Learning and Shaping Expert Knowledges: The Case of Precision Medicine

Stefano Crabu

Abstract


The aim of this article – drawing on broad ethnographic research within two major Italian organisations operating in cancer care and research – is to enlarge practice-based studies, and in particular the practice-based approach to learning. To do so, a dialogue with social studies of biomedical science and health professions will be open, thus contributing to the field of sociology of scientific practice, which often neglected to explore how practitioners locate themselves in a position to be able to act as competent agents. Accordingly, we shall ask: what kind of knowledge is enacted to create a context of work in which "precision medicine" emerges? Since research and care practices as collective activities are not merely predefined by formal education and training, how practitioners learn to work together, and to shape knowledge actionable within a precision medicine frame? In addressing these research questions, the article shows how a practice-based approach to learning might offers novel modes of understanding biomedicine and to think somewhat differently about how expert knowledges are produced and shared among diverse settings and professionals.

Keywords


Practice Theory; Biomedicine; Healthcare Professions; Learning in practice; Ethnography

References


Abbott, A. (1988). The System of Professions. Chicago: University of Chicago Press.

Akrich, M. (1992). The De-Scription of Technical Objects. In W.E. Bijker, & J. Law (Eds.), Shaping Technology/Building Society: Studies in Sociotechnical Change (pp. 205–225). Cambridge: MIT Press.

Alkemeyer, T., & Buschmann, N. (2016). Learning in and across Practices: Enablement as Subjectivation. In A. Hui, T. Schatzki, & E. Shove (Eds.), The Nexus of Practices. Connections, Constellations, Practitioners (pp. 8–23). New York: Routledge.

Blumer, H. (1954). What is Wrong with Social Theory?. American Sociological Review, 19(1), 3–10. https://doi.org/10.2307/2088165

Burri, R.V., & Dumit, J. (Eds.). (2007). Biomedicine as Culture. Instrumental Practices, Technoscientific Knowledge, and New Modes of Life. London: Routledge.

Brown, J.S., & Duguid, P. (1991). Organizational Learning and Communities-of-Practice: Toward a Unified View of Working, Learning, and Innovation. Organization Science, 2(1), 40–57. https://doi.org/10.1287/orsc.2.1.40

Cambrosio, A., Keating, P., Schlich, T., & Weisz, G. (2009). Biomedical Conventions and Regulatory Objectivity. A Few Introductory Remarks. Social Studies of Science, 39(5), 651–664. https://doi.org/10.1016/j.socscimed.2005.12.007

Cambrosio, A., Keating, P., Vignola-Gagné, E., Besle, S., & Bourret, P. (2018). Extending Experimentation: Oncology’s Fading Boundary between Research and Care. New Genetics and Society, 37(3), 207–226. https://doi.org/10.1080/14636778.2018.1487281

Casper, M.J., & Berg, M. (1995). Constructivist Perspectives on Medical Work: Medical Practices and Science and Technology Studies. Science, Technology & Human Values, 20(4), 395–407. https://doi.org/10.1177/016224399502000401

Chamberlain, J.M. (2010). Regulating the Medical Profession: From Club Governance to Stakeholder Regulation. Sociology Compass, 4(12), 1035–1042. https://doi.org/10.1111/j.1751-9020.2010.00338.x

Clarke, A.E., Mamo, L., Fishman, J.R., Shim, J.K., & Fosket, J.R. (2003). Biomedicalization: Technoscientific Transformation of Health, Illness, and U.S. Biomedicine. American Sociological Review, 68(3), 161–194. https://doi.org/10.2307/1519765

Clarke, A.E., Mamo, L., Fishman, J.R., Shim, J.K., & Fosket, J.R. (2010). Biomedicalization: A Theoretical and Substantive Introduction. In A.E. Clarke, L. Mamo, J.R. Fishman, J.K. Shim, & J.R. Fosket (Eds.), Biomedicalization: Technoscience and Transformations of Health and Illness in the U.S. (pp. 1–44). Durham: Duke University Press.

Collins, R. (1979). The Credential Society: An Historical Sociology of Education and Stratification. New York: Academic Press.

Conrad, P. (1992). Medicalization and Social Control. Annual Review of Sociology, 18, 209–32. https://doi.org/10.1146/annurev.so.18.080192.001233

Conrad, P. (2007). The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders. Baltimore: Johns Hopkins University Press.

Crabu, S. (2016). Translational Biomedicine in Action: Constructing Biomarkers across Laboratory and Benchside. Social Theory & Health, 14(3), 312–331. https://doi.org/10.1057/sth.2015.35

Crabu, S. (2017). Dalla molecola al paziente. La biomedicina nella società contemporanea. Bologna: Il Mulino.

Crabu, S. (2018). Rethinking Biomedicine in the Age of Translational Research: Organisational, Professional, and Epistemic Encounters. Sociology Compass, 12(10), e12623. https://doi.org/10.1111/soc4.12623

Dickenson, D. (2013). Me Medicine vs. We Medicine. Reclaiming Biotechnology for the Common Good. New York: Columbia University Press.

Disis, M.L., & Slattery, J.T. (2010). The Road We Must Take: Multidisciplinary Team Science. Science Translational Medicine, 2(22), 22cm9. https://doi.org/10.1126/scitranslmed.3000421

Erling, P.M., & Magnussen, J. (2011). Resisting Market-Inspired Reform in Healthcare: The Role of Professional Subcultures in Medicine. Social Science & Medicine, 73(2), 193–200. https://doi.org/10.1016/j.socscimed.2011.04.025

Foucault, M. (1973). The Birth of the Clinic: An Archaeology of Medical Perception. New York: Pantheon.

