Overview
One of the only institutional ethnographies from the standpoint of the physician
Uncovers the different elements of a complex institutional structure: the development, implementation, and everyday practice of evidence based medicine
Complicates our understanding of evidence based medicine and knowledge translation
Access this book
Tax calculation will be finalised at checkout
Other ways to access
Table of contents (7 chapters)
-
Front Matter
-
Back Matter
Keywords
About this book
This book explores how best practice for acute stroke care was developed, translated and taken up in medical practice across various sites in the province of Ontario using institutional ethnographic research. Institutional ethnography, an approach developed by Dorothy E. Smith, builds on Smith’s understanding of the social organization of knowledge, allowing for an examination of the complex social relations organizing people’s experiences of their everyday working lives.
This work thereby makes visible some of the assumptions and hidden priorities underlying the emphasis given to translating scientific knowledge into medical practice. In this study, the discourses of both evidence-based medicine and knowledge translation, purportedly designed to improve patient care, come into view as managerial tools that directed healthcare resources toward academic hospitals rather than community sites where the majority of patients receive care. These models institutionalize inequities in access to care while claiming to resolve them.
Reviews
— Grainne Kearney, Clinical Lecturer in the School of Medicine, Dentistry, and Biomedical Sciences, Queen’s University Belfast, Ireland
‘Webster’s institutional ethnographic research describes how standardizing approaches actually play out in practice. In rich, thick detail we are shown the institutional processes that organize how objective clinical evidence is “rolled out” into the context-laden, deeply social world of healthcare. Offering a unique counter-narrative, the book is illustrative of gaps and risks that may arise when local knowledge is subordinated to coordinated directives from afar.’
— Janet Rankin, Associate Professor of Nursing, University of Calgary, CanadaAuthors and Affiliations
About the author
Fiona Webster is Associate Professor in the Arthur Labatt Family School of Nursing at Western University in London, Ontario, Canada. Webster obtained her PhD in sociology under the supervision of Dorothy E. Smith at the University of Toronto, Canada.
Bibliographic Information
Book Title: The Social Organization of Best Practice
Book Subtitle: An Institutional Ethnography of Physicians’ Work
Authors: Fiona Webster
DOI: https://doi.org/10.1007/978-3-030-43165-5
Publisher: Palgrave Macmillan Cham
eBook Packages: Social Sciences, Social Sciences (R0)
Copyright Information: The Editor(s) (if applicable) and The Author(s), under exclusive license to Springer Nature Switzerland AG 2020
Hardcover ISBN: 978-3-030-43164-8Published: 25 June 2020
Softcover ISBN: 978-3-030-43167-9Published: 25 June 2021
eBook ISBN: 978-3-030-43165-5Published: 24 June 2020
Edition Number: 1
Number of Pages: XI, 127
Number of Illustrations: 1 illustrations in colour
Topics: Ethnography, Organizational Studies, Economic Sociology, Medical Sociology, Social Sciences, general, Public Health