions that favor the permanence and the student progress in the careers, as well as to identify new strategies to address this problem

Estratégias retóricas da publicidade: uma proposta de matriz classificatória

Propõe-se neste artigo uma matriz para identificar e classificar as estratégias retóricas mais abrangentes utilizadas historicamente pela publicidade. Trata-se de um trabalho de articulação teórica, escorado em pesquisa bibliográfica de alcance interdisciplinar e ilustrado com exemplos retirados da práxis publicitária. Inspirando-se na teoria lacaniana dos discursos, o texto toma a cada um destes seu traço mais característico como alicerce de uma determinada estratégia retórica: a imposição (discurso do senhor), a argumentação (discurso da universidade), a sedução (discurso da histeria) e a cumplicidade (discurso do capitalismo). Tais estratégias variam de acordo com o produto, o veículo, o público e a cultura, e combinam-se de diversas maneiras. Ao longo do tempo, pode-se constatar grosso modo o predomínio sucessivo das várias estratégias.

The invisible work of distributed medical education: exploring the contributions of audiovisual professionals, administrative professionals and faculty teachers.

Distributed medical education (DME) is becoming increasingly prevalent. Much of the published literature on DME has focused on the experiences of learners in distributed programs; however, our empirical work leads us to believe that DME changes the context significantly, not only for learners, but also for other important members of the educational community including audiovisual professionals, administrative professionals and faculty teachers. Based on a three-year ethnographic study, we provide a detailed account of how alliances between various workers involved in DME develop to produce and deliver an undergraduate medical curriculum across geographically separate campuses. We explore the question 'What is the work involved in the delivery of a DME program?' and cast a critical gaze on the essential but invisible, and therefore potentially unrecognized and underappreciated, contributions of AV professionals, administrative professionals, and faculty teachers. Our goal is to make visible the complexity of DME, including the essential contributions of these workers. The study was theoretically framed in sociomateriality and conceptually framed in Star and Strauss' notion of articulation work.

Reading between the lines: exploring methods for analysing professional examiner feedback discourse

ABSTRACTThis paper uses the remote interactions of professional examiners working for a UK-based awarding body as a vehicle for discussing the benefits of the use of different methods for analysing such discourse. Communication is an area of interest for sociocultural theory because it can potentiate cognitive shifts in participants and affords learning. In the professional examiner context the feedback given to examiners by more senior colleagues on their performance is a mechanism through which the examiners ensure that their work articulates [Schmidt 2011. “Taking CSCW Seriously: Supporting Articulation Work.” In Cooperative Work and Coordinative Practices, 45–72. Computer Supported Cooperative Work. London: Springer]. Moreover, this communication has a learning function that helps examiners to become members of the professional community. The study captures feedback interaction data from 21 examiners. Once the study context is outlined, the paper briefly discusses three different approaches that have been widely used to analyse communication data. The paper then goes on to propose, using case study analyses of some of the study data, how these methods can be used to augment each other as part of a general sociocultural discourse analysis framework to construct a broad picture of communication.

El proyecto matemático de la naturaleza en la filosofía heideggeriana del período de Marburgo (1923-1927)

El término “naturaleza” se muestra como una noción problemática en la filosofía heideggeriana anterior a los años ’30. Este término recibe variadas interpretaciones a lo largo del período de Marburgo, las cuales aparecen de forma dispersa y poco articulada. Nuestra investigación se centra en la explicitación del sentido de naturaleza que opera como trasfondo para las tareas de las ciencias ónticas de lo intramundano, esto es, las ciencias naturales. El objetivo de este estudio será el de indicar -en un trabajo de articulación de tratamientos dispersos - en qué sentido se dice “naturaleza” en las ciencias naturales. El estudio mostrará que los dos sentidos predominantes en los que las ciencias ónticas comprenden el término son a) el de conjunto total de lo que está ahí ante los ojos [Vorhandenheit], y b) el de región ontológica abierta en un proyecto matemático de la constitución de ser de los entes.