editorial - outlines.dk 2001-2/outlines-2001-2.pdflearning, medical education and 3d environments 1...

Introducing an international journal of criti-cal social studies, as a Dane, in the fall of2001, gives rise to mixed feelings. In theprevalent view, the view of the New WorldOrder, the view of globalized communica-tion – in short, in the view of the communityto which the Outlines belongs, be it ever somuch as a critical commentator – the worldchanged dramatically that ever-presentSeptember 11th. And that revolutionary spi-rit has, undoubtedly, occassioned suddenchanges, not only in ideological and politicalspheres, but also in economical prospectsand military balances. Yet critical socialstudies have long since described how socialdiscrepancies and turmoil persist and regu-larly burst into violence; and to the criticalstudent of societies, there is not much novelabout the way the world powers deal with it.From a Nordic perspective, Manhattan is nocloser than Kosovo, Grozny, or the WestBank. Why participate in the pitiless proces-sion of purported pundits?

Perhaps because when old wine is pouredinto new wine-skins, it does make a real dif-ference. At least we all seem to get new oc-cassions for our well-worn thoughts. Thus,when the Slovenian philosopher SlavojZizek was to comment on the WTC terror, he

could strike a chord he had already playedfor some time: the image of the irreality oflate capitalist consumerism, as illustrated byHollywood themes:

”It is the awareness that we live in an isolat-ed artificial universe which generates the no-tion that some ominous agent is threateningus all the time with total destruction. Is, con-sequently, Osama Bin Laden (…) not thereal-life counterpart of Ernst Stavro Blofeld,the master-criminal in most of the JamesBond films, involved in the acts of global de-struction? What one should recall here isthat the only place in Hollywood films wherewe see the production process in all its in-tensity is when James Bond penetrates themaster-criminal’s secret domain and locatesthere the site of intense labor (distilling andpackaging the drugs, constructing a rocketthat will destroy New York...).When the mas-ter-criminal, after capturing Bond, usuallytakes him on a tour of his illegal factory, isthis not the closest Hollywood comes to thesocialist-realist proud presentation of theproduction in a factory? And the function ofBond’s intervention, of course, is to explodein firecraks this site of production, allowingus to return to the daily semblance of our

1OUTLINES • No. 2 • 2001

Editorial

Outlines-2001-2.qxd 23-11-01 10:27 Side 1

Editorial

existence in a world with the “disappearingworking class.” Is it not that, in the explod-ing WTC towers, this violence directed at thethreatening Outside turned back at us? Thesafe Sphere in which Americans live is expe-rienced as under threat from the Outside ofterrorist attackers who are ruthlessly self-sacrificing AND cowards, cunningly intelli-gent AND primitive barbarians. Wheneverwe encounter such a purely evil Outside, weshould gather the courage to endorse theHegelian lesson: in this pure Outside, weshould recognize the distilled version of ourown essence. For the last five centuries, the(relative) prosperity and peace of the “civi-lized” West was bought by the export of ruth-less violence and destruction into the “bar-barian” Outside: the long story from theconquest of America to the slaughter inCongo. Cruel and indifferent as it maysound, we should also, now more than ever,bear in mind that the actual effect of thesebombings is much more symbolic than real.The US just got the taste of what goes onaround the world on a daily basis, fromSarajevo to Grozny, from Rwanda andCongo to Sierra Leone.”

Evidently, one approach to critical socialstudies can be to confront an elite of symbol-manipulators with the irreality of what theytake to be life, and introduce ”the desert ofthe real” that lies just outside it. Critique isthe trope of going out, or opening up and let-ting in the fresh air, countering the conceptu-al marginalization of not only the Other, butalso even our own bodily materiality. Cri-tique reverses the positions of essense andappearance, of knowledge and belief. Andthe movements between the artificial and thereal, facts and the counterfactual, being anddreaming, never cease to fascinate, spawn,and produce.

On the other hand, critical social studiesmay run directly counter to that very duality,

insisting that everything, including such phe-nomena as 3D environments, techno-thera-py, and Electronic Patient Records (why,maybe even including Hollywood!), is sim-ply real. This characterizes, one might claim,the three new contributions to the Techno-logy in Social Practice theme which we be-gan this spring. Even if quite divergent intheoretical perspective, the three papers havein common a rather pragmatic approach tothe introduction of information technologiesin the field of health practices. Even inclu-ding Actor-Network-Theory-inspired ana-lyses, these articles shift the emphasis slight-ly from epistemology to ontology, comparedto those of the previous issue (Outlines2001:1). But they do it without losing sightof the critical problematization of analyticconcepts.

Ludvigsen & Fjuk provide an almost clas-sic, empirically grounded, recommendationto expand the unit of analysis to include so-cial practice. Both with the concept of ‘ac-tivity system’, with its familiar triangularshape, and with the empirical field of a 3Dlearning environment, the authors directlyfollow up on previous Outlines – and theyanticipate some of those to come: next year’sOutlines are expected to substantially reflectthe 2. Nordic-Baltic Conference on ActivityTheory which was held at Ronneby, Sweden,just two days before September 11th.

In a quite similar vein (though without tri-angles or virtual worlds) Lauritsen & Elsass’unit of analysis moves from therapy, beyondits use, and out into the context of everydaylife, to even situate contextuality itself. Amovement not unlike that of Markussen &Olesen who introduce the concept of ‘trad-ing zone’ as “…a place you can ‘enter’ and‘leave’ again”, in order to be able to “sort outethnographic material” and investigate “nat-urally occuring experiments in real time set-tings”. It could hardly be any more mundaneand down-to-earth than that.

2


Yet somewhere in the back of the head,there is a devil encouraging us, once again,to ‘endorse the Zizekian lesson’ and askwhether we have not, with such radical ma-terialism, precisely taken the final step into apurely epistemological problematic?

For those who might prefer the matter-of-fact reading of ethnographic material,Hojlund’s study will be interesting. To any-one with a daily acquaintance with the field,it is amazing how rich and complex, howsurprisingly foreign, a description of chil-dren’s lives in ordinary institutions can be.Hojlund is the first anthropologist to write inthe columns of Outlines, and we hope verymuch that she will pave the way for others.

The enlightening effect of juxtaposing theways problems are dealt with in very differ-ent cultural contexts is evident and can beexperienced once again if one reads on intoRamos’ discussion, on the basis of Mexicandata and viewpoints, of a subject very closeto Hojlund’s: the relations between internaland external organizations of meaning, and,

more specifically, ordinary people’s (chil-dren’s) dealing with how (school) profes-sionals and parents categorize them.

What was said of anthropologists shouldalso be said for critical social scholars fromLatin America. In general, what is Outside ofthe dominant North Atlantic community ofresearch does not seem in the least evil orthreatening to Outlines, even when we are atour most epistemological. When Ramos con-cludes that “the personal sense about schoolis constructed over time through an indi-vidual’s participation across different socialcontexts in which the person appropriates,resists, or legtimizes diverse collectivemeanings allowing her to configure a senseof life which may or may not be associatedwith school” – it is not so hard to recognizein the Outside a distilled version of theInside – nor, perhaps, to learn from the wayit is transformed when appropriated in aplace where schooling is directly a scarceressource and an overwhelming family in-vestment.



SummaryLearning with different kinds of ICT-based tools isan important issue in today’s society. In this articlewe focus on how design of technology rich environ-ments based on state of the art learning principles cangive us new insights about how learning occur, andhow we can develop new types of learning environ-ments. Medical education constitutes the subject do-main. There has been a considerable effort to devel-op 3D technologies in this field, and the article pro-vides a careful review of how these technologies areapplied. There is, however, a substantial gap betweenthese advances and the use of technologies in med-ical education. Related work proposes individualisticassumptions or metaphors that do not focus explicit-ly on learning and technology mediation. Based ontheoretical analysis of previous literature in the fieldwe argue that there is a need for a new unit of analy-sis that includes the relationship between individualand collective activity and the role of technologyherein. The socio-cultural and especially activity the-ory is taken as the perspective which gives the possi-bility to develop the argumentation about the unit ofanalysis. The unit of analysis also has implicationsfor design of 3D environments. The design principlesare elaborated upon and examples are given in rela-tion to an application called Matador (MedicalAdvanced Training in an Artificial DistributedEnvironment). Matador is aimed at developing a sim-ulation environment for training in emergency medi-cine.

Introduction

The research on computer-supportedcollaborative learning (CSCL) is insome respects a new field, which is

growing quite fast.1 Based on socio-culturalassumptions about learning and human de-velopment, information and communicationtechnologies can help us move from tradi-tional instructor-centred teaching where thefocus is on individual learning, to collabora-tive learning. Collaborative learning is de-fined as a collective knowledge buildingprocess where students actively generate, ac-cess and organise information. This collec-tive process leads to a change in the student’sability and effort to take part in a learning ac-tivity. In the 1990s there have been consider-able efforts to develop computer systems thatcan provide new types of learning environ-ments for students (Jonassen & Land,2000).2 A recent review of CSCL researchshows, however, that the CSCL field is notvery coherent (Lehtinen, Hakkarinen, Lippo-


Sten Ludvigsen & Annita Fjuk

New Tools in Social Practice:Learning, Medical Education

and 3D Environments

1 The first CSCL conference was at Indiana Universityin 1995. The first E-CSCL was in Maastricht in 2001.

2 Jonassen & Land (2000) give a good general view ofmany important attempts, especially in USA.


Sten Ludvigsen & Annita Fjuk: New Tools in Social Practice

nen, Rahikainen & Muukkonen, 1999).Lehtinen et al. (1999) conclude that manystudies exist where there have been positivelearning effects. The problem with thesestudies is that their ecological validity couldbe considered as low, since most CSCL stud-ies are experiments or small-scale field trials(Fjuk & Ludvigsen, 2001). Related problemareas concern the level and unit of analysis(Fjuk & Ludvigsen, 2001).

The last ten years have seen a consider-able effort and focus on how to design learn-ing environments based on learning theories(Brown, 1992, CTGV, 1997; Brown, Ellery& Campione, 1998; Jonassen & Land, 2000;Fjuk & Smørdal, 2001). For CSCL researchto take a step forward we need to considercomplex relationships such as interconnec-tions between several activity systems, theo-ries of learning and instruction, subject do-mains, teachers’ roles, delivery institution’seducational praxis and tradition, organisatio-nal and administrative arrangements, costs,properties of the technological solution andavailable software, geographical distancesbetween co-students, etc. All these aspectsmight of course not be in focus in everystudy, but the degree of complexity account-ed for needs to be increased.

This article focuses on a specific categoryof learning environments that recently hasreceived increasing interest; 3D environ-ments (McLellan, 1996, Johnsen et al., 2000,Youngblot, 1998, Krange et al., 2000). 3Denvironments are loosely defined “as a classof computer-controlled multisensory com-munication technologies” (McLellan, 1996).Moreover, 3D environments “evoke a feelingof immersion, a perceptual and psychologi-cal sense of being in the digital environmentpresented to the sense” (McLellan, 1996).One important aspect of 3D environments isthe presence of the immersed feature that in-cludes the feeling of touch, sense orientationand position in space (Gorman, Meier &

Krummel, 1999). In addition, 3D environ-ments are proclaimed to be appropriate forsupporting activities that include modelbuilding and problem solving (McLellan,1996), and are as such designed with a spe-cific subject domain and content in mind.Furthermore, 3D generated objects and ava-tars often constitute basic aspects of the de-signs. The 3D-generated objects are toolsthat are manipulated and moved by actorsthat in turn are represented by avatars.

These specific features make 3D environ-ments different from other types of virtualenvironments like, e.g. Web-based environ-ments. We argue that the unique features andqualifications of 3D environments have to beexplicitly considered in analysis as well as indesigns. However, technological advanceshave unquestionably driven the design of 3Denvironments. Hoffman & Vu (1997) pointto the fact that there is a substantial gap be-tween the technologies available today andthe technology that is needed for realizingthe expectations for 3D-technologies as toolsfor learning and collaboration. There are re-cent and limited insights into what the natureof the collaborative processes in a predomi-nantly 3D environment is like. To obtain adeeper understanding of this, we wish to stepback from the technical push to explore thespecific conditions of these processes. Theseconditions, we argue, can only be properlyunderstood by extending the unit of analysisfrom technology and pedagogy themselvesto the social contexts in which the 3D envi-ronments are being used. This core argumentthroughout the paper is outlined by suggest-ing activity theory as a powerful frameworkfor understanding learning activities in dif-ferent kinds of environments and for inform-ing designs associated with virtual 3D learn-ing environments.

The field of medicine is chosen as a pro-totypical field to investigate. There exists arich body of computer-based applications

6


aimed at supporting learning and trainingwithin various areas. So far, few have em-phasised the potential of 3D environmentslike the field of medicine. In the first part ofthe article we review the literature on 3D inmedical education and emphasise what hasbeen in focus so far, and we summarise thisfrom a learning perspective. The argumenta-tion put forward in this part represents a the-oretical analysis of the field. In the secondpart we argue for a new theoretical frame-work for analysis and design. In the last partwe will, with a basis in the theoretical frame-work, suggest a set of design principles con-nected to 3D environments. Here we will usea concrete 3D environment, Matador, as anexample.

3D environments: A review ofthe literature in medicine 3

In the field of medicine various domainspecific computer systems have been de-veloped in areas such as anatomy, anato-

my of the brain, surgery, dissection of bonesand endoscopy. In surgical education the ar-guments for using 3D environments arefound in various communities. We find in-sights achieved within surgical interventionsparticularly interesting in this respect. Clini-cal experiences show that surgeons couldbenefit from training in a 3D environmentbefore they are exposed to patients (Ota,Loftin, Saito, Lea & Keller, 1995). First, thisis associated with better health care in termsof improvement resulting in fewer complica-tions and shorter hospitalisation. Second, thecost of training could be reduced if it was cut

down from five to three years (Ota et al,1995). Moreover, the standardisation ofskills associated with specific procedures isconsidered important. Third, 3D environ-ments provide possibilities for measuringdifferent aspects of a procedure. This con-tributes to a higher level of efficiency and isas such highly content driven, but is of greatimportance for the quality of work. 3D envi-ronments used in surgical education havemostly been designed to train and improveprocedural knowledge and skills.

In an invited review of the use of 3D en-vironments in surgical education Qayumi &Qayumi (1999) suggest a ‘CyberPatient’ asan essential part of a problem based learningcurriculum. The authors argue that most 3Denvironments are not designed for support-ing interactivity and interaction in any truesense. 3D-based computer systems devel-oped for the purpose of supporting a doctor-patient interaction, often include elementslike: taking the patient’s history, physical ex-amination of the patient, different kinds oftests, diagnosis development, treatment plan-ning, surgery, postoperative managementand follow up. This simulates the patient ill-ness trajectory and provides rich representa-tions of various aspects of this trajectory. Aseducational philosophy for designing a virtu-al environment, Qayumi & Qayumi (1999)suggest a Piagetan philosophy. Within thisarea of use, conceptual knowledge is empha-sised together with the procedural knowl-edge.

There are few in-depth studies that ad-dress issues connected to learning and col-laboration and the outcome of these process-es (McLellan 1996). One study that providesinsights into these issues is the one conduct-ed by Pilkington & Parker-Jones (1996). Theauthors present a 3D-based system of whichthe systems design is based on several sig-nificant elements from learning theory. Themedical area, which the student is exposed


3 We will not give a detailed description of the 3D-basedsystems that are referred to. This is because our attentionis on the collaborative knowledge construction processesand how the 3D-environement serves as a means for sup-porting them, and the environment’s implication for howto study it.



to, is the regulation of calcium of the humanbody. The system is based on the idea of cog-nitive conflict, inconsistency, and contradic-tion outlined from Piaget (1977). Theseissues are integrated with Vygotsky’s (1978)concept on the zone of proximal develop-ment. In the perspective developed by Vy-gotsky the dialogue is one of the most im-portant sources for learning. Articulation,self-explanation and elaboration becomecrucial relative to what can be learned. Thiscombination is manifested in discourse be-tween pairs of students, and in some of thedialogues an expert in the medical field canparticipate and make interventions. The ob-jective behind the systems design was then tocreate an environment that mediates the stu-dent’s knowledge construction beyond su-perficial understanding. The students foundthe simulation favourable (over other learn-ing resources) because the simulation wasrealistic and it was thus possible to test spe-cific hypotheses (Pilkington & Parker-Jones,1996). Traditional textbooks or lectures donot create possibilities of interaction with anenvironment nor with and expert, the waythis application does. It is reasonable to ar-gue that this application has inherent quali-ties, which have the potential to promotehigher order processes.

The quality of the talk among the studentsdiffers between the pairs, and it is dependentupon the intervention made by the expert.When the expert made interventions thenumber of casual explanations and reflectiveturns increased. If one looks at the materialas a whole, “the student-student dialoguewas more likely to focus on observation,preparation and monitoring activities andless likely to focus on reasoning activities”(Pilkington & Parker-Jones, 1996).

The results from the study by Pilkingtonand Parker-Jones seem reasonable both fromcognitive studies in the medical domain anda more socio-cultural view of learning and

cognition. Since there exist so few studies oflearning processes and learning outcomefrom 3D environments in medicine, it is nec-essary to draw on the literature within med-ical cognition and other approaches (whichhave studied learning in the medical field) toenrich the interpretation of the findings pre-sented.

Medical students do not have as well de-veloped illness scripts as more experiencedphysicians (Feltovich et al, 1992), and theirbasic biomedical knowledge is partly encap-sulated (Boshuizen et al, 1992). The term en-capsulated means that the knowledge isstructured in such a way that the basic bio-medical knowledge is difficult to access.These difficulties could be caused by cogni-tive and social factors. From a socio-culturalview this finding could be interpreted as atypical way of talking among the students,that is a discourse pattern. The teacher (ex-pert) is the person who constructs scaffoldsso the dialogues can move to a more ad-vanced level. Ludvigsen (1998) found thatthe teacher was the person who pointed tospecific cues of vital importance when stu-dents were talking with and about patients.The teachers asked questions, which werenecessary for the students to be able to con-struct coherence in their diagnostic activities(Gadd, 1995; Ludvigsen, 1998). The teacheralso had to help the students to integrate theirknowledge in relation to specific cases.

Gadd (1995) and Ludvigsen (1998) foundthat teachers use characterisations, reformu-lation, explanations and summaries to createpossibilities not only for students to solveconcrete problems, but also to get access totheir biomedical knowledge. These aspectsrelated to talk between students and teachersare dependent on institutional practice. Theinstitutional practice creates constraints andaffordances for the students-teacher relation.Their biomedical knowledge together withsocial and cultural factors define how the

8


students learn to get patients’ information,select information, combine information –organise information in different types ofdocuments. How physicians organise infor-mation and talk to each other could betermed as cultural scripts (Shore, 1996).Cultural scripts are part of institutional dia-logues. Institutional dialogues have otherfeatures than what are found in everydaytalk. Who can talk and in which order andwhat the participants are allowed to say fol-low a predefined order, which has implica-tions for the turn taking in the situation.What is on the agenda, and which of the par-ticipants can change the agenda are also pre-defined (Suchman, 1987; Linell, 1990 and1999; Ludvigsen, 1998).

To conclude the brief overview of 3D en-vironments’ potential and area of use withinthe field of medical education, there are twotypes of issues that have been focused inmost designs: Technological functionalityand novelty, and subject domains and associ-ated content and pre-defined tasks. We arguethat learning in 3D environments must beconsidered in terms of more complex ap-proaches that view issues like subject do-mains, theories on learning and 3D-techno-logies as critical parts of interconnected ac-tivity systems. Research aimed at under-standing the specific conditions of othertypes of learning environments (anchored inWeb-based technologies) clearly shows thatthe students’ collaborative learning process-es are mediated by a set of aspects manifest-ed in a complexity of: Theories of learningand instruction, subject domains, teachers’roles, delivery institution’s educational prac-tice and tradition, organisational and admin-istrative arrangements, costs, and propertiesof technologies. (Fjuk, 1998, Fjuk & Lud-vigsen, 2001, Wasson et al., 2000). Thiscomplexity implies that it is complicated,sometimes even impossible to consider whataspects that are most critical with respect to

learning and cognition. In spite of this, anawareness of the complexity in terms of pos-sible contradictions and interdependencies isan important component in any analysis anddesign.

In line with this argumentation we need tocreate a complex understanding of how med-ical reasoning takes place. In several studiesof clinical reasoning, social and organisa-tional aspects are critical parts of the reason-ing process (Cicourel, 1990; Ludvigsen,1998). The knowledge developed by medicalstudents is situated, or what Elstein (1995)terms, case-specific. The ability to imple-ment relevant knowledge in clinical situa-tions is not just a cognitive problem, but it ispart of the institutional context where stu-dents’ reasoning is part of different types ofactivities. In order to establish a correct di-agnosis and adequate treatment, it is impera-tive to know when and how to apply medicalknowledge.

Within such an understanding of medicalactivities, problem solving becomes a cogni-tive, social and culturally based phenome-non. This means that both the vertical andhorizontal aspects of expertise become im-portant. When focusing on the horizontal as-pects of expertise teams of health workers incollaboration and communication efforts be-come important. These types of processesneed to be analysed and understood from theview of horizontal expertise. The outputfrom the team is their collective efforts.Vertical expertise is well studied in the areaof cognitive science. The expert-novice stud-ies show how physicians have very differentknowledge structures (Schmidt, Norman andBoshuizan, 1990; Elstein, 1995). The hori-zontal aspects of expertise are not well stud-ied in general, or in the field of medicine. Itis possible to identify a few studies related tothese questions in medicine as a field. Wehave already mentioned some importantfindings from Cicourel’s (1990; 1995) stud-




ies. Ludvigsen (1998) made findings similarto Cicourel, both in the educational and inthe work context in his study of medical stu-dents and interns. Engeström (1993; 1995)has used activity theory to analyse howphysicians work in general practices. Thehorizontal aspects of medical expertise areshown and elaborated on, in all these studies.In Strauss, Fagerhaugh, Suczek & Wiener(1985) studies of the social organisation ofmedical work show how dependent physi-cians are both upon each other and on otherhealth workers.

We argue that the studies conducted byCicourel (1990), Engeström (1993) and Lud-vigsen (1998), demonstrate very clearly howcomplex and important the horizontal aspectsof expertise are in the field of medicine. Thesocio-cultural view of learning and cognitionrepresents an adequate framework for under-standing this phenomenon. The students’ rea-soning and their actions are part of a situatedpractice. If we build virtual environmentsupon this perspective the environments be-come more realistic, and the knowledge thestudents develop becomes more valid.

To improve skills in relation to clinical sit-uations, there is a need for tools that mediatevarious forms of knowledge. 3D environ-ments could serve as tools for training in thiskind of knowledge development. The stu-dents are then invited to develop mental re-presentations, situated knowledge and theability to participate with other health work-ers in collective problem-solving situations(Cicourel, 1990; Ludvigsen & Bach-Gans-mo, 1998a, 1998b).

To be able to incorporate the complexityargued in this section into analysis and de-signs, we need frameworks that provide in-sights into how humans learn, as well aswhat role technological artefacts and otherissues occupy in the learning processes.These conceptual challenges will be the fo-cus of the next section.

Steps towards a frameworkfor understanding and de-signing 3D environments

Most designs are based on key topicswithin cognitive science (e.g. me-mory, perceptions, reasoning skills)

(Hoffman, 1998). This means that learning isconsidered from an information processingperspective. Winn (1997) takes another posi-tion than those placed within cognitivescience. He emphasises an open construc-tivist approach as the premise. Concernedwith premises for design and analysis, he in-cludes both ideas from the individualistic ap-proach and from an approach that emphasisescollaboration as a central premise for learn-ing. However, Winn (1997) does not elabo-rate upon central questions as units of analy-sis and the assumptions that are connected tothe different positions he builds on.

In order to establish a new research agen-da, it is necessary to move from such a focus,often represented by content-driven perspec-tives (in relation to a focus on mental repre-sentation and cognitive structures), to an em-phasis on socio-cultural perspectives. Thisnew research agenda can give us better ac-counts for the specific nature of 3D environ-ments, and their relation to other learningtechnologies and the social contexts in whichthey are used. Such a research agenda canbring us substantial insights in what kinds ofknowledge can be developed in this type ofenvironment.

McLellan (1996) summarises other ap-proaches which have the ambition of build-ing frameworks for designing and under-standing 3D environments. The author men-tions approaches like: The ecological psy-chology perspective (based on J.J. Gibson’stheory, where direct perception and affor-dances are the key terms), The computer astheatre perspective (based on Brenda Lau-rel’s theory about drama as a metaphor for

10


understanding human-computer interaction),The space maker design perspective (basedon R. Walser’s ideas about filmmaking, per-forming arts, and role-playing games), andDesign theory and design metaphors as aperspective. We could add the approach in-fluenced by storytelling, which is also part ofsome of the approaches mentioned. The ideabehind a storytelling approach is connectedto the fact that narratives are a basic elementfor learning and human development. Theproblem with these approaches is that theydo not have an explicit focus on learning,cognition and collaboration. We argue thatthis is a fundamental condition for under-standing what can be learned in 3D environ-ments, and then judge how valuable theycould be in various types of education.

