Cognitive ethnography of medical interactions. Doctors and nurses make decisions

Abstract

The debate on medical decision-making needs naturalistic studies such as the cognitive ethnography we present here. This paper claims the needs to move from the taken for granted theory of mind to an empirical level. Following recent microsociological and cognitive science studies, we understand knowledge as the product of interaction within a working medical team. Thus, we propose a distributed and embodied cognition approach to expert knowledge. We offer examples of Activity Recurrent Episodes or ARE as our minimal unit of analysis and analyze them in medical narratives in detail. We claim that qualitative analysis helps us explain how decisionmaking really works. Finally, we pinpoint at the invisibility of the patient, which is part of the medical setting but is clearly objectified in the communicative relationships that link the doctors and nurses.