3 - Developmental studies of work as a testbench of activity theory: The case of primary care medical practice  pp. 64-103

Developmental studies of work as a testbench of activity theory: The case of primary care medical practice

By Yrjö Engeström

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Introduction

When I write about the theory of activity, I am using a double-edged notion. On the one hand, it is necessary to emphasize the unique and self-consciously independent nature of the Soviet cultural-historical research tradition, which today is commonly called activity theory (see Leont'ev, 1978; Leontyev, 1981; Wertsch, 1981). On the other hand, this tradition is not a fixed and finished body of strictly defined statements – it is itself an internationally evolving, multivoiced activity system.

Rumors about activity theory have been around in Western behavioral and social sciences for some time. But in many ways, this theoretical approach is still one of the best-kept secrets of academia. This is partly due to language barriers, partly to the epistemological foundations of activity theory, which are not immediately transparent to scholars unfamiliar with classical German philosophy and dialectics (see Ilyenkov, 1982; Lektorsky, 1980/1984; Mikhailov, 1980 – and Bakhurst, 1991, for a careful Anglo-Saxon interpretation). And when a Western researcher begins to realize the impressive dimensions of theorizing behind the activity approach, she or he may well ask: Is it worth the trouble? Can it be used to produce something interesting? How does one do concrete research on the basis of activity theory?

This chapter aims at answering those questions, if only partially and sketchily. Others have begun such bridge building in the fields of education (Moll, 1990), language socialization (Ochs, 1988), design of computer interfaces (Bødker, 1990), and explanation of skilled action (Keller & Keller, this volume). I shall focus on expert work as collective, institutionally organized activity.