3.1.1. Learning participation

The very notion of participation is used differently in ethnography and system design. In design participation is rarely reflected in relation to designers, their role and activities have been taken-for-granted. Participation has only become a matter of consideration with regard to user involvement in design activities. In ethnography, on the other hand, researcher’s participation is always carefully reflected upon and never self-evident. The question of participation, i.e. how the fieldworker finds ways to engage in the life of the studied community, is an essential concern because ethnographic fieldwork requires the personal involvement of the researcher as investigation is carried out through social encounters with members in the community.

Participant observation, i.e. immersion in the field and observation of naturally occurring activities, is a complex skill (Jordan 1996a). By immersing into the world of others and carrying out investigation through personal engagement in social encounters the fieldworker turns herself into a research instrument. This requires, besides training and experience, continuous reflection and introspection on the process which Barley has aptly captured in the phrase of “becoming a research tool” (Barley 1990b, pp. 237-244). The challenges which require an ongoing careful deliberation are epistemological as well as emotional, social and ethical, the latter especially in longitudinal fieldwork.

The fieldworker has simultaneously a double role to play, i.e. a participant and an observer. Jordan describes the difficult role of participant observer: “her primary attitude is that of a novice who tries to become a part of the life of the community; at the same time she needs to maintain enough distance to record her observations and reflect on her evolving understanding of the situations she encounters” (Jordan 1996a). Engagement as complete participant in the everyday radiology work was not a true option for me because work in modern medical settings requires such skills and expertise that makes it impossible to ‘go native’ without proper training and/or education. Furthermore, as I wanted to study the work of all occupations I considered it better to avoid taking on any group membership as this would have restricted my access to other lines of work.

Personnel in radiology departments in OUH are used to novices watching their work and learning, e.g. medical students, so in that sense I did not have difficulties in blending in as a participant non-practitioner. However, engagement as the proverbial ‘fly-on-the-wall’, i.e. complete observation, was not possible. My presence with audio and video recording devices in the premises of roentgen departments, though there already exists an abundance of technologies, attracted so much attention that I had no chance of passing for an ‘unobtrusive observer’.

In the roentgen departments I created for the ecology of a role of an ever-present and ever-curious non-radiology-professional observer as participant that did not exist before (cf. Barley 1990b). With this role I became worried that I would bore, irritate or exhaust the radiology practitioners with my never-ending questions. As I continuously found myself in wanting to learn more about what lies beyond the everyday work practice, about the principles and foundations of radiology, I decided to take an introductory course in radiology, to follow research in the field, and to read radiology literature, to fill in my obvious deficiency in the basics of the medical speciality.

Outside the roentgen departments I could melt into the hospital environment more easily because of my camouflage, the doctors’ white coat. Wearing it I could move around and about to observe, participate in the working person’s daily activities in hospital: coming in when shift starts and greeting co-workers, passing by patients in the waiting areas, being asked for instructions of directions in the maze-like corridors, going to the cafeteria for lunch with other hospital personnel, etc. This way I learned about the hospital work environment at large.

A further issue that has complicated my presence in the field throughout the empirical work has been that the ‘natives’ have known about my background in system design which brought an involuntary extra twist into the participant observation. The staff would turn to me for advice in my capacity as ‘computer expert’ in the manifold situations where help with computers was needed. Especially in the beginning of fieldwork when I was coping with learning participant observation I was overly conscious about interfering too much with the everyday work activities. In the teleradiology phase a more proactive role of participant adviser was adopted with teleradiology system use related problems (see Karasti 1997a, publication I, p. 5). In the PACS phase I felt an ethical pressure and a responsibility to take on a more developmental attitude as the implementation process kept on prolonging. Overpowered I, however, had to admit not having enough resources for an undertaking of such magnitude. The repeated incidents have started me reflecting on the varied roles of the researcher engaged in fieldwork which will be continued in section 4.1.

3.1.2. Learning observation coupled with interviewing

The unfolding practice of everyday fieldwork typically requires the fieldworker to move back and forth between participation and observation to different degrees (see Pettinari & Heath 1998, Blomberg et al. 1993). Observation is typically used to gain an access to the manifest activity, i.e. what people actually do, as it distinctly differs from the ideal behavior, i.e. what they say they do (ibid.). The interpretations of practitioners’ lived experiences are connected to the immediately observable events in the social world of work. The fieldworker is required to learn to see social situations in a way that problema­tises certain phenomena, i.e. she needs be able to identify and problematise things and incidents that the insiders take for granted and thus tend to overlook (Forsythe 1999). Consequently, she needs to use ‘the unmotivated eye’ in observation, i.e. taking as little as possible for granted. I consciously trained myself in observing actual, naturally occurring activities and appreciating the existing work practice ‘as it is’.

Observation is frequently coupled with interviews and informal discussions. Fieldwork­ers do not take what people say at face value. Rather than treating people’s views as results they are regarded as data. Though the very act of talking with people may seem to the eye of an uninitiated ‘just chatting’, the important point is what the fieldworker is doing when talking. The fieldworker’s job is to understand and analyse what people say (ibid.). When asked to verbally describe their work, practitioners may distort, either knowingly or unknowingly, accounts of their conduct. Often practitioners are able to provide only approximations of their activities which omit the detailed texture of everyday work practice. The practitioners take the most fundamental qualities of their ordinary work practice setting for granted which, obviously, is needed for the everyday functioning of the workplace. They do not have access to the inarticulated, tacit knowledge associated with certain deeply embedded activities. (Blomberg et al. 1993.) It is not their task but the fieldworker’s to reveal and make visible aspects of work practice that are not usually made explicit.

3.1.3. Learning to appreciate everyday work practice ‘as it is’

In the course of fieldwork I learned something that required me to question some of my taken-for-granted assumptions as a person having a background in system design. The learning took place gradually and it took some time to understand what had taken place as the change was so inseparably intertwined with the processes of learning to be a participant observer. I have come to call the new ability ‘appreciation for everyday work practice’ and I contrast it with how I, as a system designer, had been taught to view work. It was as if a new perspective had opened that allowed me to give room for the richness of actual everyday work practice ‘as it is’ without being limited to a certain predetermined framework saying what could be considered as relevant and interesting in the studied phenomenon.

In learning to appreciate everyday work practice ‘as it is’ I first had to question my one-sided or at least emphasised interest in the problems and difficulties of the observed practice. I needed to call in question especially my wondering why the people behaved that way when they obviously – in my opinion – ought to have behaved another way (cf. prescriptive vs. descriptive understanding, Blomberg et al. 1993, pp. 125-127). After this I was able to start paying attention to both the smoothly unfolding routinised ways of working as well as to the problems and disturbances encountered in the course of working. I was fascinated with the routines of everyday work, in the regular courses of procedures and recurrent and patterned performance of duties, that disclose the experienced and practised grasp of complex skills and competencies brought together to carry out ordinary work. Then I learned that a lot can also be revealed about the routines through a closer examination of the disturbances and predicaments. I was able to unearth how the problems emerge, how the practitioners react to the problematic situations, how the difficulties are routinely handled, how the people learn in their work etc. Problems and breakdowns in the everyday practice turned into valuable entries through which new insight could emerge, they were no longer something that was harmful or had to be fixed quickly and efficiently.