I am studying for a master?s degree in health humanities. Looking into
knowledge production. Using the example: a randomised controlled trial,
because it is considered a gold standard in clinical practice today. As an
example I am using Mary E. Hannahs study: Planned caesarean section versus
planned virginal birth for breech presentation at term: a randomised
multicenter trialReading the article one can see that it is well organized
and respond to many prime principle of a wellconducted RCT. In my study I
try to use Latour (a social scientist) who suggested using actor-network
theory to study science in action. It to late to study the Term Breech
Trail (TBT) while it was conducted. So I have to use the protocol,
newletters, stories, letters that was written in respons to the trial and
so on, to try to get behind the scene- to understadn how this new knowledge
came into beeing and why it had such streengt that it could change
practice. Latour talks of black boxes a concept used by cyberneticians
whenever a piece of machinery or a set of commands is to complex. In its
place they draw a little box about which the need to know nothing but its
input and output??There are several black boxes in this trial (as it is in
all trials). There is two black boxes that interest my mostly: that is
A) The obstetrical practice
B) The labelling process of the ?experienced clinician?
How is the relationship between the description in the articel and the
lived practice?
Before the trial was started a consensus meeting was held in Canada: on
?how to conduct a vaginal breech delivery?.. The principle for good
obstetrical care being laid out. (Such as no total extraction should be
done/ controlled delivery of the head by forceps or Mauriceau-Smelie-Veit
manoeuvre should be used) I wonder how these recommendation far/near to
practice this recommendation where in the participating centres and how
these pricipel was translated into different clinical practices? Maybe you
where a midwife working on one of the participating centres? Would you tell
about the practice around virginal breech delivery, before and during the
trial? I also wonder if any of you participated in the study as clinicians?
The study only use the word clinician or obstetrician, never midwife. Don?t
midwife attend to breech deliveries in any of the participating countries?I
would also love to hear how the study has affected practice in your
centre/country. do you know it the history of the study has been reported
anywhere /maybe interviews?) who initiated it and supported it?
Looking forward to hear from you
jette Clausen (midwife)
Ladefogedvej 90
8200
Århus N
Denmark
telephone:8678 2327
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