Sanna Rimpilainen

A review of emerging trends in Digital Health and Care was requested by Technology Enhanced Care to help inform the future direction of the programme and support wider digital interests in Scotland. As the digital environment is fast-paced and constantly fluctuating, the trends which are identified capture the position of the Digital Health and Care sector at Autumn 2018, with a probable ‘shelf-life’ of around 3 - 5 years. This report provides an overview of the emerging trends in digital health and care but does not claim to be exhaustive. The report is based on rigorous research but has not been subjected to academic peer-review process and should therefore not be read as such.

The report presents a high-level review of patient-centred Electronic Health Records for NHS Grampian. The report showcases 13 case studies on the design of person-centred electronic health records as used by multidisciplinary health and care teams.

One of the fastest growing economic sectors globally is Digital Health and Care, spearheading the digitisation of health and care services. A recognised factor restricting the growth of the Digital Health and Care sector in Scotland is the lack of suitably skilled workers. In the Digital Health and Care sector, based on research carried out by the DHI, staff is most urgently required in the following six occupational categories: Software Developers, Product Owners, Implementation Facilitators, Knowledge Engineers, Health Data Analysts and Cyber Security Specialists. This report, produced in partnership with Skills Development Scotland, probes into the nature of these roles, the required skills and capabilities of people employed in these roles, the education and career pathways taken by professionals currently engaged in these roles, and the currently available educational pathways into these roles. The main purpose of this study is to highlight issues underlying the lack of clear career pathways and offer pointers for organisations involved in planning the education and training provision for the (Digital) Health and Care sector in Scotland.

The study aims to understand what makes a 'successful simulation', one that follows the planned sequence of events embedded in the simulated scenario, thus producing the intended learning path and learning outcomes for the participating students. The study is based on observations of 15 full-scale simulation sessions of acute trauma handling during inter-professional training of medical and nursing students. The study shows that the briefing preceding the simulation frames the students' emergent actions during the scenario by demarcating 'possibilities' and 'impossibilities' for actions during the exercise. This in turn defines what actions are 'appropriate' and 'inappropriate' when the scenario is enacted. The simulation exercises are emergent and co-constituted by the diverse participating, socio-material actors. The extent to which this socio-material assemblage manages to produce and maintain the enactment of the patient during the simulation signifies the success or failure of the intended learning path of the exercise. Biographical notes: Song-ee Ahn is a Senior Lecturer at the Department of Behavioural Sciences and Learning, Linköping University in Sweden. Her research interests focus on socio-materialities and educational practices in higher education, such as inter-professional learning, simulation-based medical education and international education.

Abstract: This qualitative study focuses on how knowings and learning take place in full-scale simulation training of medical and nursing students, by drawing upon actor-network theory (ANT). ANT situates materiality as a part of the social practic- es. Knowing and learning, according to ANT, are not simply cognitive or social phenomena, but are seen as emerging as effects of the relation between material assemblages and human actors being performed into being in particular locations. Data consists of observations of simulations performed by ten groups of students. The analysis focuses on the emerging knowings in the socio-material— arrangements of three locations involved in the simulation—the simulation room, the observation room and the reflection room. The findings indicate that medical knowing, affective knowing and communicative knowing are produced in different ways in the different locations and material arrangements of the simulation cycle.

What do different research methods and approaches do in practice? The article seeks to discuss this point by drawing upon socio-material research approaches and empirical examples taken from the early stages of an extensive case study on an interdisciplinary project between two multidisciplinary fields of study, education and computer sciences. The article examines how divergent disciplinary hinterlands influence the enactments of research methods, and how the choice of research approach affects the types of knowledge and realities produced in the research process.

