Lookup NU author(s): Dr Tim Rapley,
Professor Carl May,
Dr Ben Heaven,
Professor Madeleine Murtagh,
Dr Ruth Graham,
Professor Eileen Kaner,
Professor Richard Thomson
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In this paper, we draw on the analytic perspectives of ethnomethodology to explore doctor-patient encounters in an experimental trial of a complex intervention: an efficacy randomised controlled trial (RCT) of decision-support tools in the UK. We show how the experimental context in which these encounters take place pervades the interactions within them. We argue that two interactional orders were at work in the encounters that we observed: (i) the ceremonial order of the consultation and (ii) the assemblage of the decision-support tool trial. We demonstrate how doctors in the trial oscillate between positions as authoritative clinician and neutralistic decision-support tool-implementer, and patients move between positions as passive recipients of clinical knowledge and as active Subjects required to render their experience as calculable in terms of the demands of the decision-support tools and the broader trial they are embedded in. We demonstrate how the RCT coordinates the world of the clinical environment and the world of experimental evidence. (c) 2005 Elsevier Ltd. All rights reserved.
Author(s): Rapley TJ, May CR, Heaven BRJ, Murtagh MJ, Graham RH, Kaner EFS, Thomson RG
Publication type: Article
Publication status: Published
Journal: Social Science & Medicine
ISSN (print): 0277-9536
ISSN (electronic): 1873-5347
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