October 2017 April 2016

Te Puawai Method or Madness?: The Dominance Of The Systematic Review In Nursing Scholarship Article by: Annemarie Jutel First published in: Aporia The Nursing Journal, 2012 Vol.4, Issue 4 pages 52-57 Reprinted with permisssion Aporia The Nursing Journal can be viewed here: http://www.oa.uottawa.ca/journals/aporia/ In 1972, Irving Zola published his seminal piece, “Medicine as an institution of social control,” in the journal Sociological Review. This eloquently written article defines medicalisation and develops an explanatory theory for medicine’s expanding jurisdiction and social authority in contemporary society. This piece stood in contrast to his earlier empirical social science research, interviewing attendees at the Ear Nose and Throat clinic about their presenting complaints. [1] He could not have known at the time, any more than could have his publishers, the impact that his reflections on medicalisation would have on the field. Presented differently, reflecting different methodological perspectives, both publications nonetheless contributed to furthering of the sociology of health and illness. As the example of Zola underlines, there are many ways to advance knowledge, and scholarship takes many forms. A discipline which is generous in determining what it values as scholarship and how it can be presented is poised to embrace the novel, the exceptional and the transformative. Who would have thought, for example, that comedy might contribute to academic discussions of medicine? The benefit of hindsight shows us the importance of Leonard Stein’s 1968 “DoctorNurse Game”.[2] This text was included in a tome entitled “classic texts in health care”[3], and is cited prolifically in nursing, medical and interdisciplinary journals which explore inter-professional relationships in health. Remarkably however, this article was presented as humour, complete with cartoon caricatures of swan-necked, white-capped sisters, and eyebrow-raised, stethoscoped medical specialists throwing darts at a professional wheel of fortune. It is not alone in its genre. Richard Smith’s[4] light-hearted “In search of non-disease” made important points about the social framing of disease which have been well-exploited by numerous academic writers since its rather recent publication. Like humour, simple stories also deliver important truths. Arthur Frank’s At the Will of the Body, an account of his personal experience of serious illness is a poignant example of scholarship through narrative. His stories and others like it now buttress a wide range of disciplinary discussions in nursing, social science and medicine. I take particular inspiration in my own work from Suzanne Fleischmann[5] and Mildred Blaxter’s[6] respective (and poignant) accounts of the diagnostic trajectory in illnesses which were ultimately to prove fatal to both. They “speak” eloquently to me as nurse, as I identify with the authors’ suffering, but they also highlight important critical principles like the transformative nature of the diagnostic label, and the silencing impact of diagnostic technology. © Te Puawai College of Nurses Aotearoa (NZ) Inc 12

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