Biomedical Engineering Reference
In-Depth Information
• Individual allo-confrontations with the filmed producers and with
the producers who had not been filmed, in order to make visible
the diversity of know-how present in the collective and to make the
producers elicit it
• A collective confrontation gathering the filmed producers, located
remotely from one another
Results allowed the authors to show that individual allo-confrontation
formed a tool to share know-how: examining the activity of other pro-
ducers allowed each producer to access part of his or her knowledge and
know-how. This method, in a sense, allowed producers to compensate for
the lack of a shared location. Furthermore, individual allo-confrontation
constituted a tool for training and learning: confrontation with the activ-
ity of others led the producers to either strengthen their own representa-
tions and know-how or modify them, thanks to the elicitation process it
provoked. Collective confrontation, finally, allowed not only setting off a
process of formalizing know-how based on the analysis of work activity,
but also the producers to realize the interest of sharing individual experi-
ences, taking ownership of video as a tool for analysis and sharing, and
organizing collective sessions of flowers' pruning (separation of the pistil
of the flower), so that the activity might become a resource for the con-
struction of a collective experience.
A reflection on practices based on nonnominal situations
The two studies presented here illustrate a form of reflective activity rely-
ing on processing nonnominal situations (NNSs), that is, situations that
deviate from the prescriptions or raise issues of application of this pre-
scribed work.
The first study consisted of analyzing the running of multidisciplinary
consult meetings (MCMs) in oncology. These weekly meetings gather spe-
cialists from various specialties (surgery, medical oncology, radiotherapy,
gynaecology, etc.) to propose therapeutic solutions in the case of NNSs,
where therapeutic frameworks are difficult to apply.
Analyzing the activity that takes place in an MCM (Mollo, 2004; Mollo
and Falzon, 2008) showed that, in accordance with expectations, MCMs
made it possible to guarantee the reliability of decision-making, but the
benefits of MCMs go beyond assisting decision-making. The collective rea-
soning carried out in MCMs generates a critical cross-examination of the
various alternatives proposed, making it possible to collectively define the
space of acceptable solutions and the space of unacceptable solutions. Thus,
it makes it possible to delineate the boundaries of the local genre, within
which doctors are free to choose between the available options the option that
seems to best correspond to particular situations and their own expertise.
