The Social Construction of Technological Reality: The Case of Cochlear Implants. Raghu GARUD. Michael A. RAPPA'''. New York University. Massachusetts ...
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ALFRED
P.
WORKING PAPER SLOAN SCHOOL OF MANAGEMENT
The Social Construction of Technological reality: the case of cochlear implants Raghu Garud
Nrw
York University
January 1992
Michael A. Rappa Massachusetts Institute of Technology
Sloan
WP # 3397-92
MASSACHUSETTS INSTITUTE OF TECHNOLOGY 50 MEMORIAL DRIVE CAMBRIDGE, MASSACHUSETTS 02139
^fs?^^ Massachusetts Institute of Technology
THE Social Construction of Technological REALITY: THE CASE OF COCHLEAR IMPLANTS Michael A. Rappa
Raghu Garud
New
Massachusetts Institute of
York University
Technology
Sloan
January 1992
I99I
WP# 3397-92
MASSACHUSETTS INSTITUTE OF TECHNOLOGY
Alfred P. Sloan School of
Management
Massachusetts Institute of Technology
50 Memorial Drive, E52-538 02139-4307 Cambridge,
MA
T.
MR
USr 9 1992
I
The Social Construction of Technological The Case of Cochlear Implants Raghu
New
GARUD
Reality:
Michael A. RAPPA'''
York University
Massachusetts Institute of Technology
abstract This paper explores
how
technological trajectories
and
are socially constructed through the interaction researchers.
selection
mechanisms
of a community of an illustrative case, a
Using the field of cochlear implants as investigating the emergence of a new technologies through
framework for
the assessment of a
community of researchers
is
developed.
introduction The development of new of both firms and nations.
modern technology, in
Among
in
which they
norms, values, and
the various actors
researchers play a curious role.
new knowledge,
developing
communities
technologies can significantly affea the economic well being
beliefs.
As
who
influence the advancement of
yet they cannot escape the
are deeply
Ultimately,
embedded
they strive for objeaivity
scientists,
in a social
some have argued,
human
aspect of research
context that dictates a set of
it is
the subjective reality that
emerges from the interaction of researchers that influences the speed and direction of technological development (Latour, 1987).
construaed by the
communities a
The
The
social context as they are the result
critical
question of
of the forces of nature makes research
subjea of study when understanding technological emergence.
who
constitutes a
community of
researchers
is
more
in the
restrictive. roles,
such
evaluators
A as
it
directly
development of a new technology, although such a view can be overly
more comprehensive view might include government
who
then
difficult
might seem. Boundaries tend to be drawn around those individuals who are engaged
much
possibility that technologies are as
regulators, investors,
individuals in other important
market gate-keepers, and other independent
nonetheless have an interest in the technology and
its
application.
influence that each of these groups have on a technology's development can
depend
The
largely
*
Raghu Garud is assistant professor of management with New York University. Michael Rappa is assistant management with the Massachusetts Institute of Technology. An earlier version of this paper was presented as the TIMS/ORSA Meeting (Las Vegas, Neveda) May 1991. We thank Andrew H. Van de Ven professor of
and
several cochlear implant industry participants for providing the information contained in this paper.
upon
their particuJax frame of reference,
which may be quite
different
and oftentimes hard
to reconcile.
For instance,
scientists
who
are direaly
engaged
in the
development of a technology
might be concerned most with making advances that demonstrate the superiority of respective approaches.
They pursue
"technological trajectories" that are shaped by their
staning assumptions and aaivities (Nelson and Winter, 1982; Dosi, 1982). scientists associated
with funding agencies (such
associated with regulatory agencies (such as the
It is
in
Understanding
trajectories,
while those
Food and Drug Administration) might be
safety.
which
who
certain technological trajectories are created
exerts
we examine how
focusing on
the
roles
how new
from the sociology of science and technology
These methods
technology. Lastly,
indirectly
implants. First, in
we
associated
with the
review relevant literature
order to introduce certain concepts that
our inquiry. Next, we explore the methodological implications of
tracking the development of a researchers.
technologies emerge over time. In this
of researchers directly and
— cochlear
basis of
out.
technological trajectories and selection environments emerge by
development of a new technology
form the
and selected
what kind of influence on a technology's development and when,
provide important insights into
paper,
contrast,
the complex interaction of researchers with diverse perspectives that fosters the
environment
may
By
the National Institutes of Health)
as
might encourage the exploration of different technological
concerned most with the consumer
their
we
new technology through
the vantage point of a
are then applied to study the
community of
emergence of cochlear implant
use our findings from cochlear implants to formulate a set of
general propositions regarding the development of
new
technologies.
