Organizing Knowing in Interdisciplinary MRI Practice: On the hybrid configuration of technology's domestication

This paper addresses organizational knowledge practices pertaining to the interdisciplinary work of Magnetic Resonance Imaging (MRI) at a hospital radiology department. The setting occasions an interesting venue for exploring domestication of MRI as it unfolds in distributed settings of collective practice, pertaining to the selection, examination and diagnosing of patient conditions. The processes cut across diverse domains of knowledge practices and interrelated competencies, at once simplified, yet, also complexified, through the sociomaterial practices of organizing (following Mol & Law, 1994). The displacement and tension in such hybrid configurations of knowing and organizing (Patriotta, 2003) are related to the realm of technology’s domestication in a pluralistic performative context, grappling with the complexity, non-linearity and multi-vocality of its framing as it unfolds. The ethnographically informed study engages particularly the practices of different occupational groups (radiographers, radiology nurses, clinicians and radiologists) as these are implicated in the imaging work and in relation to the radiology department’s clinical surroundings. A broadened constellation of personnel were envisaged to deal with the department’s appropriation of a new MRI scanner, occasioned by the replacement of an existing model. Work was reorganised to reflect this aspect in the practice protocols from early on, where personnel previously assigned only to other imaging modalities such as the department's CT-scan and X-ray machines, were to take on MRI scanning, on an albeit rotational basis. Opening up to a broader group of operators to the scanning practice was to allow for organizational flexibility and a broader basis for competence building among radiology staff, where different occupational groups familiar with the existing scanning practice were involved in the development and use of ‘in-house’ protocols for conducting the MRI examinations. The paper elaborates on how users and their knowledge practices were translated with respect to the MRI and in the (re)organization of work, facilitating, and yet, in tension with, efforts at organizational transformation – its occasioning(s), mediations and contingent effects. The case study is based on direct observation and interviews, exploring and drawing upon the idea of different units of analysis as a methodological means to address the intricate, hybrid underpinnings of domestication in interdisciplinary practice. The implications this holds for the understanding of the co-constitution and enactments of organizing and knowing is also the paper's contribution to STS research. Here, actor-network theory and its non-dualistic stance prove fruitful in grappling with configuration and tensions in knowledge and practice without any resort to pre-defining users, interdisciplinary coordination, or knowledge, in some well-delimited sense. Rather, what comes to expression in the study’s approach to domestication is the configuration of knowing and organizing as part and parcel of de-centred instances of occasioning and effects, coordinating, while also interfering with, collective engagements of practice both within as well as across departmental settings. Working (with) protocols, enacting them in their development and practice, as but one such site of study, embodies past negotiations and enter into the collective mediation of situated practice(s), rendering a multiplicity of objects as well as their situated contexts, mutually relevant to address.