Instrumental action: the timely exchange of implements during surgical operations

In this paper we analyse an apparently simple collaborative activity, that of passing an implement from one person to another. The particular case we consider is surgical operations where nurses and surgeons routinely pass instruments to one another. Through fine-grained analysis of specific instances we address,- the preparatory work engaged in prior to passing, the ways in which the layout of artefacts is organised with respect to the temporal ordering of the activity, and how this arrangement can be reconfigured in the light of problems and circumstances that arise in an operation. We examine how passing an implement is finely shaped within the course of its articulation with regard to emerging actions of the participants. We suggest that an analysis of fine details of seemingly simple activities with objects may have implications for our understanding of collaborative work, and a one or two key concepts that have informed the design of advanced solutions.