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Dieticians Understanding of Coeliac Disease: An Empirical Investigation of Interactional Expertise. Robert Evans 1, and Helen Boyce 2 1 Centre for the.

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Presentation on theme: "Dieticians Understanding of Coeliac Disease: An Empirical Investigation of Interactional Expertise. Robert Evans 1, and Helen Boyce 2 1 Centre for the."— Presentation transcript:

1 Dieticians Understanding of Coeliac Disease: An Empirical Investigation of Interactional Expertise. Robert Evans 1, and Helen Boyce 2 1 Centre for the Study of Knowledge, Expertise and Science (KES), Cardiff School of Social Sciences http://www.cardiff.ac.uk/socsi/expertise 2 Health Services Research Unit, Dept. Of Public Health, University of Oxford

2 Overview The Imitation Game Key Ideas Software and data Imitation Games with Coeliacs Hypotheses Aggregate Results Successes, Failures and Interactional Expertise Conclusions What next?

3 Imitation Game

4 Two Kinds of Expertise Contributory expertise: enables those who have acquired it to contribute linguistically and practically to the community through the expertise is sustained. The most common usage of the word expert. Interactional Expertise: expertise in the language of a specialism in the absence of expertise in its practice. Like contributory expertise, it requires the tacit-knowledge acquired by immersion in a form-of- life (i.e. socialisation). It enables individuals to talk as if they had contributory expertise even though they lack practical or craft skills. Collins and Evans (2002)

5 Embodiment and Expertise http://bmrc.berkeley.edu/courseware/cs298/spring99/w9/slides/sld006.htm

6 Turing Tests and Imitation Games In the Turing Test, the judge must decide which is the computer and which is the human. In the Imitation Game, the judge must decide which participant shares their social group.

7 Modern Imitation Game Female judge setting questions Female answering naturally Male pretending to be female How often do you pluck your eyebrows? R2 not very often, when they need doing R1 once a week R2 is female because I expected the man to believe women are more regulated in their beauty regime than they actually are

8 Coeliac Disease

9 Autoimmune condition affecting approx 1 per cent of population Intolerance to gluten Usually accompanied by symptoms but only confirmed by blood test Leads to damaged intestine and reduced uptake of nutrients Treatment Life-long gluten-free diet From 1998

10 Doctors and Patients Scientific vs lay/patient understandings Too often, it seemed, parents had received from such experts a message of despair when they were desperate for one of hope. Knowledge was offered in the wrong form, reflecting priorities different from those of practical action; in the wrong way … ignoring emotional traumas which parents might be undergoing (Layton et al (1993, Inarticulate Science).

11 Research Questions Judge is coeliac Target expertise isliving with coeliac disease Dieititian has to pretend to have coeliac disease Prediction: Judge will succeed in identifying dietitian Reason: disciplining expertise Outcome = Identify Condition Judge is coeliac Target expertise isliving with coeliac disease Dieititian has to pretend to have coeliac disease Prediction: Judge will NOT succeed in identifying dietitian Reason: interactional expertise Outcome = Chance Condition

12 Imitation Games with Dietitians

13 Sample and data Coeliac sample recruited Snowball sample via family and friends Facebook and Yahoo groups for people living with Coeliac disease Dietitian sample recruited by Direct email to online directory of freelance dietitians Direct email to NHS depts 119 Imitation Games in total 12 Phase 1 games 107 Phase 2 games

14 Aggregate results and recoding Key:Coeliac = correct identification of contributory expert Dietition = incorrect identificaton / dietitian fools judge

15 Identification Ratio 40 53 26 106 13 IR = 0.11

16 Comparisons Between Topics Mean IR approx 0.02

17 Comparisons across topics Mean IR for ID condition approx 0.6 Mean IR for Chance condition approx zero

18 Comparisons between dietitians

19 Dietitians Knowledge -- success

20 Dietitians Knowledge Eating Out All dietitians demonstrated some interactional expertise e.g. difficulties at social events, need to plan ahead, bring emergency supplies Could be common knowledge? Emotional aspects Only dietitians with higher levels of interactional expertise were explicitly acknowledged as getting this right e.g. stress caused by being seen as fussy eater

21 Dietitians Knowledge -- Mistakes

22 Dietitians Knowledge Dietitians Identified by Mistakes – not careful enough to avoid cross- contamination, reading labels, not an allergy Limited identification – bringing own food does not always make you feel part of the crowd, gluten-free baking is not easy! Wrong discourse – Coeliac disease is not a problem Stylistic factors – use of examples often persuasive; clinical or advisory style often a giveaway Repair work Some really bad answers excused by judges who think dietitian is newly diagnosed patient

23 Conclusions Overall outcome is chance condition Dietitians have interactional expertise Level of interactional expertise varies Caveats Need control group of lay persons Imitation Game as comparative method with different health professionals with different illness or health issues with different training / education

24 Imitation Game References Collins, Harry and Robert Evans (2002) The Third Wave of Science Studies: Studies of Expertise and Experience, Social Studies of Sciences, 32 (2): 235-96. Collins, Harry and Robert Evans (2007) Rethinking Expertise, Chicago, IL: The University of Chicago Press. Collins, Harry, Robert Evans, Rodrigo Ribeiro and Martin Hall (2006), Experiments with Interactional Expertise, Studies In History and Philosophy of Science, Volume 37, No. 4 (Dec 2006), pp. 656-674. Evans, Robert and Harry Collins (forthcoming, 2010) Interactional Expertise and the Imitation Game in Michael Gorman (ed) Trading Zones and Interactional Expertise: Creating New Kinds of Collaboration, Chicago, IL: MIT Press


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