Technology and Tools Appropriation in Medical Practices

Introduction

The design and use of technological artifacts in medical practices involve the participation of several experts communities including engineers, scientists, and medical doctors. Thus, to delve into what happens to artifacts (designed by engineers) when they enter into medical practices implies not only to uncover what engineering and medical practices entail, but also to address how both agendas could converge or incorporate common goals. Regarding the engineering as a discipline, the National Research Council (NRC) (2009) pointed out its problem solving approach to design and create human-made products under certain conditions or constraints. Some of those constraints involve taking into account principles that encompass science and scientific laws, budget restrictions, available materials, sustainability, ergonomics, and ethical issues.

Progress in science and engineering goes hand in hand, science advances often depend on tools developed by engineers and reciprocally scientific knowledge guides and permeates engineering designs. Nowadays, it is not unusual to find engineers working with medical doctors and researchers in the design of artifacts that aim to improve human health.

Engineering design is a purposeful activity bound by specifications and constraints and an eminently collaborative enterprise. It involves an interactive process in which the design is tested and modified and it often offers several solutions to a particular problem (NRC, 2009). In general, the design and the construction of artifacts are tasks that require an expertise in science of materials, control, ergonomics and biomedicine. And there is set of standards that any medical artifact needs to fulfill in order to be used within the medical community. However, as Béguin (2003) pointed out the design of artifacts does not finish when the tool or object fulfills material and technical requirements; it should include how users transform the artifact into an instrument. Then, how does the medical community develop the needed expertise to use those artifacts efficiently in medical practice? This question becomes important to identify and delve into a research area that examines ways in which medical doctors transform and artifact (physical devise) into an instrument to solve problems. Then, what information and actions are important to characterize the process to transform an artifact into an instrument? Hadolt, Hörbst & Müller- Rockstroh (2012) cited a four-phase model (Hahn, 2004) that includes appropriation, objectification, incorporation, and conversion activities. The authors stress that the incorporation of artifacts into practices depends on social, cultural, and economic conditions.

It is important to analyze the extent to which medical doctors construct cognitive schemata that explain what we called their appropriation process of an artifact. In this process, it is recognized that tools shape and are shaped by the users’ actions. Trouche (2004) pointed out the importance of considering the instrument as an extension of the body that becomes an organ formed by the artifact itself and by a psychological part that helps the user to mobilize the artifact to carry out activities and solve problems. Béguin (2003) emphasizes the difference between an artifact and an instrument or a problem- solving tool. The latter is made up by the artifact and the user’ social and private cognitive schemata. The artifact characteristics that include ergonomics and constraints and the cognitive schemata developed by the user during the activities are important for the transformation of the artifact into a problem-solving tool or instrument to solve problems.

Artigue (2002) pointed out that users need to get involved in an appropriation process to transform an artifact or physical devise into an instrument for specific use. This process leads users to gradually construct personal schemata or to appropriate pre-existing social schemata to appreciate its potentialities and use them in problem solving situations. Thus, relations between users and objects are shaped by ways in which a community of practice acts in problem solving environments. Trouche (2004) also mentioned that the development of the user’s psychological component could be categorized in terms of three related functions: A pragmatic function where the subject achieves a particular goal, a heuristic function in which the subject visualizes and pursues an action plan; and an epistemic function where the subject comprehends and makes sense of what is being achieved.