Åsa Mäkitalo

• Brandenberger, Isabel Alexandra & Mäkitalo, Åsa (2025). Care with assistive technologies: professional responsibility when learning to navigate the unforeseen in homecare services. Journal of Workplace Learning. ISSN 1366-5626. doi: 10.1108/JWL-05-2024-0111. Full text in Research Archive Show summary

  Purpose This study aims to explore how responsibility is managed by an interprofessional team of healthcare professionals when unforeseen challenges in the use of assistive technologies in homecare raise concerns for care. Design/methodology/approach An ethnographic approach was used to study the daily work of integrating assistive technologies into homecare services. By observing 27 interprofessional team meetings, this paper investigated how challenges in using these technologies for specific cases were handled collectively through professional discussions. Sociomaterial and practice-theoretical perspectives were used to analyze actors and relations expressed as healthcare professionals discussed their concerns, and how responsibilities were reconsidered in ongoing patient care. Findings In analyzing the meeting discussions, this paper found that unforeseen challenges put the professional responsibility of the healthcare team at stake in knowing how to respond. This paper found that healthcare workers collectively managed distributed responsibilities by a) reviewing specific user cases and b) reconsidering responsibilities. This paper propose that this “responsibility work” and the care for entanglements it entails contribute to the stabilization of homecare service practices by embedding the use of technology in the constantly changing health needs of users. Originality/value This article proposes the notion of responsibility work as a constitutive part of practitioners’ knowing and learning at work in complex organizations under digital transformation. In such work, the complexities stemming from emerging concerns and specific entanglements are collaboratively managed as matters of care through professional discussions in situated workplace practices.

• Sadorge, Christopher; Nerland, Monika & Mäkitalo, Åsa (2023). Conditioning the work of colleagues: health professionals’ explorative work in technology design. Vocations and Learning. ISSN 1874-785X. doi: 10.1007/s12186-023-09331-0. Full text in Research Archive Show summary

  Abstract Professional learning at work is related to the opportunities to participate in explorative and constructive practices. Co-designing tools and technologies to support work offers such opportunities, which need to be better understood in the field of professional and vocational learning. As digitalisation initiatives become more ambitious and aim at wider service reorganisation, more professionals from nontechnical domains become involved in the work of designing technologies and developing routines for their practice. This study explores how health professionals participate in the design of a technology for the registration and sharing of patient information across healthcare units in a Norwegian city. Over a year, we observed the design meetings with a team of health professionals and IT developers. The health professionals were mandated this task as part of their regular work to ensure that the way of categorising and displaying patient information would serve the services’ needs. The interactions in the design meetings were analysed to examine how categories of patient information were explored and negotiated as objects of design. Our findings show how the team needed to test candidate categories for various contexts of use. This implied both negotiation of future service routines and efforts to reconfigure tasks and responsibilities in multiple service contexts. This work brings extended responsibilities and opportunities for learning to health professionals. We discuss how their decisions are consequential beyond their own workplace as the information system and its categories condition the work of colleagues in the wider service chain.

• Silseth, Kenneth; Hontvedt, Magnus & Mäkitalo, Åsa (2022). Teachers’ enactment of policy in classrooms: making students accountable through inscriptions from the curriculum in classroom interactions. European Journal of Psychology of Education (EJPE). ISSN 0256-2928. 38(2), p. 881–902. doi: 10.1007/s10212-022-00610-3. Full text in Research Archive
• Damsa, Crina I.; Erstad, Ola Andres; Sefton-Green, Julian; hillman, Thomas; Moya, Andres Arturo Araos & Richter, Christoph [Show all 12 contributors for this article] (2022). Platformization in and of education ̶Exploring a new research agenda. Computer-Supported Collaborative Learning Series (CSCL). ISSN 1573-4552. Full text in Research Archive
• Cederberg, Matilda; Fors, Andreas; Ali, Lilas; Goulding, Anneli & Mäkitalo, Åsa (2022). The interactive work of narrative elicitation in person-centred care: Analysis of phone conversations between health care professionals and patients with common mental disorders. Health Expectations. ISSN 1369-6513. doi: 10.1111/hex.13440. Full text in Research Archive Show summary

