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Semiotic analysis of clinical chemistry: for " knowledge work " in the medical sciences

Abstract In this thesis a socio-cultural perspective of medical science education is adopted to argue the position that undergraduate medical scientists must be enculturated into the profession as knowledge workers and symbolic analysts who can interact with computers in complex analytical procedures, quality assurance and quality management. The cue for this position is taken from the transformations taking place in the pathology industry due to advances in automation, robotics and informatics. The rise of Evidence-Based Laboratory Medicine (EBLM) is also noted and the observation by higher education researchers, that knowledge systems are transforming in such a way that disciplines can no longer act in isolation. They must now collaborate with disparate fields in transdisciplinary knowledge systems such as EBLM, for which new skills must be cultivated in undergraduate medical scientists. This thesis aims to describe a theoretical basis for knowledge work by taking a semiotic perspective. This is because, semiotics, a theory of signs and representations, can be applied to the structure of transdisciplinary scientific knowledge, the logic of scientific practice and the rhetoric of scientific communications. For this purpose, a semiotic framework is first derived from a wide range of semiotic theories existent in the literature. Then the application of this semiotic framework to clinical chemistry knowledge, context, logic, and rhetoric is demonstrated. This is achieved by interpreting various clinical chemistry data sources, for example, course materials, laboratory spatial arrangements, instruments, printouts, and students' practical reports, collected from a teaching laboratory situation. The results of semiotic analysis indicate that the clinical chemist working in the computerised laboratory environment performs knowledge work, and the term is synonymous with symbolic analysis. It is shown that knowledge work entails the application of a systematic structure for clinical chemistry knowledge derived in terms of the validation procedures applied to laboratory, data, results and tests; the application of logic in the classification and selection of instruments, their rulegoverned- use, and in troubleshooting errors; pragmatic decisions based on availability of space, services and budgets; discrimination among values in laboratory test evaluations in EBLM, for the cost-effectiveness and relevance of pathology services; and the recognition of rhetorical strategies used to communicate laboratory test information in graphs, charts, and statistics. The role of the laboratory context is also explained through semiotics, in terms of its spatial arrangements and designs of laboratory instruments, as a place that constrains the knowledge work experience. This contextual analysis provides insights into the oppositional trend brought to wide attention by analysts of computerised professional work, that more skills are needed, but that there are fewer highly skilled positions available. The curriculum implications of these findings are considered in terms of the need to cultivate knowledge workers for highly complex symbolic analysis in computerised laboratories; and also the need to prepare medical science graduates for the transdisciplinary knowledge system of EBLM, and related venues of employment such as biomedical research and clinical medicine. In meeting the aims to define and demonstrate knowledge work from the semiotic perspective, this thesis makes an original contribution to knowledge by the application of semiotics to a field in which it has probably never been tested. It contributes to the scholarship of teaching in higher education by formulating a structure for transdisciplinary medical science knowledge, which integrates scientific with other forms of knowledge, and with real world practice.

Identiferoai:union.ndltd.org:ADTP/264802
Date January 2003
CreatorsCarberry, Helen
PublisherQueensland University of Technology
Source SetsAustraliasian Digital Theses Program
Detected LanguageEnglish
RightsCopyright Helen Carberry

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