A stitch in time: Instructing temporality in the operating room


  • Alan Zemel University at Albany, SUNY
  • Timothy Koschmann Southern Illinois University School of Medicine




conversation analysis, operating room, sequence, surgical education, temporality


This paper examines how time is made explicitly relevant in the way the attending surgeon monitors and corrects the performance of a resident during a kidney transplant surgery. In so doing, we observe how the attending constitutes time as a significant and constituent feature of the surgical actions performed by the resident. In order to instruct temporal competence in the performance of surgical procedures, the attending surgeon identifies and makes instructably observable the temporally significant features of the surgical work just as that work is performed, by (a) producing countdowns, pace prompts, and temporal accounts when and as avoidable errors occur, and (b) planning and coordinating current and upcoming actions in relation to other actions. Instructing a trainee in the temporal features of his/her performance occurs when the attending (a) coordinates the production of specific verbal tokens, remarks, and accounts with specific actions performed by the resident as the resident performs them, or (b) anticipates the performance of subsequent actions in relation to current surgical actions underway. This case demonstrates how temporality becomes an observably instructable matter in interaction.

Author Biographies

Alan Zemel, University at Albany, SUNY

Alan Zemel received his PhD from Temple University and is an assistant professor at the University at Albany, SUny. his research interests include learning and instruction, health communication, interaction in psychotherapy, and conversation analysis.

Timothy Koschmann, Southern Illinois University School of Medicine

Timothy Koschmann is a Professor of medical Education at Southern Illinois University. his research focuses on the practical organizations of instruction and learning, a line of inquiry with roots in sociology and that draws frequently on findings in conversation analysis. he does fieldwork in the sites in which physicians and surgeons acquire professional skills.



How to Cite

Zemel, A., & Koschmann, T. (2016). A stitch in time: Instructing temporality in the operating room. Communication and Medicine, 12(1), 85–98. https://doi.org/10.1558/cam.v12i1.25988