  Introduction: Narratives play a central part in person-centred care (PCC) as a communicative means of attending to patients' experiences. The present study sets out to explore what activities are performed and what challenges participants face in the interactive process of narrative elicitation, carried through in patient-professional communication in a remote intervention based on PCC. Methods: Data were gathered from a randomized controlled trial (RCT) in a Swedish city where health care professionals (HCPs) conducted remote PCC for patients on sick leave due to common mental disorders. A sample of eleven audio‐recorded phone conversations between HCPs and patients enroled in the RCT were collected and subjected to conversation analysis. Results: Three interactive patterns in narrative elicitation were identified: Completed narrative sequences driven by the patient, question‐driven narrative sequences guided by the HCP, and narrative sequences driven as a collaborative project between the patient and the HCP. In the question‐driven narrative sequences, communication was problematic for both participants and they did not accomplish a narrative. In the other two patterns, narratives were accomplished but through various collaborative processes. Conclusion: This study provides insight into what challenges narrative elicitation may bring in the context of a remote PCC intervention and what interactive work patients and HCP need to engage in. Importantly, it also highlights tensions in the ethics of PCC and its operationalization, if the pursuit of a narrative is not properly balanced against the respect for patients' integrity and personal preferences. Our findings also show that narrative elicitation may represent an interactive process in PCC in which illness narratives are jointly produced, negotiated and transformed. Patient or Public Contribution: Stakeholders, including patient representatives, were involved in the design of the main study (the RCT). They have been involved in discussions on research questions and dissemination throughout the study period. They have not been involved in conducting the present study.

• Wiszmeg, Andréa; Lundin, Susanne; Mäkitalo, Åsa; Widner, Håkan & Hansson, Kristofer (2021). Transforming trash to treasure Cultural ambiguity in foetal cell research. Philosophy, Ethics, and Humanities in Medicine. 16, p. 1–12. doi: 10.1186/s13010-021-00104-y. Full text in Research Archive
• Mäkitalo, Åsa; Bivall, Ann-Charlotte & Säljö, Roger (2021). Our business is problem-solving: Learning, remembering and inscriptions at the IT helpdesk. In Gunther, Kress; Selander, Staffan; Säljö, Roger & Wulf, Christoph (Ed.), Learning as Social Practice Beyond Education as an Individual Enterprise. Routledge. ISSN 9781003139188. Full text in Research Archive
• Erstad, Ola; Kumpulainen, Kristiina; Makitalo, Åsa; Schrøder, Kim Christian; Pruulmann-Vengerfeldt, Pille & Jóhannsdóttir, Thuridur (2016). Tracing learning experiences within and across contexts: A Nordic approach. In Erstad, Ola; Kumpulainen, Kristiina; Makitalo, Åsa; Schrøder, Kim Christian; Pruulmann-Vengerfeldt, Pille & Jóhannsdóttir, Thuridur (Ed.), Learning across Contexts in the Knowledge Society. Brill | Sense. ISSN 9789463004145. p. 1–14. doi: 10.1007/978-94-6300-414-5_1. Full text in Research Archive

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• Winthereik, Brit Ross; Aanestad, Margunn & Mäkitalo, Åsa (2024). Digital Inclusion. DJØF Forlag. ISBN 9788757455250. Full text in Research Archive
• Kumpulainen, Kristiina; Kajamaa, Anu; Erstad, Ola Andres; Mäkitalo, Åsa; Drotner, Kirsten & Jakobsdottir, Solveig (2022). Nordic Childhoods in the Digital Age. Insights into Contemporary Research on Communication, Learning and Education. Routledge. ISBN 9780367702526. 217 p. doi: 10.4324/9781003145257. Full text in Research Archive Show summary