Theoretical foundation In recent years a series of alternatives tostandard cognitivist approaches to learningand cognition has evolved.4 In spite of dif-ferent terminologies, research traditions, andmethodological preferences, the approachesshare the assumption that learning has to beunderstood as actions and activities integrat-ed in a complexity of social, institutional,cultural and historical practices. The unit ofanalysis is widened from viewing the indi-vidual as a “solo student” to including thestudent’s practice in relation to activities incommunities of practice. We will here em-phasise one of these theories, which gives usa rich framework for design and empiricalstudies of 3D environments.

Activity theory constitutes a rich frame-work for studying different forms of prac-

tices as developmental processes, with indi-vidual and social issues interlinked at thesame time (Kuutti 1996). An important fea-ture of activity theory is that the system isdriven by a collective motive that expandsbeyond the level of individual intentions.Activity systems are not reducible to a sumof individual actions, they have “... cyclicrhythms and long historical half-lives”(Engeström et al, 1995). In other words, ac-tivity theory affords analyses of social phe-nomena on different levels; activity – at thelevel of social systems; action – at the levelof the individual student acting intentionally;and operation – at the level of the concreteoperation, procedure or behaviour. To fullyunderstand an activity, its history and devel-opment should be taken into consideration.This expands the unit of analysis even be-yond the context of one given activity sys-tem.

In an activity system there are potentialcontradictions or tensions between all com-ponents of the systems (Engeström, 1987).Contradictions are used to indicate ‘misfit’within elements of an activity, and betweendifferent developmental phases of a singleactivity. Contradictions manifest themselvesas problems, breakdowns, clashes, etc. with-in the system itself or in relation to other sys-tems (Kuutti, 1996). The objective ofEngeström’s systemic model is to considerthe socially based nature of human activityby including rules of communication and di-vision of work. In agreement with Enge-ström’s systemic model, Fjuk & Smørdal(2000) introduce three aspects that togetherconstitute a useful basis for understandingthe nature of computer-mediated collabora-tive learning. The interconnected aspects are:Development of meaning and knowledgeconstruction, exchange processes and role-taking processes. These aspects are illustrat-ed in figure 1. The upper triangle concernsthe individual student’s actions directed to-


4 These approaches are situated action (Suchman 1987),situated learning (Lave & Wenger, 1991; Greeno, 1998),distributed cognition (Huchins 1995), cultural psychology(Cole, 1996), mediated action (Wertsch, 1991), and activ-ity theory (Engeström, 1987; Engeström & Miettinen,1999).



wards knowledge construction and thought,– mediated by a constellation of artefactsthat are situated within the 3D environment.The model shows that a student is not isolat-ed but is a part of a 3D-generated learningcommunity, represented by the aspects of ex-change and role-taking processes. The ex-change processes thus concern the student’sactions directed towards the shared learningcommunity, – mediated by the embeddedrules of that community (laws, traditions,physical distances, etc.). The role-takingprocesses concern computer-mediation ofactions directed towards the shared commu-nity’s division of tasks and responsibility.

An individual’s actions will then be af-fected by three major factors: the artefactsused, the 3D environment she belongs to andits explicitly or implicitly expressed rules,and the division of work within that commu-nity of students. These factors interact in thecreation of the social practice, and contradic-tions within the system influence the wholecollaborative situation. When the unit ofanalysis expands to the interaction betweendifferent activity systems, the complexitythat we are dealing with increases. Figure 1illustrates these issues, focused through vir-tual 3D learning environments.

12

By using activity analysis on 3D environ-ments, it would include all use activities, toolproducing activities, all teaching and knowl-edge construction activities, as well aschanges and contradictions in the use activi-

ties. This complexity makes it difficult toidentify and delimit the activity systems thatare of interest for the analysis (Bødker,1996). As such, we do not need to analyse allthe systems, but to be aware of contradictions

Figure 1: Activity analysis of 3D environments (Inspired by Engeström (1987))


between the activities a student is influencedby in her development of meaning andknowledge construction. Figure 1 illustrateshow certain didactical principles, institution-al traditions as well as the community’s col-lection of artefacts mediate a student’s rela-tionship with the 3D environment. Further-more, the community’s commitment to thedevelopment of a shared learning environ-ment and individual knowledge is mediatedby the roles embedded in the collaboration(e.g. the power each wields, tasks each is re-sponsible for, etc.).

The figure also illustrates how contradic-tions associated with didactical principlesand the 3D environment lead to production ofnew didactical principles and technologicalsolutions, respectively. In analysis, and in de-signs also, this complexity can be opera-tionalised in terms of questions like: How dothe constellation of artefacts serve as media-tors for the student’s actions directed towardsdevelopment of meaning, as well as towardsthe development of a shared learning com-munity? How do the didactical principles me-diate the student’s action in the 3D communi-ty? How do established institutional tradi-tions mediate the community’s distributedwork and progress? In what follows, designprinciples from these key issues of socio-cul-tural theories in general and activity theory inparticular are outlined. The usefulness of theprinciples are shown through an example, –the 3D environment labelled Matador.

Design principles for 3D-mediated learning environ-ments. Matador: An example

This section provides design principlesthat are operationalised from socio-cultural perspectives where learning

is considered to be the student’s “ability touse a particular set of tools in productiveways and for particular purposes” (Säljö,1999, pp. 147). In agreement with this basicissue, new designs of 3D environments mustcarefully consider what role 3D-based mech-anisms should entail in social interaction andin reflection. The section includes ideas ofhow the key principles should be applied innew designs associated with the environmentdeveloped in the MATADOR project.

MatadorThe project MATADOR (Medical AdvancedTraining in an Artificial Distributed Environ-ment) is aimed at developing a simulationenvironment for training in emergency medi-cine. The environment enables a group ofstudents to communicate and collaborate in anetworked and 3D-generated collaborativeenvironment5. Figure 2 shows one part of the3D environment. The students are aimed atbeing distributed in different geographicallocations6. In the 3D environment, the stu-dents are represented by avatars, which arehuman like 3D figures. The avatars are theeyes and the hands of the students. Both amouse and a haptic device will be used.


5 The technological platform for the development ofMatador is DOVRE API (Hagen, 1999). DOVRE API pro-vides possibilities for integrating multimedia technologiessuch as sound, video, speech, and tactile feedback.

6 In what follows we use Matador to term the 3D envi-ronment.



The Matador environment will be developedwith a particular focus on communication,collaboration and leadership in teams amonghealth professionals. In the teams there willbe physicians and other health workers,which means that the social complexity ofhealth work is built into the application. Thehorizontal dimensions of expertise are sig-nificant for the problem solving process. The3D environment will enable concurrent tu-toring, feedback, and evaluation of all theparticipants.7 The haptic device gives the

students possibility to get in ‘touch’ with the‘patient’. The team exposed to the 3D envi-ronment will perform different cases. Inthese cases the life-threatening conditionsare built in and can be activated dependenton the students’ actions. The team have totalk, act and create specific activities and re-vise their action and activities in a collabora-tive effort to solve the problem inherent inthe cases. One example of this is when theblood pressure falls and there is an increasein the heart rate. This must be detected andthe team has to communicate about this andfind solutions to the problem. The history ofthe patient is part of the cases, but the contextfor the team is in an emergency room in ahospital. After a team has performed thecases, there will be debriefing sessions withan experienced supervisor.

14

Figure 2: A patient arrives at the operating theatre. The doctors, thepatient and the ambulance driver are all avatars, but the student’s ac-tions are represented by the doctor-avatars.

7 The content associated with the application is inspiredby a Norwegian course in trauma medicine. The group be-hind this course has worked with a concept ‘Improvedquality and systematic trauma treatment’. The course isgrounded upon recommendations from the ATLS(Advanced Trauma Life Support) (Brattebø et al.,1998/99). This concept is developed by the AmericanCollege of Surgeons, and is considered a standard inemergency medicine (Bell et al., 1999).


Operationalising the theory for designIn-depth studies of Web-based environments(Fjuk, 1998; Smørdal, 1999) show that an in-dividual actor’s computer applications ham-pered the actions directed towards the ex-changing- and role-taking processes (cf. fig-ure 1). A simple example is: A painting pro-gram is a potential tool for linking thoughtand articulation of it into drawings. Usingthe program is quickly routinised, but be-cause of software incompatibility betweenthe collaborative actors’ programs, thethoughts manifested into drawings did notappear as appropriate means for collectivelyarticulating the actors’ argumentation andnegotiations of meaning. The constellationof computer-based artefact (in use) ham-pered the mutual relationship between indi-vidually and collectively oriented actions.The operation of the action was not conduct-ed automatically, – thoughts are directed to-wards the artefact itself. Due to internalisa-tion of the properties and behaviour of thecomputer-based artefacts, the artefacts didnot become integrated parts of the actor’sactions. Rather, the use of networked com-puters involved thought that stemmed fromproblems of using them due to breakdownsor due to unfamiliarity with them.

These observations clearly indicate thechallenge of designing virtual learning envi-ronments in which various computer-basedartefacts have an essential role in learningand social interaction. Seen from a computersystems designer’s standpoint, the relationbetween individually and collaboratively ori-ented interactions often conflict, forcing de-signers to make computer-based mecha-nisms for one at the expense of the other(Gutwin & Greenberg, 1998). Design thatsupports individual actions often hinders col-laboration, and vice versa. For example, thistrade-off becomes apparent when trying tosupport both the individual’s needs of inte-grated and transparent tools and control over

the artefacts, and the collaborative communi-ty’s needs regarding information sharing, di-vision of work, creation of joint understand-ing, etc. Based on these observations andstudies, Fjuk & Smørdal (2001) have devel-oped a framework that is aimed at guidingsystems designers in their process of struc-turing the analysis concerning the role ofcomputer-based artefacts in collaborativelearning. The authors argue that systems de-sign has to be aimed at understanding thecommunicative aspect of action in order tooffer good solutions for the operational as-pect. To support the mutual interplay be-tween individual and collective processes ofthe learning activity, the challenge is foundin the duality and interplay between the as-pects presented in figure 1.

Although many artefacts have a doubleposition of mediating both the communica-tive aspect of an action and the operationalaspect of the same action, this is an essentialproperty of computer applications in general(Fjuk & Smørdal, 2000) and of 3D environ-ments in particular. For example, group deci-sions and common plans (manifested in e.g.activity responsible charts) and joint produc-tions (manifested in e.g. project report) arepotential signs (i.e. the communicative as-pect) for the exchange- and role-taking pro-cesses. Technology such as groupware sys-tems, co-authoring software, project ma-nagement software, etc. are potential toolsfor operationalising the actions directed to-wards these signs and for making changesupon them. The interplay between the indi-vidualistic and collective aspects (in figure1) exhibits very differently in 3D environ-ments than in e.g. Web-based environments.3D environments offer richer opportunitiesof feeling the presence, sharing time andspace, observing the actions of others, etc.These typical features of 3D environmentsimply that the operation of individual actionsbecomes explicit and visual in the shared




3D-based learning environment. This meansthat the mutual relationship between actionsdirected towards development of meaningand collective processes, becomes moretransparent than in other virtual environ-ments (Krange et al., 2000). Thus, the inter-play between the three aspects, and embed-ded actions, becomes even more interwovenand blurred than in e.g. text-based and asyn-

chronous environments (as in most Web-based environments).

Table 1 illustrates the three aspects interms of various awareness issues. The com-municative part of an action is focused, sincethe operationalised part is more or less asso-ciated with a concrete 3D-technology andenvironment.

16

Aspects

Development of meaning

Exchange processes

Role-taking processes

The role of signs and tools in collaborative learning

Various 3D mechanisms (such as objects, avatars and oralspeech) are targeted toward the aim of human activity.Some are means for changes upon the aim of human activi-ty, while others are aiding thought and reflection upon theaim. Concept awareness is a means towards this aspect.

Some 3D mechanisms and human actions mediate thought,knowledge and perspectives among students participatingin the 3D environment. Other 3D mechanisms are meansfor changes upon objects. Task awareness is a meanstowards producing a common task.

Some 3D mechanisms mediate the division of tasks and re-sponsibility, like common decisions, commitments, andwork arrangements. Various types of shared mechanismsare means for a community to collectively make changesupon an object and to be aware of the patterns of action inthe 3D environment. Social- and workspace awareness aremeans in this context.

Table 1: The role 3D mechanism (like e.g. objects, avatars and oral speech) in 3D environ-ments.

As indicated in table 1, awareness informa-tion is a notion that is particularly interestingin this context, and that has been focused incomputer systems designs to reduce themeta-communicative efforts needed to col-laborate across physical distances and incomputer-mediated environments (e.g. Gaver,1991; Dourish & Bellotti, 1992; Palfreyman

& Rodden, 1996; Gutwin et al., 1995; Gut-win et al., 1996). Dourish & Bellotti (1992)introduced the concept of awareness, con-nected it to shared workspaces and defined itas “an understanding of the activities ofothers, which provides a context for ownactivity” (ibid. p. 107). Moreover, Gutwin etal. (1995) understand workspace awareness


as “the up-to-the-minute knowledge aboutother students’ interactions” and proclaimthat such information plays an “integral partin how well an environment creates opportu-nities for collaborative learning” (ibid. p.147). Gutwin et al. (1995) suggest three ad-ditional categories of awareness informationthat should be considered with respect to col-laborative learning. Social awareness con-cerns social aspects of how to participate ina group or community. The students mustmake decisions about what role they musthave in a particular community, what theyshould expect of the other actors and howthey want to interact with people in the com-munity, etc. Moreover, a collaborative envi-ronment is made up of many tasks carriedout over time, and divided according to vari-ous situated criteria amongst the students.This particular feature of collaboration con-cerns issues that Gutwin et al. (1995) calltask awareness. Task awareness is concernedwith how to complete the common task (e.g.What do we know about the task, how muchtime do we have, what steps must we take tocomplete the task, etc.). Gutwin et al.’s cate-gories of social awareness and task aware-ness correspond with what Fjuk & Smørdal(2001) term role-taking processes. A thirdcategory of awareness suggested by Gutwinet al. (1995), concept awareness, is more di-rectly related to the knowledge constructionprocess. The student must activate what theyalready know about the problem at hand andneed to find ways of how to achieve newknowledge so as to fulfil the task.

Outlined from socio-cultural principles ingeneral and the framework in table 1 in par-ticular, Fjuk & Krange (1999) and Krange etal. (2000) suggest three relationships thatparticularly characterise 3D environments.These are actor-object8, object-object and,

actor-actor. In line with the theoretical heri-tage, and in agreement with the frameworkdeveloped by Fjuk & Smørdal (2001), the re-lationships cannot be considered separatelybut mutually. Concerning the first, the actor-object relationship, it represents first andforemost a student’s actions mediated by anobject embedded in the 3D-environment.This operationalisation is conducted by ma-nipulating the object directly by clicking,lifting, moving, etc. The actor-object rela-tionship clearly supports awareness informa-tion of how a task is completed. This is be-cause the students internalise the same im-ages and this ability reduces the need tometa-communicate all interactions. As such,the result of the operation functions as a vis-ible sign for the co-students, guiding them toindividual reflection and further action. Fjuk& Krange (1999), however, discuss whetherit is necessary to achieve knowledge regard-ing who is doing what, how, where and whenin all parts of the collaboration. As suggest-ed, the designs’ ideals thus become to createopportunities for the student to move be-tween closeness to co-students through someextent of workspace awareness, and a dis-tance to peers in order to articulate thoughtsthrough reflection.

The second relationship, the object-objectrelationship concerns how manipulation onone object influences the situated conditionsof another object. This object-object rela-tionship has a twofold effect on collaborativelearning and awareness information. On theone hand, it explicitly visualises the conse-quences of the individual’s actions on an ob-ject and constitutes an essential sign for fur-ther actions related to divisions of tasks anddiscussions about the tasks. On the otherhand, it mediates the student’s informationawareness on how their action constitutes apart of a greater wholeness. This is an essen-tial factor in how well an environment cre-ates opportunities for collaborative learning,


8 It is important to note that the term “object” is here un-derstood as a 3D-generated object, and does not necessa-rily refer to an object in an activity theoretical perspective.



rather than workspace awareness and taskperformance per se (ibid.).

The last relationship, actor-actor relation-ship, concerns the social interactions and tosome extent what Gutwin et al. (1995) termsocial awareness. Fjuk & Krange (1999) ar-gue that efficient task performance is not suf-ficient for providing learning effects of 3Denvironments. Rather, the learning effects ofcollaboration become optimal when the vir-tual environment creates opportunities fordiscussions and argumentation about thetasks (cf. Dillenbourg, 1996). Oral dialoguesbetween the actors may mediate this interac-tion, but also by the two other relationships(actor-object, object-object). This argumentparticularly supports a need for explicitlyconsidering the situated effects of awarenessinformation, and thus in terms of the dyna-mic interplay which the framework of table 1underlines. One way to provide learning ef-fects of this situatedness is to organise forgood interactional conditions so that theystimulate the student’s mindful engagement,personal responsibility and discussions (Fjuk& Krange, 1999). Although design of 3D en-vironments is explicitly related to the subjectdomains, the specific problem area and itscontents (more than e.g. Web-environments),this is first and foremost connected to the ex-ternal goal of the learning activity, and notnecessarily to the 3D environment in itself.In line with this argument, Storås (2000) em-phasises that design of 3D environmentsmust strive to define a rather complex objectof the learning activity, so as to force socialinteractions and reflection. In spite of theirsimilarities to physical and co-located learn-ing environments, 3D environments do not,in their own right, stimulate social interac-tions and reflection.

The discussed design principles givesome directions for new designs associatedwith the Matador-environment and medicaleducation: First, the goal of the learning ac-

tivity must be complex in the sense that itstimulates to reflections and collectiveprocesses. In the Matador case, this issue isclosely related to practical examples and var-ious simulations of practice. These examplesand simulations must be designed so as tochallenge current knowledge and meaning,and furthermore stimulate to discussions andsharing of reflections amongst the students.An example of this issue is when the stu-dents, through their communication in theshared 3D environment, have access to a va-riety of medical information as test results,information from instruments about the heartcondition, blood pressure, X-rays etc, andthey have to reach a common understandingand act collectively based on their under-standing of the actual and evolving situation.Figure 3 illustrates such a situation.

This process could be related to both furtherdiagnostic activity and treatment of the pa-tient.

This leads us to the second issue, that is, thenecessary relationship between individualand collective processes. The social interac-tions (e.g. operationalised in terms of the ac-tor-actor relationship) must not necessarilytake place within the virtual environment.Rather, they can take place outside it, – in atraditional physical situation or in othertypes of virtual environments. The 3D-gen-erated artefacts may, together with othertypes of artefacts, serve as tools for mediat-ing the mutual interplay between individualand collective processes. The situated effectsof various awareness issues must be con-sciously considered in this respect. To con-sider 3D environments as closed systemscould be misleading when trying to under-stand their impact on learning processes. Thelearners will use knowledge from previousexperiences in the same types of situations.The activities in the 3D environment are part

18


of their learning trajectory, which is stretch-ed out over activities in different settings.

When it comes to the actor-object and ob-ject-object relationships, they must be con-sciously considered with respect to the goalof the learning activity. For example, the ac-tor-object relationship should be designed soas to provide feedback related to how differ-ent diagnostic activities are connected. Whena student investigates the abdomen, the 3Denvironment can give feedback about whattype of pain and the location of pain. Thestudents’ interpretation of this finding givesdirection for how to proceed. This can be ap-proached by various operations on the pa-tient. The object-object relationship can beused to simulate what happens with the pa-tient when the blood pressure decreases and

how this and other biological processes indifferent organs are affected (or not affected)by each other. This will create situationswhere the systemic nature of the humanbody becomes more transparent. The actionperformed by the students influences onother processes than the interventions are di-rected towards. A set of unpredictable eventswill create the environment, which actuallyshows the situated nature of problem solvingin a dynamic environment. The learning en-vironment becomes realistic, because theproblem solving process is dependent onhow the students are able to create a collec-tive effort. Without this collective effort thedegree of distributed expertise for solvingthe problem will not be reached.


Figure 3: The students collaborate in the shared 3D environment and haveaccess to medical information like X-rays



Conclusion

We have argued that the socio-cul-tural perspectives (with activitytheory as the major example) pro-

vide us with a more adequate understandingof learning processes in 3D environments,than approaches based on information pro-cessing perspectives on human learning.These perspectives give us important direc-tions for the design of 3D environmentswhere students use various types of re-sources, including artefacts and the knowl-edge owned by co-students. The theoreticalframework also affords the opportunity forunderstanding the learning processes, whichtake place in the 3D environment in relationto the other activity systems of which the stu-dent is a part. The latter argument is of par-ticular theoretical and methodological im-portance, since this is not the case in mostCSCL research nor in the field of using 3Denvironments in medicine. If we expand theunit of analysis and analyse learning pro-cesses as part of activities on different levels,we will be able to develop a better under-standing of learning in technology rich envi-ronments and how these learning processesare related to other activity systems. Thesetypes of analyses will be useful for severalpurposes. First, they contribute to an under-standing of the learning processes takingplace in 3D environments, other clinical sit-uations and their relation. Second, they pro-vide guidelines for designing courses andlarger units in professional education. Andlast, they provide us with ideas for clarifyingthe educational benefit of using 3D environ-ments as tools for learning in relation tolearning in other forms of tools and repre-sentational media.

In the 3D environment described – Mata-dor – it is possible to study collaboration,communication and how cognition is distrib-uted, in detail. This can give us new insights

into the efficiency of 3D environments asso-ciated with problem solving situations andhow different types of expertise relate toeach other. Studies of vertical and horizontalaspects of expertise will give us possibilitiesto discuss how these types of expertise couldbe understood when they are parts of collab-orative efforts.

AcknowledgementWe want to thank Telenor R&D, Nordunet 2,and the University of Oslo for financial sup-port to this research. We also want to thankproject leader Ragnhild Halvorsrud and themembers of the team involved in the devel-opment of Matador for discussions whichhave helped frame the argumentation in thisarticle. Ivar Kjellmo has developed thegraphical design for the environment.

LiteratureBell R.M., Krantz B.E., Weigelt J.A. (1999):

ATLS: a foundation for trauma training. Ann.Emerg. Med. 34: 233-7

Berge, O. (1997): Making Distance EducationCollaborative through Internet. Transcendingthe Traditions of Distance Education andCollaborative Learning. Cand. Scient. thesis,Department of Informatics, University ofOslo, Norway.

Boshuizen, H.P.A., Hobus, P.P.M., Custers,E.J.F.M, & Schimdt, H.G (1992): CognitiveEffects of Practical Experience. In Evans,D.A. and Patel, V.L. (Eds.) Advanced Modelsof Cognition for Medical Training andPractice (337-348). NATO ASI series Vol.97.

Brattebø G., Wisborg T., Brattebø J., Kvitting P.,Aksnes A., & Brinchmann-Hansen, Å. (1998/99) Kvalitetssikring av traumebehandling isykehus. Internal note, the NorwegianMedical Association.

Brown, A. (1992): Design Experiments:Theoretical and Methodological Challengesin Creating Complex Interventions in Class-room Settings. The Journal of the LearningSciences, Vol. 2, 2, 141-178.

20


Brown, A.L., Ellery, S. og Campione, J.C.(1998): Creating Zones of Proximal Devel-opment Electronically. In Greeno, J.B. &Goldman, S.V. (Eds). Thinking Practices inMathematics and Science Learning (341-368). New Jersey. Lawrence Erlbaum Ass.

Cole, M. (1990): Cultural psychology: A onceand future discipline? In Berman, J.J. (Eds.)Cross-cultural Perspectives. Nebraska sym-posium on motivation. Lincoln: University ofNebraska Press.

Cole, M. (1996): Cultural Psychology. A onceand future discipline. Cambridge Mass.:Harvard University Press.

Clancy, W.C.(1997): Situated Cognition. OnHuman Knowledge and Computer Repre-sentation. Cambridge; Cambridge UniversityPress.

Cicourel, A.V. (1990): The Integration ofDistributed Knowledge in Collaborative Me-dical Diagnosis. In Galegher, J., Kraut, R.E.,& Egido, C. (Eds.) Intellectual Teamwork.Social and Technological Foundations ofCooperative Work (pp. 221-242). Hillsdale,New Jersey: Lawrence Erlbaum Ass.

Cicourel, A.V. (1995): The Interaction of Cog-nitive and Cultural Models in Health CareDelivery. Presented at the 9th conference ofEuropean Health Psychology Society. Ber-gen, Norway.

CTGV (1997): The Jasper Project. Lessons inCurriculum, Instruction, Assessment, andProfessional Development. New Jersey:Lawrence Erlbaum Associates Inc.

Dourish, P. & Bellotti, V. (1992): Awareness andCoordination in Shared Workspaces. Turner,J.; Kraut, R. (Eds.): CSCW-92. Sharing per-spectives. Proceedings of the Conference onComputer-Supported Cooperative Work, pp.107-114. ACM Press.

Dillenbourg, P. (1996) Some technical implica-tions of distributed cognition on the design ofinteractive learning environments. Journal ofArtificial Intelligence in Education, 7 (2),161-179.

Elstein, A.S. (1995): Clinical Reasoning inMedicine. I Higgs, J. & Jones, M. (Eds.).Clinical Reasoning in the Health Professions(pp. 49-59). Oxford: Butterworth-Heineman.

Engeström, Y. (1987): Learning by expanding:An activity-theoretical approach to develop-mental research. Helsinki: Orienta-Konsultit.

Engeström, Y. (1993): Developmental studies ofwork as a testbench of activity theory: Thecase of primary care medical practice. InChaiklin, S & Lave, J.(Eds.) Understandingpractice, Perspectives on activity and context(s. 3-34) N.Y.: Cambridge University Press.

