Professionals as Change Agents or Instruments of Reproduction? Medical Residents’ Reasoning for Not Sharing the Electronic Health Record Screen with Patients

Celeste Campos-Castillo, Noelle Chesley, Onur Asan

    Research output: Contribution to journalArticlepeer-review

    1 Scopus citations

    Abstract

    The stability of physicians’ authority over patients despite decades of changes in medicine conflicts with newer institutionalist accounts of professionals as change agents rather than instruments of reproduction. We analyzed whether the cultural scripts that twenty-one residents used to justify their approach to a new change, the electronic health record (EHR), signaled a leveling of the patient-physician hierarchy. Residents are intriguing because their position makes them open to change. Indeed, residents justified using the EHR in ways that level the patient-physician hierarchy, but also offered rationales that sustain it. For the latter, residents described using the EHR to substantiate their expertise, situate themselves as brokers between patients and the technology, and preserve the autonomy of clinicians. Our findings highlight how professionals with little direct experience before a change can selectively apply incumbent scripts to sustain extant structures, while informing newer institutionalist accounts of professionals and the design of EHR systems.

    Original languageEnglish
    Article number367
    JournalFuture Internet
    Volume14
    Issue number12
    DOIs
    StatePublished - Dec 2022

    Keywords

    • agency
    • neo-institutionalism
    • professional autonomy
    • screen sharing
    • sociotechnical systems

    Fingerprint

    Dive into the research topics of 'Professionals as Change Agents or Instruments of Reproduction? Medical Residents’ Reasoning for Not Sharing the Electronic Health Record Screen with Patients'. Together they form a unique fingerprint.

    Cite this