  This book adds to the international research literature on contemporary Nordic childhoods in the context of fast-evolving technologies. It draws on the workshop program of the Nordic Research Network on Digital Childhoods funded by the Joint Committee for Nordic research councils in the Humanities and Social Sciences (NOS-HS) during the years 2019–2021. Bringing together researchers from Finland, Norway, Sweden, Denmark and Iceland, the book addresses pressing issues around children’s communication, learning and education in the digital age. The volume sheds light on cultural values, educational policies and conceptions of children and childhood, and child–media relationships inherent in Nordic societies. The book argues for the importance of understanding local cultures, values and communication practices that make up contemporary digital childhoods and extends current discourses on children’s screen time to bring in new insights about the nature of children’s digital engagement. This book will appeal to researchers, graduate students, educators and policy makers in the fields of childhood education, educational technology and communication.

• Mäkitalo, Åsa (2020). Designs for Experimentation and inquiry. Routledge. ISBN 9781138592711. 213 p. Full text in Research Archive
• Makitalo, Åsa; Nicewong, Todd E. & Elam, Mark (2019). Designs for Experimentation and Inquiry. Approaching Learning and Knowing in Digital Transformation. Routledge. ISBN 9781138592711. 256 p. Full text in Research Archive
• Makitalo, Åsa; Linell, Per & Säljö, Roger (2017). Memory Practices and Learning: Interactional, Institutional and Sociocultural Perspectives. Information Age Publishing. ISBN 9781681236193. 432 p. Full text in Research Archive
• Erstad, Ola; Kumpulainen, Kristiina; Makitalo, Åsa; Schrøder, Kim Christian; Pruulmann-Vengerfeldt, Pille & Jóhannsdóttir, Thuridur (2016). Learning across Contexts in the Knowledge Society. Brill | Sense. ISBN 9789463004145. 260 p. Full text in Research Archive

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• Reinås, Karl Henrik Storhaug; Rootwelt-Revheim, Mona-Elisabeth; Fretheim, Håvard Halland; Johnsrud, Kjersti; Midtvedt, Øyvind & Sherwani, Alexander Gul [Show all 8 contributors for this article] (2026). Time is crucial: An Interaction analysis study of dilemmas between patients with inflammatory rheumatic diseases and health care professionals at a PET-CT facility. Annals of Rheumatic diseases. 34(2-4), p. 2387–2387. doi: https:/eular.sharepoint.com/sites/AbstractBookletPublication/Shared%20Documents/Forms/AllItems.aspx?id=%2Fsites%2FAbstractBookletPublication%2FShared%20Documents%2FEULAR%202026%20Abstract%20Book%20%28pre-Congress%29.pdf&parent=%2Fsites%2FAbstractBookletPublication%2FShared%20Documents&p=true&ga=1. Full text in Research Archive Show summary