Engeström, Y. (1995): Objects, contradictionsand collaboration in medical cognition: an ac-tivity-theoretical perspective. Artificial Intel-ligence in Medicine, 7, 395-412.

Engeström, Y. & Miettinen, R. (1999): Intro-duction. In Perspectives on Activity Theory(Eds.) Engeström, Y., Miettinen, R., Puna-mäki, R.L. Cambridge. Cambridge Univer-sity Press.

Feltovich, P.J., Coulsen, R.L., Spiro, R.J., &Dawson-Saunders, B.K. (1992): KnowledgeApplication and Transfer for Complex Tasksin Ill-structured Domains: Implications forInstruction and Testing in Biomedicine. InEvans, D.A. og Patel, V.L. (Eds.) AdvancedModels of Cognition for Medical Trainingand Practice (213-244). NATO ASI seriesVol. 97.

Fjuk, A. (1998): Computer Support for Distri-buted Collaborative Learning. Exploring aComplex Problem Area, Dr. Scient Thesis,Department of Informatics, University ofOslo.

Fjuk, A.& Dirckinck-Holmfeld, L. (1997): Arti-culation of Actions in Distributed Colla-borative Learning. In Scandinavian Journalof Information Systems, Vol. 9, No. 2, 3-24.

Fjuk, A. & Krange, I. (1999): The situated ef-fects of awareness in distributed collaborativelearning: Interactive 3D an example. InHoadley, C. & Roschelle, J. (Eds.) Pro-ceedings for: Computer Support for Colla-borative Learning. Designing New Media fora New Millenium: Collaborative technologyfor learning, Education and Training. Stan-ford University.

Fjuk, A.& Ludvigsen, S. (2001): The Com-plexity of Distributed Collaborative Learn-ing: Unit of Analysis. In Dillenbourg, P.,Eurelings, A. & Hakkarainen, K. (Eds.) EC-SCL – European Perspectives on Computer-




Supported Collaborative Learning. Proceed-ings of E-CSCL: University Maastricht.

Fjuk, A. & Smørdal, O. (2001): Incorporatingnetworked computers in collaborative learn-ing. In Dillenbourg, P., Eurelings, A. &Hakkarainen, K. (Eds.) ECSCL – EuropeanPerspectives on Computer-Supported Colla-borative Learning. Proceedings of E-CSCL:University Maastricht.

Gadd, C.S. (1995a): Ruminate: A model of themultiple roles of diagnosis in the communica-tion and evaluation of expertise. PhD,University of Pittsburgh.

Gaver, W. (1991): Sound Support for Colla-boration. Proceedings ESCW’91, 293-308.

Gorman, Meier, & Krummel, (1999): Simu-lation and Virtual Reality in Surgical Edu-cation. Archives of Surgery, Vol 134, No. 11(http:/ /archsurg.ama-assn.org/issues/v134n11/full/ssa9016.html).

Grenno, J.G. & Moore J.L. (1993): Situativityand Symbols: Response to Vera and Simon.Cognitive Science. Vol. 17, No 1, 49-61.

Greeno, J. (1998): The Situativity of Knowing,Learning, and Research. American Psycho-logist, January, Vol. 53, No.1, 5-26.

Gutwin, C., Stark, G. & Greeberg, S. (1995):Support for Workspace Awareness in Edu-cational Groupware.

Schnase, J. L. & Cunnius, E. L. (Eds.): Com-puter Support for Collaborative Learning.Proceedings of CSCL’95. The First Inter-national Conference on Computer Supportfor Collaborative Learning (147-156). NewYork: Lawrence Erlbaum Associates.

Gutwin, C. & Greenberg, S. (1998) Design forIndividuals, Design for Groups: Tradeoffs be-tween power and workspace awareness. InProceedings of the ACM Conference onComputer Supported Cooperative Work.ACM Press, 207-216.

Gutwin, C., Roseman, M. & Greenberg, S.(1996): A Usability Study of Awareness Wid-gets in a Shared Workspace GroupwareSystem. In Proceedings of ACM CSCW’96.Conference on Supported Cooperative Work.Boston, Mass, ACM Press.

Hadzimahmutovic, Z., Healy, D., Tsaltas, J.,Lawerence, A.S., Brown, T. & Flanagen, B.(1999): Gynaecological endoscopy training

simulators, Gynaecological endoscopy 8,129-135.

Hagen, S. (1999): DOVRE white paper. Internalreport, Telenor R&D.

Hoffman, H. & Vu, D. (1997): Virtual Reality:Teaching Tool of the Twenty-first Century?.Academic Medicine, Vol. 72, No 12/December, 1076-1081.

Hoffman, H.G. (1998): Virtual Reality: A Newtool for interdisciplinary psychology research.CyberPsychology & Behavior: The impact ofthe Internet, Multimedia and Virtual reality onBehavior and Society, 1, 195-200.

Hutchins, E. (1995): Cognition in the Wild.Cambridge, Ma.: The MIT Press.

Johnson, W. L., Rickel, J. W. & Lester, J. C.(2000): Animated Pedagogical Agents: Face-to-Face Interaction in Interactive LearningEnvironments. International Journal of Arti-ficial Intelligence in Education, 11, 2000.

Krange, I. et al (2000): Collaborative learning inschools by distributed use of interactive 3Dtechnology. FoU report 18/2000.

Krapichler, C., Haubner, M., Engelbrecht, R. &Englmeier, K.H. (1998): VR interactiontechiques for medical imaging application.Computer Methods and Programs in Bio-medicine, 56, 65-74.

Kutti, K. (1996): Activity Theory as PotentialFramework for Human Computer InteractionResearch: In Nardi, B. (ed.) Context andConsciousness. Activity and Human-comput-er interaction. London: The MIT Press.

Jonassen, D.H. & Land, S.M. (2000): Theo-retical Foundations of Learning Environ-ments. New Jersey: Lawrence Erlabaum Ass.

Larsen, A. & Krange, I. (2000): Analysing learn-ing and collaboration in distributed 3D learn-ing environments. Working paper, TelenorR&D.

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

Lehtinen, E., Hakkarinen, K., Lipponen, L.,Rahikainen, M. & Muukkonen, H. (1999):Computer supported collaborative learning:A review of research and development. InJ.H.G.I Giebers Reports on Education, 10.Department of Educational Science. Uni-versity of Mijmegen, The Netherlands.

22


Linell, P. (1990): De institutionaliserade samtal-ens elementäre former: om möten mellan pro-fessionella och lekmän. Forskning om utbild-ning, Vol. 4, 18-35.

Linell, P. (1998): Approaching Dialogue. Talk,interaction and contexts in dialogical per-spectives. Impact: Studies in Language andSociety. Amsterdam: John Beenjamins Pub.Company.

Ludvigsen, S.R. (1998): Læring i medisinsk ut-dannings- og arbeidskontekst. Avhandling fordr.polit graden. Pedagogisk forskningsinsti-tutt. Universitetet i Oslo. (Learning medicinein an educational and a work context.)

Ludvigsen, S.R. & Bach-Gansmo, E. (1998a):Report from the project: Effects of multimediaapplications in medical education related topractical procedures. Working paper (InNorwegian).

Ludvigsen, S. R., & Bach-Gansmo, E. (1998b):Learning medical procedures. Analyzing me-dical multimedia applications. Working pa-per (In Norwegian).

Mantovani, G. (1996): New CommunicationsEnvironments. From Everyday to virtual.London: Taylor & Francis.

McLellan, H. (1996): Virtual Realities. InJonassen, D.J. (Ed.) Handbook of Researchfor Educational Communications and Tech-nology. New York: Macmillian.

Nielsen, K. & Kvale, S. (1997): Current issuesof apprenticeship. Nordisk Pedagogik (Spe-cial Issue: Apprenticeship-Learning as SocialPractice) Vol. 17, No. 3, 130-139.

Ota, D., Loftin, B., Saito, T., Lea, R. & Keller, J.(1995): Virtual Reality in Surgical Education.Comp. Biol. Med. Vol. 25, No. 2, 127-137.

Palfreyman, K., Rodden, T. (1996): A Protocolfor User Awareness on The World Wide Web.In Ackerman, M. S. (ed.) ACM 1996 Con-ference on Computer Supported Co-operativeWork. Cooperating Communities. Proceed-ings, ACM Press, 130-139.

Piaget, J. (1977): The development of thought:equilibration of cognitive structures. NewYork. Viking.

Pilkington, R. & Parker-Jones, C. (1996):Interacting with Computer-Based Simula-tion: The role of Dialogue. Computers Educ.Vol. 27, No. 1, 1-14.

Qayumi, A.K. & Qayumi, T. (1999): Computer-Assisted Learning: cyberPatient – A Step inthe Future of surgical education, Journal ofinvestigative Surgery, 12, 307-317.

Salomon, G (1992): What Does the Design ofEffective CSCL Require and How Do WeStudy Its Effects? Sigcue Outlook, 21(3),Spring 1992, ACM, 62-68 (http://www-cscl95.indiana.edu/cscl95/outlook/62_Salo-mon.html).

Shore, B. (1996): Culture in Mind – Cognition,Culture, and the Problem of Meaning. NewYork: Oxford University Press.

Strauss, A., Fagerhaugh, S., Suczek, B. &Wiener, C. (1985): The social organization ofmedical work. The University of ChicagoPress: Chicago.

Suchman, L. (1987): Plans and Situated Actions.The problems of human-machine interaction.Cambridge: Cambridge University Press.

Sundar T. (1999) Simulering – øvelse som gjørmester. Tidsskr. Nor. Lægeforen. 119:2700-01

Säljö, R. (1999): Learning as the use of tools: asociocultural perspective on the human-tech-nology link. In Littleton, K. & Light, P. (Eds)Learning with Computers. Analysing produc-tive interaction (44-161). London. Routledge.

Vygotsky, L.S. (1978): Mind in Society. Cam-bridge: Harvard University Press.

Wasson, B., Gurbye, F. & Mørch, A. (2000):Projects DoCTA: Design and use ofCollaborative Telelearning Artefacts. Reportsfrom ITU, University of Oslo: UniPub.

Wenger, E. (1998): Communities of Practice.Learning, Meaning, and Identity. Cambridge.Cambridge University Press.

Wertsch, J. V. (1991): Voices of the Mind. ASociocultural Approach to Mediated Action.Cambridge MA.: Harvard University Press.

Wertsch, J.V. (1998): Mind as Action. New York:Oxford University Press.

Winn, W. (1997): The Impact of Three-Dimensional Immersive Virtual Environ-ments on Modern Pedagogy. HITL TechnicalReport R-97-15. Paper for NSF Workshop.

Youngblot, C. (1998): Educational use of virtualreality. Alexandria: Institute for Defense Ana-lyses.



SummaryWithin psychiatric research, the field of ‘technother-apy’ has been centred primarily on attempts to as-sess the computer as a treatment tool. The situationof daily clinical usage is, however, often ignoredwithin such research, as for instance in controlledclinical trials.

Our empirical study illustrates how health pro-fessionals and clients use different concepts of sci-ence and health in the attempts of formulating stan-dards for using computers in psychiatric practice.The psychiatrists at a major psychiatric hospital de-cided and justified clients’ use of computers on thebasis of a ‘techno-medical’ quality assurance. At thesame hospital the occupational therapists stressedthe improvement of social relations as a treatmentgoal. And, at a psychiatric outside clinic the clientsused concepts of ‘normality’ for articulating qualityin computer use.

Our study exemplifies how the use of computersis a multifaceted ‘performance’. What is called for isa kind of research not limited by artificial borders of‘the context’ and the ‘user-perspective’. In much hu-manistic research as well as in action research con-cepts of ‘context’ and ‘user-perspective’ imply asomehow romantic view on practice as pure and un-contaminated by the outside world contrasted to a‘general’ or an ‘objective’ way of knowing theworld. These sharp distinctions were however diffi-cult to maintain in our study, where health profes-sionals and clients took local contingencies into ac-count when they interpreted computer use, whilethey simultaneously drew on a socio-historicalreservoir of resources.

Since the sixties use of computers inpsychiatric settings has been at thecentre of a sometimes heated debate.

Some haveseen the new technology as a wel-comed tool promising major improvementsin psychiatric treatment (Colby, 1979 &1995). Others have been more reluctant andconcerned with the danger of a ‘dehumanis-ing’ practice caused by the computer’s lackof ability to respond empathetically to theclient (Weizenbaum, 1985; Murphy and Pa-deck, 1986).

In this article we report our experiencesfrom an investigation of clients’ use of com-puters in two psychiatric institutions. As willbe exemplified this use is a multifaceted‘performance’. Obviously, the activity is lo-cated in a specific setting and dependent onlocal contingencies (Suchman, 1987). Thus,in order to understand situations where psy-chiatric clients use computers, concepts suchas ‘context’ and ‘user perspective’ seem rele-vant. These seductive concepts are, however,too vague and imprecise, and must be quali-fied.

In its early days the discussion of psychi-atric clients’ use of computers was restrictedto the scientific community, but today the sit-uation has changed. Like most other areas ofsociety computers have become part of the


Peter Lauritsen and Peter Elsass

Computers in PsychiatryNotions of science and health as resources

for conceptualising computer use in two psychiatric contexts


Peter Lauritsen and Peter Elsass: Computers in Psychiatry

daily life of health professionals and clientsat many psychiatric institutions. This diffu-sion raises an important question: accordingto what standards can the quality of compu-ter use be measured, and what are the appro-priate methods through which such a ques-tion can be answered? Such questions are notonly related to the specific case of psychi-atric clients using computers, but relate to amuch more general debate on ‘quality assur-ance’ – a concept often used in discussionsof treatment practice in a compound setting.

A large number of methods for assuringquality in treatment show how the healthcare system, in Denmark as well as in othercountries, has taken different positions in re-lation to evaluation and validation of treat-ment procedures (Sundhedsstyrelsen, 1996).Most dominantly, medical doctors have de-veloped methods for quality assurance thatare closely related to the scientific norms offormal studies in medicine. This has, howev-er, been criticised by other professionalgroups, e.g. psychologists, who in accor-dance with much humanistic research arguethat evidence-based practice promotes a‘techno-medical’ view (Elliot, 1998). Othergroups, such as occupational therapists, haveargued for more context-sensitive methodsas found in narrative analysis and case-stud-ies (Mattingly, 1998). And advocates of ac-tion research have been arguing that qualityassurance must involve the ‘user-perspec-tive’, which has been one of the main issuesin the conceptualisation of subjectivity andobjectivity found in this kind of research(Krogstrup, 1997).

Through examples from our investigationit will be shown how psychiatrists, occupa-tional therapists and clients use various ‘re-sources’ when articulating standards of qual-ity in situations where clients use computers.Some of these resources for explaining prac-tice are, in a sense, found outside the speci-fic practices. Thus, health professionals and

clients use conceptualisations of science andhealth in formulating and justifying stan-dards for using computers in the psychiatricpractice. The psychiatrists at a major psychi-atric hospital in Denmark see a number ofreasons for the clients’ use of computers. Yet,these psychiatrists emphasise that an evalua-tion of treatment related usages must bebased on controlled clinical trials. At thesame hospital occupational therapists stressthe social relations of the client, and theyperceive their own professional knowledgeas a necessary condition for ‘good’ computeruse. At a psychiatric outside clinic the clientsuse computers in activities related to workand leisure. However, not only do theymeasure the quality of computer use accord-ing to standards such as ‘having fun’ or ‘get-ting work done’, they also use a concept of‘normality’ as a resource for articulatingquality in computer use.

Technotherapy

Within psychiatric research mucheffort has been made to assesswhether or not the computer

could prove to be an efficient treatment tool.With few exceptions, these efforts can besummarised under the heading ‘technothera-py’ because they advocate a form of therapybased on the use of information technology.A now classic example is Weizenbaum’scomputer program Eliza (Weizenbaum,1966). In accordance with much researchwithin the field of Artificial Intelligence,Weizenbaum investigated the possibility ofdeveloping computers which were capableof communicating in the ‘natural’ languageof the user without requiring him or her touse formalised expressions and codes. Aspart of this research Weizenbaum construct-ed Eliza which imitated a Rogerian therapist.

Despite the fact that Weizenbaum clearlyrecognised that Eliza was only able to parti-

26


cipate in very simple conversations andmerely simulated understanding (Weizen-baum 1966 & 1985), the idea was taken upby a number of psychiatrists through whichthe computer was established as a promisingtool for performing therapy. Thus, Colbystated that: “We have written a programwhich can conduct psychotherapeutic dia-logue” (Colby et al., 1966, p. 148). Althoughthis clearly was an overstatement the diffi-culties were largely seen as ‘technical’ andwere supposed to vanish as the new technol-ogy advanced. As is clear today this did notprove to be the case. But the idea of replac-ing therapists with computers has been diffi-cult to put aside not least because of thepromises ‘computertherapy’ was supposed tohold. In 1979 Colby wrote:

The advantages of a computer psychotherapistwould be several. It does not get tired, angry, orbored. It is always willing to listen and to giveevidence of having heard. It can work at any timeof day and night, every day and every month. Itdoes not have family problems. It does not try toperform when sick or hungover. It has no facialexpressions of contempt, shock, surprise, etc. Itis polite, friendly, and always has good manners.It is comprehensible and has a perfect memory. Itdoes not seek money. It will cost only a few dol-lars a session. It does not engage in sex with itspatients. It does what it is supposed to do and nomore. (Colby, 1979: 154f.)

Colby is basically arguing that therapeuticpractice is flawed by its dependency on thesubjectivity of the therapist. The way toovercome these flaws, and thus improvepractice, was believed to be the applicationof models and techniques developed andevaluated within the framework of techno-medical science (Turkle, 1997). From thisperspective the computer was consideredvaluable because the subjectivity of the ther-apist was erased. Not only did the computeravoid making ‘human mistakes’, it alsomade possible that models and techniques

derived from psychiatric theory could be im-plemented in the program and thus applied tothe psychiatric practice through the use ofcomputers (Colby, 1976 & 1979; Bloom,1992).

Today, many researchers would distancethemselves from the rhetoric used by Colby.However, the basic assumptions made byColby can still be found within a contempo-rary technotherapeutic perspective. Hopes todevelop the ‘human speaking’ psychothera-pist have diminished, but integration of com-puters in psychiatric settings is still basedupon the assumption that therapeutic prac-tice would improve if it was based on infor-mation technology developed and evaluatedaccording to theories and methods of techno-medical science. Thus, the development ofcomputer programs for testing and treatmentof clients, e.g. through various exercises,continues and have increasingly commer-cialised.

Within the technotherapeutic perspectivequality of computer use is ensured throughthe application of mainly two standards. Oneis related to the computer’s ability to performas a human (e.g. Heiser et al., 1979; Baer etal., 1993). This criterion was dominant in theearly days of psychiatric computer use. Butwith the diminishing hope of constructing ar-tificial intelligence it has lost some rele-vance, although it can still be found. Anothermore important standard is the computer’s‘medical’ effect. Computer programs are of-ten developed with the anticipation that theuse will have a positive effect on the illnessof the client (e.g. Benedict, et al., 1994;Medalia et al., 1998). Accordingly, the eval-uations of the programs seek to verify thishypothesis through controlled clinical trialswell-known from the evaluation of ‘ordi-nary’ medicine (Hougaard 1987).

Viewed from within the perspective ofmuch humanistic research and action re-search the technotherapeutic perspective is




much too limited. The objection is of coursenot related to the interest in improving ther-apeutic practice through the use of comput-ers. The problem is rather the view on prac-tice found within the technotherapeutic per-spective. Standards are developed ‘far away’from psychiatric practice and based uponconcepts taken from techno-medical science.The everyday life of health professionals andclients is not taken into account. Thus, thecomputer is in a way liberated from its tech-nomedicalised context.

Computers in psychiatricpractice

In collaboration with Klaus Kaasgaard,Peter Lauritsen carried out fieldwork onthe use of computers in psychiatric prac-

tice. As part of this fieldwork, psychiatristsand occupational therapists at a psychiatrichospital as well as clients at an outside clinic(with former clients as board members) wereinterviewed. In addition, participant observa-tion, including participatory design and eva-luation processes, was carried out in bothplaces (Kaasgaard and Lauritsen, 1995 &1997; Lauritsen et al., 1997; Lauritsen andKaasgaard, 1997).

The following analysis of the collectedmaterial shows how the use of computers inpsychiatric practice is conceptualised alongseveral lines. These conceptualisations in-clude, but also expand, the technotherapeuticperspective. In other terms, health profes-sionals can approve clients’ computer use forseveral reasons, but the use must still meetvarious standards of quality. This is also thecase when it comes to clients, who first of allview the computer as a possibility of becom-ing ‘normal’. This term must, however, beseen in a socio-historical perspective insteadof a medical.

The computer in the perspective ofhealth professionals: psychiatrists andoccupational therapistsIn psychiatric practice clients use computersin various ways. It is used for work, leisureand education, and it is furthermore integrat-ed in activities of treatment. In principle,health professionals see the value of all theseuses. Thus, the computer is not just seen as atreatment tool but as a flexible technology.This flexibility entails that the decision onwhether or not the computer should be usedand the purposes for which it should be usedis based on local circumstances. These ‘lo-cal’ decisions are, however, informed bymore general concepts of how to ensurequality.

An important theme in the perspective ofthe psychiatrist, which to some extent alsocan be found among the occupational thera-pists, is the use of computers for improve-ment of activities directly related to treat-ment. For example, cognitive dysfunctionsmight be rehabilitated through the use ofcomputer. Thus, as can be seen in the fol-lowing quote from a project descriptionmade by a psychiatrist, traces of the tech-notherapeutic perspective can still be found:

The purpose of this investigation is to study thefollowing questions relevant to treatment:

1. Can a computer based rehabilitation programadvance and sharpen patients’ (persons in tre-atment) attention span?

2. Can a possible positive effect be generalised toother ‘attention tasks’ not rehabilitated?

The hypothesis that computer use might im-prove the cognitive function of the patient iswell-established within technotherapy (Bene-dict et al. 1994; Medalia et al. 1998). Thequestion is, however, if a positive outputfrom the computer use can be transferred tothe broader ecological setting of the patient’sdaily life.

28


Another central theme in the perspectivesof both psychiatrists and occupational thera-pists is that providing access to computers isa way of accommodating the clients. Ac-cording to the health professionals it is im-portant that psychiatric institutions reflectthe surrounding society where use of com-puters is a common activity. Therefore, theinstitution must offer its clients the possibil-ity of using computers. It is, however, clearthat the clients’ wish for using computers im-plies a motivation for engaging in other ac-tivities. Especially the occupational thera-pists, but also the psychiatrists, view theclients’ use of computers as a possibility ofimproving social relations. To some clientsintimate social relations, for instance face toface relations, are difficult to handle. In thesesituations the use of computer can make therelation more anonymous and thereby affordbetter communication between client andhealth professional. Furthermore, the occu-pational therapists believe that the use ofInternet and e-mail can strengthen the socialrelations of the client in his or hers ordinarylife. This shows in the following statementby an occupational therapist:

There are so many possibilities [in using compu-ters]. I have a vision that we had a writing work-shop. A place with computers where one couldwrite poems or maybe communicate with otherpeople in the world through e-mail… It is also away of getting in touch with other people. It is afunny thought that a patient with schizophrenia,who might be rather isolated in his flat… eve-ryday goes to a place in order to get food and so,[and then he] also takes a game of chess with aguy in Russia or wherever. It opens possibilitiesof becoming more active than just staring at theblue sky.

Thus, the Internet makes it possible forclients to transgress the limits of the very lo-cal setting and join a wider community. In

this way the border between ‘the local’ and‘the global’ context becomes blurred.

The health professionals identify a posi-tive potential in the clients’ use of computers.They do, however, also identify certain nega-tive aspects. For example, social relationscan be damaged if the clients use the com-puter too much and get too occupied by it,and thus cut off relations to health profes-sionals and other clients. Furthermore, it isfeared that some clients become psychoticby using computers. According to the psy-chiatrists and occupational therapists it istherefore important that certain mechanismsare put in place in order to ensure the quali-ty of the clients’ use of computers. Thus, it isfound necessary that health professionalstake control over the clients’ computer use. Ahealth professional made the following re-mark:

The computer has to be placed in a pre-definedstructure. Otherwise – and this we have experi-enced – some [patients] would be inclined to sitin front of the screen all of the time. There is a re-lative risk attached to [the use of] the computer.It is, however, not a complete obstacle, I guess.One can just make some rules on how to use it.

In the end it is for the health professionals todecide whether or not a client should use thecomputer and for what purposes it should beused. To make this decision professionalknowledge is called for. While the need forsuch knowledge is underlined by the occupa-tional therapists, the psychiatrists highlightthe need for controlled clinical trials if thecomputer is to be viewed as a treatment tool.Thus, even though the computer must be ap-plied and evaluated according to local con-tingencies both psychiatrists and occupation-al therapists draw on general standards ofhealth for ensuring quality in the use of com-puters by psychiatric clients.




The computer in the perspective of theclientsThe clients at a psychiatric outside clinic usethe computer in various work-related activi-ties (word processing, DTP, etc.). Thus,taken at face value, the computer is a work-ing tool, which in addition is used for enter-tainment and leisure. The computer is, how-ever, conceptualised along different lines andmeasured against other standards than justbeing a tool or a leisure activity.

