–9–
participants (i.e., a sequence of dissection and cautery tools employed by Resident, a retractor
tool used by Attendings, and the rod lens controlled by Clerk) enter the patient’s body through
different "ports" (see, again, Figure 3) but converge at a common worksite within the patient’s
abdomen. Looking within the endoscopic space was a team effort, therefore, in which Clerk
steadied and directed the fiber-optic lens, Attending held aside obstructing organs, while
Resident attempted to isolate relevant structure from surrounding connective tissue. One of the
greatest technical challenges confronting them was to correctly identify the cystic artery, as
serious post-operative complications may arise if an incorrect vessel were inadvertantly ligated.
"Can you see the cystic artery yet?"
Here we analyze a fragment of interaction of approximately one minute in duration
among Attending (ATT), Resident (RES), and Clerk (CLK). An extended transcript for the
fragment of videotaped interaction analyzed here can be found in Appendix B.
3
As the
fragment begins, Attending continued with a description of the surgical procedure for the benefit
of Clerk.
4
As Attending went on, Resident produced an ostensive reference in overlap with Attending’s
"that way there is nuthin."
development" (ZoPD) whereby the performance of learners is enhanced or "scaffolded" by the assistance
provided by more capable others (Newman, Griffin, & Cole, 1989; Vygotsky, 1978). Resident and
Attending might be considered to create a ZoPD for Clerk, while Attending in more subtle ways also
provides a ZoPD for the resident.
3
The transcription conventions used here were developed by Gail Jefferson and are described in Atkinson
and Heritage (1984). These conventions are summarized in Appendix A.
4
Sometimes Attending instructs and teaches Clerk in ways that may subtly prompt Resident.
1 ATT: Yeah (.) the other “thing to do:: is make sure you
2 have your cystic (.) artery out §too.
3 RES: ”(Right there)
4 CLK: Uh huh
Convention