  Background: Communication between health care professionals (HCP) and patients is essential in how to learn coping strategies for how to live satisfactorily with Inflammatory rheumatic diseases (IRDs). Communication act as a key resource for knowledge-sharing. It also supports a process of meaning-making, enabling both HCP and persons with IRDs to gain insights into the patients’ condition when the communication can occur in a safe, secure and trustful manner within the context of the health care sector. Person-centred care (PCC) emphasises that the relation between the HCP and patient should be in the form of a partnership, where the patients’ experiences are necessary to merge with the HCP’s professional training (evidence-based education) and clinical experience, to lay the best foundation for a fruitful collaboration that could benefit the tailor-made diagnosis and treatment trajectory. To facilitate an increase in health literacy (HL) for patients through communication, PCC could be useful, as one of several available intervention approaches. Even though PCC is implemented and known to various degrees, the principles are often used implicitly by showing empathy and concern for the patient’s condition and well-being. Oftentimes HCPs are facing communicative dilemmas for what to say and how to say it, to make their message as understandable and acceptable for the patient as possible, while avoiding misunderstandings that could prevent the communication to work properly. Preparation sessions for positron emission tomography and computer tomography (PET-CT), using fluorodeoxyglucose (FDG), are a health care setting that could make visible the challenges in implementing PCC for IRD patients under time-pressure. Time constraints are often present in the health care sector. As a result, time is crucial in shaping how HCPs are abled or constrained to help the patients to increase their HL. Objectives: Communicative dilemmas need to be resolved to ensure that patients receive the health care they need and get the knowledge required for conducting the PET-CT procedure. Such knowledge, combined with the rationale behind the procedure, also helps lay the foundation for the patients to understand on which conditions the image-taking and diagnostic information is based. To understand how HL could be increased in IRD-patients undergoing a preparation session for PET-CT, we asked: 1) In what way does the use of time in the health care encounter restrict or afford possibilities for learning? and 2) What communicative dilemmas do preparation sessions for PET-CT procedures entail? Methods: Fourteen patients (57.9±11.7 years, 9 women) with indications of IRDs (diagnosis=IgG4-related disease, sarcoidosis, spondyloarthritis, Kawasaki, unknown) and ten HCPs (31.2±5.5 years, 6 women) (7 radiographers and 3 biomedical scientists) taking part in a preparation session for a PET-CT scan at a large Norwegian hospital were videorecorded in November 2024-September 2025. A rheumatologist referred the IRD-patients to the study, whereupon they were called to confirm their interest in taking part in the study and later signed a written consent form before undergoing the procedure, as did the HCPs. Video recordings of the sessions were transcribed and analysed with interaction analysis (1), where the standardised structure of the interactional pattern was described and themes were identified through parts of the transcripts that thematized similar interaction sequences. Communicative dilemmas were used as an analytic lens, to investigate how the interaction sequences of interest were built up. Results: The interaction analysis identified four communicative dilemmas. 1) Informing about the time vs. overemphasising the duration, 2) Informing about the radioactive substance vs. provoking concerns, 3) Informing about the venous cannula insertion vs. making the venous cannula insertion too invasive and into focus, and 4) Timing the procedure accurately, adequately and correct vs. not be able to open for the experiences, concerns and small talk in the interaction. Balancing the emphasis between carrying out the medical procedure and explicitly recognizing the patient as an autonomous and capable individual was a significant challenge for HCPs, particularly when compounded by the constraints of limited time. The agency of the patient was shown through their initiation of asking questions and in how they followed up and responded to questions from the HCPs, while the HCPs differed in the degree to how much they deviated from the procedure’s checklist and added other kinds of information through their communication than they were required to from the standardised procedure and practice. Conclusions: Overall, we see that how to give precise, correct and enough information without worrying the patient unnecessary is a continuous challenge, that needs to be solved satisfactorily to help the patient cope with the situation and provide meaningful learning opportunities that could increase the HL for both patients and HCPs. The necessity to time the procedure, due to the radioactive substance and queue of patients, is a constraining factor in the context that limit the options for communication approaches that can be chosen and could sometimes make it harder to find satisfactory solutions for the communicative dilemmas the situation entails. However, it seems possible to provide information to patients that could improve the patients understanding of the procedure and the foundation for the diagnostic information through the images taken, despite time pressure, adapted to the needs and interests of the patients. Longitudinal studies could shed light on what IRD-patients have learned through the communication with HCPs in preparation sessions for PET-CT scans and how this could help living well and cope with the chronic disease. REFERENCES: [1] Jordan B, Henderson A. Interaction Analysis: Foundations and Practice. The Journal of the learning sciences. 1995;4(1):39–103. Acknowledgments: NIL. Disclosure of Interests: None declared. DOI: 10.1136/annrheumdis-2026-eular.C.29

