A Socio-Technical Analysis of Knowledgeable Practice in Radiation Therapy
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The role of the modern radiation therapist is directed and driven by the organizational system. Changes affecting their role are implemented as a response to changes in the industry. Operations of the modern cancer center, with new and changing treatment technologies bring questions regarding the learning process of radiation therapists at a time when optimal patient care requires informed radiation therapists with good independent judgment abilities. Radiation therapists monitor accuracy through a human interface with technology. It is through this interaction where levels of awareness, critical judgment are called upon to control the outcome. Problem recognition for the user is heavily dependent on foundations of knowledge to connect a screen display to the unseen treatment processes occurring within the treatment room. The purpose of this qualitative case study was to understand how staff radiation therapists learn new skills and build on existing knowledge within a highly technical environment. This study used a socio-technical frame providing structure to my research and data analysis according to the multi-layers of socio-technical systems. Three research questions focusing on the organization’s infrastructure, info-structure, and info-culture guided this study to answer the broad research question, how do radiation therapists learn new skills to develop a “knowledgeable practice” in a highly technical environment? My interpretation of the data, based on Situated Learning Theory describes the growth and development of “Junior Rangers” within the organization. The same principles provide the framework to describe linkage between the removal of processes (participation), the loss of a practice for the profession linked with diminishing boundaries to develop maximum potential for the role of the radiation therapist. I correlate the loss of participation with the emergence of a treatment practice with a limited knowledgeable practice. Resting on modern socio-technical literature, reported behavioral patterns and perspectives of technical socialization, and a review of the literature across various industries, I conclude with the argument of the loss of foundational knowledge through a process of “knowledge appropriation.” Foundational radiation therapy knowledge is appropriated by technology and replaced with the knowledge required to operate the new equipment and technology. Data from the case study; supporting literature; situated learning perspectives; and findings from a workflow cross analysis of pre and post technology processes forms the argument of knowledge appropriation.