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Problem of Expertise in Anaesthesia

Project: Research


Funded by the NHS Executive (North West), this ethnographic study combined observation of anaesthetic work and interviews with the anaesthetic team in an English hospital. Our principal aim was to understand the un-codified, un-formulised knowledge used by anaesthetists in their everyday practice. We hope that by understanding how expertise and the tacit and explicit elements of practice are acquired and transferred this research would inform the training of anaesthetists.

The research team included social scientists, an anaesthetic nurse and a consultant anaesthetist, allowing the use of 'insider' (researchers with a background in anaesthetics) and 'outsider' (social science trained) perspectives. Extensive periods of time were spent observing and recording information about anaesthetic practice in surgical and other settings (e.g. teaching, pain clinics etc). This produced detailed field-notes or transcripts that attempt to capture the procedures, actions and talk that occur in day-to-day practice. In-depth and focussed debriefing interviews were conducted with different members of the anaesthetic team to explore in detail the acquisition of expertise. Dissemination included detailed reporting to the hospital anaesthetic staff at meetings and in briefing reports and to the Royal College of Anaesthetists. We have also produced a large number of publications in both social science and clinical journals

Selected publications from this project

Pope, C, Mort, M, Goodwin, D and Smith, A (2007) Anaesthetic talk in surgical encounters, In Iedema, R (Ed) Discourses of Hospital Communication and Organization. Palgrave Macmillan

Goodwin D, Pope C, Mort M, Smith A (2006) Access, boundaries and their effects: legitimate participation in anaesthesia. In: Allen D, Pilnick A (eds) The Social Organisation of Healthcare Work. Oxford: Blackwell, : 167-82

Smith AF, Goodwin D, Mort M & Pope C, (2006) Adverse events in anaesthetic practice: qualitative study of definition, discussion and reporting, British Journal of Anaesthesia, 2006; 96: 715-21 doi 10.1093/bja/ael099

Smith AF, Pope C, Goodwin D, Mort M (2005) Communication between anesthesiologists, patients and the anesthesia team: a descriptive study of induction and emergence. Canadian Journal of Anesthesia 52: 915-20

M. Mort, D. Goodwin, A. F. Smith & C. Pope, (2005) 'Safe Asleep? Human machine relations in medical practice', Social Science & Medicine, Vol 61, 9, 2027-2037.

Goodwin, D, Pope, C, Mort, M and Smith, A (2005), Access, Boundaries and their effects: legitimate participation in anaesthesia. Sociology of Health and Illness, 27 (6): 855-871.

A Smith, M. Mort, D Goodwin & C Pope, (2003) Making Monitoring 'Work': human-machine interaction and patient safety in anaesthesia, Anaesthesia, 58, 1070-1078.

Smith AF, Goodwin D, Mort M, Pope C (2003) Expertise in practice: an ethnographic study exploring acquisition and use of knowledge in anaesthesia. British Journal of Anaesthesia 2003; 91: 319-28

Goodwin, D, Pope, C, Mort, M and Smith A (2003) 'Ethics and ethnography: an experiential account', Qualitative Health Research, Vol 13 (4) 567-577.

Pope C, Smith A, Goodwin D, Mort M (2003) Passing on tacit knowledge in anaesthesia: a qualitative study. Medical Education 37: 650-5
Effective start/end date1/04/001/03/02

Research outputs