One aspect, which is often mentioned bythe clients, is that it can be hard to performactivities, which are easy for most otherpeople, for example writing minutes or let-ters. However, when a word processor isused mistakes can be corrected and are notreflected in the final product. This was oftenstressed by the clients as a way of escapingtheir stigmatising diagnosis. Furthermore,computer skills are clearly given high statusby the clients. A client stated:

Well, one day there will be a huge gap [between]those who use computers and those who do not.That is the way I look at it. And I realised that along time ago. So that is why I have always beeninterested in [computers]; because to me [com-puters] have always been the future.

Thus, to do well in society is closely relatedto the ability to master information technol-ogy. This connection between computers and‘success’ entails that computers can be usedin other kinds of ‘activities of normalisa-tion’. For example one client said:

I am not proud of being here… On the one handI need that people recognise that I am ill, and Ineed that people pay attention to that. On theother hand, I would like to appear as normal aspossible. So, if I can stick out from the crowd[the other clients] by being a computer expertthen I can better defend being here.

As indicated here the clients can use thecomputer for ‘mobilising arguments’ thatjustify their stay at the clinic to themselves,family and friends. However, the use of com-puter does at the same time create an ‘inter-nal’ differentiation between users and non-users. Thus, computer users are likely tostick out as ‘more normal’ than clients whodo not engage in computer related activities.

In our investigation the clients made veryfew critical remarks on the use of computersand often clients, who were unfamiliar withthe new technology, expressed a wish for be-coming computer users in the future.However, negative evaluations might be hid-den by a tacit avoidance behavior and an in-complete knowledge of how to use the com-puter.

DiscussionAs described above, the technotherapeuticresearch perspective views psychiatric prac-tice as flawed by ‘the too human therapist’who relies more on intuition than on theoriesand methods approved by techno-medicalscience. This is clearly expressed in the callfor controlled clinical trials. But the exam-ples taken from our empirical study of com-puter use at two psychiatric institutions showhow the technotherapeutic perspective itselfis flawed and too limited. It ignores, for ex-ample, situations of use which are not direct-ly related to treatment, although these situa-tions are important to health professionalsand clients. In other terms, the technothera-peutic perspective does not offer much helpto health professionals and clients who aretrying to develop standards that can assurequality of computer use in other situationsthan treatment in a narrow sense of the word.Thus, it would be reasonable to concludethat technotherapeutic research is insuffi-cient because it ignores the context of com-puter use, and the users’ perspective on this

30


use. Following this, another research per-spective with close affinity to the context ofthe users, which could contribute to the de-velopment of practice, would seem impor-tant.

However, the call for such a research per-spective is not entirely unproblematic. Ar-guing for a closer attention to practice runsthe danger of unreflexively falling back uponthe concepts of ‘context’ and ‘user-perspec-tive’. In much humanistic research as well asin action research these concepts arguablyimply a romantic view on practice as pureand uncontaminated by ‘the outer world’.Thus, ‘context’ is viewed as a container de-marcating the local practice from ‘the glo-bal’. Likewise ‘the user perspective’ seemsto denote a ‘subjective’ world-view closelylinked to the local context and thus contrast-ed to ‘a general’ or ‘an objective’ way ofknowing the world. These sharp distinctionsare, however, difficult to maintain. As our in-vestigation shows the perspectives of thepsychiatrists are clearly informed by techno-medical science. And in the ‘local’ practicesof the occupational therapists and clients onefinds traces of ‘general’ concepts of health.Thus, what is needed is a kind of researchnot limited by artificial borders of ‘the con-text’ or ‘the user-perspective’.

Such a perspective on practice couldbenefit from several theoretical positions.Thus, both discourse theory (Foucault,1990), and Actor-Network-Theory (Callonand Latour, 1981; Latour, 1993) have at-tempted to free actors from their entrapmentin local contexts without placing themselvesin a structuralist position. Thus, according toCallon and Latour (1981: 279)…

We cannot distinguish between macro-actors (in-stitutions, organizations, social classes, parties,states) and micro-actors (individuals, groups, fa-milies) on the basis of their dimensions, since

they are all, we might say, the ‘same size’, orrather since size is what is primarily at stake intheir struggles it is also, therefore, their most im-portant result.

And even in the phenomenological tradition(sometimes used for legitimising the focuson ‘context’ and ‘user-perspective’) onefinds concepts breaking the barrier to thesurrounding world. This is apparent in thework of Alfred Schutz, well-known for hissociological analysis of the life-world(Schutz and Luckmann, 1985 & 1989).According to Schutz every situation is, in astrict sense, unique. It is, however, at thesame time typical. When actors organise, or‘construct’, a situation they draw on a reser-voir of experiences on how to handle ‘thiskind of situation’. These experiences are or-ganised in ‘types’. That is, ‘frames’ or‘heuristics’ which enable the actor to recog-nise and handle the present, unique situationbecause of its similarity to other situations.Even though the types held by the actor areunique and applied in different ways accord-ing to the specific situation, the interpreta-tion of the situation is not solely dependenton local contingencies. This is so because thetypes of the individual are founded in the so-cial history of wider society. Through pro-cesses of socialisation the individual takesover typical ways of handling typical situa-tions. What is briefly indicated here is im-portant to our investigation and to the moregeneral discussion of ‘context’ and ‘user-perspective’. Following Schutz, health pro-fessionals and clients take local contingen-cies into account when understanding com-puter use, but at the same time they draw ona socio-historical reservoir of resources. Ifthis is neglected the concepts of ‘context’and ‘user-perspective’ might be reduced toseductive devices for well-meaning research.




AcknowledgementThe authors wish to thank Henrik Bødker,Casper Bruun Jensen and Stinne HoejerMathiasen for comments on earlier drafts ofthis article.

ReferencesBaer, L.; Brown-Beasley, M.W.; Sorce, J. and

Henriques, A.I. 1993. Computer-AssistedTelephone Administration for Obsessive-Compulsive Disorder. American Journal ofPsychiatry, 150:11, 1737-1738.

Benedict, R.H.B.; Harris, A.E.; Markow, T.;McCormick, J.A.; Nuechterlein, K.H. andAsarnow, R.F. 1994. Effects of AttentionTraining on Information Processing inSchizophrenia. Schizophrenia Bulletin, vol.20, no. 3, 537-544.

Bloom, B.L. 1992. Computer-Assisted Psycho-logical Intervention: A Review and aCommentary. Clinical Psychological Review,vol. 12, 169-192.

Callon, M. and Latour, B. 1981. Unscrewing theBig Leviathan – How do Actors Micro-structure Reality?. In Cetina, K. K. and Ci-courel, A. (eds.) Advances in Social Theoryand Methodology toward an Integration ofMicro and Macro Sociologies. London:Routledge and Keagan Paul, 277 – 303.

Colby, K. M. 1976. Clinical Implications of aSimulation Model of Paranoid Processes.Arch. Gen. Psychiatry, vol. 33, 854-857.

Colby, K. M. 1979. Computer Simulation andArtificial Intelligence in Psychiatry. InSerafetinides, E.A: Methods of BiobehavioralResearch. New York: Grune & Stratton.

Colby, K.M. 1995. A Computer Program UsingCognitive Therapy to Treat DepressedPatients. Psychiatric Services, vol. 46, no 12,1223-1225.

Colby, K.M.; Watt, J.B. and Gilbert, J.P. 1966. AComputer Method of Psychotherapy: Preli-minary Communication. Journal of Nervousand Mental Disease, vol. 142, no. 2, 148-152.

Elliott, R. 1998. Editor’s introduction: A guideto the empirical supported treatments contro-versy. Psychotherapy Research, 8, 115–125.

Foucault, M. 1990. The History of Sexuality: AnIntroduction. New York: Random House.

Heiser, J.F.; Colby, K.; Faught, W.S. andParkinson, R.C. 1979. Can PsychiatristsDistinguish a Computer from the Real Thing?The Limitations of Turing-like Tests as aMeasure of the Adequacy of Simulations.Journal of Psychiatric Research, vol. 15,149–162.

Hougaard, E. 1987. Psykoterapeutisk Effekt-forskning: Design og målemetoder, Psyko-logisk Skriftserie Aarhus, vol. 12, no. 17,Psykologisk Institut, Aarhus Universitet.

Krogstrup, H. 1997. Brugerinddragelse og or-ganisatorisk læring i den sociale sektor.Aarhus: Systime.

Kaasgaard, K. & Lauritsen, P. 1995. The Use ofComputers in Cognitive Rehabilitation inDenmark. American Journal of Speech-Lan-guage Pathology, vol. 4, no. 2, 5-8.

Kaasgaard, K. & Lauritsen, P. 1997. Parti-cipatory Design at a Psychiatric Daycenter:Potentials and Problems. In Pappas, C.;Maglaveras, N. & Scherrer, J.-R: MedicalInformatics Europe ‘97, Amsterdam: IOSPress.

Latour, B. 1993. We have never been Modern.New York: Harvester Wheatsheaf.

Lauritsen, P. & Kaasgaard, K. 1997. ComputerPrograms and Clinical Contexts: TwoComputer Based Exercises for CognitiveRehabilitation. In Pappas, C.; Maglaveras, N.& Scherrer, J.-R: Medical Informatics Europe‘97, Amsterdam: IOS Press.

Lauritsen, P.; Kaasgaard, K. & Elsass, P. 1997.Computere i Psykiatrien. En undersøgelse aflægers og ergoterapeuters ‘i-tale-sættelse’ afcomputerens anvendelsesmuligheder i arbej-det med psykiatriske patienter. In Elsass, P.;Olesen, F. & Henriksen, S.: Kommunikationog forståelse. Kvalitative studier af formid-ling og fortolkning i sundhedssektoren. Aar-hus: Philosophia.

Mattingly, C. 1998. Healing dramas and clinicalplots. The narrative structure of experience.Cambridge: Cambridge University Press.

Medalia, A.; Aluma, M.; Tryon, W. and Mer-riam, A.E. 1998. Effectiveness of AttentionTraining in Schizophrenia. SchizophreniaBulletin, vol. 24, no. 1, 147-152.

32


Murphy, J.W. and Pardeck, J.T. 1986. Tech-nologically Mediated Therapy: A Critique.Social Casework: The Journal of Contem-porary Social Work, vol. 67, no, 10, 605-612.

Schutz, A. and Luckmann, T. 1985. The Struc-tures of the Life-World, vol. I. Evanston:Northwestern University Press.

Schutz, A. and Luckmann, T. 1989. The Struc-tures of the Life-World, vol. II. Evanston:Northwestern University Press.

Suchman, L.A. 1987. Plans and SituatedActions. The Problem of Human-MachineCommunication. Cambridge: Cambridge Uni-versity Press.

Sundhedsstyrelsen. 1996. Kriterier, standarderog indikationer for kvalitet. Kommiteen forSundhedsoplysning.

Turkle, S. 1997. Life on the Screen. Identity inthe Age of the Internet. London: Orion Books.

Weizenbaum, J. 1966. ELIZA – A ComputerProgram For the Study of Natural LanguageCommunication Between Man and Machine.Communications of the ACM, vol. 9, no. 1,36-43.

Weizenbaum, J. 1985. Kurs mod Isbjerget.København: Gyldendal.



SummaryInformation technologies (IT) have become a politi-cally important issue over the last ten years.Governmental reports promote the idea of a new in-formation society, or network society, where ITs area prerequisite for the economic and social develop-ment. The discourse and the rhetoric about technolo-gy and its relation to society are dominated by mod-ern, rational and macrosocial understandings of tech-nology. In this paper we challenge dominant rationaldiscourses on technology and present alternativeviews to bring new perspectives to the subject in or-der to complicate and enrich our understanding oftechnology and how it relates to society. Our aim isto develop a theoretical framework that can accountfor a dynamic and microsocial approach to studyingthe implementation of an Electronic Patient Record(EPR) at a Danish hospital. The key notions in theframework are ‘trading zone’, ‘cooperation’ and‘technological translations’.

Introduction

Information technologies (IT) have be-come a politically important issue overthe last ten years. Governmental reports,

such as Information Society Year 2000(Dybkjær & Christensen 1994), or the morerecent Digital Denmark (Dybkjær & Linde-gaard 1999), promote the idea of a new soci-

ety, an information society, knowledge soci-ety or network society, where these tech-nologies are a prerequisite for the economicand social development. Advanced ITs areconsidered a necessary investment in orderfor society to survive in international compe-tition.

The message is that technology can re-form and revolutionize every sector of soci-ety. The discourse and the rhetoric abouttechnology and its relation to society aredominated by modern, rational and macroso-cial understandings of technology. The pre-occupation with learning, knowledge and in-formation as key elements in the economyand in society points to the spreading of cog-nitivist and cybernetic discourses and ima-geries.

In this paper we want to challenge domi-nant rational discourses on technology andpresent alternative views. The idea is to bringnew perspectives to the subject in order tocomplicate and enrich our understanding oftechnology and how it relates to society. Ouraim is to develop a theoretical frameworkthat can account for a dynamic and microso-cial approach to studying technology. Moreprecisely we want to develop an approach by


Randi Markussen & Finn Olesen

Information Technology andPolitics of Incorporation

– The Electronic Trading Zone as coordination of Beliefs and Actions


Randi Markussen & Finn Olesen: Information Technology and Politics of Incorporation

which to study the implementation of anElectronic Patient Record (EPR) at a Danishhospital.

Instead of addressing these questions atmacrosocial or macropolitical levels, we pre-fer to focus on the mundane processes in-volved in implementing or domesticatingtechnologies locally. We draw on methodsand insights coming out of the Humanitiesand newer research fields such as ‘Sociologyof Scientific Knowledge’ (SSK) and ‘Sci-ence and Technology Studies’ (STS) and notleast on some of the controversies withinthese fields, especially concerning agencyand materiality (Olesen 1996, Markussen2000, Lykke 2000). Before we dig deeperinto the theoretical framework that guidesour fieldwork, we will map out the terrain byintroducing two different perspectives onpower and technology.

Spreading the work –Modern and amodernperspectives on technology

It is quite common to see a technologysuch as the EPR as a tool by which to ap-ply national (or global) standards to local

health care practices. It is not surprising,then, that the EPR is often taken to be an in-strument of power; a political, economic ortechnical power building on macrosocialideals of rational or efficient health carework to enforce specific improvements to thequality of health care. But this does not needto be the only way of understanding the cir-culation and incorporation of EPR in thepractices of health care. In ‘The Powers ofAssociation’, the French sociologist, BrunoLatour, has suggested a distinction betweentwo models of understanding the circulationof facts and artefacts: ‘the diffusion model’and ‘the translation model’ (Latour 1986).

Latour points out three key elements inthe diffusion model of the circulation of facts

and artefacts through time and space: 1)There is an initial power or energy that startsthe circulation; 2) There is a certain inertiathat preserves this energy; and 3) There is amedium through which the fact or artefactcirculates. (Latour 1986:266f). The one whoinitiated the circulation, is thus in a verypowerful position according to this model.The great advantage is that one can explaineverything by pointing to the person or theparty with the initial power, or by pointingout the degree of resistance in the medium.

In the diffusion model it is not the dis-placement of the artefact or fact that need tobe explained, but the speed by which it isdistributed; and that depends on otherpeople’s actions and reactions. The circula-tion of an EPR, for instance, is fairly easy toexplain within the diffusion model. The EPRhas some initial qualities which pretty muchguarantees its success as a rationalising tool,and when it does not succeed it is due to thereactions by reluctant people or organisa-tional barriers. Such (groups of) people slowdown the speed of the EPR’s diffusion –while proponents will attempt to speed upthe process.

In contrast to this rationalistic modelLatour suggests another one in which it is as-sumed that the fate of a fact or an artefact isin the hands of later users. Each of them willreact to it in many different ways: by throw-ing it away, neglecting it, bending it, betray-ing it, modifying it, etc. They translate it inaccordance with their own interests and pro-jects. An order is for instance rarely trans-mitted faithfully through many links in achain of people – and “if it occurs it requiresexplanation.” (Latour 1986:267).

It means that if no one takes over a certainfact or artefact, nothing more will happen!Power is not something you have or are ableto accumulate. You may have power in prac-tice, but then you do not have it; or you mayhave power in theory, and then you have no

36


power. This model of circulation is similar toa game of football in that the initial kick-offis no more important than the 10th or the324th kick at the ball. The ‘diffusion’ of anEPR is persistent work. This also means thatone should not look at users as passive ‘mailmen’ whose sole spectrum of behaviour hasto do with slowing down or speeding up theprocess of circulation. Rather, they are ‘ac-tors’ who contribute equally to the circula-tion of the EPR by translating it to fit withtheir own projects and (perhaps) by bringingit on to new actors.

In short, if we follow Latours suggestion,we may, on the one hand, choose to look forthe forces and people who initiated the EPR,and for the subsequent effects in the healthsystems that make the process of diffusionslow down or speed up. On the other hand,we may study how each separate actor, tak-ing over the EPR, will translate it in accor-dance with her own projects. In the formermodel the fact or artefact is assumed to betransmitted through the medium. In the latterit is taken to be transformed by the actors. Inthe former it is the derivation from the origi-nal EPR that needs to be explained; in thelatter it is the invariant qualities that shouldbe accounted for.

As the Dutch sociologist, Marc Berg, hasshown (Berg 1998, 2000), a formalism (e.g.an EPR), and the reality domain, covered bythat formalism (e.g. a local oncology ward)are simultaneously transformed in processesof implementation and use. Hence, formal-ism is not above reality. It is itself a workingelement in a practical context with the possi-bility of being incorporated into local idiomsand practices, while the local context is si-multaneously being transformed in certainrespects by the work of the formalism. Thisdual aspect of bringing formalisms into playwith a reality domain may be expressed bythe term ‘local universality’, emphasisingthat universals, or standards always are in-

corporated – reflexively – in a local setting.Here ‘local setting’ can be anything from award at a hospital to a department at the Mi-nistry of Health.

In this paper we will take over Latourstranslation model and use it to kick off ourown project. By doing that we renounce themacrosocial belief in transparent transmis-sions of technology through time and space.Instead, we will assume that ‘successful cir-culation’ of technological systems is the ef-fect of local processes of translation.

In what follows we will first discuss someaspects of the diffusion model, which is stillat the heart of political discourses on ratio-nalising the health services. Second, we sug-gest an analytic tool to understand and de-scribe the local transformations involving theEPR, and third, we return to Latour to dis-cuss some shortcomings of the – modernist –distinctions between facts and fictions, andtext and materiality. If we assume that suchseparations are ontologically given, we willnot be able to understand the boring, but per-sistent border-crossings between texts andmateriality, the unmentioned commonplacesin everyday work practices that abjure di-chotomies between signs and things.

Standards of Work andmaking standards work

On a macropolitical level, the DanishPublic Health Services are challeng-ed by political decisions to boost

computer based information technology inhealth work on a national scale. The practi-cal extent of the challenge is becoming moreand more lucid through the ambitious plansto develop and implement a national EPR. Itis an explicit objective in contemporary gov-ernmental or other political programmes tomake basic functions and activities in the na-tional health services more rational and effi-cient, and hence more economical in order to




improve the treatments of patients and up-grade the organisation of health care work.

For such ambitions to be fulfilled, thegovernmental agencies aim to secure ashared set of standards. These standards areof different kinds. There must be common orinterchangeable standards for database struc-ture, search hierarchies, programming lan-guages, and hardware capacity. These stan-dards are all taken to be of a ‘purely’ techni-cal or semi-technical sort. There will further-more have to be a focus on the use of profes-sional language and terminology; for in-stance classification and definition of keywords, and how to structure processes ofcommunication; this is about semantic stan-dards (Sundhedsstyrelsen 2000). User inter-face is yet another domain, in which therehave to be considerations about shared stan-dards. Moreover, job performance will haveto be coordinated by the various groups ofhealth professionals, both internally and inaccordance with other groups and domains.Without tending to all levels of the standardi-sation work, it will probably not be possibleto achieve the desired computer supportedhealth services on a national scale.

The coordinated work of standardisationis thus crucial for a successful implementa-tion of the electronic patient record to hap-pen. We believe, however, that this immenseundertaking will not come out well if thetask of articulating standards is understoodin a too rigid sense, which excludes ambigu-ous interaction and a certain recognition ofwhat we term an electronic ‘trading zone’.Standardisation will also have to encompassaxiological, communicative, material and or-ganisational aspects of the health services.But these aspects can not be conceived asanything but independent tasks of standardi-sation.

When for example Danish nurses partakein an assignment to explicate their profes-sional terminology to bring it in accordance

with the International Classification of Nur-sing Practice, ICNP, they also contribute to aredefinition of nursing practice as such. Thesubtitle to the first Danish ICNP report (Mor-tensen 1996) is, in our translation: A Com-mon Professional Language in Nursing1. Wethink those words express rather well thewish of the proponents to promote – one ver-sion of – an improved, shared reality in nurs-ing to overcome geographic and communica-tive barriers. But if only a limited number ofvery general concepts are included in themaster classification, that work is not likelyto overcome the unwanted barriers. While anew standardised classification may provokea number of changes among nurses in localhospital wards, that does not necessarilymean that their communication has becomeeasier. One may characterise all the differentkinds of standardisation work as politics ofincorporation to stress that such heteroge-neous kinds of action are non-exclusive di-mensions of health care work, and any otherenterprise involving coordinated actions.

The Trading Zone

The basic assumption guiding our ap-proach to investigating the incorpora-tion of an EPR is that processes of

change have to be described within a frameof description which encompasses both for-mal and informal, both symbolic and ma-terial, and theoretical and practical aspects ofEPR implementation. In an attempt to estab-lish such an approach we suggest the conceptof a trading zone as the key term to signify abroad but still vigorous frame of analysis. Byintroducing this term we wish to explorewhether the multiple processes of EPR im-plementation in the health care services canbe understood analytically as ‘trading withina demarcated area’.

38

1 Mortensen: “Et fælles fagsprog i sygeplejen.”


The concept of a trading zone, as suggestedhere, has been developed by the historian ofscience, Peter Galison, as an analytic tool toencompass collaboration and coordination inlarge-scale, high-energy physical experi-ments (Galison 1997). The core question Ga-lison wishes to answer is: What makes theo-rists, experimentalists, instrumentalists andparticipants from other advanced professionsable to cooperate for an extensive period oftime on a high-end physical experiment – inspite of vast differences in outlook, method-ology, skills, and grasp of the problems in-volved? How might a historian of sciencebest be able to grasp the involved processesand relations avoiding both the “Scylla of ex-aggerated homogeneity and the Charybdis ofmere aggregation”? (Galison 1997:46). –Galisons stimulating suggestion is that theexperimenters succeeded because they en-gaged in ‘trade in a limited zone’. The con-cept emphasises local coordination withoutreference to some external standard, and thata trading zone should be seen as “a social,material, and intellectual mortar binding to-gether the disunified traditions (.)” (Galison1997:803).

In this and the following sections we willelaborate on the concept of trading zone, tomake these ideas clearer. We do not pretendto remain loyal to Galisons conception, be-cause our target is different from his. Hewishes to explore texts and machines of pastevents, and we want to investigate what, fol-lowing Latour, we term: ‘naturally occurringexperiments’ in real time settings. Hence,while Galison uses the trading zone to sortout historical material about highly profiledevents of the past, we look for concepts thatcan sort out ethnographic material aboutmundane and taken for granted events of thepresent.

In a first approximation a trading zone isa place you can ‘enter’ and ‘leave’ again.This point is important, because it makes it

possible to describe how various actors cantake part in some coordinated work and leaveit again. Not least in the domain of EPR wethink this dimension is relevant. Designers,who are engaged in developing such systemsall day, may easily forget that their cus-tomers are not computer literate like them-selves; rather they are professionals of vari-ous kinds who – on some occasions duringwork – might engage in EPR related tasks. Hence, we do not believe that most healthprofessionals will regard the EPR as somesort of omnipresent work environment;rather it will be used in measured dosesalongside other means of work. By using thetrading zone as a reminder of the demarca-tion between inside and outside the zone, itis possible to see the incorporation as a num-ber of processes on level with other tasks in-volved in health care work. This understand-ing goes against macrosocial ideas of theelectronic medical record as something hov-ering above various work practices and func-tions in the hospital ward.

The term ‘trade’ should be understood inthe broadest sense as sale, exchange, transferor bartering of everything from goods andservices, over methods and tricks, to knowl-edge and beliefs. In the zone the traders canreach agreement about the specifics in an ex-change in spite of vast differences in how toconceive of the goods, or what meaning toassign to the trading activity. Hence, tradingis not an activity involving participants on anequal footing; some of them may only par-ticipate from necessity and small capital,while others bring great enthusiasm and for-tune to the trading zone.

Most likely, some health professionalswill meet the introduction of an EPR in a lo-cal medical ward with great enthusiasm andothers with utter dislike. Some of the formermay be involved in deciding to implementthe system in the first place; some may al-ready be proficient computer users, or they




are keen to learn more. Other health profes-sionals might not want to use computers at allfor various reasons, for fear that they makefatal mistakes, or because they do not feel upto the task of handling technical systems, orperhaps based on different ideas about gen-uine medical work. In between these twopoles there will be a whole range of attitudesand coping strategies. But the point is thatmost of these actors, who enter the zone ofEPR-handling, will expect certain coordinat-ed actions and assumptions about patientsand electronic registration etc. from them-selves and other ‘traders’. And because ofthese expectations they will be able to do thetrading in spite of other differences.