"How do the socio-materialities present at an educational setting, together with the affordances of semantic technologies, affect the process and outcome of technology development? It is usually only the results we see at the end of such process - the means by which we got there are faded out of the picture as irrelevant. This paper examines one instance of technology design, the development of a prototype for a Data Aggregating Document, in detail. The paper pertains to a longitudinal ethnographic case-study of Ensemble (2008-11), an interdisciplinary research and technology development project between education and computer sciences. Drawing upon socio-materialities and Actor-Network Theory, the research and technology development are conceptualised as processes of translation and of socio-material tuning. 
Data Aggregating Document (DAD) is a piece of semantic technology originally developed as part of the work of Ensemble-project with archaeology teaching in mind. DAD is, in short, a digital document with smaller pieces of semantic technology, ‘semantic exhibitlets’, embedded in it. These can visualise data aggregated from various sources, e.g. as maps or timelines.  The DAD emerged as a proposed piece of technology around ‘Artefact-projects’, a structured report written by final year archaeology students on a selected object from the museum archive. Originally only handed in as hard-copy, there was an identified need to digitise the reports in order to make them more available for others at the museum archive. At the same time, this piece of technology was also envisaged to support the creation and teaching of ‘Artefact-projects’.  The paper discusses how the socio-materiality of the ‘Artefact-project’ and the affordances of the semantic technologies mutually affected the technology development process, and how the DAD found its uses in more ‘semantic-ready’ settings.
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Actor Network Theory (ANT) is one of the more controversial approaches in social sciences. It arose in the early 1980s out of criticism towards the more traditional Sociology, which tended to disregard the role of the material and the natural in the constitution of ‘social reality’. In ANT terms, the social is not seen as the ‘glue’ holding society together, but as something made up of essentially non-social components (human, non-human, animate, inanimate entities) constituting networks of relations and being constituted by them. (Latour 2005, 4-5; Law 2007.) The main aim of ANT is to overcome the subject-object divide, the distinction between the social and the natural worlds and to see the reality as enacted. Over the years the ANT approaches have developed into various directions in the hands of different thinkers and disciplines. The aim of the paper is to disentangle some of the conceptual messiness of ANT while considering the potential of applying a strand of the approach in my PhD study, which is linked to an interdisciplinary (Education and Computer Sciences) research and development project Ensemble.

As work and workplaces become increasingly distributed, professional knowing practices are more complex and now reflect an interconnected array of people, ideas, technologies, and other objects. Indeed, sociomaterial sensibilities suggest that it takes both human and nonhuman actors to enact any practice. Actor Network Theory (ANT) is part of the contemporary turn to the relational and material and is well suited to studying hybrid and fluid practices, including connectivity between diverse network elements and the effects generated by such connections.

Yet, not only are approaches to studying these gatherings and heterogeneous processes not well developed, the researcher’s toils in this respect are not often evident in ANT accounts. Having engaged with ANT in our own research, we have learned that it is often challenging to actually apply these approaches to one’s own research questions, methodology, and data. This paper focuses on how we drew on ANT to examine knowing practices of professionals in different work settings and how ANT assisted and resisted our efforts in doing this. We explore more nuanced approaches for the popular ANT edict to “follow the actors” and the importance of attending to multiple and contradictory realities enacted in knowing practices.

We draw on two empirical studies to inform our discussion. Thompson’s research examines how the everyday online work-related learning and knowing practices of the contingent workforce (i.e., self-employed workers) are changing as web and mobile technologies become integrated into globally distributed work-learning spaces. Web-enabled and mobile knowledge spaces are diverse, diffuse, often quite messy, and end up evoking questions of inclusion. Using several ANT-influenced heuristics in an effort to “interview” objects, Thompson examined practices in which human entanglements with objects, such as the posting, the delete button and one’s digital footprint work to shape the learning practices enacted in online spaces. ANT was also used to question the politics of such assemblages. Rimpiläinen carried out a longitudinal, ethnographic case-study, following the unfolding processes of educational research and technology development in an interdisciplinary higher education project called Ensemble, which studied case-based learning in order to develop semantic technologies to support that learning. By drawing on ANT as theoretical practice, approaching the topic through critical ethnographic participation, and using multiple methods for data generation and accumulation, Rimpiläinen opened up to scrutiny the practices, the doing of research and technology development, and was able to trace the emergence of a piece of educational technology through the multiple, at times competing and conflicting, knowledge practices enacted in the project.

Deciding to engage with ANT propels the researcher down a path, influencing the questions asked, the way researchers explore phenomena, what is attended to, how one understands and thinks with their data, and how it might be represented. By exploring the philosophical and practical tensions generated in ANT-influenced research, we hope to create an opportunity for conference participants to interrupt their own knowledge practices as researchers and educators.