• Nerland, Monika & Mäkitalo, Åsa (2025). Learning through metawork in digitalised healthcare: The case of monitoring patient falls. Full text in Research Archive
• Nerland, Monika; Hasu, Mervi; Grisot, Miria; Aanestad, Margunn; Mäkitalo, Åsa & Saari, Eveliina (2024). Which challenges do digitalisation processes present to healthcare workers? ​ ​Implications for professional expertise, identities and competencies from digital innovation initiatives. Full text in Research Archive Show summary

  Symposium comprising three presentations from the project CORPUS: 1) Shifting demands to professional expertise and opportunities for learning in everyday care work ​ (Monika Nerland & Åsa Mäkitalo);​ ​ 2) From care practitioners to back-office service integrators: frontline care workers’ identity formation in digital platform-based care management practice ​ (Mervi Hasu & Eveliina Saari);​ ​ 3) Infrastructural work: competencies required for health workers’ participation in technology design processes ​ (Margunn Aanestad & Miria Grisot). Comments from Davide Nicolini, University of Warwick and Claus Harald Jebsen, BI.

• Nerland, Monika & Mäkitalo, Åsa (2024). Learning by stabilizing. Health care work in the multi-layeredness of digital transformation. Full text in Research Archive
• Mäkitalo, Åsa & Dalevi, Linn (2022). Mastering care? Welfare technologies in health care team decision practices. Full text in Research Archive
• Sadorge, Christopher; Nerland, Monika & Mäkitalo, Åsa (2022). New challenges for health professionals. Full text in Research Archive
• Lundin, Mona; Aanestad, Margunn; Mäkitalo, Åsa & Winthereik, Brit Ross (2021). Digital Services in the Nordic Welfare States: what about the Partially Digital User? Full text in Research Archive Show summary

  The Nordic countries have pursued digitalization with a strong user-perspective and have provided self-service solutions within all welfare areas; social service, public education, and health care. However, as citizens engage in encounters with the welfare state through these services, it is increasingly clear that there are still unmet needs. The ongoing pandemic has in many ways heightened the crucial issues of digital inclusion, digital divides and data literacy. For instance, citizens who struggle with social, cognitive or health-related challenges may refrain from using the digital solutions put in place by the public authorities, or their agency as digital citizens remain partial as more or less extensive communicative support is required for them to access welfare services. In the Nordic project: Infrastructures for partially digital citizens: Supporting informal welfare work in the digitized state, from which this study reports preliminary findings, we refer to citizens, who need such informal support, as partially digital users. This notion is used to direct attention to the need for support in the face of digitalization. Our mapping of informal support work around digital services in three Nordic countries (Norway, Denmark and Sweden) will be used to inform and challenge public authorities’ design principles and practices. It may also generate socio-digital innovations that better will facilitate support from the network around the user. Currently, we conduct a comparison of how different national regulations condition digital participation. For instance, e-identifications (e-IDs) are a key gatekeeper for accessing digital infrastructures in all three countries. Booking a covid-test and/or a vaccination slot constitutes very concrete examples of how such e-IDs has become a structuring resource for digital inclusion/exclusion. Although the countries report on high levels of access to e-IDs, the numbers of citizens that need support in order to access public self-services is substantial and hidden statistics are assumed.

• Sadorge, Christopher; Nerland, Monika & Mäkitalo, Åsa (2021). Categorisation work in the design of health information systems. Full text in Research Archive
• Sadorge, Christopher; Nerland, Monika & Mäkitalo, Åsa (2021). Negotiating categories in design work. A study of a team developing a patient information system. Full text in Research Archive
• Wittek, Anne Line; Thompson, Ian; Daniels, Harry; Makitalo, Åsa; Hontvedt, Magnus & Silseth, Kenneth [Show all 10 contributors for this article] (2016). Collaboration matters - symposium. Full text in Research Archive
• Seltzer, Michael; Makitalo, Åsa & Vagli, Åse (2012). Dorothy E. Smith Interview of 7 October 2011 in Oslo. [Journal]. Sosiologisk Årbok. Full text in Research Archive

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