AbstractsMedical & Health Science

Abstract

This study examined why breakthroughs in scientific and technological knowledge may fail to be translated into medical practice. In addition, it supported previous research that has underscored that these failures often are related to their lack of alignment with existing practices, or because they cut across established professional boundaries and power structures. Further, research has demonstrated that establishing practices across heterogeneous groups of actors, i.e. science, politics and industry, can facilitate interactive innovation. This project investigated how this was accomplished in practice. Thus, the main aim of the project was to study how cross-disciplinary technology development in hospitals evolves, and thereby contribute to our understanding of changing practices. The dissertation is based on a longitudinal case study of the Interventional Centre, Rikshospitalet University Hospital, Norway. The dissertation consists of an introductory section and five papers. There are especially three elements that bind the five papers together. First, they all examine different aspects of changing practice at the Interventional Centre. Second, the research material was collected during the same period by the same researcher(s). Third, all of the papers are positioned within practice-based studies of learning, change and innovation. The first paper addressed the challenges in developing new medical knowing in practice when groups based on different knowledge traditions need to collaborate. The second paper examined the role of artefacts, such as research protocols, in cross-disciplinary knowledge production and innovation. The third paper was a detailed study of an innovation project, focusing on how technology, different professional communities and practice mutually influenced each other. The fourth paper investigated how new practices challenge established power relations within and across communities by examining two projects within the field of laparoscopy. The final paper examined the role of boundary organising for changing practices. The main contribution of the study was to provide rich insights into organising, learning, change and innovation, all of which were developed in the different papers. There were also several specific contributions to theory: The papers drew broadly from different theoretical approaches in order to explain complex phenomena. This was illustrated in the first paper, which was a detailed analysis of how the epistemic cultures of different communities of practice had implications for how and what type of knowledge was produced. Several of the papers also critically addressed the role of communities of practice in innovation, which is an area that thus far has been under-researched. The papers also emphasised the ongoing, multilevel activities that are important for overcoming different boundaries in order to develop and stabilise new medical knowing in practice. The dissertation also fore grounded how power relations both within and across communities of practice become…