A Dynamic Theory of Expertise and Occupational Boundaries in New Technology Implementation: Building on Barley's Study of CT Scanning

Abstract

In this paper, we develop a theory to explain why the implementation of new technologies often disrupts occupational roles in ways that delay the expected benefits. To explore these disruptions, we construct a dynamic model grounded in ethnographic data from Barley's widely cited (1986) study of computed tomography (CT) as implemented in two hospitals. Using modeling, we formalize the recursive relationship between the activity of CT scanning and the types and accumulations of knowledge used by doctors and technologists. We find that a balance of expertise across occupational boundaries in operating the technology creates a pattern in which the benefits of the new technology are likely to be realized most rapidly. By operationalizing the dynamics between knowledge and social action, we specify more clearly the recursive relationship between structuring and structure. *