Skip to main content

Theorizing Team Process Through a Foucauldian Perspective: Gaining a Voice in Team Activity at the Clinical Coalface

  • Chapter
  • First Online:

Part of the book series: Advances in Medical Education ((AMEDUC,volume 3))

Abstract

While Michel Foucault’s work on the birth of the clinic in Enlightenment France, and the subsequent development of the ‘medical gaze’ as a diagnostic method, has been widely discussed and critiqued, there is little in medical education that deals with his later work on ‘technologies of self’. This work focuses on identity construction as a ‘work’ that is both aesthetic (self-forming) and ethical (practices of the self in relation to others). Foucault returned to late Greek and early Roman sources to show that the forming of self is a characteristic strand throughout Western cultural practices and not a modern invention.

In relation to communication and teamwork in medicine, Foucault’s mapping of power as both resistance and a form of making identities can be readily adapted to explain the nature of clinical team dynamics. Central to how capillary power operates, as a means of resistance to dominant discourses, is parrhesia or ‘truth telling’, also a ‘speaking out’ and ‘moral courage’. While much has been made of ‘whistleblowing’ in medical culture, parrhesia offers a more powerful concept for understanding the dynamics of speaking out in interprofessional team settings, as an essential component of patient safety.

This is a preview of subscription content, log in via an institution.

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   129.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD   169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Agamben, G. (1998). Homo sacer: Sovereign power and bare life. Palo Alto, CA: Stanford University Press.

    Google Scholar 

  • Allard, J., Bleakley, A., Hobbs, A., & Vinnell, T. (2007). ‘Who’s on the team today?’: Collaborative teamwork in operating theatres should include briefing. Journal of Interprofessional Care, 21, 189–206.

    Article  Google Scholar 

  • Beger, H. G., & Arbogast, R. (2006). The art of surgery in the 21st century: Based on natural sciences and new ethical dimensions. Langenbecks Archives of Surgery, 391, 143–148.

    Article  Google Scholar 

  • Bleakley, A. (2001). From lifelong learning to lifelong teaching: Teaching as a call to style. Teaching in Higher Education, 6, 113–116.

    Article  Google Scholar 

  • Bleakley, A. (2002). Teaching as a gift: The gendered gift and teaching as hospitality. In G. Howie & A. Tauchert (Eds.), Gender, teaching and research in higher education. London: Ashgrove.

    Google Scholar 

  • Bleakley, A. (2006a). ‘You are who I say you are’: The rhetorical construction of identity in the operating theatre. The Journal of Workplace Learning, 18, 414–425.

    Article  Google Scholar 

  • Bleakley, A. (2006b). A common body of care: The ethics and politics of teamwork in the operating theater are inseparable. Journal of Medicine and Philosophy, 31, 1–18.

    Article  Google Scholar 

  • Bleakley, A., Bligh, J., & Browne, J. (2011). Medical education for the future: Identity, power and location. Dordrecht, Netherlands: Springer.

    Book  Google Scholar 

  • Bleakley, A., Boyden, J., Hobbs, A., Walsh, L., & Allard, J. (2006). Improving teamwork climate in operating theatres: The shift from multiprofessionalism to interprofessionalism. Journal of Interprofessional Care, 20, 461–470.

    Article  Google Scholar 

  • Bleakley, A., Hobbs, A., Boyden, J., & Walsh, L. (2004). Safety in operating theatres: Improving teamwork through team resource management. Journal of Workplace Learning, 16, 414–425.

    Article  Google Scholar 

  • Bleakley, A., Marshall, R., & Brömer, R. (2006). Toward an aesthetic medicine: Developing a core medical humanities undergraduate curriculum. Journal of Medical Humanities, 27, 197–214.

    Article  Google Scholar 

  • Daston, L., & Galison, P. (2007). Objectivity. New York: Zone Books.

    Google Scholar 

  • Flynn, T. (1987). Foucault as parrhesiast: His last course at the College de France. Philosophy and Social Criticism, 12, 213–229.

    Article  Google Scholar 

  • Foucault, M. (2001). Fearless speech. New York: Semiotext[e].

    Google Scholar 

  • Franĕk, J. (2006). Philosophical parrhesia as aesthetics of existence. Continental Philosophy Review, 39, 113–134.

    Article  Google Scholar 

  • Frank, A. W. (1999). Relations of power and ‘informed choice’: Commentary on Rose Weitz’s ‘watching Brian die’. Health, 3, 239–246.

