Marlot Kuiper

93 On Ethnography ing First of all, it is of crucial importance that the research field fits the (theoretical) research problem. An important observation from the literature was that the reconfiguration of professional work through the implementation of formalised standards was a highly ‘alive’ and debated topic in the medical domain. This becomes for example visible in the emergence of the field of ‘implementation science’ and the many studies on standard implementation that are conducted in this subfield (see also chapter 2). Exploratory conversations with key actors in the field underlined that the implementation of standards in this domain is also considered an important practical problem that is of great concern to many. Further, the specific nature of surgical care makes this an especially relevant field to study the reconfiguration of professional work through standardization. First of all, professionals working in surgical care are considered the ‘archetypical’ professionals (see e.g Etzioni, 1969;Fox, 1992 Freidson, 1970). In this field, the contrast between a long tradition of autonomous work characterised by professional judgment, and the introduction of strict formalised standards is assumed to become most evident. Secondly, characteristic for this professional environment is that consists of various professional segments. Strong socialization within subgroups makes that the different segments each have their own taken-for-granted ways of acting and talking (Baker et al., 2011; Cameron, 2011; Freidson, 1994; Hall, 2005). New standards increasingly require professionals to apply generic, formal standards, and cross the boundaries of their professional segments. The matter of connectivity that is an important part of the research problem, is an urgent and complex issue in this domain. Thirdly, the surgical domain is undergoing constant development in surgical interventions and technologies, and as a result, surgery had not only become a specialized system of work, but also a domain where continuous adaptation is normal (Benn et al., 2008). Given the capacity to adapt and the many successes of innovations and ground-breaking therapies, the paradox of introducing a seemingly simple new standard such as a safety checklist that shows problematic in practice, makes this a crucial field to probe into. Secondly, although the suitability of the research field may be considered most important, access to the field is prerequisite to conduct an in-depth ethnographic study. An important aspect in the selection of surgical care therefore was access to the field. The university department from where I conducted this research project, established a firm and enduring collaboration with the medical faculty of the University (for example resulting in the ‘focus area’ Professional Performance) which smoothened access to the field. Further, a gate-keeper (Burgess, 1982, 4