The tacit order of teamwork: Collaboration and embodied conduct in anesthesia

This article explores the interactional organization of collaborative work in the field of anesthesia. "Anesthetic teams" provide a distinctive case for the analysis of collaborative work, because their work is undertaken with, around, and on an aware and variously involved coparticipant, namely, the patient. To explore such collaboration, this article draws on ethnomethodology and conversation analysis to examine audiovisual data of naturally occurring preoperative anesthetic work recorded in a British hospital. There are three key consequences of the analysis that we elaborate: first, it points toward the limitations of Erving Goffman's regions metaphor for explicating the organization of collaborative work in settings like anesthesia; second, it reveals key organizing practices and skills associated with in situ teamworking that are distinctly absent from the literature on health-care teams; third, it points toward the critical importance of analyzing embodied conduct, not just language or talk, when examining copresent organizational activities. [Practice]... includes all the implicit relations, tacit conventions, subtle cues, untold rules of thumb, recognizable intuitions, specific perceptions, well-tuned sensitivities, embodied understandings, underlying assumptions and shared world views. Most of these may never be articulated, yet they are unmistakable signs of membership in communities of practice and are crucial to the success of their enterprises.