Marlot Kuiper

90 Connective Routines 4.1 Introduction “Ethnography is not for the faint hearted” – Mary Dixon-Woods This chapter describes the research design and methodology that I used in this study, hereby answering the question: “How can professional standards in performance-oriented medical practice be studied?” The question how and why standards work, requires a close and in-depth look at real-life situations. My perspective is a relational one; through a routine lens I examined the mechanisms that fuel (inter)action in professional settings. In order to do so, I adopted an ethnographic methodology. This chapter starts with introducing ethnography ing – a verb - to emphasize the active, processual and iterative nature of this research strategy. I will describe and account for the decisions I made throughout the research process, structured along the three main activities in this ethnographic study: headwork, fieldwork, and textwork (Hulst et al., 2017; Van Maanen, 1995, 2011). As the researcher plays a crucial role in ethnographic studies, I will pay explicit attention to my position and discuss some ethical issues in the remainder of this chapter. The boxes provide additional information for the reader to better able to interpret the findings, concerning the specific case, the Surgical Safety Checklist, the composition of surgical teams, and the surgical trajectory. 4.2 Ethnographying, an ongoing process ‘Ethnography’ is a concept that can refer to a variety of things. Ethnography can for example mean the outcome of a study, a book, ‘an ethnography’. Ethnography can also refer to the process, a methodology, that results in such an ethnography. Next, there are various styles that are all conducted under the same ‘ethnography heading’. Though generally, ethnography means three things: reading and selecting theories, concepts and frameworks, and making sense of the findings (headwork), doing research ( fieldwork ), and articulating and presenting those understandings ( textwork ) (Van Hulst, Ybema and Yanow, 2017; Van Maanen, 1995). It is therefore argued that “ethnography is not a particular method of data collection but a style of research” (Brewer 2000:59) that is distinguished by its objectives to understand the social meanings and activities of people in a field,