To us, the important thing is to develop ananalytic framework that captures the proces-ses through which individuals and groupsbecome able to reach agreement, processesthat make them succeed in coordinating theirbehaviour inside the local borders of thezone, even though they may disagree on alarge scale outside this domain. This empha-sises the need to understand local coordina-tion of material, symbolic and cultural sys-tems. The subcultures, to use Galison’s ter-minology, or groups involved in trade maydisagree about the equivalencies they haveestablished, or about the information theyhave exchanged in the process. But none theless, if the EPR works satisfactorily, theyhave reached a stable level of exchange forthe time being. They restrict, as Galison sug-gests, their beliefs and actions to receivesome ends. This points to another feature ofthe trading zone, which also concerns its lev-el of stability.

Zone language

It might be tempting to think of the zoneas some sort of fixed place or territory,neutral to the exchanges that take place

within the area. This is not the idea. In some

cases a zone of trading can be unstable be-cause of its infrequent nature. The annualfair in the local town can be an example ofthis, just as pilot projects and provisional ex-periments with user involvement in compu-ter systems development. Probably mosttrading under such circumstances will bebased on already established values, like thetypical price of a soft drink at the fair, or for-mer work experiences with computers. Inshort, it is not such a big deal, and trading ispredominantly non-committing to the partiesinvolved.

Trading zones of a more committing na-ture are characterised not only by specificmeeting places, but also by a contact lan-guage that ensures stable contact. The capac-ity of the contact language will vary frompractical jargon, over functional pidgin, tofully developed Creole. Let us say a bit moreabout this linguistic aspect of trading to hintat the potential, analytic richness of under-standing EPR incorporation in such terms.(Galison 1997, chapter 1 & 9, Todd 1990)

Practical jargon is contact language of avery rudimentary kind, like the Englishphrase: ‘how much?’. Such phrases seem tobe universally valid in economical exchange,however large the linguistic barrier may oth-erwise be. Pidgin is a hybrid language usedin exchanges between e.g. European andEast Asian traders. Pidgin was adopted toChinese, and contains English, as well asvarious Asian words and phrases. A Pidgin isonly used as a contact language, and al-though it may develop into a fairly stablemeans of contact, it is not spoken on a dailybasis outside the zone.

Creole was the language spoken by theoriginal slave population in the West Indiesand parts of South- and Central- America.‘Creole’ has become the common term forall such languages with simplified grammarand strong phonetic changes of the originallanguages, e.g. French, Spanish or Portu-

40


guese. As a pidgin expands to cover a widervariety of events and objects, it starts to playa larger role in people’s life. When childrenare brought up in a zone of expanded pidgin,this language will have to serve a muchwider set of needs. And it may now be calleda Creole, to signify this change of status.

Both pidgin and Creole are linguistic con-cepts that refer to language at the boundariesbetween distinct groups of people. Pidgindescribes the contact language people devel-op to engage in trade, and which they tend toleave behind when departing from the zone.A Creole, by contrast, is a pidgin that has be-come so complex, that it is able to serve as afairly independent and stable, native lan-guage to ‘inhabitants’ in a zone of extendedcommon practices.

In her outline of a pragmatic theory of lan-guage, Barbara Herrnstein Smith suggeststhat pidgins, or contact languages, can beseen as a good model of how linguistic normsemerge through ad hoc pragmatic coordina-tion. She describes communication as a lan-guage loop, a “circuit or system of reciprocaleffectivity, that is, a dynamic process thatworks – has appropriate effects, but not thesame effects – for both those who act andthose who re-act”. (Smith 1997:54). Lan-guage should be seen as a ‘slice of social life’without clear boundaries between the begin-ning or the end of the realm of the verbal.One can argue that facial expressions, bodilygestures, clothing, material equipment etc.should be in- or excluded in language, thusmaking the slice thinner or thicker.

Verbal agents do not follow autonomousrules, and verbal forms have no inherent sig-nifying powers. “The relatively stable goingof that circuit is what makes our behaviour asverbal agents seem rule-governed, and alsowhat makes it seem that particular recurrentverbal forms (words, phrases, inscriptions,inflections, gestures, intonations, pauses,and so on) have particular ostensive, connec-

tive, effective, or evocative powers –“mean-ings” – within or attached to them.”(Smith1997:55). Her account emphasises that pid-gins not only occur at boundaries betweencultures or subcultures. From her pragmaticperspective pidgins can also stress the condi-tions of communication and interaction moregenerally.

We suggest that zone language may be abeneficial analytic tool when trying to graspthe symbolic and material exchanges thattakes place and develops between variousprofessional groups and individuals involvedin accommodating an EPR in a practical set-ting. By studying the literature on EPR, ac-cessible to the relevant professional groups,and by listening to their exchanges while en-gaged in EPR-related tasks, we hope to beable to map the linguistic resources of thesegroups to develop a zone language. Thisanalysis of language use may reveal some-thing about the abilities of the various actorsto enter the zone; if there are dominantgroups; how an improved command of thezone language may change the understand-ing of the electronic patient record; and howfar it makes sense to compare zone lan-guages with profession-based languages inorder to study incompatibilities, minglingand transformations.

Slicing the zoneWhile the concept of a zone language mayshow useful as a means to understand someof the symbolic interaction, it should not ex-clude or be seen as opposed to material orspatial conditions of the trading activity, assuggested by Herrnstein Smith. In Galison’scase the idea is explicitly “to expand the no-tion of contact languages to include struc-tured symbolic systems that would not nor-mally be included within the domain of “nat-ural” language” (Galison1997:835). Galisonstresses that even “natural” languages are




conditioned by intentional interventions thatmakes it difficult to establish a clear distinc-tion between the natural and the ‘artificial’ or‘unnatural’ such as for instance a computerlanguage or electronic circuit design.

Thus Galison is concerned with specify-ing the ‘slice of social life’ that makes up thecontact zone for distinct subcultures withinphysics and the media of exchange they de-ploy, be it language or material analogues:

“This suggests that the process of “black boxing”can be seen as the precise material analogue ofthe more linguistic forms of pidginization; just asterms like “electron” can acquire a decontextua-lised meaning, so items like a local oscillator, acharged coupled device, and a computer memorycan function as binding elements between sub-cultures when stripped from their original con-texts and coordinated with new ones.” (1997:836)

Furthermore, Galison suggests that it is theability to restrict and localise symbolic sys-tems for the purposes of coordinating themat the margins that makes the linking of thesubcultures of physics possible. He stressesthat it is not a question of translating fromone subculture to another, but to work out “apowerful, locally understood language to co-ordinate their actions.” (1997:833).

In a revealing passage Galison makes anexplicit comparison between a trading zoneand the concept of a ‘boundary object’ as de-veloped by Leigh Star and Griesemer(1989). Star and Griesemer want to showthat certain objects can simultaneously takepart in separate group’s very different ideasand practices about these objects while up-holding a uniform identity across suchboundaries at the same time. To Galison the“...notion of cooperation through hetero-geneity is key for their project and mine.”(Galison 1997:47, note 48). While Star andGriesemer speak about ‘translations’ be-tween various groups of the objects, Galison

argues that languages are more generousthan allowing different groups to exchangenouns designating some objects. Languagewill allow of “...locally shared proceduresand interpretations as well as objects.”(1997:47)

Both parties deal with historical analysesof successful examples of cooperation. Theconcept of trading fits fairly well within asymbolic interactionist tradition, which Starand Griesemer’s approach comes out of.This shows for instance in the explicit use ofAnselm Strauss’ concept of social worlds.They carry, however, their approach further,when they bring in the concept of translation.By doing so they refer to an understanding ofpower and materiality as demonstrated byLatour. In our reading, there is a tension be-tween the latter, amodern latourian approachand Galison’s modern insistence on the trad-ing zone as a limited zone that relies on a re-stricted language, a pidgin. Nevertheless, wehave chosen to consider this tension a re-source within our own approach that needsto be further developed. We will return tothis issue further below.

At this point, however, we want to stressthat although a computer is a symbol pro-cessing machine, it is also a very materialpiece of equipment, and the surroundings inwhich all computer related interaction takeplace possess a number of material qualities.The activities in a trading zone causes cer-tain kinds of material or spatial relations tooccur; between human actors, and betweenhumans and non-humans. We want to de-scribe the development and maintenance ofthese relations by using the term ‘zonespace’.

Zone spaceThe gradual installation, improvement andtuning of the inventory of the zone spacecontribute to an increased coordination ofcommon actions and beliefs. A study into the

42


technical and ‘carthograpic’ abilities of thevarious health professionals will hopefullyyield independent information about thetrading activity in the zone. Not least theirtechnical understanding, their patterns ofmovement, spatial conceptions and aware-ness of inside/outside the zone is worthstudying.

These reflections on zone space are notleast inspired by ethnographic field studiesin scientific laboratories, better known as‘laboratory studies’ (Gooding 1989, Hacking1988, Knorr Cetina 1992, Knorr Cetina1999). Some of those studies have docu-mented how the actual laboratory as a spa-tial-material environment contributes to theformation of scientific theories by reconfi-guring a particular emerging order of self-other-thing. As Knorr Cetina states in herbook Epistemic Cultures: “Not only objectsbut also scientists are malleable with respectto a spectrum of behavioural possibilities. Inthe laboratory, scientists are methods of in-quiry; they are part of a field’s research strat-egy and a technical device in the productionof knowledge.” (Knorr Cetina 1999:29) Justas scientists may become reconfigured andworkable in relation to the interiour of thelaboratory, so may secretaries, doctors, phar-macists and nurses be malleable componentsin the gradually emerging order following asuccessful incorporation of an EPR. Alter-natively, the lack of mouldable agents mayserve as a resource in trying to understandwhy some attempts at incorporations failed.

We believe that a focused attention to theunique qualities of the zone space will dis-close something important about non-discur-sive and non-mental components of the co-ordinated actions to incorporate an EPR inthe work practices in a hospital ward.

Let us now return to the tension betweenthe analytic concept of a trading zone as sug-gested by Galison and the micro-sociologi-cal concepts developed by Latour. As stated

earlier, Galison takes the zone to be a kind ofcommon meeting ground, where various al-ready established individuals and groups willdevelop a shared set of standards to coordi-nate their actions, beliefs and technologies.But how well does that fit with conceptsstemming from Latour’s approach in tryingto understand the dynamics of zone develop-ment in time and space? In an attempt to an-swer that question, one may try to considerhow a new project, plan or undertaking be-gins, and how it will develop from there, ac-cording to the proposals stated above.

Initially there is a firm relation betweenwhat is context and content in any new pro-ject. For instance, a small group of designersand health professionals in a hospital ward, acomputer system, a wish to improve on thequality of written documentation, some soft-ware, and the space of a meeting room maybe the sole context; the incorporation of anew computer system in the ward might bethe content. At this stage it is inconsequen-tial, however, to talk about the universallygiven EPR; there is not yet a locally embed-ded (universal) EPR that will improve on thequality of the written documentation. Only ifthe networks of the content is extended –separated from the initial context – and sta-bilised will it be possible to speak about theEPR as ‘the more effective means of writtendocumentation’ – as if it has always existedindependent of its original context. Thus, ifthe computer system, the wish to improveand the initial group of people are able to ini-tiate some new sets of standardised practicesand some new sociotechnical competenciesat the hospital wards, and if the computersystem is malleable enough to reciprocatevarious styles of clinical practice (Fujimura1994); only then will the content and contextbe separated. In other words, only if later ac-tors take over the EPR and use it in their pro-jects, will the ‘better, more efficient’ systemof the EPR become a black box and, conse-




quently, turn into the universally given stan-dard by which to measure the health carework in all hospital wards, etc.

As we saw earlier, Galison spoke aboutmaterial black boxing as a “…precise mater-ial analogue of the more linguistic forms ofpidginizasions”. A first indication of the ten-sion between his position and Latour’sshows, we think, in his clear distinction be-tween the material and semiotic dimensionsof the zone. The latourians would insist thatsuch dichotomies are transformed and dis-obeyed in many ways during the evolvementof the zone. Hence, what was taken to becategories of materiality and language in theinitial phase of a joint project may not besuch distinct categories at a later stage. Ga-lison represent in this respect, then, a modernview of language as separate from its ma-chines (Masten et al. 1997), while Latourwould talk about translations and displacedlinks between material and semiotic agen-cies.

Furthermore, the human agents seem tobe fairly stable participants in the varioussubcultures of the zone in Galison’s perspec-tive. They are the ones who perform certainacts in order to establish a contact languageand to coordinate the skills and beliefs with-in the zone. On the other hand, the Latour-perspective would assume that not just thematerialities and textualities, but also theagencies are transformed in the developmentof a network. Hence, both humans and non-humans are folded in dynamic contextu-alised, sociotechnical practices. In short,while Galison, as historian of science, is con-fronted with the written documentations ofmodern mans endeavors in his laboratory,the latourians are confronted with the messypractices of stabilising the present.

We think the above discussion indicatessome part of the tension between the built-inmodern approach to the topic of research inGalison’s concept of the trading zone, and

the explicit break with modernity in the la-tourian approach. We wish to emphasise thatwe also find a high degree of implicit and ex-plicit agreement between the two approach-es, but here we want to make the tensionproductive. In the next section we will elab-orate further on that difference betweenmodern and amodern approaches to studyingEPR and other technological systems.

Sociotechnical discourses –and politics of incorporation

In his analysis of technical mediationBruno Latour suggests that we abandonthe subject – object dichotomy and con-

sequently a modern perspective on technolo-gy. Instead, he recommends that we talkabout humans and nonhumans and how theyconstantly interact in collectives. He de-scribes technical mediation as a process oftranslation that modifies both the human andthe nonhuman components involved in ac-tions. In his symmetrical analysis actions arenot a human privilege but involve nonhu-mans as well, stressing the collective of hu-mans and nonhumans. Actions become aproperty of associated entities, not a proper-ty of humans. Technical artefacts never existjust as objects, they are always embedded ininstitutions. In Latours words: “Boeing 747sdo not fly, airlines fly.” (Latour 1999:193)

Furthermore, technical mediation in-cludes a crossing of the boundary betweensigns and things. Latour uses the example of‘the sleeping policemen,’ the speed bumpsthat prevent you from driving too fast in amuch more literal manner than a sign indi-cating ‘Don’t drive too fast’ does. He showsthat this is not a question of shifting fromdiscourse to matter, but a complex process ofdelegations involving several shifts: An ‘ac-torial’ shift: The policeman or the sign is re-placed by a bump. But the shift is also spa-tial: A new actant has come into existence

44


that changes what it means to drive there. Inaddition, the shift is temporal as the bump isthere all the time while the actors/actants –humans and nonhumans – involved in theconstruction of the bump, have gone, eventhough their actions are still active and alive(1999:188f).

The transformative power of an artefactsuch as a medical record rests on its ability toaccumulate inscriptions and coordinateevents. It recollects what happened to a pa-tient, so that the doctor is relieved of think-ing of it. It affords cooperation betweenhealth care workers without a need for per-sonal communication. An actant such as therecord involves crossings of the boundarybetween signs and things, just as well as spa-tial and temporal shifts. Delegation impliesthat we are ‘folded into nonhumans’ asLatour puts it. Whenever we confront a tech-nical object, we are never at the beginning,but at the end of a long process of mediators.Latour’s account throws light on recent de-velopment in discourses on technology. Theinterdisciplinary field of health care infor-matics in Denmark, for instance, does notconsider systems development merely aquestion of programming and design. It doesnot believe that formal models map theworld correctly, and that human interactionis best described within these terms. Orga-nisational questions have come to the fore,and many people find the idea of user in-volvement rational and a reasonable step inorder to construct both solid designs and usersupport. Thus many initiatives involve pilotprojects and local experiments with user in-volvement at hospitals in Denmark.

One of the early projects took place in themid 90s at Hvidovre Hospital (DSI rapport96.05). The aim of the project was to reveal‘necessary user demands,’ and the reportabout the experiences stresses the organisa-tional questions in the process. It describes

the task of the new field of medical infor-matics as bridging between informationtechnology and health care work (1996:31).It considers the question of understanding in-formation technology in the ‘traditionalsense’ as secondary and the health careprocesses as the primary topic and the van-tage point from which to understand IT(p.12).

The idea of a primary and a secondarysubject establishes a dualism with healthcare processes at the one pole and technolo-gy at the other. It reflects the modern subject– object distinction and suggests that healthcare work and patient care management canprovide a unique base from which one canmake demands on the technology. The tech-nology, on the other hand, is considered sec-ondary and neutral, but none the less, some-thing one is free to make demands on, re-quirements that the technology is supposedto honour.

The idea, that technology is neutral, alsoshows in the widespread use of the term sup-port. IT should, among other things, supportthat the patients get the best treatment with-out unnecessary waiting, and support thatthey feel they are informed the best way, justas it should make administrative work andresearch more efficient (1996:33). It is un-mistakable that the unique features of thework are mixed up with images of the tech-nology and what it can do, even though thereport does not recognise this paradox. Whatis described as the subject, the unique fea-tures of the work, is thus replaced with thesecondary thing, the object, as technology isregarded as the medium that guarantees theimprovements.

This move is also at stake in the discus-sion of one of the important concepts in thereport, the handling of patient trajectoriesthat the EPR should be made to support.




“A trajectory of a patient can be seen from diffe-rent points of view. For instance a health profes-sional, an administrator, or the patient can eachhave their own perspective that again might varydepending on where they are situated within the‘system’. Different levels of details are also atstake. Does a trajectory of a patient consist in asequence of events (visitations for instance),which can be related to certain states (illness/di-seases ex), and actions (nursing for instance)? Itis not simple to find an unambiguous definition.”(DSI 1996:44)2

The quote demonstrates a subtle move fromrecognising the heterogeneity in the work tothe need for a homogenous and unambigu-ous definition that a computer can under-stand. The position is that “design of a usableEPR is not just a task for informatics butmostly a question of understanding healthcare work practices.” (DSI 1996:44). It re-cognises that social and organisational as-pects of work practices are important in in-formation system development and evenstates that these aspects are the most impor-tant in order produce the best fit between thetechnology and the work.

The approach can be called a modern so-ciotechnical approach as it builds on a sub-ject – object dichotomy and an a priori dis-tinction between the social and the technical.The idea of the technical is similar to a for-mal approach, while work and organisation-al aspects are described as belonging to an-

other domain. The metaphor bridging de-picts a politics of incorporation that presup-poses two separate domains and still under-stands technology as neutral. In order to dothe bridging, medical informatics needs abroader definition of the EPR-concept thanthe strictly technical. The report names it aholistic picture that can be broken down indifferent points of view: patient care manage-ment, a problem-oriented approach, ethics,organisation and information technology(DSI 1996:20).

The amodern approach can also be termedsociotechnical, but the politics of incorpora-tion is very different. The principle of sym-metry involves giving up on the idea that so-ciety and nature a priori belong to two onto-logically different domains. Action is nolonger a human privilege, and the subject-object dichotomy is replaced by humans andnonhumans that constantly interact in collec-tives. Metaphors or concepts such as media-tion, translation, folding, modification, andtransformation emphasise that no one is leftuntouched by the encounter, and neither isthe one reduced to the other.

Both the modern and the amodern ap-proach and not least the tension betweenthem are important in clarifying and develop-ing our frame of description and the idea ofthe electronic trading zone. By rejecting theidea of translation and the symmetrical ap-proach to humans and non humans, Galisonstays within a modern approach. It remains tobe seen where our experiences with studyinga naturally occuring experiment at a localward and our experiments with ‘electrifying’the trading zone will take us.

46

2 In Danish: Et patientforløb kan anskues ud fraforskellige synsvinkler, fx vil en sundhedspro-fessionel, en administrator eller patienten havehver deres perspektiv, som igen vil variere, altefter hvor de befinder sig i “systemet”. Der erogså tale om forskellige detaljeringsgrader. Detenkelte patientforløb, består det af en række be-givenheder (fx visitation), der igen kan relaterestil tilstande (fx sygdom) og handlinger (fx pleje).Det ligger ikke lige for at finde en entydig defi-nition på patientforløb.


References Berg, Marc. 1998. Order(s) and Disorder(s): Of

Protocols and Medical Practices. In Diffe-rences in Medicine: Unravelling Practices,Techniques and Bodies. Edited by M. B. &.A. Mol. Durham: Duke University Press.

Berg, Marc and Stefan Timmermans. 2000.Order and Their Others – On the Constitutionof Universalities in Medical Work. 8 (1): 31-61.

DSI Rapport 96.06 1996. Elektronisk patient-journal: Hvepsprojektet – erfaringer og per-spektiver. København: Institut for Sundheds-væsen.

Dybkjær, Lone and Søren Christensen. 1994.Info-samfundet år 2000 – Rapport fra udval-get om informationssamfundet år 2000. Kø-benhavn: Forskningsministeriet.

Dybkjær, Lone and Jørgen Lindegaard. 1999.Det digitale Danmark – Omstilling til net-værkssamfundet. København: Forsknings-ministeriet.

Galison, Peter 1997. Image and Logic – AMaterial Culture of Microphysics. Chicago:University of Chicago Press.

Gooding, David, Trevor Pinch & Simon Shaffer(ed.), 1989. The Uses of Experiment – Studiesin the Natural Sciences. CambridgeUniversity Press.

Hacking, Ian 1988. Philosophers of Experiment.In Arthur Fine & Jarrett Leplin (ed.) The 1988Biennial Meeting of the Philosophy ofScience Association. Evanston, Illinois: PSA,p. 147-156.

Knorr Cetina, Karin 1992. The Couch, TheCathedral, and the Laboratory – On theRelationship between Experiment and La-boratory in Science. In Andy Pickering (ed.)Science as Practice and Culture. Universityof Chicago Press, p. 113-38.

Knorr Cetina, Karin 1999. Epistemic Culture –How the Sciences Make Knowledge. Cam-bridge, Mass.: Harvard University Press.

Latour, Bruno. 1986. The Powers of Association.In Power, Action and Belief. Edited by J. Law.London: Routledge & Kegan Paul. 264-80.

Latour, Bruno. 1999. Pandora’s Hope – Essayson the Reality of Science Studies. Cambridge,Mass.: Harvard University Press.

Lykke, Nina, Randi Markussen and Finn Olesen.2000. There are always more things going onthan you thought! – Interview med DonnaHaraway. In Kvinder, køn og forskning. 9 (4).

Markussen, Randi, Finn Olesen and Nina Lykke2000. Cyborgs, Coyotes and Dogs. A Kinshipof Feminist Figurations. Interview medDonna Haraway. In Kvinder, køn og forskn-ing. 9 (2).

Masten, Jeffrey, Peter Stallybrass and Nancy J.Vickers. Introduction: Language Machines inJeffrey Masten, Peter Stallybrass, and NancyJ. Vickers (eds.). 1997. Language Machines –Technologies of Literary and Cultural Pro-duction. London: Routledge.

Mortensen, Randi 1996. Et fælles fagsprog isygeplejen. I Den internationale klassifika-tion for sygeplejepraksis ICNP. Vojens:DISS.

Olesen, Finn. 1996. Konstruktive studier af vi-denskab og virkelighed – Fra sociologi tilkulturforskning. In Philosophia 25 (3-4): 9-44.

Smith, Barbara H. 1997. Belief and Resistance:Dynamics of Contemporary IntellectualControversy. Cambridge: Harvard UniversityPress.

Star, Susan Leigh & James R. Griesemer 1989.Institutional Ecology, ‘Translation,’ andBoundary Objects – Amateurs and Profes-sionals in Berkeley’s Museum of VertebrateZoology, 1907-1939. In Social Studies ofScience, vol. 19, p. 387-420.

Sundhedsstyrelsen 2000. Forslag til grundstruk-tur for udveksling af oplysninger i ElektroniskPatientjournal. København: Kontor for Medi-cinsk Informatik.

Todd, Loreto, 1990. Pidgins and Creoles. (2.ed.) London: Routledge.



SummaryBased on an ethnographic fieldwork the article analy-ses the experiences of 8-10 year old children in threedifferent institutions. It is shown how the children cre-ate and maintain different social landscapes in eachsetting. This means that children’s experiences are re-lated to the position they have in the landscape.

The notion social identity is used to discuss andexplain these findings. With this notion identity isexplained as an interplay between internal and ex-ternal factors: between group-identification and cat-egorisation. Children’s different identities in differ-ent settings are not created by children themselves,but must bee seen in relation to the categorisationused by the adults to classify children. The profes-sional categorisations of children are a central partof the social space in relation to which children act,talk, and play.

Introduction

This article analyses the relationshipbetween children’s experiences andtheir institutional context. Through a

comparison of children’s experiences in dif-ferent institutional settings I will argue thateach setting creates different social spacesand thereby different possibilities of socialidentity for the children. My purpose is toshow that to act, talk and participate as achild is closely connected to the social andsymbolic context of the setting.

The empirical findings and analyses pre-sented in this article are part of my ethno-graphic Ph.D. study, which has as its purposethe analysis of interpretations of childhoodin three different Danish institutions: A chil-dren’s ward in a hospital, a school, and an af-ter-school-institution. I have, through a 13months fieldwork, followed 8-10 year oldboys and girls and their professionalsthrough these institutions. The study is basedon sociological and anthropological discus-sions of ‘the childhood-paradigm’, of whichtwo main theses are that children should beseen as social actors, and that childhood canbe viewed as a social construction (see forexample James, Jenks and Prout 1998).

