Technology use and patient participation in audiological consultations

In this paper, we present a study of audiologists’ use oftechnology in consultations with patients. We highlight theways in which the hardware and software the audiologistuses to adjust the settings on the patient’s hearing aid arenot designed with their necessary use within theconsultation’s interaction in mind. Rather, the technology isdesigned for use by a single user with audiological training.Furthermore, the local interactional context (in theconsultation) in which the technology is used createsdifficulties for patients to follow the course of their owntreatment. For example, the relevance of the audiologists’actions with the technology is often not available to thepatient. Patients cannot know (due to both thearrangement of the computer and the technicalsophistication of the software’s interface) whether or notthe audiologist is actually addressing their problem whendoing something with the technology. We argue that thetechnology is much more than simply a professional medicaltool that mediates an adequate solution to patients’difficulties. The move towards “patient-centred” design oftechnologies must appreciate the variety of roles of thesetechnologies in the consultation. Such roles of thetechnology in a consultation include patient education,explanation, demonstration, and the medical professional’sjustification of treatment decisions. In making theseobservations, we suggest that the existing design and use oftechnology can marginalise patients’ own participation intheir treatment.