A strand of Actor Network Theory (ANT) states that knowledge, as well as reality, objects etc, ‘emerge as continuously generated effects of webs of relations within which they are located’ (Law 2007). This characterization amounts to knowledge being emergent, fluid, contextualized and constructed, produced within heterogeneous material-semiotic-human networks. Being characterised as a sensibility (e.g. Law 2007) rather than a theory or a methodology, ANT is notoriously vague in terms of methods. While it offers ways of tracing the networks out of which knowledge is seen as emerging, it offers very little in terms of helping to answer the question of how precisely does that knowledge emerge, and how to study that. This question became pertinent in trying to find a way of studying the practices of researchers in a large, interdisciplinary research and development project between education and computer sciences. The methods -question was further complicated by the existence of multiple, potentially conflicting epistemological positions present at the project – how to study these without having to pass a value judgement in terms of their validity and reliability? As a potential solution to these questions, this paper proposes examining the ANT take on the emergence of knowledge (reality, objects) through John Dewey’s Philosophical Pragmatism and his transactional theory of knowing. (Biesta & Burbules 2003; Biesta 2009).

What can you learn when participating in an international online course? This is one story about the experiences gained and thoughts that arose during a virtual course on Progressive Inquiry and Knowledge Building. The story is told jointly by Sanna, one of the course tutors and Heli, one of the students. A presentation about the course given at Interactive Technology in Education (ITK07) -conference is accessible in the story.

This chapter illustrate how the social and material arrangements for interprofessional simulation produces different conditions for learning. The first section focuses on the emerging medical knowing, affective knowing and communicative knowing in the socio-material arrangements of three locations involved in the simulation, i.e. the simulation room, the observation room and the reflection room, during the course of events in the scenario. The second section focuses on emerging rhythms of collaboration. Different ways of relating to the manikin as a technical, medical and human body, and the relevance of these findings for simulation pedagogy are described.

This is an ethnographic case-study of research and development practices taking place in an interdisciplinary project between education and computer sciences. The Ensemble-project, part of the Technology Enhanced Learning programme (2008-12), has studied case-based learning in a number of diverse settings in Higher Education, working to develop semantic technologies for supporting that learning. Focussing on one of the six research settings, the discipline of archaeology, the current study has had three purposes. By opening up to scrutiny the practices of research and development, it has firstly sought to understand how a shared research question is answered in practice when divergent research approaches are brought to bear upon it. Secondly, the study has followed the emergence of a piece of semantic technology through these practices. The third aim has been to assess the advantages and disadvantages of Actor-Network Theory (ANT) in studying unfolding, open-ended processes in real time. Through critical ethnographic participation, multiple ethnographic research methods, and by drawing on ANT as theoretical practice, the study has shown the precarious and unpredictable nature of research and development work, the political nature of research methods and how multiple realities can be produced using them, and the need for technology development to flexibly respond to changing circumstances. We have also seen the mutual adoption and extension of practices by the two strands of the project into each others’ domains, and how interdisciplinary tensions resolved, while they did not disappear, through pragmatic changes within the project. The study contributes to the interdisciplinary fields of Science and Technology Studies (STS) where studies on the ‘soft sciences’, such as education, are few, and a new field of Studies in Social Science and Humanities (SSH) which is emerging alongside and from within the STS. Interdisciplinary endeavours between fields pertaining largely to the natural and the social sciences respectively have not been studied commonly within either field.

How do divergent, competing and collaborating human and non-human actors - the socio-materialities - present at any educational setting affect the process and outcome of a design process? How do the affordances of the technology being developed interact with these socio-materialities present in the setting? Usually our attention is on the final outcome of a design process, while the trials and tribulations designers and researchers face during the process of design are faded out of the picture as irrelevant. It is this mundane minutiae that this presentation delves into.
In this presentation we will focus in detail on one instance of technology design, the development of a prototype for use in archaeology teaching. The presentation draws upon a longitudinal ethnographic case-study of Ensemble (2008-11), an interdisciplinary research and technology development project between education and computer sciences (see Rimpilainen 2012). We will examine how a prototype for a Data Aggregating Document (DAD), a piece of semantic educational software, emerged through interdisciplinary practices engaged by the Ensemble, and how the socio-materiality of the archaeology setting and the affordances of the semantic technologies mutually affected the technology development process. We will also see how the designers often worked at the “mercy” of the socio-materialities involved in the process, and guided by them, rather than the other way round. Theoretically the presentation pertains to the broad field of sociomaterial theories (Pickering 1995) and Actor-Network Theory (e.g. Law 2004, Latour 1987, Latour 2005, Mol 2002).