THE SOCIAL CONSTRUCTION OF SCIENCE AND TECHNOLOGY In describing the various perspectives that have been used to study the sociology of scientific
and other
communities. Crane (1972) notes the relevance of interactions between science social institutions: that
is,
how
social
faaors shape science and
how
science, in
turn shapes society. Jagtenberg (1983:14) points out that this "social shaping" perspective creates an artificial
dichotomy between
scientists
and
their context, because scientists
themselves create the context that directs their future work. Instead of a dichotomy, Jagtenberg proposes the duality between scientists and their context, wherein the context constituted during the course of scientific activities.
is
Examining the duality between
One way
a social system.
scientists
and
their contexts implies studying science as
the duality between scientists and their contexts unfolds
is
through the accumulation of knowledge. In particular, accumulated knowledge can shape intellectual patterns
Kuhn
Similarly,
(Toulmin, 1963) that direct present and future
(1962) proposes the notion of paradigms. Paradigms are models of
advancements that
scientific
scientific activities.
set guidelines for research.
aimed
science, or puzzle-solving activities
at
Kuhn
exploring the limits of a paradigm, and
revolutionary episodes as a model of change in science.
condua
influenced by the artifaas employed to
distinguishes between normal
research.
At
Normal first,
science
strongly
is
theories direct the type
of anifaas that are developed to explore phenomena. Over time, phenomena take on the appearance of objeaive
fact
by virtue of their construaion through these anifacts (Latour
and Woolgar, 1979). These
activities
unable to explain natural phenomena.
motion a chain of events that
the context
is
is
The appearance of such anomalies
eventually sets in
development of a new paradigm.
result in the
The construaion of faas and research context
continue until existing theories and artifacts are
artifacts in the laboratory represents
one way
created during the process of doing science (Whitley, 1972).
also
in
which a
However,
created through the interaction of scientists, thereby giving the
impression that science
is
The outcome of
"negotiated."
this
interaction can confer
legitimacy on certain results, while disregarding others as spurious. As Latour and
Woolgar (1979:243) construa
reality."
suggest, scientific aaivity
For Latour and Woolgar,
of a dispute rather than
Examining science
its
is
not about nature, but a "fierce fight to
"reality"
is
the consequence of the settlement
cause.
as a social
system thus recognizes that context
outcome of the reproduction of
practices"
institutionalization represents situations
(Giddens,
embedded and
whenever there
is
as routines.
will influence the
The
Over
This process of
and Luckmann (1967:54)
are
state
a "reciprocal typification of habitualized
by types of actors." Reciprocal typification occurs
actions
1979:5).
both medium and
where the context of research and legitimacy
constituted during the course of scientific activities. Berger that institutionalization occurs
"is
as habitualized actions
become
time, these routines will be taken for granted by the aaors
direaion of research.
degree to which a scientific
field
becomes institutionalized
will coincide
with the
degree to which scientists are able to exercise spontaneity and choice. This spontaneity and
choice that
is
progressively circumscribed as routines, equipment, skills and shared meanings
emerge through
scientific aaivities in the contexts
of research and legitimacy. At one
4
extreme, a high level of institutionalization implies routine thought and aaion; at the other
extreme, minimal structures
may
research activities. Transitions
from a
resulting in greater spontaneity
exist,
state
where the
in
low
to
of institutionalization
is
is
high represent "moments of inversion"
Moments of
inversion allude to key instances in the
a state where the level of institutionalization
(Latour and Woolgar, 1979:240).
level
and choice
development of science when routines, equipment,
skills
and shared meanings that were
constituted during the process of scientific activities begin directing future scientific activities.
Building upon the insights from the study of science literature has (e.g.
Bijker,
as a social
system, a parallel
developed that examines the social construction of technological systems
Hughes and Pinch, 1987;
1988). As with scientific activities,
Elliott,
understanding the evolution of technologies from a social systems perspective requires a recognition of the duality between technology and
its
(1988:67) suggests that "we should not assume that
applied context. For instance,
it
is
necessarily the social that
Law
molds
the technological nor indeed the converse." Systems are created in the course of interaaions
between "heterogeneous elements" that include people,
skills,
phenomena. People
attribute different
and anifacts based on their
technological frames
and
therefore are shaped
meanings
to facts
artifacts
and natural
their levels of inclusion (Bijker, 1987). Technological systems
by the differing
levels
of inclusion of actors within different
technological frames.
The shaping of technological is
systems through the interaaion of heterogeneous elements
analogous to the process of institutionalization
development of a technology,
in
science.
For researchers directly
engaged
in the
itself in
the form of technological trajectories (Nelson and Winter, 1977; Dosi, 1982).
this process
of institutionalization manifests
Trajectories are progressions of a technology that are directed by researchers' initial
staning assumptions and
activities.
Early during the development of a technology,
researchers hold different beliefs about
"what
is
feasible or at least
worth anempting"
(Nelson and Winter, 1982:258-59). Because of the ambiguity and uncertainty associated with technology development (Anderson and Tushman, 1990),
determine the success or
failure
it is
not possible to ex ante
of any particular technological trajeaory. Given limits to
human
cognition, researchers do not behave in a completely rational manner, but instead,
engage
in "profit-seeking" behavior.
researchers
employ search
Rather than employ comprehensive search routines,
heuristics, like genes,
which
are
determined by researchers'
staning assumptions. These search heuristics result in the development of technological
trajectories,
where future progress
is
own
directed by researchers'
expectations of their
trajectories.