According to Berry Mayall, who also stud-ied children in different contexts, the specialthing about studying children from a socio-logical perspective is not that they act differ-ently in different settings and situations. Thesame is true for adults. Studying children, sheargues, is special because of their dependenceon adults, and mostly adults with certainknowledge and ideas about children andchildhood. Children are always in one or an-other way engaged in intergenerational rela-tions (Mayall 1994). Every institutional set-ting with children bears this relationship, andit is here that my focus is placed.


Susanne Højlund

Social Identities of Children in different

Institutional Contexts


Susanne Højlund: Social Identities of Children in different Institutional Contexts

Analytically I construct ‘childhood’ as ameeting between three different forms ofknowledge (Barth 1989,1995): Children’sexperience-near knowledge of being a child;adults’ professional knowledge about how toteach, bring up and take care of children; andthe discursive and collective knowledge insociety, which among other things decidesthe policy of the institutions. In my study Ianalyse how these 3 levels are connected. Atthe child-experience level I concentrate onthe different perspectives arising when tryingto understand what is important for the chil-dren at each institution. At the professionallevel I look at how children are categorisedand valued and how the adults, through theirpractise, communicate this categorisation tothe children. At the institutional level I take ashort insight to the official documents aboutthe purpose of the institution.

Throughout the article most attention willbe placed on the children’s very different ex-periences at school and in the after-schoolinstitution. In the concluding section I makesome connections with the two other ‘child-hood-levels’ in order to show that the per-spectives of the children not only inform usabout their lives, but also tell us about whichideas of childhood the institutions are prac-tising. This illustrates the social constructionof childhood and emphasises that ‘the child’is not a universal phenomenon, but a socialcategory which must be understood in rela-tion to place and space.

Children’s cultural knowl-edge about the social land-scapes of the institutions

Ibegan my fieldwork at the hospital,where I was for 4 months before I wentto the school. The school-study took

place in a class (3.klasse) with 18 children(8-10 years old) in a big city in Denmark. I

followed the children’s school day for sixmonths, then gradually expanded the field-work to the after-school-institution (inDanish: SFO), where I followed the childrenfor further 4 months.

When I moved from one institution to an-other during my fieldwork, I had to ask my-self every time: What is it that these childrenknow about the life here, that I don’t know?I was often surprised at how easily theychanged behaviour in relation to the settingthey were in. For example at the hospitalCarina was very quiet when doctors andnurses were in the room, but in relation to meshe was lively and open, asking a lot of ques-tions and in the hospital-school she wasprotesting frequently in opposition to herteacher. I wondered how and why the differ-ent professionals (both the nurses, the teach-ers and the pedagogues) during her staycame to an agreement on Carina’s personali-ty, while I saw more and more differentCarinas. I had several of these experienceswith the children, as McDermott describeshis Adam (McDermott 1993): At school younever heard or saw Mikkel, but in relation tome he had a lot to tell, and when observinghim at the after-school institution, I wrote inmy diary: “Is this the same boy as the Mikkelin school? – I can’t recognise him. He isplaying football and acting and shouting as Inever saw it in the schoolyard.” Time aftertime I thought, that I had grasped the normsand conventions which the children organ-ised their life around, and time after time Ihad to admit, that I was incompetent in my‘feel for the game’, as Bourdieu puts it. Atthe hospital I couldn’t see gender for in-stance, but when entering the school therewas gender-separation everywhere. I thenthought that I had not been clever enough toinvestigate this at the hospital, but followingthe same children to the after-school institu-tion, I was surprised yet another time. Girlsand boys who in school said that they hated

50


each other and who would not engage in anycommon activities there could often befound in the after-school institution playingand chatting together.

When I asked the children in the differentsettings if they could tell me about the ruleshere, I always got very detailed answersabout where children are allowed to be, whatmakes the teacher angry or which rights chil-dren have or do not have. Two boys ex-plained to me at the hospital: “You are not al-lowed to leave the ward, you can’t enter theoffice, and you have to be very quiet here.”“Did anyone tell you?” I asked. “No, do youthink we are stupid? We just know!” was theanswer. It is this ‘knowing’ how to move, be-have and orientate oneself in each setting Itried to follow.

During my fieldwork the children oftenreprimanded me, when I did not follow theseimplicit rules: “You can’t put your jacketthere” some girls told me on my first schoolday. “That’s the boy’s rack.” When playingtable- tennis I was instructed to shout at theplayer who won, and in the after-school-in-stitution I was told that girls only can use theboys’ toilet when it’s not school-time. Thechildren had a knowledge of implicit rulesand norms that I often lacked. Their sociallife was not spontaneous and their play wasnot totally ‘free’. Something organised theiractivities and mutual relations – and this tac-it organisation changed from institution toinstitution. The focus of my participant-ob-servation was to grasp parts of this culturalknowledge (Hastrup 1992).

Obviously the children shared a knowl-edge about the elements in these processes.But this shared knowledge did not mean thatthey used their knowledge in the same way.In other words, children’s experiences can-not be represented from one position, calledchildren. What the children also knew wasthat norms, rules and rights are distributed.Some children can act, talk and break the

rules when others cannot. It is this distribu-tion that differs from setting to setting. WhenJannie told me about how to play table tennisin the right manner, it is worth noting thatshe never played the game herself, onlywatched. When 8 year old Sara told me at thehospital in detail about her heart disease, andI expressed surprise at how well-informedshe was, she answered: “Nobody ever toldme. But I usually don’t tell what I know toany adults. They don’t think, that I knowabout it.” When I observed that Mikkel wasmostly quiet at school, or Carina was thesame at hospital, but they both had a lot totell me about life and things there – it was notbecause they did not have the ability to talkor reflect, or because they had a very person-al relationship with me. They just knew thatnot everyone can talk, ask or say what theywant everywhere. They knew when to showand use their knowledge and when not to.This is not only a matter of individual differ-ences or choices, or only a matter of beingpositioned as ‘child’. Every setting showed adistribution of children, a social landscape ofdifferent categories of children.

In order to analyse and explain this phe-nomenon I have used the notion social iden-tity (Jenkins 1996). Identity, viewed from thistheoretical perspective, is a social process.This means firstly, that it is based on socialrelations, and secondly that it is changeable.In addition, it has two dimensions: an inter-nal dimension, which is based on group-iden-tification, and an external dimension, whichis based on categorisations defined by others(ibid). Using this notion to analyse the field-data, it becomes important to look at the chil-dren’s cultural knowledge as knowledge ofhow to create, maintain and separate groups.In the following section, I will describe sometypical group-processes from the internalperspective of the children. The first part de-scribes children’s experiences at school andthe next part follows the children at the SFO:




Being a school-child:three typical perspectives

The teacher had asked the children todo push-ups for two minutes in orderto increase their heartrate and after-

wards to count it. A large group of girls didthe push-ups lying on the floor close together.They did the exercise in time with each otherand counted the numbers loudly in harmony.Thereby they finished at the same time, andsaid to the teacher: “We got 77”.

The boys on the other hand, did not sayanything, but worked intensively one by one.Afterwards most of them shouted to eachother: “I got 80, how many did you get?”And a quarrel began about cheating with thecounting, and who was the fastest.

A first impression of this scenario is thatthe class is divided into two groups: boys andgirls. But there were also boys and girls whodidn’t say anything, did not quarrel and didnot do push- ups in time with the others.

This 3-parted division of the class wasvery typical: girls, boys and outsiders. Thisdivision, was not only around the gender-boundaries but also around being popular ornot. I shall in the following describe each ofthem.

A gender-perspective – belonging to thegirl’s group:Most of the girls defined themselves explicit-ly with gender, and this definition was oftenused to focus on and maintain equality.Therefore when doing push-ups they did notcompete, but did the same number. The “We– got 77” referred to the sameness and this‘we’ was often used to explain things to meabout school-life, or to explain differencesbetween groups, as in the following example:The class had been outside doing experimen-tal mathematics. Four girls had finishedquickly and were asked by the teacher to goto the class and continue with written mathe-

matics. Tom entered the room and said tothem: “I don’t understand how you can bebothered to make extra mathematics”. Katri-ne answered him: It’s because it’s only girlswho feel like doing that, boys only want tomake noise and trouble.”

The boundary around this group was de-fined by separating, verbally and bodily fromthe boys. From this perspective the worldwas divided into ‘us’ and ‘ them’ – girls andboys. These girls seemed to have a mutualsilent contract to fight against boys at everypossible moment, as in a PE lesson where allthe children were standing in a circle andplaying ‘tik’, a game where you must catcheach other. When a girl was the leader sheonly chose girls as the next leader until thegame broke down because the boys started toprotest against their exclusion. During les-sons when asked to divide in groups, thegirls would always make girl-groups, andprotest loudly if the teacher forced them tomake groups of both boys and girls. Duringthe fieldwork I too was drawn into this girl-world because of my sex, with lots of in-structions about where to sit and who to playwith in the breaks, as Maria told me: “Youare a girl, then we shall play together in nextbreak.” In the lessons these girls could man-age to communicate silently with each otherwith signs and small letters behind the teach-ers back. They were very much aware of therules of being in the class-room without dis-turbing, but that did not mean, that they did-n’t do other things to avoid boredom. AsMaria explained to me: “I can look like I amthinking of mathematics (then she shows mehow to count on her fingers) but in reality Iam thinking of Spice Girls.”

An individualistic activity-perspective –belonging to the boy’s group:Another group was defined explicitly aroundinterests and knowledge, especially aboutfootball, computer-games and video-films.

52


This group was made up of boys, but theydid not define themselves in terms of gender.Here you are not ‘we’ but ‘I’. The group wastied together by a common focus on thegroup-member’s abilities and courage to com-pete with each other – to show each otheryour individual differences.

In any given break these boys played foot-ball and once I tried to become a member oftheir team. In the process of negotiating mypossible membership, I was not evaluated bymy sex, but for my abilities. Among the boysthere was a discussion about whether I couldplay, and they allowed me to participate as agoalkeeper because I once had been a hand-ball keeper. The few times I was allowed toplay, I learned that while walking off thepitch you had to evaluate each other and tochoose who played the best, and often I wasasked: “Who did you think was the bestplayer today?” I had to suppress my (adult orgirlish?) desire to say that ‘they were all justas good as each other.’ Instead I had to trainand learn how to evaluate good kicks andtackles.

These boys were acting more like individ-uals showing each other their personal qual-ities. There was a daily exchange of infor-mation between members of the group aboutsport-results and the latest videos. This wasalso the case during lessons, with no atten-tion to the teacher’s demands for silence andwithout considering the rest of the class.Their individual interests and immediatecommitment seemed to be of first priority,while being told off did not seem to botherthem. The experiments in a science-lecturecould absorb them completely, as could themusical instruments in the music-room, eventhough the teacher would be asking them tosit still, wait for further instructions or stoptalking.

As Berrie Thorne points out, this pictureof boys and girls seems like a stereotypedpresentation emphasising gender difference.

She believes that these two perspectives arevariations of the same story: Different waysof acting as a popular child (Thorne 1993) –or I would say ‘pupils’. There are other chil-dren in the classroom, and they do not dividethemselves into gender-groups. They aresimply without group-attachment.

A ‘loner’ perspective – being a silentobserver:This third perspective in the classroom, wasfrom what I call ‘the silent observers’ or whoin other studies are called ‘the loners’ (Cor-saro 1997:157). They were both girls andboys and they did not relate to each other asa group. Their experiences, however, werenot individual, but had many common char-acteristics, showing a common conscious-ness of their position. Often Mikkel told me:“Do remember to write in your book, that Ihave got no friends.” In this way he told methat he stood outside the group community.These children were, according the chil-dren’s own accounts, excluded for differentreasons. In relation to the boys, it was withthe argument that “he hasn’t got football onhis brain”. Concerning Jannie the other girlssaid that “she preferred to walk alone”.According to these girls, Jannie did not ac-cept being a member of the girls-club.

It was these children who showed the mostinterest in being interviewed by me and I of-ten was surprised by their reflectivity, flow ofwords and knowledge about the social lifeand its implicit rules. Especially becausethese children most of the time at school weresilent, when they did talk, they spoke quietly.In relation to the teachers they were nevertold off, perhaps because these children nev-er disturbed the class by shouting, talking,moving around or engaging in inappropriatebehaviour. Throughout the interviews I per-ceived that they were very much aware of theimplicit rules, both in relation to the otherchildren and their teachers, but this know-




ledge did not make it possible for them to act,talk and participate in the same way as theother children. Another common characteris-tic of these children was that they needed ex-tra help either from the teacher or a special-needs class. Mike reflected on this in a waythat showed that according to him you can’tboth be in need of extra help AND be a pupil,who is wild and gets told off at the same time:He said: “I’m not wild, I don’t get told off.But I get a lot of help.”

With these short insights into school-lifefrom children’s perspectives I want to em-phasise that being a child in this institution isvery different depending on which angle youare looking from. In this class, three per-spectives dominated and this distribution ofchildren determined the different ways of or-ganising activities and relations both withpeers and with teachers.

Being an SFO-child

The interesting thing is that when fol-lowing the same children across thecorridor into another institution – in

Danish called SFO (school-free-time-ar-rangement), the distribution of childrenchanged. There was a different choreographyfor the activities, with about 125 childrenaged from 6 to 11 years old being together in5 different rooms with 2 pedagogues in each.Most of the time, however, the children usedthe whole institution, the playground, thekitchen and the different activity-rooms.

The children explained the SFO to me inthe following terms: “Here the adults cannotforce us to do anything.” – “We can decideourselves what to do”. “We have to playhere”. “At school the adults decide every-thing – in the SFO we ourselves decide whatto do”.

These headlines of free choice and freeplay however, did not mean that what thechildren did at this institution was without

structure or rules. Hilde Liden notes in herstudy of children in the same type of institu-tion that it is often taken for granted that chil-dren’s free play is chaotic and in oppositionto the structures made by adults in order toorganise children’s lives (Liden 1994). Butwhen adults do not structure the time andspace of everyday life, children make theirown ways of organising their social life, ar-gues Liden (1994). I will add that this organ-ising at the children’s level is not only thechildren’s own work, but has to do with thesocial space in which this takes place.

But firstly, we have to look at how chil-dren at an SFO organise their everyday life.Following the children from third grade, Iwas at the beginning of my fieldwork veryconfused. Life at the SFO seemed withoutproblems; more than 100 children movedaround in the institution, playing, shouting,laughing and walking around in smallgroups. I saw adults playing together withthe children and many different types of ac-tivities taking place at the same time. Youcould bake in the kitchen, roll on roller-skates, go to the swimming pool, look atvideos, play table-tennis or football and lotsof other things. Obviously the choice was‘free’, nobody had made plans for the chil-dren except for two daily arrangements: chil-dren had to stay outside for half an hour justafter school-time, and they had to participatein an ‘assembly’ in their particular room toeat at two o’clock.

I spent a long time wondering how thechildren here worked out what to do and whoto be together with, since nobody told them.Should one choose playmates and activitiesfrom the beginning every day?

Being together and attached to a groupseemed to be a fundamental way of being inthe SFO for the children, but how were thesegroups decided and maintained and whatwas their inner content, I asked myself?From my field-material I identified 4 differ-

54


ent forms of groups in which the childrenfrom the third grade were involved:

In friend-groups it is decided beforehandwho to play with. What to do in this group isnot the most important thing. As a girl ex-plained to me: “We are always playing to-gether the four of us. What we are going todo together – well, we don’t decide, it justcomes to us”. When following these 4 girlsin the institution I saw, that they were able tomaintain their group wherever they were,and they could change activities from mo-ment to moment. But they never invitedother children into their group.

Another form of group had common inter-ests for a game as a focus, such as football orSpice Girls. Children who had the abilities,knowledge and interests in this activity weremembers and they were aware of this.Therefore they did not need to make ap-pointments with each other. When one ortwo started the game, the other potentialmembers of the group would show up andjoin in without negotiation. They were ac-cepted in advance. This group was main-tained by two types of activities: playing thegame (football, or being a music-group forexample) at a certain place in the institution,and exchanging knowledge, photos and newsabout their idols whenever they met duringthe day.

These two types of groups were normallyeither all male or female, whereas the twofollowing group activities could be arrangedacross gender-boundaries:

The spontaneous activity group was oftenarranged at school in the morning, as Ina andMarie did in a break where I heard them ar-ranging a treasure hunt for the boys the sameafternoon. When I arrived later at the SFO,the two girls were together with two othergirls planning tasks for the boys. Two dayslater both girls and boys were engaged in thishunt, and afterwards they continued to set upother competitions.

Another day I found both girls and boysfrom the class sitting close together in theplayroom in a coach talking about love.Afterwards they began to play hairdresser,continuing for the rest of the afternoon tocreate fancy hairstyles for each other – bothgirls and boys. To exclude other childrenfrom this kind of group, the children oftenchose rooms and places at the institution thatwere defined as ‘private space’ – for examplein the playroom where the children were al-lowed to lock the door, or behind the littlewood outside, where adults seldom came.This signal were understood by all the chil-dren.

The last form of group among these chil-dren was created around a common condi-tion – perhaps boredom or being restless.Again, the use of space in the institution wasa signal to the other children about howstable the boarders around the group were.Both boys and girls could hang around insmall groups, typically in the areas with a lotof traffic moving up and down the corridors.It looked as if the inner meaning of thesegroups was: Let’s see what happens. Thesegroups could be interrupted and changedwithout conflict, which suggests that theboarders around them were very unstable.You could meet somebody, and they wouldperhaps invite one from the group to playtable-tennis, and so the group would be bro-ken up.

These examples show that the childrenmanaged different forms of being togetherand that they knew how to create small is-lands in the institution where 3, 4 or 5 chil-dren could play together without being dis-turbed by the other 135 children or theadults.

But through the fieldwork and the follow-ing analysis it became increasingly clear tome, that this was only one perspective of be-ing a child in the SFO. And again this is theperspective of the popular children, the chil-




dren with the most power and possibilities toact and negotiate with the adults, which theydid daily, for example, by protesting againstthe rule of ‘assembly’.

That the SFO was experienced from otherperspectives was hidden to me for a longtime, because I only followed the 8-10 yearold children. But by becoming aware of howthe children valued play-things and spaces inthe institution, I came to see that the 8-10year olds, or more correctly ‘the childrenfrom third grade’, held a special status in theinstitution. And I realised that most of thesechildren did not include younger children intheir groups.

When I spoke with the children about theSFO, it was often repeated to me that thefunny thing about SFO is to ‘have’ the play-room or the swings for example. “It is funbeing here when I get the swings.” With thislittle word ‘to get’ a thing, I became aware ofthe daily silent fights in the institution to getthese things and the different techniquesused to occupy a room, a bicycle or a swing,since 140 children could not all have thesame popular play thing. To be the first, to bemany wanting a thing, or to hold things foreach other were some of these techniques.But the easiest way to ‘get’ a thing or occu-py a space was simply to be a child fromthird grade: The oldest children in the insti-tution. Eva explained this to me when Iasked her how to get a swing: “The big chil-dren can always have one. We can alwaysforce the smaller children to leave.” Over thefollowing days I observed that she was right.I some times placed myself near the swingsin order to find out how to get one. A typicalsituation:

Four third grade girls from the friend-group came running to the swings. One wasfree, so Eva started to swing. The other threegirls were running around her, chatting andlaughing. Smaller girls were swinging on theother three swings. When the friend-group

entered the area, the smaller girls stoppedtheir activity and watched. One left herswing silently and Caroline – another girlfrom the friend-group – took over. These 4girls never stopped their activity to watch thesmaller girls.

Being an audience was a typical role forthe smaller children in relation to the chil-dren from the third grade. When the Spice-Girls group, for example, was doing theirtraining, chairs were arranged for the audi-ence, which mostly consisted of youngerchildren. These 6-8 year old children did notuse the institutional space in the same way asthe third grade children, and in relation to theadults they were not negotiating and protest-ing as the older children were. Often theyoungest children were sitting around a tablein the room with a pedagogue, making draw-ings or cutting with scissors. In the play-ground the younger boys never entered theolder children’s football area, but stayed intheir own smaller pitch.

After these analyses I now understoodbetter why Mikkel at the SFO was differentfrom the Mikkel at school, as described ear-lier. At school I have described him as one ofthe ‘silent observers’, in need of extra helpand outside the popular groups during play-times. The earlier example where I observedhim at the SFO was while he was playingfootball: but it is worth noting that he did notplay on the football pitch where childrenfrom third grade normally played. He playedwith the younger children. And in relation tothem he – in this institution – had the powerto shout, run and be the leader of the team.And this is perhaps why I never saw Jannieand Mikkel playing together with their ownclassmates, but seeming to prefer playingwith younger children.

The SFO seemed to offer more possibili-ties for the third grade children to engage indifferent group activities. The popular chil-dren did not make two groups with strong

56


boundaries as they did at school, but seemedto make more flexible groups. The lonersfrom school were still excluded from theirown classmates, but had status in relation tothe younger children. According to these ex-periences at the children’s level, a central,but tacit principle of organisation in the SFOwas that of age. The talking, acting, protest-ing, negotiating and occupying-things, and-space were reserved for the oldest children.

The external dimension

The children’s experiences show thateach institution has tacit rules whichdistribute the children into a social

landscape of differences, split them up intogroups and loners and make distinctions be-tween who has status and who has not. Orwho is competent and who is not. Who cantalk and act and who cannot. The analyses ofthe fieldwork at the hospital concludes, likemany other researchers have found (see forinstance Davis 1982, Aldersson 1993, May-all 1994, Bluebond-Langner 1978), that thehospital setting does not show many varia-tions in the social landscape of the children.It seems as if only one position is possible:Being incompetent, silent and unknowing.

My argument is, that these different formsof social organisation, of having status ornot, cannot in isolation explain the character-istics of children. Even though the childrenat the SFO describe themselves as ‘free’ todecide, what they want to do, this is not to-tally ‘self-government’. The children refer toa ‘we’ and thereby to a collective under-standing (Corsaro 1997) and not to the pos-sibility of individual choices: they don’t say‘I’ am free to decide, but say ‘we’.

To understand the different social identi-ties that the institutions offer the children, itis necessary to include the external perspec-tive (Jenkins 1996), represented here by theprofessional adults. To explain their role in

relation to the children I will refer toBourdieu’s concept of ‘social space’. Ac-cording to Bourdieu, your position in the so-cial space has to do with which kind of offi-cial acknowledgement you possess, in histerms ‘symbolic capital’. Thus in a socialspace you have value-systems which definehow groups are related, their mutual powerrelationship and the actors’ right to speak.These value-systems are built upon officialallocations of acknowledgement; a diplomaand a good mark are examples of allocationof symbolic capital. Actors in the space, hav-ing the most symbolic capital, also have themost power – which among other thingsmeans that they have the right to define cate-gories in the space (Bourdieu 1990). Thiscategorisation is communicated to the chil-dren throughout their daily practise. Teach-ers and pedagogues possess the official au-thorisation to allocate acknowledgement to,and take it away from the children. This hap-pens daily in public – by praising them, giv-ing them awards, telling them off, decidingsanctions and punishment, giving or takingrights, making rules, deciding who can talk,and so on. The children are judged in publicaccording to their behaviour and – especial-ly at school – also according to their intel-lectual performance. These judgements arenot only supervised by the adults’ individualknowledge about children, but are related tothe professionals’ institutional duties, theireducational background, collective and per-sonal understanding of childhood and the in-stitution’s official ideas of what the purposeof working with children is. When investi-gating, by interviews and observations, howthe professionals administered this knowl-edge, it is striking how closely the children’sexperiences of different social landscapescorrespond to the professionals’ ascribedvalues or capital.

At school I asked the teachers if theycould identify any groups in the class. They




then divided the children into three groups,identical to the perspectives which I de-scribed from the children’s level: girls, boysand ‘the weak children’ as the teachers calledthem. A female teacher said to me: “Thereare the children with abilities and willing-ness. Then there are the children with abili-ties, but without willingness. And thirdlythere are the children, who have the willing-ness to learn, but not the abilities”. In hervalue-system, two criteria were important:Ability and willingness. In the teachers’practise in general, you could find thesevalues as a foundation for the public distri-bution of capital to the children. The girls,for example, were often given positive atten-tion because of their good behaviour. Theteacher used their obedience as a good ex-ample and often placed the girls in the class-room between some boys to help quietenthem as seen, for example, when a teachersaid to Katrine after a boy complained thatshe hit him with a pencil: “I understand you,Katrine, he is in fact intolerable”. The ‘un-willing’ boys were often told off, excludedfrom the classroom or isolated on a single-seat. But, on the other hand, they were oftenpraised for their schoolwork like the girls,and in addition they enjoyed a more implicitacknowledgement from the teachers, who infact liked the boys being a bit naughty andwild. “It would be boring to be a teacher ifeverybody were like girls” a teacher told me,and added; “The Danish school-systemshould not be like the English with all thatdiscipline”. Often the male teacher duringlessons referred to the ‘old days’ with funnystories, emphasising his own role as ‘rule-breaker’. So if you just show some intellec-tual abilities, it is OK for a boy sometimes tobe a rule-breaker – that seems to be the sig-nal, that the teachers communicate to thisgroup. The third group, with learning dis-abilities did not receive much capital fromthe teacher, even though they did not break

the teachers’ rules of good behaviour. Theywere not used as good examples for thenoisy boys, they were not praised in publicfor their willingness. And when the teacherdistributed praise or reprimands for good orbad spelling or counting, they were not evenmentioned.

