The reconfiguration of expertise in oncology: The practice of prediction and articulation of indeterminacy in medical consultations

Broom, Alex and Adams, Jon (2010) The reconfiguration of expertise in oncology: The practice of prediction and articulation of indeterminacy in medical consultations. Qualitative Health Research, 20 10: 1433-1445. doi:10.1177/1049732310373042

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Author Broom, Alex
Adams, Jon
Title The reconfiguration of expertise in oncology: The practice of prediction and articulation of indeterminacy in medical consultations
Journal name Qualitative Health Research   Check publisher's open access policy
ISSN 1049-7323
1552-7557
Publication date 2010-10
Sub-type Article (original research)
DOI 10.1177/1049732310373042
Volume 20
Issue 10
Start page 1433
End page 1445
Total pages 13
Editor Janice M. Morse
Place of publication Thousand Oaks, CA, U.S.A.
Publisher Sage Publications
Collection year 2011
Language eng
Formatted abstract
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.
© The Author(s) 2010
Keyword Cancer
Communication, medical
Evidence-based practice
Interviews
Sociology
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2011 Collection
School of Public Health Publications
School of Social Science Publications
 
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Citation counts: TR Web of Science Citation Count  Cited 7 times in Thomson Reuters Web of Science Article | Citations
Scopus Citation Count Cited 8 times in Scopus Article | Citations
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Created: Wed, 16 Feb 2011, 15:42:29 EST by Debbie Lim on behalf of ___Unknown Unit