Tuesday, December 18, 2007

Proving or improving

The joys of being a PhD student! Just as I find my voice on an issue, I find I am not alone, my fumbled thoughts have found their way into words eloquently writ elsewhere.

‘Anyone can have big ideas”, said Concepcion. “I have had some big ideas, and most of them I thought of for myself, and then I found out that others have thought the same, and then I found out that other people have big ideas that are exactly the opposite, and when I think about it even more, I decide that only small ideas can be true, and the big ideas are too big to fit inside anybody’s mind, so there is no point in trying to have them. You know what my mother used to say when I asked her a question like “why does God let babies die?” She said “Pregunta a las mariposas”. Go and ask the butterflies, because they don’t know any better than anyone else.’
(de Bernieres, 1993, p 278)
Whether to prove or improve practices in health care research is well discussed by Annemarie Mol. I discovered this article while clearing a backlog of reading:
As it is, clinical trials are the gold standard of health care research, employed to prove that the care practices they study are good. Here, the author suggests that we would do better to develop research methods that work toward another goal: to improve care practices. This requires that we no longer foreground the effectiveness but, instead, investigate the various effects of interventions. If undesirable, they might then be tinkered with. As a part of this, the effects on bodily parameters and on the intricacies of daily lives should not be separated out but studied in connection. With examples drawn from studies into care practices for patients with diabetes or atherosclerosis, the author argues that instead of trying to turn the clinic into a laboratory, we should strive to support and strengthen clinical ways of working.
Annemarie Mol (2006),
Proving or Improving: On Health Care Research as a Form of Self-Reflection

This approach also encompasses the issues raised by cj:
... in new ways of doing things (aka technology)... for the most part, the original intent of the gizmo is rarely the use that is taken up....this points to an interesting habit where we tend to assume that gizmo X was actually designed to do what it is now being used for, i.e. the myth of design, make and appraise of technology as it is often taught in schools.
We also know that the making life easier line plays out interestingly when you, for example, have say two online information sources, one which is has richer resources but devilishly difficult to use, the other much poorer resources but dead simple to use. The easier to use resource wins. Then there is the small initial advantage a particular technology may develop, perhaps randomly, which is then amplified quickly over time. The Beta vs. UHS video format comes to mind. There are others.
For me, all of this underlines that we are always considering the sociotechnical, not just the technical that somehow gets taken up or adopted as diffusion theory suggests. It's all about negotiation between people and things. Delegation of work to a thing which is never a simple matter as Latour elegantly demonstrated a long time ago.

There is richness to be had in investigating the practices as they unfold, rather than attempting an evaluation of goodness, badness, rightness or wrongness.

It seems i need to take several steps forward to find myself standing in the same place and I am finding an essential ingredient for a Phd student is the ability to laugh at myself ;)

No comments:

Post a Comment