At the SFO, the children’s abilities tolearn were not an important value. Here thepedagogues expressed freedom (in opposi-tion to schoolwork), being happy and play-ing without adults nearby as important. Amale pedagogue explained to me: “Modernchildren are too much kept under surveil-lance. Therefore we have made a lot of spacefor the children, where they can be them-selves.” The pedagogues often referred totheir own childhood with examples of themother ‘just being there’ but not interrupting,and comparing the institution with a ‘home’.Free choice and independence from adultswere central and often cited values.

As in the school, these values were as-cribed to the children in a way that reflectsthe division of children I have described,separating the big from the small. During theinterviews the pedagogues often referred to‘big’ and ‘small’ children. When I askedthem what separated the two kinds, they al-ways gave me answers including indepen-dence, as in this statement: “I like the oldestchildren the best. They only come to us ifthey need help. But most of the time they justplay themselves. And in this institution, theycan be totally themselves.”

The pedagogues used other techniquesthan the teachers to communicate their value-system to the children. They seldom told thechildren off, and made only few explicitrules for proper behaviour. But they gave thechildren from the third grade more rights inthe institution, more responsibility and werenot watching them as much as the smallerchildren. These children, for example, had adaily duty to make toast for the rest of the in-

58


stitution (a rule which the children did notprotest against). And the adults arrangedmeetings, especially for the third-grade chil-dren, where they could express their wishesabout forthcoming arrangements. Parallel tothis, the adults accepted the oldest children’sright to decide for themselves. Ken, for in-stance, always made his own toast when hewas hungry. And these children often suc-ceeded in their attempts to avoid ‘assembly’. I once asked the manager of the institution ifhe had ever thought of making rules for howto get a swing, or other popular things. Heanswered: “Well, we don’t need to. Thesmall children will be big – as time goes by.”In this institution status (and independence)come as a natural thing – as you grow up,while status at school is something you fightfor and deserve.

Putting the study intoperspective

Currently there is a public debate inDenmark about how to create con-nections between the different expert

systems and institutions which have childrenin their care. The official argument is thatchildren need a more coherent daily-life.Within the school-system there is a historicalchange on its way, where schools and after-school institutions are going to be united –called the ‘unified school’. It is not clear, however, whose need this co-herence meets. Obviously it is a need formu-lated by adults and not based on research try-ing to understand the children’s experiencesin the institutions. According to my study,some children can use the different socialcontexts of the institutions to change theirsocial identity, to gain more status and there-by have more possibilities to act, talk andparticipate in social relations. We need moreresearch that focuses on children’s experi-ences and cultural knowledge in relation to

place and space before we can know if theunifying of institutions is better for children.At the theoretical level we also need moredebate about how to interpret the changingsocial identities. Does this mean that child-hood is a purely relative phenomenon? Anddoes it mean, that children only act in rela-tion to external categorisations imposed onthem? The study reveals a need for furtherdiscussion about the connection between theinternal and the external dimensions of so-cial identity. In a time when the diagnosis ofchildren is a daily occurrence in the mediadebate and professional practice, this studypoints to a need for research into the extentto which the professional ways of categoris-ing children affect children’s possibilities todevelop their own identity.

The article is based on a paper presented atthe conference: “From Development toOpen-ended Processes of Change”, Instituteof Anthropology, University of Copenhagen,April 6th-7th 2000.

ReferencesAlderson, P. (1993): Children’s Consent to

Surgery. Open University Press, Bucking-ham.

Barth, F. (1989): The Analysis of Culture inComplex Societies. Ethnos 54 (3-4).

Barth, F. (1995): Other knowledge and otherways of knowing. In: Journal of Anthropolo-gical Research, vol. 51.

Bourdieu, P .(1990): Socialt rum og symbolskmagt. Oversættelse i: Callewaert et al (red):Pierre Bourdieu. Centrale tekster inden forsociologi og kulturteori. Akademisk Forlag.

Corasaro, W. (1997): The Sociology of Child-hood. Pine Forge Press.

Davis, A.G. (1982): Children in Clinics. ASociological Analysis of Medical Work withChildren. Tavistock Publications, London.




Hastrup, Kirsten (1992): Det antropologiskeprojekt om forbløffelse. Gyldendal Intro, Kø-benhavn.

James, Allison; Jenks, Chris; Prout, Alan (1998):Theorizing Childhood. Polity Press, London.

Jenkins, Richard (1996): Social Identity. Rout-ledge, London.

Liden, H. (1994): Barns perspektiv – de voksnesutfordring? In: Liden, Øie og Hauf (eds.):Mellom Skole og Fritid. Universitetsforlaget,Oslo.

Mayall, B. (1994): Children in Action at Homeand School. In Mayall (ed): Children’sChildhoods. Observed and experienced. Fal-mer Press, London.

McDermott, R. (1993): The acquisition of achild by learning disability. In: Chaiklin andLave (eds.): Understanding practise. Per-spectives on activity and context. CambridgeUniversity Press.

Thorne, B. (1993): Gender Play. Girls and Boysin School. Open University Press, Bucking-ham.

60


SummaryThis study contributes to the contemporary discus-sion on school drop-out. Based on ethnographic ma-terials I analyze the life contexts of working-classfamilies in Mexico. Two case-stories from these ma-terials on school drop-outs are presented and ana-lyzed here. These two young people constructed nar-rative self-understandings and orientations abouttheir lives and school drop-out in which they describetheir experiences of school as a way to participate in“multiple worlds” across different social contexts insearch of more rewarding life options than school.Confronted with collective cultural meanings aboutschool, children and teenagers are able to construct apersonal sense legitimating or resisting these collec-tive meanings. This is occurring in a situation whereimportant changes are taking place across genera-tions concerning the meaning of school resultingfrom historical, economical and national changes andfrom the ways in which people use and enact collec-tive cultural meanings about school. I argue for areevaluation of the forms of participation of workingclass families and children in school. And I concludethat we need to replace the predominant disconnect-ed understanding of the value of school learning andschool knowledge with an understanding of themeaning of school in children’s and teenagers’ par-ticipation across different contexts with different re-lations to others.

Introduction

In the current discussion on the personalimportance of school some questionshave not been addressed explicitly, such

as “Why and for what purpose does someonego to school?” and “How far should shestudy?” Different explanatory levels havebeen generated concerning these questions:at a general level, e.g. educational policies,levels of schooling and academic perform-ance are pointed out as indicators of a coun-try’s degree of socio-economic development(García & Suárez, 1996). More specific re-search was carried out during the second halfof the twentieth century concerning issuessuch as group status and culture (ethnicgroup, gender, race) as conditions that affectschool performance (Delgado-Gaitán 1994a;Gibson 1982; Hemmings 1996; Holland &Eisenhart 1990; Ogbu 1982, 1990; Pieke1991), working-class culture from whichnorms of orientation and school use emerge(Willis 1977; Biggart & Furlong 1996;Muñoz 1996), about learning favorable orunsuccessful educational practices (Fernán-dez 1986; Lichtenstein 1993; Mehan 1986;


Claudia L. Saucedo Ramos

“That world is not for me”:Constructing a personal

sense of oppositionagainst school obligations


Claudia L. Saucedo Ramos: “That world is not for me”

Perrenoud 1990; López et al. 1984, 1988),about the impact of family practices con-cerning school on the reproduction or break-down of a school tradition in each family(Connell et al 1982; Schneider & Lee 1990;Suárez-Orozco 1987), and finally about theinfluence of friendship groups on academicperformance (Rymes 1995). In this body ofresearch there were several diverse topics ofinterest, such as, school failure, processes ofadaptation and assimilation to school cul-ture, uses of school, processes of individual-ization in school trajectories, and so on.Traditional research attributed the responsi-bility for school failure to the children’s owndisabilities (see CRESAS 1982), but morerecent analyses locate the person in particu-lar socio-historical contexts and discuss thediverse socio-cultural relations and practicesinvolved in the way persons relate to school.

Two important analytic perspectives whichhave grown out of this research so far allowus to locate the relations of persons toschool. The first argues that in each particu-lar historical-social context specific practicesand meanings define someone as an “educat-ed person” or enable a person to considerhow many years to stay in school (Levinson& Holland 1996). The second perspectivenotes that each person’s school trajectory isunique. This is so because all persons havetheir own experiences in school which theysynthesize with elements from the socialcontext they live in (collective meaningsabout school, its effects on the material con-ditions of life and students’ educational prac-tices, etc.) and with subjective aspects con-structed over time (ways of interpretingmeanings, modes of reacting to school disci-pline, skills for using available material re-sources, etc.) (Charlot et al 1992; Rochex1989). A main problem to be discussed con-cerns the relation between the person and herenvironment, in this case, between the col-lective culture with certain shared meanings,

the social norms and everyday life practicesconcerning school, and the personal culture,symbols, practices and objects which everyperson constructs during the course of herschool trajectory.1

A further problem concerns what we fo-cus on when we ask why a person goes toschool: Do we focus on the school itself? Onthe family? On friends? On labor opportuni-ties? The personal sense attributed to schoolemanates from the person’s life experiencesin which school is but one context of a per-son’s social practice and not isolated fromthe other contexts she participates in. Per-sons participate in more than one social con-text, and the personal meaning of each con-text depends on its relationships with othercontexts in the structure of that person’s so-cial practice (Dreier 1999; Hojholt 1997). Inconstructing a personal culture, an individualmust weigh, relate, balance, and contrast herparticipation and concerns across these dif-ferent contexts.

In Mexico research on school phenomenafrom a cultural perspective is scarce andmostly concerned with analyzing the influ-ence of socio-economic inequalities on gain-ing access to and remaining in school. Thissocio-economic dimension is important, butit is also necessary to know a person’s mean-ings and values about school and the natureof their practical personal involvement in it.In my research I analyze how people discur-sively construct the value of school and theirdescriptions of their participation in it. I alsoattempt to identify how persons establish andelaborate relationships between interdepen-dent social contexts in their personal narra-tives. I adopt a perspective of analysis simi-lar to Phelan et al (1991) who argue that in

62

1 The concepts of “collective culture” and “personal cul-ture” are taken from Valsiner (1997). In order to analyzethe narratively constructed meanings attributed to school Iuse the concepts of “personal sense” and “personal cul-ture” as synonyms.


order to explain school dropout it is neces-sary to go beyond an analysis which onlyconsiders isolated traits like gender, race, orsocial class and instead talk about the “multi-ple worlds” students participate in every day.I also take into consideration the personal in-terpretations of the relationship between theschool and other social contexts and how per-sons identify the important influences in theirlives and in their decision to drop out ofschool. According to my interpretation, a per-son uses the shared meanings about educa-tion in a collective culture to construe a par-ticular personal sense which becomes part ofthat person’s particular experience.

In this paper I analyze the life stories oftwo young adults, Carlos and Yasenin whoquit school as teenagers. First, I briefly con-sider why I chose to work with life stories.Then, I describe some aspects of the socialcontexts in which these two young persons’working class families live in order to de-monstrate the multiple worlds they partici-pate in. After that, I analyze the life stories ofCarlos and Yasenin who told me why theyconstrued a personal sense which led them toreject school. And finally, I return to the cen-tral idea that the experience of school is con-strued across social contexts or multipleworlds in an interplay between the elementsof collective culture and personal sensewhich individual persons handle actively intheir stories.

The life story in the analysisof the experience of school

Alife story is a subjective interpreta-tive reconstruction based on a per-son’s past experiences. Several fac-

tors interact in this reconstruction: the per-son’s abilities to tell her life according to thediscursive practices in the social context shelives in; the memory filters which make herremember some things and not others; her

conscious selection to tell some aspects ofher life and not others; and even a joint con-struction of a story in which the selection ofmemories may be guided by the dialogue be-tween the interviewer and the interviewed.(Bertaux 1988; Bruner 1996; Middleton1997). When persons participate in socialcontexts, they appropriate available discur-sive structures in order to interpret their ex-periences over time. But every person assi-milates the words and discourses of othersselectively in constructing stories of theirown life (Tappan, 1991), and, as noted byWertsch (1998), narratives are cultural arti-facts persons use to establish a mediated re-lation between their own experiences and thesocial world. Narratives are collective be-cause they contain a set of meanings and re-presentations which are comprehensible tomany individuals, but persons may use themin a unique way to sketch their experiencesas being unique or to understand their socialreality. Wertsch (1998) exemplifies this bysaying that the history of national heroes, orthe narration of national emblems, are taughtin schools, and children get to know themand repeat them in a process of appropria-tion. Yet, this process is not necessarily a le-gitimization because students may believethat those stories have no value or relation-ship to their own identities as persons. Thisis a common phenomenon in the regulationof school discipline in as much as many stu-dents have read these stories or know them,but do not accept them as a guide for theirown conduct. The values of school and thespecifications of how to participate in it, aretransmitted to children and teenagersthrough socializing stories with specificgoals, but children use them in differentways and accept them or reject them throughtheir experiences as students.

There are two reasons why I chose towork with life stories. First, it is difficult tocarry out longitudinal studies which grant us




access to individuals’ personal experiencesof school at different moments in their lives.Second, in a life story a person is able to de-scribe aspects of her participation in the dif-ferent social contexts in which her life pass-es, including the school, and the relation-ships she has established between them. Indoing so, a person must necessarily use col-lective meanings to make sense of the lifeshe has led and, in particular, to configure apersonal sense about the value of school inher particular experiences.

About this studyI carried out ethnographic work in a commu-nity of families in which the father or motherare retired from or work for FerrocarrilesNacionales de Mexico (FNM), the Mexicanrailway company. The aim was to detect ele-ments of working class culture and its rela-tionship to the parents’ expectations abouttheir children’s schooling. I visited the homesof fourteen families to obtain the life storiesof the parents and one of the children in everycase. I knew several of the social contextsthey participate in, such as: the urban com-plex where these families live, their homes,and the gardens and parking zones their chil-dren and teenagers frequent to play and chat.Near the urban complex there is a park, mo-bile markets, schools (kindergarten, elemen-tary school, secondary school, technical ju-nior high school), medical centers and a com-munity center for parties. I was also able toidentify and analyze some of the practices ofsocialization in the families, schools, peergroups, and romantic relationships betweenteenagers. It is not possible to present muchof the information I have in this paper. I shall,therefore, only try to ground the stories ofCarlos and Yasenin in relation to some of thecollective meanings in those social contextsconcerning the importance of school andwhat it means to be a valuable person.

Elements of the collective culture aboutschool in a community of “railway families”The parents in this community had a longworking career characterized by employ-ment stability and rising into higher posi-tions (in general not beyond the level of awell-qualified worker and, in a smaller pro-portion, as clerical staff). In their life stories,these parents said that they were able to fin-ish no more than elementary school becausethey came from poor families and had towork as teenagers to support their parents.They emphasized that when they were chil-dren, there was no strong interest in educa-tion in their families, and they saw that assomething negative in their lives. They con-strued an image of their childhood andteenage lives as persons being determined byfamily circumstances with no possibility tochoose whether they wanted to continue tostudy or not. In these parents’ stories there isalso a strong link between the importance oftheir own job and their support for their chil-dren’s higher levels of schooling. A commonphrase was: “It is my greatest pride that myjob enabled me to give my children every-thing.” They thus linked their identity asworkers with their family and their chil-dren’s socialization. A major educational ex-pansion took place in Mexico during thenineteen seventies, and many childrengained an opportunity to stay in school formore years. Secondary school became com-pulsory in 1993 when the expectation of ahigher level of scholarship had become com-mon in the Mexican population. In their lifestories these parents used the current criteriaabout what it means to be an “educated per-son” to assess their past, and, at the sametime, they strengthened their belief that edu-cation is the key to facing the economic cri-sis in Mexico since 1980. In that sense, par-ents integrated collective meanings about thevalue of schooling with a more particular

64


personal sense derived from their situation asrailroad workers which allowed them to sup-port their children economically in schoolfor a larger number of years.

In these families a semiotic organizationaround the concept of “becoming some-body” is expressed in the socialization oftheir children with values such as individualresponsibility, being prepared to face eco-nomic crisis, supporting their families in thefuture, and having a better life than their par-ents. Regarding the kind of jobs these par-ents expect their children to obtain (middlemanagement and specialized staff), they no-ticed that the labor market demands a seniorhigh school education as a minimum. Theseparents’ stakes are focused on providingtheir children with material conditions suchas buying school tools and uniforms, lookingfor the right school, etc., and a strong ten-dency to use moralizing stories (“consejos”)with a cultural dimension which integratesemotional empathy, compassion, and familyexpectations (Delgado-Gaitan 1994b). Forinstance, a father tells his children: “I tell mychild to study so that he won’t go throughwhat I did.” In general, these parents do nothelp their children to do their homework orprepare for an examination since they do notbelieve this to be their obligation but that thechildren must be responsible and do theirpart of the deal.

These parents believe that their seventeenor eighteen year old children are not suffi-ciently grown up to work. They insist thattheir children must continue to study, and ifthe children quit school, the parents eithersearch for another school for them or forsome work oriented training. If, finally, achild decides to drop out of school, the par-ents use the expression, “The one who wantsto, studies, and the one who doesn’t want to,just doesn’t”, as an explanatory resourcewhich integrates the idea of having providedfor the appropriate conditions to study with

the perception of a lack of will in their chil-dren that makes them leave school. When theparents tell their children that they will nothave to work, the parents open spaces in timefor their children to select among an array ofeducational choices while they resign to thewill of those children who do not want tocontinue studying. The parents find them-selves actively combining parental supportwith promoting and accepting their chil-dren’s individuality.

The family works in order to be able toencourage the children’s education. How-ever, the family is not the only social contextin which the children participate, learnmodes of action, are influenced or makechoices. The children in these families go toschool as a part of their everyday life, butthey also help to clean the house, do theirhomework, and hang around with friends liv-ing in the same neighborhood. Usually chil-dren and teenagers, boys as well as girls,spend several hours outside home with theirfriends. Their parents see this as acceptableand necessary because “children get bored athome”. The pastimes of young people in-clude organizing parties, listening to tropicalmusic, watching television, playing videogames, practicing (amateur) soccer and bas-ketball in the parking lots of the neighbor-hood and chatting with their friends. Affairswith a boyfriend or girlfriend are very im-portant for teenagers around eleven or twelveyears of age and sometimes end in prematurepregnancies. Teenagers may also have for-mal and informal jobs from an early age on(approximately the age of thirteen), for ex-ample as packers in supermarkets, groceryand stationery store clerks, in mobile mar-kets and in helping neighbors dispose oftheir garbage. For these young people thevalue of work is associated with the possibil-ity of buying sport wear, trainers and shoesof well-known brands which their parentssay they cannot afford.




In the schools I visited, elementary and sec-ondary school teachers share a negative vi-sion of the railway families. They think thatthe children from these families are problemchildren, bad students, and that their parentsdo not help them to study nor take care todiscipline them. At the same time, theseschools have major deficiencies in their ownsystems of pedagogy and in their organiza-tion of discipline. Punishments, low gradesand expulsion are common recourses in deal-ing with “bad students”. The teachers’ nega-tive representations of the children from rail-way families prevent them from noting theexamples of good students (whom I do notanalyze in this paper) who continue to studyin high school or even at a major university.Every day these children and teenagers par-ticipate in the different social contexts previ-ously mentioned. They learn to establish re-lationships between those contexts, to com-pare the different options of participation, touse the available resources and to look forplaces where they are recognized as valuablepeople or acquire different kinds of skills.Their personal sense of school begins to un-fold with their appropriation of the represen-tations adults transmit to children, and it istransformed as every child or teenager ex-periments in a practical way with what itmeans to be in school.

The stories of Carlosand Yasenin

When I carried out this study, Carloswas twenty-one and Yasenintwenty-two years old. Carlos is

the son of a divorced couple and always livedwith his mother. The mother studied den-tistry at a university but only worked as adentist for a couple of years. She worked asan office clerk for twenty-five years in FNMand is now retired. Carlos’ father alsoworked for the FNM but only for a short time

and later had other kinds of jobs. Carlosdropped out of secondary school and beganto have informal jobs. At the age of 18 hejoined an adult school and got his secondaryschool certificate. His mother forced him towork for the FNM where he was trained tobecome an electrician, and he liked his jobthough he would like to have other job op-tions in the future.

Yasenin was adopted by her mother’s hus-band when she was one year old. Her motherwas a janitor in a factory, and her adoptivefather was a train conductor at FNM. WhenYasenin dropped out of secondary school,she then entered a secretarial school becauseher mother had insisted upon it. She attend-ed that school for two years, then left it tooand worked in several places as a clerk. Latershe was trained as a hairdresser and workedin a beauty parlor until she got married. Sheis now a housewife and has a baby.

I cannot go into all the aspects of theirlives as told to me by Carlos and Yasenin.Analyzing life narratives implies that the re-searcher does some re-construction and re-ordering, departing from the tape transcriptsuntil what is the substance of analysis is res-cued (King 1991; Magrassi & Rocca 1980;Fraser 1990). My interest is to understandthe sense of school for these young people.For that purpose I shall concentrate on thosemoments in their narratives where Carlosand Yasenin describe their modes of partici-pation in school and elaborate the personalperspective from which they resist the valueof education as an obligation.

Characteristics of their narratives Carlos’ and Yasenin’s narratives are neitherlinear nor homogeneous, but mix times andtopics. Concerning their own developmentthey point out changes from one stage to an-other and from childhood to adolescencewith the change from elementary school tojunior high-school as a central reference. In

66


general, they say very little about what theyhave learned during their school trajectorybecause, as they say, they do not rememberthings, and they hardly speak at all concern-ing academic topics. By contrast, they gointo much more detail when they speak ofevents that had to do with their emotional re-lations, such as conflicts with teachers, fam-ily problems which affected them, their in-terpersonal relations, and their social rela-tions with friends.

The personal sense in the organizationof the school narrativeThe following four examples from these nar-ratives allow us to delineate the kind of rela-tionships and attitudes Carlos and Yaseninhad with school:

A. Restricted location.2 For Carlos andYasenin school was an obligation. Carlossays:

“About why I go to school? Well, maybe it wasstill an obligation to keep on studying. I mean,seeing something in it, a future like that for me,boy no! It didn’t keep on being an obligation.Maybe it was a way of doing something, yousee? While something happens in your life.”

Yasenin also relates:

“Well, I used to ask my mother what I was stu-dying for, and she used to tell me: ‘It’s just that Idon’t want you to be working in a factory just theway I am’. Boy, it’s all right. And I go there be-cause of an obligation and not because I wouldlike to.”

In these extracts Carlos and Yasenin locatethemselves as being obliged to go to school,and their expressions of discomfort showtheir degree of dislike of being obligated todo so. I call this restricted location since theyboth let us see that they had to be in school,but it is not a constrained location in an ab-solute or static manner. In their narrativesthey mention a temporary dimension: “whilesomething happens in your life” or “becauseI don’t want you to be working in a factory”,which refers to their condition of students-children and implies that they must not yetwork or that they must wait to do other adultthings. This location and temporary dimen-sion allows us to get an idea of the elementsof the collective culture in which schoolseems to be a defining space in children’scircumstances, and the voice of Yasenin’smother giving advise shows her expectationof overcoming her own working situation.Besides, it allows us to realize how they lo-cate themselves in relation to what they hadto do: going to school but without pleasure.

B. Configuring a personal sense regardingschool. Their restricted location at schoolwas no absolutely determining condition fortheir performance. Over time Carlos andYasenin develop their own construction oftheir participation in school. As they them-selves say, there were moments when theydid “try harder” (“le echaban ganas”) inschool in order to reach certain objectives. Inelementary school, Carlos was moved to an-other school where he had to improve hisgrades if he wanted to be in the same schoolas his sister. By then he thought:

“My sister had always been my back-up, and shewas sent to another school. I remember I triedeven harder (le echaba muchas ganas), I tried alot harder in order to be in that school with mysister, to get into the other school.”

Yasenin says:


2 I want to use the concept of “restricted location” basedon Valsiner’s concept of “bounded indeterminacy of de-velopment” where he states that “Children’s developmentis socially guided through constraint structures that em-power children to explore novel ways of acting and think-ing, as they relate to the constraint structures in differentways. First, he or she can accept the limiting role theseconstraints play in the child’s relationship with the envi-ronment. Second, he or she can act upon the given con-straint structure with the aim of modifying it, transformingit into another form. Dependent on circumstances, such ef-forts may, or need not, succeed”(1989:8).



“My mother would always realize from my gra-des (that I didn’t like school), and then she justtold me ‘If you don’t do your best (te apuras),The Three Wise Men won’t bring you a gift’, andI, well, I used to do my best (me apuraba), butthen, boy, not any more.”

“Echarle ganas” (try harder) and “apurarse”(do one’s best) refer to strategic attitudeswhich Carlos and Yasenin applied in relationto their performance in school in order toproduce an effect in another context. In Car-los’ case the emotional closeness to his sisterand in Yasenin’s to obtain a present for an in-fant celebration. Nonetheless, these mo-ments of trying harder were not common be-cause they describe themselves in their nar-ratives as restless (inquieto), trouble makers,and uninterested in school. Yasenin says:

“Every now and then I was at the principal’s of-fice because I used to misbehave, I used to startjoking around, I didn’t pay attention to the class,I used to be very absent-minded.” And then whenshe was in junior high school: “Ugh, getting upearly, coming to school, oh dear! And there wereso many subjects that I said to my mother, ‘Am Ireally going to study that much?’.”

