Osterlund "Documenting Practices"

Osterlund (2003) "Documenting Practices: The indexical centering of medical records". Outlines: Critial Social Studies 2: 43-69. [Online]: http://blogs.iis.syr.edu/osterlund/wp-content/uploads/2006/05/DocumentingPractices.pdf

This paper asks "why is it that senior residents and junior interns in a given hospital use entirely different documentary systems despite dealing with the same patients and coping with the same pressures?"

As far as I'm concerned, this paper is relevant because Osterlund uses ethnographic methods to analyse differences between two groups in an organisation, because he examines objects that are shared by more than one cultural group (the documents are used by both types of docs and potentially by others as well) - i.e. boundary objects, and because my research may involve looking at the use of shared documentation.

It has been argued that knowledge is either:

• messy, heterogeneous, local, situated, concrete

or

• explicit, homogeneous, global, abstracted, non-embedded

It is generally viewed as the case that documentary systems can make the first kind of knowledge into the second and so transportable and communicable, or that they damage this type of knowledge so much as to make it impoverished by the conversion.

To overcome this dichotomy, and to answer the original question, Osterlund deploys the idea of indexical centering, drawing on the work of linguistic anthropologist Hanks (1990)Referential Practice.

The essential idea is that the various indexical tools that we employ in our everyday linguistic life are key drivers in our ability to understand what everyone else is saying. Osterlund believes that the different requirements satisfied by indexicals in the documentary practices discussed here explain their differences and resolve the issue of situated knowledge becoming transferable/transportable:

• The senior residents are not around particular patients as much as the interns. In addition, the interns work very closely together. Thus, the interns require here and now action points, and not the more detailed, richly indexical notes that the residents rely on.
• The indexicals serve as the bridges between documentation at situated practice: they make documents "both in and about practice" and "situated and situating".

I like the deliberate ambiguity in the title: should we stress the first or the second word? The paper is about both ways to document practices and different practices in documenting.