On the phone: Effects of mobile phone use on clinical practices

In most Danish hospitals clinicians are being equipped with a mobile phone in order to improve their availability. Based on an ethnomethodological approach (Garfinkel, 1967) the present paper explores how mobile phones shape clinicians´ practices. Using Nexus Analysis (Scollon & Scollon, 2004) as a general ethnographic framework, complemented with Conversation Analysis (Sacks, 1992) and Goodwin’s (Goodwin, 2000) analytical terminology of contextual configuration, the paper reports the findings of an analysis of video data from interactions between clinicians and patients at a Danish hospital. The analysis shows how the mobile phone becomes part of the way clinicians choreograph body movement in interactions with patients, how they arrange their bodies and how they gesture and position themselves. It is demonstrated how the use of mobile phones can mediate the clinicians´ accomplishment of an action space with the patient, the boundaries of attention created by the clinicians and the trajectories of actions. The analysis further shows how the mobile phone allows for the clinicians to negotiate and co-construct their practices across space and physical materiality. It is demonstrated how the use of mobile phones mediate the way clinicians interactionally achieve spatiality and mobility (Mondada, 2011) within their practices, how they construct space within talk and multimodal conduct and how they organize their mobility across epistemic and embodied spaces, using the mobile phones to co-construct actions, though being located physically separate. Finally, the analysis reveals how the use of mobile phones can distance the clinicians from bodily sensing and experiencing the patient, using the phone as a mediational means (Scollon & Scollon, 2004) or semiotic field (Goodwin, 2000) to accomplish the knowledge necessary to do diagnostic work (Büscher, Goodwin, & Mesman, 2010), instead of using an array of visceral-affective resources to sense and experience the knowledge directly from the patient’s body. The analysis thus establishes how the affordances of the mobile phone can bypass the multifaceted embodiment of the clinicians. Büscher, M., Goodwin, D., & Mesman, J. (2010). Ethnographies of diagnostic work: Dimensions of transformative practice. Basingstoke: Palgrave Macmillan. Garfinkel, H. (1967). Studies in ethnomethodology New Jersey: Prentice-Hall. Goodwin, C. (2000). Action and embodiment within situated human interaction. Journal of Pragmatics, 32(10), 1489-1522. Mondada, L. (2011). The interactional production of multiple spatialities within a participatory democracy meeting. Social Semiotics, 21(2), 289-316. Sacks, H. (1992). In Jefferson G. (Ed.), Lectures on conversation, volumes I and II. Oxford: Blackwell. Scollon, R., & Scollon, S. B. K. (2004). Nexus analysis: Discourse and the emerging internet. London: Routledge.