Carlos remembered the days when he wentto junior high school:

“I used to have a friend, I can’t remember hisname, but I remember his last name was Mendez,and I used to hang around with this guy. And wenever stopped messing around, him and me. Wewould always be playing ... We were requested toget a lab coat, tools for our workshop and ‘Noway! Us!’ Who knows where we had left thethings! I think that unconsciously we did this justto upset the teacher.”

The way they characterize themselves intheir narratives gives us an insight into thebehavior expected of pupils in school: be-having correctly, paying attention, bringingmaterials, etc.. However, Carlos and Yaseninhighlight the specific use they made ofschool as a place to have fun. This is reflect-ed in their misbehavior and in their joy over

doing something different from what theirteachers requested. Besides, we increasinglynotice their discomfort and their indifferencetowards having to deal with school issues.

C. Adopting a stance and leaving school.Carlos and Yasenin narrate their trajectory asschool children by referring to situations thathad turned out to be problematic for themdue to their tendency to “mess around” andnot to live up to school. They both remem-bered that they were not stupid, that they hadtried harder when they wanted to, and thatthey had managed to get good grades, butthat their restlessness and their desire to dosomething else had a major impact on theirperformance. As concerns adolescence, theytend to point out emotional interpersonal re-lationships as being very important topics intheir narratives. School is no longer just aplace to have fun with their friends or whereone is a problem child, but rather a place tofind and build emotional relationships.Yasenin and Carlos both used to have asweetheart in junior high school, and theyrecognize these interpersonal relationshipsand their adoption of a stance towards schoolas an important element in their decision toleave school. Yasenin says:

“I was thrown out of school because I wasjumping over the wall when a teacher, the princi-pal’s assistant, pulled me by my foot saying ‘Getdown!’, and I said ‘No!’ So, zip! I kicked her andwent out. And since I was very messy (“relajien-ta”) and always failing that subject, short handand mathematics, the principal’s assistant toldme: ‘Well, if you want to return to school you aregoing to start back in second grade’.3 She wasgoing to put me in my boyfriend’s class, and Inever got along well with his female friends. SoI said ‘No, I would rather leave’.”

68

3 The equivalence of 8th grade in the USA.


Yasenin explains that she kicked the teacherbecause she was messy showing us her loca-tion as a certain kind of student. Confrontedwith the condition for rejoining school,Yasenin balances it against the possible ef-fect which being in the same class as herboyfriend and his female friends would haveon her. As a result, she adopts a personalstance deciding that it is inconvenient for herand, therefore, leaves school.

Carlos establishes a similar connection.He narrates his attitude in a music lesson at aparticular time in junior high school whenthey were rehearsing an anthem: “I was lis-tening and, I don’t know, I felt, ‘What now?Now I’m here, then what? What does whatI’m listening to have to do with me?’” Thislarge indifference towards school subjects iscontrasted with what they considered to bemore meaningful aspects of his life:

“Well, ... the one who was the love of my dreams,I mean, I don’t want to blame her, but I missedschool for her. Well, I didn’t miss it, I let it go. Itwas for her that I started having problems and forher that I used to go to school... I used to startcrying, and that was why I decided not to go toschool.”

In his narrative Carlos more emphatically than Yasenin points out his large indifferencetowards school subjects and identifies theimpact of personal emotional relationshipson him and on his decision to leave school.The school context is not homogeneous inthe sense that the practices and meaningsconstructed in it are uniform. In their narra-tives Carlos and Yasenin let us see how, with-in the same physical space, they move fromthe context of school to the context of emo-tional personal relationships. As I have not-ed, at other times they tried harder at schoollearning in order to obtain good grades andproduce effects in other contexts of social re-lationships, such as Carlos being close to hissister and Yasenin receiving a present.However, their movement can be reversed

when their interpersonal emotional relation-ships affect them and make their continuedpresence in school even more troubled. Inthis reversed movement they go from thecontext of their emotional relationships toproduce an effect in the school context:adopting a position that ends with the deci-sion to leave school.

D. Self assessment. After trying to finish sec-ondary school and again in an open schoolsystem and at the beginning of her secretari-al course, Yasenin decided not to continue:

“I used to tell my mother, ‘It is just that this is notfor me, mom, send me to another school where Ican start working soon’. Or then I used to say,‘No, I just want to start working. Help me getin!’”

She had worked as a clerk in various jobs andwas pleased to narrate that she used to feelvery good about being a jewelry sales agentbecause she had had an aptitude for that kindof work, or being hairdresser because shelearned the occupation fast. She assessed thatshe was able to help her husband economi-cally, in spite of not having finished second-ary school, because she could work as a hair-dresser in her own house.

Before Carlos left school he used to havesmall manual jobs, such as helping a black-smith, painting and gardening. About his de-cision to leave school he says:

“I don’t know, perhaps that world wasn’t for me.I don’t know... I used to go to work with my dad.Maybe I wasn’t interested in school. I was moreinterested in having money for her, or to go outwith her (his girlfriend).”

Later he said that he finished secondary school in a school for adults and began towork for the FNM as an electrician. He de-scribed himself as someone who is very ca-pable of carrying out different types of workand not afraid to lose his job because he hadlots of initiative with which to find other op-tions.




I want to extract two central ideas from theirassessments of themselves. First, the last ex-cerpts show us their narrative organization oftheir participation and movements in differ-ent social contexts: In Yasenin’s case, as thecrossroads between her restricted location“send me to another school”, and her per-sonal stance: “I just want to start working,help me in”. This is a curious, heterogeneousformula of character which integrates collec-tive culture and personal sense. Collectiveculture in terms of practices of socializationand meaning which the parents deal with fortheir children, and personal sense as anadopted stance regarding those elements. InCarlos’ case, the decision to work in order tohave money is a product of the balance ofbenefits gained from his personal actions:“have money for her”. The second centralidea is that both move from one context tothe other, from family to school, from schoolto work, from school to the emotional rela-tionships, and they establish different mean-ingful connections and relationships be-tween them. In their narratives school is nota well-defined, separate space but related tosome of the other contexts they participatein, and Carlos and Yasenin show that they areindividuals capable of deciding their ownorientations and movements among thosecontexts.

The personal sense facingschool obligations

In the railway families the parents usepublic discourses to legitimate the valueof school. They expect their children to

stay longer in school because they believethat school certification opens possibilitiesfor getting certain types of jobs and facingeconomical crisis. The children and teen-agers do not always find their parent’s visionreasonable but construct their own perspec-tives. In my study I cannot analyze the

process of construction, but I can analyze theway Carlos and Yasenin, at present, discur-sively elaborate the value of school for them-selves at different moments in their lives.Their stories were an instrument which en-abled them to construct images of them-selves as children and teenagers located ininterconnected social contexts (as children ofa family, students, friends, mates, and so on),and which allowed them to discuss the valueof school transmitted by their parents. Intheir narratives they evaluated the meaningof school obligations and compared it withother collective meanings of what was ofgreater importance for their experience oflife.

Initially, they accepted going to school be-cause their parents told them it was compul-sory. However, very soon they began to nar-rate a self-identity as students who used tobreak the rules or who were not interested inlearning. How could we understand Carlos’phrase “What does what I’m listening tohave to do with me?” or Yasenin’s “I used tomisbehave”? In these explanations they ap-pear as responsible for their own misbehav-ior or indifference to learning even thoughschool plays an important role in these prob-lems. An encyclopedism which saturates stu-dents with lots of scientific contents notlinked to their everyday lives is a defect ofsecondary school teaching in Mexico.School learning does not make sense to stu-dents because they cannot use much schoolknowledge in the other social contexts whichmay interest them more (Quiroz 1991). Onthe other hand, teachers in public schoolshave a very heavy workload. They must dealwith fifty student groups and fulfill extensiveteaching programs. It is understandable thatteachers do not have the time or capacity tomotivate and direct students’ participationtowards learning. Disciplinary control is,therefore, a common resource for teachers inmanaging difficult situations. Carlos and

70


Yasenin described their identity as problemstudents which they surely constructed in theschool context by means of signals from theteachers and assessments in examinations orgrades. Nonetheless, facing this attributedidentity, they broke its disqualifying charac-ter and gave it a different sense when theynarrated examples of their bad behavior as ifthey were adventures or done for fun. Seve-ral researchers have analyzed the studentvoice as agency and provided examples ofdiverse forms of resistance such as: studentsnot accepting the social representations withwhich teachers attempt to construct theiridentity as students (being a donkey, a badstudent, and so on), resisting to work hard inaccordance with the demands, or resisting toaccept disciplinary rules addressed at theiractions (Mirón & Lauria, 1998). This re-search would lead us to conclude that stu-dents have the power to face institutionalidentities constructed in school contexts anda capability for independent decision mak-ing, regarding, for example, whether to con-tinue school or leave it.

Carlos’ and Yasenin’s parents said theycould not study for a longer time becausethey had to work to help their families. Theyhad an image of themselves as victims oftheir circumstances. Carlos and Yasenin, onthe other hand, said that they made their owndecisions and left school even when theirparents did not want them to. From one gen-eration to the next there is a change in theway identity is narrated. The parents usedone narrative style while Carlos and Yaseninused another to configure their lives as indi-viduals who are not controlled but capable ofmaking their own decisions. How was thispossible? Railway families currently havebetter living conditions than in the past, andthey are able to keep their children in schoolfor longer. In the seventies the parents wereinfluenced by public discourses emphasizingthe importance of education and the need to

have a higher school certificate in order toaccess job markets. Perhaps these importantchanges increased the parents’ educationalexpectations for their children and madethem construct practices which encourageindividuality, as, for example, when they in-sist on the value of individual responsibilityfor school matters (doing your homework orstudying on your own accord) or when theyresign themselves to accepting that they can-not change the decisions their children makeaccording to their own will. I heard the par-ents say: “The one who wants to, studies,and the one who doesn’t want to, just does-n’t” while their children were listening to ourconversation, and I think that those momentshave an important effect on the way the chil-dren learn to define themselves as individu-als or to talk about themselves.

Carlos and Yasenin expressed the person-al sense they had configured concerningschool when they recalled the rare momentswhen they had been “good students”, theirfun, their main friendships and emotional re-lationships in school. When we narrate our-selves, we select the aspects we rememberbest because they have or had importantmeaning for our life. Besides, the way wetalk about them (annoyed, amused or reflec-tively) expresses our personal sense aboutwhat we narrate. Carlos and Yasenin fre-quently expressed an irritation and indiffer-ence indicating their dislike for school andtheir preference for other social relation-ships, such as friendships or romantic rela-tionships. Their evaluations of themselves intheir narratives is a moment of great impor-tance. Yasenin says: “That just doesn’t fitme”, and Carlos says: “I don’t know, perhapsthat world wasn’t for me”. These phrases ex-press that their adoption of a stance to re-ne-gotiate the semiotic system of constraints.Carlos and Yasenin did not criticize the roleof schools, but they did question its characteras an obligation because they did not find a




personal sense of life in school. They did notdefine themselves as individuals determinedby their parents or by the value the adults at-tributed to school, but as individuals whoevaluated their situation in school and foundthat they did not match: that world was notfor them.

When a person constructs a personalsense concerning something (school, family,friendship), she does not disconnect it fromthe collective meanings dealt with in everyother social context she participates in, butrather uses them to question them, to com-pare them, to evaluate them and to make apersonal synthesis in a way which enablesher to explain her choices. Personal sense isnot a matter of a pure subjectivism but is en-couraged by specific socialization practicesand is a result of the process by which everyperson appropriates, adapts, resists or legit-imizes the collective meanings they have ac-cess to. Carlos and Yasenin grew up in fami-lies which encouraged an individuality thatenabled them to construct images of them-selves as individuals who have a will of theirown that cannot be changed. The phrase“The one who wants to, studies, and the onewho doesn’t want to, just doesn’t” opens thepossibility of thinking about oneself as a per-son who, lacking the will to study, may de-cide to do something else. In their narratives,Carlos and Yasenin made reference to di-verse collective meanings such as the valueof school to get a good job, being a good stu-dent or a problem child, the importance ofgetting a present from the “three wise men”,the importance of having a boyfriend or girl-friend, the value of paid work, and so forth.They used these collective meanings to con-figure a personal perspective, from which todescribe their participation in school as com-plex actions and to describe how they estab-lished relationships among the different con-texts of school, friendship, family, and work.At the same time, Carlos and Yasenin evalu-

ated these collective meanings in their narra-tives because they chose which ones madesense to them and which ones did not. Forexample, they rejected the value of schoolobligations, because they did not like to go toschool, and they legitimated the value ofpaid work because it was more meaningfulfor them to work and to have money than tostudy. When they said “I just want to startworking” or “I was more interested in havingmoney”, they defined themselves as personswho had a will or personal interests whichmade them decide to quit school. Therefore,the personal sense they constructed in con-trast to the value of school obligations wasthe result of an implicit acceptance of thecharacter of individuality their parents trans-mitted to them and of the evaluations andcomparisons they made of the different col-lective meanings they encountered in theirparticipation in the social contexts linked toschool.

Conclusions

The sense the parents constructed con-cerning school implies a strong mani-festation of collective meanings asso-

ciating scholarship with the possibility ofgetting a good job. However, in their inter-pretations of the importance of school, theparents disregard changes across generationsin their own families, the success theyachieved in their careers in FNM, as well astheir economic possibilities as member ofthe working class. In that sense, the parentsdo not merely reproduce public discourses,they construct a personal sense which syn-thesizes meanings from different public andpersonal sources. In contemporary discus-sion, there is still a strong tendency to evalu-ate the perspective of working class parentsin relation to criteria derived from other so-cial groups. Reay & Ball (1997) say thatmany investigators and school teachers do

72


not understand the parents’ choices andmodes of action in relation to school becausetheir explanatory models are only able to de-pict them negatively in terms of deficiencies.The teachers in the schools I visited haveconstructed explanatory models with whichthey experience the railway families andtheir children as persons having insufficientinterest in succeeding in school. Becausethese teachers have a different interpretationthan the parents of what participation inschool should be, they are unable to valuethese parents’ effort to support their children.The parents, on the other hand, are con-vinced that they have done what is necessaryin order to help their children and grant themtheir own responsibility for their success inschool. At the end of this chain of influences,the teenagers who decided to drop out ofschool justify that they “did not want” tocontinue because they found other moregratifying life options. The blaming of otherswithout being able to see failures in oneselfends with the student assuming individualresponsibility and not conceiving herself as avictim, but as a person capable of decidingand choosing her own life.

My investigation shows that the personalsense parents and children construct in rela-tion to school results from their own experi-ences of life and thus using meanings de-rived from the collective culture, they con-figure explanatory models that are not neces-sarily similar to the ones the teachers or pub-lic discourses hold about what it means tosucceed in school. In the research on work-ing class families and their relationship to-wards school, Willis’ (1977) work has beenrepresentative. Willis analyzed the opposi-tion students developed towards school as aresult of oppression and class stratification.Pupils from working class families repro-duced forms of behavior which are favorableto the culture of factory work but not toschool culture, because these pupils experi-

enced themselves as future workers whoanyway soon were to leave school. Theyoung people I interviewed belong to theworking class families of FNM workers.Following Willis’ explanatory logic, I shouldsearch for the possible relationships betweenclass membership and modes of reaction inschool, but that would make me overlookimportant historical changes across genera-tions and countries. Even in England, Big-gart & Furlong (1996) note, it is difficult tomaintain that the modes of relating to schoolWillis identified still exist, due to the strongdecline in job opportunities for young peo-ple. Students who had hoped to leave schoolearly and get a job, were forced to remain inschool as they realized the difficulties theywould encounter in getting a job. Biggart &Furlong call this new phenomenon “discour-aged workers”. It has implied that youngpeople develop an instrumental relationshipto school staying longer to get a higherschool certificate and waiting for the time toget a job. Pries (1997) says that in Europeancountries the working class culture existednot only as a relationship between the work-ers and the factory, but as a lifestyle in whichfactory workers expressed a vibrant self-es-teem. There was a natural certainty that theywould be wage workers all their lives, andtheir life in the factory, their neighborhoodand in leisure time practices were related tothis certainty. According to this authorMexico is different because paid factoryworkers are a minority in our country with avery heterogeneous working population.

In this study I proposed that it is not pos-sible to limit the analysis of persons’ experi-ences of school to isolated references such associal class, gender or race. It is necessary toanalyze a person’s complex participationacross social contexts encountering differenttypes of collective meanings in relation tomultiple references not circumscribed by so-cial class. Carlos and Yasenin described their




experiences of life and mentioned the rela-tionships they established between the dif-ferent contexts they participated in, and theyconstructed a personal sense not legitimatingthe value of school that their parents trans-mitted to them. In Willis’ study (1977) thecultural production of students in school wasstrongly oriented towards claiming theiridentity as future workers, while Carlos andYasenin remembered that they were not in-terested in their future adult lives, but used tothink about the present, the needs they had,the money they wanted to have to buy per-sonal goods, their love affairs. Having moneyto spend with his girlfriend or to buy a pairof expensive shoes of a famous brand are im-portant signs of how a person knows valuesand social meanings which are not circum-scribed by his social class, but located in so-cial contexts that are open to multiple influ-ences.

It is a major problem of adult discoursesin school and families that they try to trans-mit a too abstract value about school, dis-connected from the interests and rewardsstudents meet every day in their participationin school. In general, school is not consid-ered to be related to other contexts. It is ex-pected to be of value in itself, for example,that students must legitimate scientificknowledge in its abstraction. Carlos’ andYasenin’s narratives show that this is notpossible. The personal sense about school isconstructed over time through an individ-ual’s participation across different socialcontexts in which the person appropriates,resists or legitimizes diverse collectivemeanings allowing her to configure a senseof life which may or may not be associatedwith school. Further discussion is neededabout the criteria for evaluating the choicesof students who drop out of school and aboutwhat constitutes a “good job” or an accept-able lifestyle.

Acknowledgements.I am grateful to Ole Dreier and to CharlotteHojholt for their insightful and pertinentcomments on the previous version of this pa-per, and I appreciate the editorial changesmade by Ole Dreier on the final version.

References Biggart, A. & Furlong, A. (1996). Educating

“discouraged workers”: cultural diversity inthe upper secondary school. British Journalof Sociology of Education 17(3), 253-266.

Bertaux, D. (1988). El enfoque biográfico: suvalidez metodológica, sus potencialidades. In:P. Joutard et al. (Eds.), Historia Oral e Historiade Vida. Costa Rica: FLACSO, Cuadernos deCiencias Sociales No. 16, 55-80.

Bruner, J. (1996). The narrative construal of re-ality. In: The Culture of Education. Cam-bridge: Harvard University Press, 130-149.

Charlot, B., Bautier, E. & Rochex, J. Y. (1992).École et savoir dans les banlieus et ailleurs.Paris: Armand Colin Editeur.

Connell, R. W., Ashenden D. J., Kessler S. &Dowsett G. W. (1982). Making the difference.Schools, families and social division. SydneyAustralia: G. Allen and Unwin.

CRESAS, (1982). El fracaso escolar no es unafatalidad. Buenos Aires: Ed. Kapelusz.

Delgado-Gaitan, C. (1994a). Russian refugeefamilies: accommodating aspirations througheducation. Anthropology & Education Quar-terly 25 (2), 137-155.

Delgado-Gaitan, C. (1994b). Consejos: thepower of cultural narratives. Anthropology &Education Quarterly 25 (3), 298-316.

Dreier, O. (1999). Personal trajectories of parti-cipation across contexts of social practice.Outlines. Critical Social Studies 1, 5-32.

Fernández, P. (1986). Evaluación y cambio ed-ucativo. Análisis cualitativo del fracaso esco-lar. Madrid: Ediciones Morata.

Fraser, R. (1990). La formación de un entrevis-tador. Historia y Fuente Oral. No. 3, Barce-lona, España, 129-150.

García, M. H. & Suárez, Z. M. (1996). Perfil ed-ucativo de la población mexicana. México:

74


INEGI, CRIM, UNAM.Gibson, M. (1982). Reputation and respectabili-

ty: how competing cultural systems affectstudents’ performance in school. Anthro-pology & Education Quarterly, 18 (1):3-27.

Hemmings, A. (1996). Conflicting images?Being black and a model high school student.Anthropology & Education Quarterly 27(1):20-50.

Holland, D. & Eisenhart, M. (1990). Educated inromance: women, achievement and collegeculture. Chicago: University of ChicagoPress.

Hojholt, Ch. (1997). Child development in tra-jectories of social practice. In: W. Maiers, B.Bayer, B. Duarte Esgalhado, R. Jorna, E.Schraube (Eds.). Challenges to TheoreticalPsychology. York: Captus University Publi-cations, 278-285.

King, D. (1991). La grabación de campo en lahistoria oral. Historia y Fuente Oral, No. 4.Barcelona, España, 63-78.

Levinson, B. & Holland, D. (1996). The culturalproduction of the educated person: an intro-duction. In: B. Levinson, D. Foley and D.Holland (eds.), The cultural production of theeducated person. Critical ethnographies ofschooling and local practice. Albany: StateUniversity of New York Press, 1-54.

Lichtenstein, S. (1993). Transition from schoolto adulthood: case studies of adults withlearning disabilities who dropped out ofschool. Exceptional Children, 59(4): 336-347.

López, G., Assael, J. & Neuman, E. (1984). Lacultura escolar responsable del fracaso?Santiago: Programa Interdisciplinario deInvestigación Educativa.

Lopez, G., Adduard, A., Assael, J. & Edwards, V.(1988) El fracaso escolar: ajustes y con-tradicciones entre perspectivas diferentes.Santiago: Programa Interdisciplinario de In-vestigación Educativa.

Magrassi, G. & Rocca, M. (1980). La historia devida. Buenos Aires: Centro Editor de Amé-rica Latina, S.A.

Mehan, H. (1986). Educational handicaps as acultural meaning system. Ethos, 14 (1)73-91.

Miron, L. & Lauria, M. (1998). Students voiceas agency: resistance and accommodation in

inner-city schools. Anthropology &Education Quarterly 29 (2): 189-213.

Middleton, D. (1997). The social organization ofconversational remembering: experience asindividual and collective concerns. Mind,Culture and Activity 4 (2), 71-85.

Muñoz, H. ( 1996). La valoración educativa, re-flexiones, interpretaciones y comentarios. In:Los valores educativos y el empleo en Méxi-co. México: Centro Regional de Investigacio-nes Multidisciplinarias, Instituto de Investi-gaciones Sociales, Miguel Angel Porrúa,Editor, 131-145.

Ogbu, J. (1982). Cultural discontinuities andschooling. Anthropology and EducationQuarterly, XIII (4):290-307.

Ogbu, J. (1990). Cultural models, identity andliteracy. In: . J. W. Stigler, R.A. Shweder & G.Herdt (Eds.), Cultural psychology. New York:Cambridge University Press, 520-541.

Phelan, P., Davidson, L. & Thanh, H. (1991).Students’ multiple worlds: negotiating theboundaries of family, peer and school cul-tures. Anthropology & Education Quarterly22 (3), 224-249.

Perrenoud, P. (1990). La construcción del éxito ydel fracaso escolar. Madrid: Ediciones Mo-rata.

Pieke, F. (1991). Chinese educational achieve-ment and folk theories of success. Anthro-pology & Education Quarterly 22(2), 162-180.

Pries, L. (1997). Conceptos de trabajo, mercadosde trabajo y proyectos biográficos laborales.In: De la O, M., De la Garza, E. y Melgoza,J. (comp.) Los estudios sobre la cultura obr-era en México: enfoques, balance y perspec-tivas. México: CONACULTA, 141-187.

Quiroz, R. (1991). Obstáculos para la apro-piación del contenido académico en la es-cuela secundaria. Infancia y Aprendizaje 55,45-58.

Reay, D. & Ball, S. (1997). “Spoilt for choice”:the working classes and educational markets.Oxford Review of Education 23 (1): 89-101.

Rochex, J. (1989). Histoire sociale et histoiresscolaires: biographie et orientation. In : G.Pineau et G. Jobert (eds.), Histoires de vie.Utilisation pour la formation. Paris: L’Har-mattan, 107-114.




Rymes, B. (1995). The construction of moralagency in the narratives of high-school drop-outs. Discourse & Society, 6 (4):495-516.

Schneider, B. & Lee, Y. (1990). A model for aca-demic success: the school and home environ-ment of East Asian students. Anthropology &Education Quarterly 21 (2):358-377.

Suárez-Orozco, M. (1987). “Becoming some-body”: Central American immigrants in U.S.inner-city schools. Anthropology & Educa-tion Quarterly 18 (4), 287-299.

Tappan, M. (1991). Stories lived and stories told:the narrative structure of late adolescentmoral development. Human Development 32,300-315.

Valsiner, J. (1997). Personality and psychology:common sense and general assumptions. In:The guided mind. Cambridge, Ma.: HarvardUniversity Press, 7-40.

Valsiner, J. (1989). Collective coordination ofprogressive empowerment. In: L. T. Winegar(ed.), Social interaction and the developmentof children’s understanding. Norwood, N.J.:Ablex Publishing Corporation, 7-20.

Willis, P. (1977). Learning to labor: how work-ing-class kids get working-class jobs. Farn-borough: Saxon House.

Wertsch, J. (1988). Mind as action. New York:Oxford University Press.

76


editorial - outlines.dk 2001-2/outlines-2001-2.pdflearning, medical education and 3d environments 1...

Documents