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Hybrid presence: Integrating interprofessional interactions with digital consultations

Line Maria Simonsen
Line Maria Simonsen
   | 09 sept. 2021
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Publié en ligne: 09 sept. 2021
Pages: 22 - 44
DOI: https://doi.org/10.2478/nor-2021-0039
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© 2021 Line Maria Simonsen, published by Sciendo
This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Figure 1

Overview of the settingComments: The first doctor (D1) sits in front of the laptop on the left, and the second doctor (D2) is the person standing a meter or two away at the door. On the one side, D1 has complete access to the digital consultations and to D2. On the other side, D2 must coordinate with D1 while D1 works with digital consultations. The figure shows the two agents directing their gazes in different directions, indicated by the red arrows.
Overview of the settingComments: The first doctor (D1) sits in front of the laptop on the left, and the second doctor (D2) is the person standing a meter or two away at the door. On the one side, D1 has complete access to the digital consultations and to D2. On the other side, D2 must coordinate with D1 while D1 works with digital consultations. The figure shows the two agents directing their gazes in different directions, indicated by the red arrows.

Figure 2

The cognitive trajectoryComments: The white triangles illustrate the points in time where salient interactional transitions emerge. In Phase I, D1 manages digital consultations alone in the breakroom in silence. Phase II commences as D2 enters the room. Although D1 continues to manage digital consultations, he distributes his attention between these and D2 as he declaratively asks, “and you are the mail reader?” This prompts the two doctors to engage in the stage of problem management. In Phase III, the two doctors elaborate the solution they found in Phase II, and finally, in Phase IV, the interaction closes.
The cognitive trajectoryComments: The white triangles illustrate the points in time where salient interactional transitions emerge. In Phase I, D1 manages digital consultations alone in the breakroom in silence. Phase II commences as D2 enters the room. Although D1 continues to manage digital consultations, he distributes his attention between these and D2 as he declaratively asks, “and you are the mail reader?” This prompts the two doctors to engage in the stage of problem management. In Phase III, the two doctors elaborate the solution they found in Phase II, and finally, in Phase IV, the interaction closes.

Figure 3

Event pivots in Phase IIComments: This figure illustrates transitions (white triangles) and event pivots (blue triangles), that is, the definitional transitions (in CEA terminology) that configure the cognitive trajectory of the problem management event in Phase II. As CEA works backwards and starts with the cognitive result, the primary event pivot marks the cognitive result of the interaction: when D1 pays attention to conducting a medical home visit with the laptop in his possession as a result of the problem management event. The opening event pivot is marked as secondary and indicates the point in time when D1 first orients to D2 as the mail reader. Between the event pivots, the phase undergoes a micro-interactional transition (white triangle), which indicates a change in attention from problem presentation to solution probing.
Event pivots in Phase IIComments: This figure illustrates transitions (white triangles) and event pivots (blue triangles), that is, the definitional transitions (in CEA terminology) that configure the cognitive trajectory of the problem management event in Phase II. As CEA works backwards and starts with the cognitive result, the primary event pivot marks the cognitive result of the interaction: when D1 pays attention to conducting a medical home visit with the laptop in his possession as a result of the problem management event. The opening event pivot is marked as secondary and indicates the point in time when D1 first orients to D2 as the mail reader. Between the event pivots, the phase undergoes a micro-interactional transition (white triangle), which indicates a change in attention from problem presentation to solution probing.

Figure 4

Reorganising task-performance (lines 1–10)Comments: I have employed and adapted with minor changes the transcription conventions from Sacks and colleagues (1974, 1992): “xx” in parentheses indicates the transcriber's uncertainty about the words articulated by the speaker; numerals in parentheses indicate the length of pauses in seconds; punctuation in parentheses indicates micropauses; an opening square bracket indicates the point in time when the speaker's talk is overlapped by another; a hyphen indicates the speaker's self-interruption; a degree sign ( ° ) indicates when the speaker lowers his or her voice. All transcripts have been translated from Danish to English in collaboration with a professional English translation agency.
Reorganising task-performance (lines 1–10)Comments: I have employed and adapted with minor changes the transcription conventions from Sacks and colleagues (1974, 1992): “xx” in parentheses indicates the transcriber's uncertainty about the words articulated by the speaker; numerals in parentheses indicate the length of pauses in seconds; punctuation in parentheses indicates micropauses; an opening square bracket indicates the point in time when the speaker's talk is overlapped by another; a hyphen indicates the speaker's self-interruption; a degree sign ( ° ) indicates when the speaker lowers his or her voice. All transcripts have been translated from Danish to English in collaboration with a professional English translation agency.

Figure 5

Solving the problem (lines 11–19)Comments: I have employed and adapted with minor changes the transcription conventions from Sacks and colleagues (1974, 1992): “xx” in parentheses indicates the transcriber's uncertainty about the words articulated by the speaker; numerals in parentheses indicate the length of pauses in seconds; punctuation in parentheses indicates micropauses; an opening square bracket indicates the point in time when the speaker's talk is overlapped by another; a hyphen indicates the speaker's self-interruption; a degree sign ( ° ) indicates when the speaker lowers his or her voice; and an equal sign indicates that there is no interval between the speakers’ talk. All transcripts have been translated from Danish to English in collaboration with a professional English translation agency.
Solving the problem (lines 11–19)Comments: I have employed and adapted with minor changes the transcription conventions from Sacks and colleagues (1974, 1992): “xx” in parentheses indicates the transcriber's uncertainty about the words articulated by the speaker; numerals in parentheses indicate the length of pauses in seconds; punctuation in parentheses indicates micropauses; an opening square bracket indicates the point in time when the speaker's talk is overlapped by another; a hyphen indicates the speaker's self-interruption; a degree sign ( ° ) indicates when the speaker lowers his or her voice; and an equal sign indicates that there is no interval between the speakers’ talk. All transcripts have been translated from Danish to English in collaboration with a professional English translation agency.

Figure 6

Ticking the wingsComments: In this image, D1 (who sits at the laptop) gestures toward D2 (who stands out of the camera frame beyond the upper-right corner of the image) while synchronously verbalising the digital function “ticking the wings”. D1's gesture works as a reenactment of a shape similar to the “√” symbol in the system.
Ticking the wingsComments: In this image, D1 (who sits at the laptop) gestures toward D2 (who stands out of the camera frame beyond the upper-right corner of the image) while synchronously verbalising the digital function “ticking the wings”. D1's gesture works as a reenactment of a shape similar to the “√” symbol in the system.
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