    Google Scholar 

  • Gawande, A. (2009). The checklist manifesto: How to get things right. London: Profile Books.

    Google Scholar 

  • Gawande, A. A., Zinner, M. J., Studdert, D. M., & Brennan, T. A. (2003). Analysis of errors reported by surgeons at three teaching hospitals. Surgery, 133, 614–621.

    Article  Google Scholar 

  • Giddings, A. E. B., & Williamson, C. (2007). The leadership and management of surgical teams. London: The Royal College of Surgeons of England.

    Google Scholar 

  • Hardt, M., & Negri, A. (2001). Empire. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Hardt, M., & Negri, A. (2006). Multitude: War and democracy in the age of empire. Harmondsworth, England: Penguin.

    Google Scholar 

  • Hardt, M., & Negri, A. (2009). Commonwealth. Cambridge, MA: Harvard University Press.

    Google Scholar 

  • Heron, J. (2001). Helping the client: A creative practical guide (5th ed.). London: Sage.

    Google Scholar 

  • Hobbs, A., & Bleakley, A. (2005, March 18–19). Close-call reporting. In Risk management: Health care risk report.

    Google Scholar 

  • Iedema, R. (Ed.). (2007). The discourse of hospital communication: Tracing complexities in contemporary health care organizations. Basingstoke, England: Palgrave Macmillan.

    Google Scholar 

  • Levinas, E. (1969). Totality and infinity. Pittsburgh, PA: Duquesne University Press.

    Google Scholar 

  • Lingard, L., Reznick, R., DeVito, I., & Espin, S. (2002). Forming professional identities on the healthcare team: Discursive construction of the ‘other’ in the operating room. Medical Education, 36, 728–734.

    Article  Google Scholar 

  • Lingard, L., Reznick, R., Espin, S., Regehr, G., & DeVito, I. (2002). Team communications in the operating room: Talk patterns, sites of tension, and implications for novices. Academic Medicine, 77, 232–237.

    Article  Google Scholar 

  • McGushin, E. (2007). Foucault’s askēsis: An introduction to the philosophical life. Evanston, IL: Northwestern University Press.

    Google Scholar 

  • Pignatelli, F. (1993). Dangers, possibilities: Ethico-political choices in the work of Michel Foucault. Philosophy of Education. Retrieved from http://www.ewd.uiuc.edu/EPS/PES-Yearbook/93_docs/PIGNATEL.HTM

  • Pronovost, P., & Vohr, E. (2010). Safe patients, smart hospitals: How one doctor’s checklist can help us change health care from the inside out. New York: Hudson Street Press.

    Google Scholar 

  • Rabinow, P. (1994). Modern and countermodern: Ethos and epoch in Heidegger and Foucault. In G. Gutting (Ed.), The Cambridge companion to Foucault (pp. 197–214). Cambridge, England: Cambridge University Press.

    Chapter  Google Scholar 

  • Sharpe, M. (2007). A question of two truths? Remarks on parrhesia and the ‘political-philosophical’ difference. Parrhesia, 2, 89–108.

    Google Scholar 

  • Sorensen, R., & Iedema, R. (Eds.). (2008a). Managing clinical processes in health services. Sydney, New South Wales, Australia: Mosby, Elsevier.

    Google Scholar 

  • Sorensen, R., & Iedema, R. (Eds.). (2008b). Managing clinical processes in health care. London: Elsevier.

    Google Scholar 

  • Strauss, A., Schatzman, L., Ehrlich, D., Bucher, R., & Sabshin, M. (1963). The hospital and its negotiated order. In E. Freidson (Ed.), The hospital in modern society (pp. 147–169). New York: Free Press of Glencoe.

    Google Scholar 

  • Whyte, S., Lingard, L., Espin, S., Ross Baker, G., Bohnen, J., et al. (2008). Paradoxical effects of interprofessional briefings on OR team performance. Cognition, Technology & Work, 10, 287–294.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Bleakley, A. (2014). Theorizing Team Process Through a Foucauldian Perspective: Gaining a Voice in Team Activity at the Clinical Coalface. In: Patient-Centred Medicine in Transition. Advances in Medical Education, vol 3. Springer, Cham. https://doi.org/10.1007/978-3-319-02487-5_12

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-02487-5_12

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-02486-8

  • Online ISBN: 978-3-319-02487-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics