Socio-material mediations : learning, knowing and self-produced media within healthcare

The thesis discusses lessons learned and issues raised when exploring how self-produced rich media can facilitate sharing of meaning between healthcare professionals at an intensive care unit and between healthcare professionals and patients within a hand surgery clinic. Design experiments conducted at the intensive care unit focused on how healthcare professionals could collaboratively produce ‘best practice’ videos displayed on handheld devices and accessed through barcodes placed out in the unit. The making of the videos it is argued can be seen as a temporary convergence of different views when reifying ‘best practice.’ Design experiments conducted at the hand surgery clinic focused on how healthcare professional and patients collaboratively could produce, during consultations, rich media documents that are tailored to the patients’ specific needs. The rich media documents made can be seen as a temporary convergence of two distinct practices; namely that of hand surgery treatment and the practice of everyday life. Making of rich media documents in both projects resulted in developing relational spaces of informal learning, which engendered the making of rich reifications that function well in close relation to participation. To engender the making of the rich media documents demanded the establishment and hardening of a socio-technical infrastructure which can be seen as a temporary convergence between tools and practices where both the tools and practices are changed. In both cases using these videos in turn demanded that the videos, a form of local collaborative hardenings, needed to be translated anew and so to speak “defrosted.” The design consequences are that designers need to acknowledge materiality as an ongoing process which is given meaning through participation over time within and across communities of practice. Materiality and human agency in this instance are not seen as discrete elements, but rather highly intertwined. The second design consequence is that we need to acknowledge the complexity, partiality, and multiplicity of such relational spaces. Methodologically, the consequences are that it is important to consider where the designers position themselves and the artifacts in the network of relations, since different positioning will have different implications for the subsequent spaces of action.