This article deals with surgical practice as it is locally organized within the course of the operation; it focuses on the way in which surgical action shaping the body for the local purposes of the operation is organized in a timely, situated, interactive manner. In order to do that, I offer a systematic analysis of the instructions addressed by a chief surgeon to his assistant in the form of directives during a surgical operation, as well as of instructed actions of (...) the assistant following the directives of the surgeon. In this way, I aim to show how surgery is a methodic collaborative achievement, relying on finely tuned coordination between staff members. More generally, the article sketches a systematic and detailed analysis of instructions as situated accomplishments in time, and of instructed action as resulting from an embodied and indexical understanding of directives and requests as they are produced in time and in context. (shrink)

Examining a fragment of interaction that occurred during a surgery at a teaching hospital, we explore how particular instructed experiences are produced for two trainees, a surgeon in the residency program and a medical student in a surgical clerkship. We are concerned with what is produced as learnable in each case. Stated slightly differently, we are interested in the ways in which the attending surgeon uses demonstrations as instruction and the ways in which recipients of that instruction, in this case (...) the resident and the clerk, respond with enactments of those demonstrated actions. The recipients of this kind of instruction participate in a form of experiential learning in which they enact their own versions of the instructor’s demonstrated actions to be observed and assessed by the instructor. These enactments provide learners with experiential access to the instructor’s demonstrated actions. They are designed to be experiences that learners may draw upon to make experientially warranted claims at some later time. (shrink)