A collective clinical gaze: Negotiating decisions in a surgical ward


  • Gro Underland Diakonova University College
  • Aksel Tjora Norwegian University of Science and Technology




decision-making, hospital, knowledgesharing, negotiations, redundancy, surgeons


This article explores collaborative aspects of clinical decision-making, based on a focused ethnography and video recordings of meetings in clinical practices in two wards for gastro-intestinal diseases at the surgical department of a large Norwegian university hospital. By studying clinicians’ communication during patient introduction, handling uncertainties and surprises, collecting information, and negotiating acceptance, we elaborate on how collaborative teamwork in the hospital ward is developed. Further, by drawing on detailed studies of meetings, in which patients are not physically represented, we explore ways in which a ‘collective clinical gaze’ of each patient is constructed on the basis of documents, memory, and a consensus-directed discussion among clinicians who are present. Although electronic patient record systems and the like are expected to produce firm bases for clinical decision-making, our analysis suggests that more emphasis should be put on how clinicians in their daily practice establish collectively based validity of any decision being made.

Author Biographies

Gro Underland, Diakonova University College

Gro Underland is an Associate Professor at Diakonova University College, Norway. Her current research interest is organisational changes when implanting new information systems. knowledge production and knowledge exchange are an important part of this research.

Aksel Tjora, Norwegian University of Science and Technology

Aksel Tjora is Professor of Sociology at the Norwegian University of Science and Technology and manager of the Sociology Clinic in Trondheim. His research includes a wide range of themes such as organisations, public and semi-public spaces, technologies, and health and medicine, always with a special interest in material–social interaction.


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How to Cite

Underland, G., & Tjora, A. (2017). A collective clinical gaze: Negotiating decisions in a surgical ward. Communication and Medicine, 13(1), 23–35. https://doi.org/10.1558/cam.18432