Coordinating the expertise of scientists, health professionals and patients in interventional re-search against cancer
Résumé
As part of the REFLEXISS research contract (funded by INCa, French National Institute of cancer), sociologists and psychosociologists have integrated a workshop on the co-construction of a therapeutic patient education program (TPE) concerning the taking of oral anticancer drugs (OACD) led by the Department of Support Care (DISSPO) of the University Institute of Cancer Toulouse (IUCT-O). Over the course of a year, this monthly workshop brought together experts in oncology and TPEs (Therapeutic Education Program), specialty physicians, pharmacists, and nurses. All these professionals are trained in TPE (40h). They work in hospitals or "in the city". This system also integrated patients—current and former OACD users—recruited by the heads of DISSPO for their practical knowledge. The researchers acted as observers in the workshops. Through monthly shared reflexivity seminars (organized under REFEXISS research contract), they endeavored to share their analyses with the heads of DISSPO and the patients in the workshops. The REFLEXISS contract research try to reduce inequalities by considering and bringing out the patients knowledge and coordinating these expertise with those of scientists, and health professionals. Using qualitative research interviews (15), analysis of discussion from the reflexivity seminars, and ethnographic observation of these workshops, the research shows that the transfer and circulation of knowledge and approaches of thought is closely related to the nature of the relationships that are established between the different key players. We are particularly interested in the way in which trust relationships develop between the workshop participants. The survey related that an important work of supervision and accompaniment is necessary for build exchanges and trust. The researchers who led the reflexivity seminars, such as the heads of DISSPO who led the workshop, strove to erase the asymmetries of knowledge and power between the different key players. In order to promote more fluid relationships, greater circulation of resources, and the extension of what we perceive as a sociotechnical network (Akrich, Callon, Latour, 2006), these leaders deployed five types of generic sociocognitive skills beyond the specific knowledge they possessed; namely interessement, enrolment, translation, hybridization, and formalization. The paper will show how these five skills are more or less available to the participants and how the facilitators will try to build them by using different pedagogical tools. Ultimately, the survey reflects difficulties and successes in the desire to coordinate the knowledge of patients, health professionals and scientists to build collective expertise. The research also highlights the effects of co-learning between these different actors.
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