The Reconfiguration of Expertise in Oncology

The Practice of Prediction and Articulation of Indeterminacy in Medical Consultations

Bibliographic Data

ID4685259
AuthorsAlex Broom (0000-0003-1258-1140, The University of Sydney, corresponding author), Nicole Cort (0000-0001-8434-5994, University of Sydney, Sydney, Australia,), Jon Adams (0000-0002-9901-5717, University of Queensland, Brisbane, Queensland, Australia)
Year2010
Volume20
Issue10
Pages1433-1445
Publication date2010-10-01
Peer ReviewedYes
Open AccessYes
TypeARTICLE
VenueQualitative Health Research (JOURNAL)
Journal identifiersISSN: 1049-7323 • E-ISSN: 1552-7557
PublisherSAGE Publications Inc (PUBLISHER)
DOI10.1177/1049732310373042
PMID20562253
OpenAlexW2147895755
LanguageEN
Citations received11
References cited58

Evidence-based medicine has enhanced the predictive capacity of biomedicine in population terms, but it has also introduced new challenges for patient care and biomedical expertise. In this article we examine the negotiation of prediction and indeterminacy by oncology clinicians, exploring the ways in which they report delivering prognosis and engaging with indeterminacy in conversation with their patients. We examine oncologists' strategies for delivering "news," the technological mediation of uncertainty, and reported conversational turns toward a focus on indeterminacy and individual response. Drawing from these accounts, we argue that, although predictive capacity remains central to oncological expertise, notions of individualism, subjectivity, and self-determination are being heavily drawn on by clinicians. Rather than presenting a challenge, such ideas might be becoming increasingly central to oncological expertise. Interviews with cancer nurses illustrate their precarious relationship with evidence, uncovering tensions in their approach to patients and in their attempts to traverse diverse paradigms of care. We argue for an understanding of oncological expertise as evolving within the context of potentially competing contemporary cultural shifts, and against a simplistic notion of indeterminacy as necessarily eroding expertise

Control reconfiguration · Epistemology · Medical education · Political science · Clinical Reasoning and Diagnostic Skills · Computer Science · Medicine · Mental Health and Psychiatry · Patient-Provider Communication in Healthcare · Psychology

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