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Arranging for visibility

Paper i proceeding
Författare Jonas Ivarsson
Hans Rystedt
Oskar Lindwall
Åsa Mäkitalo
Publicerad i Paper presented at the European Association for the study of Science and Technology conference, Trento, Italy
Publiceringsår 2010
Publicerad vid Linnécentret for forskning om lärande (LinCS)
Institutionen för pedagogik, kommunikation och lärande
Språk en
Ämnesord radiology, ethnomethodology, video, sts
Ämneskategorier Diagnostisk radiologi, Kommunikationsvetenskap

Sammanfattning

With an approach based on ethnomethodological studies of work, this presentation discusses a theme that we call arranging for visibility. First, we present a case where professionals in medicine arrange so called learning sessions in order develop visual expertise in relation to a novel medical imaging technology. Characteristic for these sessions is that members of the team arrange the situations so as to be able to visually discern critical details. Second, we discuss how the members’ orientation to visual details necessitates analytical access to these details, and – in relation to this – what arranging for visibility might mean for us as analysts. The case that we discuss concerns a multidisciplinary team of scientists and professional radiologists. Diagnosis and follow-up of pulmonary diseases are most commonly done with conventional chest radiography. A fundamental problem with chest radiography is that overlapping anatomic structures may obstruct the detection of tumours and other pathologies. With a new form of digital tomography called tomosynthesis it becomes possible to visualise the chest as a set of slices. Within the first months of clinical use of the technology, experienced thoracic radiologists were able to increase their detection of pulmonary nodules, from about 25% to over 90%. The increase in the detection of true positives, however, was also paralleled by an increase of false positives. The introduction of the new technology did not just simply augment the professional visual of the thoracic radiologists. Rather, it reconfigured the expertise by installing new ways of seeing and acting. As a response to this, and in order to highlight critical issues in detection of pulmonary nodules, the team arranged learning sessions during which previous cases were collectively reviewed: two separate projector screens allowed for side-by-side comparisons of CT and tomosynthesis data from the same patient; historical records of all individual markings effectively displayed any incongruence of earlier judgements; the use of large screens and laser pointers enabled rapid and precise indexing; the uneven distribution of expertise made it relevant to provide extended instruction in professional ways of seeing. The elaborate arrangement of learning sessions could be seen as an enabling condition for the team members’ ensuing orientation towards critical details in the interpretation of images. As a consequence of this, investigations of the learning sessions have the potential to shed light on important aspects of the relation between technological shifts and reconfigurations of expertise. Video recordings becomes a indispensable tool in this research: since the interest lies in the orientation to visual detail by the members, there is a need for records that preserve this orientation in necessary detail. The work of us as analysts also makes relevant elaborated arrangements of transcripts, images and different camera angles. There are thus both parallels and differences between the arrangements for visibilities made by members and that made by us as analysts – an issue which connects to the more general issue of the relation between the perspective of the member and that of the analyst in social scientific research.

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