Freidson, E. (1970). Professional Dominance: The Social Structure of Medical Care. New York: Atherton Press.

Freidson, E. (1985). The Reorganization of the Medical Profession. Medical Care Review, 42(1), 11–35. https://doi.org/10.1177/107755878504200103

Gardner, J. (2017). Rethinking the Clinical Gaze. Patient-Centred Innovation in Paediatric Neurology. Cham: Springer International.

Garfinkel, H., & Liberman, K. (2007). Introduction: The Lebenswelt Origins of the Sciences. Human Studies, 30(1), 3–7. https://doi.org/10.1007/s10746-007-9045-x

Gherardi, S. (2009). Knowing and Learning in Practice-Based Studies: An Introduction. The Learning Organization, 16(5), 352–359. https://doi.org/10.1108/09696470910974144

Ginsberg, G.S., Willard, H.F. (Eds.). (2013). Genomic and Personalized Medicine. London: Academic Press.

Hafferty, F.W., & Castellani, B. (2013). Two Cultures: Two Ships: The Rise of a Professionalism Movement Within Modern Medicine and Medical Sociology’s Disappearance from the Professionalism Debate. In B.A. Pescosolido, J.K. Martin, J.D. McLeod, & A. Rogers (Eds.), Handbook of the Sociology of Health, Illness, and Healing (pp. 201–220). New York: Springer.

Hallowell, N., Cooke, S., Crawford, G., Lucassen, A., & Parker, M. (2009). Distinguishing Research from Clinical Care in Cancer Genetics: Theoretical Justifications and Practical Strategies. Social Science & Medicine, 68(11), 2010–2017. https://doi.org/10.1016/j.socscimed.2009.03.010

Jasanoff, S. (Ed.). (2004). States of Knowledge. The Co-Production of Science and Social Order. New York: Routledge.

Keating, P., & Cambrosio, A. (2003). Biomedical Platforms. Realigning the Normal and the Pathological in Late-Twentieth-Century Medicine. Cambridge: MIT Press.

Keating, P., & Cambrosio, A. (2012). Cancer on Trial. Oncology as a New Style of Practice. Chicago: University of Chicago Press.

Haraway, D.J (1997). Modest_Witness@Second_Millennium.FemaleMan®_ MeetsjOncomouse™: Feminism and Technoscience. New York: Routledge.

Latour, B. (1992). Aramis ou l’amour des techniques. Paris: La Découverte.

Lave, J., & Wenger, E. (1991). Situated Learning. Legitimate Peripheral Participation. Cambridge: Cambridge University Press.

Lewis, J., Hughes, J., & Atkinson, P. (2014). Relocation, Realignment and Standardisation: Circuits of Translation in Huntington’s disease. Social Theory and Health, 12(4), 396–415. https://doi.org/10.1057/sth.2014.13.

Lock, M., Young, A., & Cambrosio, A. (Eds.). (2000). Living and Working with the New Medical Technologies. Intersections of Inquiry. Cambridge: Cambridge University Press.

Morgan, M., Barry, A.C., Donovan, J.L., Sandall, J., Wolfe, C., & Boaz, A. (2011). Implementing “Translational” Biomedical Research: Convergence and Divergence among Clinical and Basic Scientists. Social Science & Medicine, 73(7), 945–952. https://doi.org/10.1016/j.socscimed.2011.06.060

Nelson, N.C., Keating, P., Cambrosio, A., Aguilar-Mahecha, A., & Basik, M. (2014). Testing Devices or Experimental Systems? Cancer Clinical Trials Take the Genomic Turn. Social Science & Medicine, 111(6), 74–83. https://doi.org/10.1016/j.socscimed.2014.04.008

Prainsack, B. (2017). Personalized Medicine. Empowered Patients in the 21st Century?. New York: New York University Press.

Rabeharisoa, V., & Bourret, P. (2009). Staging and Weighting Evidence in Biomedicine Comparing Clinical Practices in Cancer Genetics and Psychiatric Genetics. Social Studies of Science, 39(5), 3–36. https://doi.org/10.1177/0306312709103501

Rose, N. (2007). The Politics of Life Itself. Biomedicine, Power, and Subjectivity in the Twenty-First Century. Princeton: Princeton University Press.

Shove, E., Pantzar, M., & Watson, M. (2012). The Dynamics of Social Practice: Everyday Life and How It Changes. London: Sage.

Sydney, H., & Anspach, R.R. (1993). The Study of Medical Institutions: Eliot Freidson's Legacy. Work and Occupations, 20(3), 279–295. https://doi.org/10.1177/0730888493020003002

Swan, J., Bresnen, M., Newell, S., & Robertson, M. (2007). The Object of Knowledge: The Role of Objects in Biomedical Innovation. Human Relations, 60(12), 1809–1837. https://doi.org/10.1177/0018726707084915

Timmermans, S., & Berg, M. (1997). Standardization in Action: Achieving Local Universality through Medical Protocols. Social Studies of Science, 27(2), 273–305. https://doi.org/10.1177/030631297027002003

Timmermans, S., & Berg, M. (2003). The Practice of Medical Technology. Sociology of Health & Illness, 25(3), 97–114. https://doi.org/10.1111/1467-9566.00342

Zuiderent-Jerak, T. (2015). Situated Intervention: Sociological Experiments in Health Care. Cambridge: MIT Press.




DOI: 10.6092/issn.1971-8853/9405

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