Researchers pursue different technological trajectories and attempt to influence each other with respea to the criteria and methods against which the
new technology should be
evaluated. In this sense, technological systems, too, are negotiated orders. Competition
between
trajectories
during
this process
of institutionalization occurs not only
in the
market, but also in terms of standards and testing techniques (Meyer and Rowan, 1977;
Constant,
1987).
Eventually,
some
institutionalized, reinforcing
certain
practices
and
trajectories over others
standards
evaluation
and thereby leading
are
to their
dominance. Once a dominant trajeaory emerges, technological aaivities take the shape of refinements of the selected trajectories (Unerback and Abemathy, 1975).
This brief review provides certain orienting concepts that
our subsequent
will direct
inquiry into the development of cochlear implant technology. This literature suggests that
technologies evolve through a process of interaction between researchers, and that as practices
and evaluation standards
are institutionalized, certain technological trajeaories
are selected out while others are reinforced. Therefore, to study the
technology, it
it
is
imponant
to
understand
becomes a black box, opaque
how
the field becomes institutionalized
longitudinal approach
several reasons. First,
it is
is
— before
to scrutiny.
METHODS AND RESEARCH
A
emergence of a
SITE
required to examine the process of institutionalization for
important to track the emergence of routines and
skills
before
they are taken for granted by the actors involved. Moreover, a recognition of the uncertainty and ambiguity that pervades the development of a
new technology
renders
post-hoc efficiency and functional explanations of technological trajectories inadequate.
To
avoid this retrospective rationality trap,
it
is
important to provide a symmetric
account of different trajectories irrespective of whether they were eventually
successfiil or
not (Pinch and Bijker, 1987).
What
how new
should the longitudinal data consist of? As the focus of this paper
is
on explaining
technologies emerge over time, data should contain observations that provide
insights on: (1) the direction of technical change,
reinforced panicular trajectories.
To
and
(2)
forces that selected out or
study these issues from the perspective of an
emerging community of researchers, references
and track
their levels
it
is
important to identify researchers' frames of
To
of involvement and interactions over a period of time.
manner, multiple data sources capture these diverse frames of references in any significant
and multiple methods have
are required
Our in
task
to
is
to be
employed.
demonstrate the usefulness of the concepts and methods introduced above
new
studying the development of a
technology. Tracking different groups of researchers
can be a longitudinally by employing multiple sources and methods
Consequendy, the concepts and methods suggested the
in this
development of only one new technology. Given
important to choose a strategic research research site
is
one
technologies, (2)
is
site (Bijker,
that: (1) has the potential to
manageable, and
(3)
researchers with different reference frames
A new
demanding
task.
paper will be applied to study this
illustrative
purpose,
Hughes and Pinch, 1987).
demonstrate the
A
it
is
strategic
social construction
of
promises to bring into play diverse groups of
and motivations.
technology that matches these requirements
is
cochlear implants, which are a
sensation of implanted hearing devices that provide the profoundly deaf with a socio-psychological products sound. Cochlear implants have been described as unique several groups of is highly user specific. Moreover,
surgically
because interpreting their effectiveness researchers have played key
and
development of cochlear implants.
visible roles in die
Multiple sources and methods were employed on a
real
time and archival basis to
sources include publicly available study the development of cochlear implants. These data entries in computer data bases, information, anicles in trade and technical journals, major regular observations at meetings
attendance participants.
at trade
An
conducted by one of the leading firms
in
the industry,
industry conferences, and periodic surveys and interviews of key
associated adaptation of a data collation scheme utilized by researchers
to conven the voluminous with the Minnesota Innovation Research Program was employed
data into a form conducive to qualitative analysis (Van de
conversion involved the identification of
critical
Ven and
Poole, 1990). Data
incidents consisting of:
events
(1)
observations (which were (defined as major recurrent activities and changes) and (2) researchers). From judgments or interpretive sutements about events made by key
incidents providing insights
This chronology serves
The
as
on
researchers' roles
were abstracted
in a
list,
chronological order.
the basis for the description that follows.
research was conducted using' a qualitative case format.
suited to analyze a
this
phenomenon
in
its
real
life
A
case format
is
best
context where the boundary between
phenomenon and context useful
when
the objeaive
is
not dearly defined (Yin, 1984). Moreover, a case method
is
to generalize findings ft-om a setting to a theory rather than
is
from a sample to a population.
Case descriptions can be
at different levels
1986; Jagtenberg, 1983:108). Thick descriptions are a
"abstract" descriptions (Abell, researcher's
(Geertz,
first
1973).
of abstraction ranging from "thick" to
order construaions of others' construaions of what they have been up to
development of a theory. In
constitute the
abstract descriptions
contrast,
In
this paper,
development of the cochlear implant
we
steps
first
in
the
provide an abstract description of the
will
field to flesh
out and elaborate on the evolutionary
metaphors and theoretical perspectives of the development of technological systems.
THE SOCIAL CONSTRUCTION OF COCHLEAR IMPLANT TECHNOLOGY
We
examine the institutionalization of the cochlear implant
conceptually bracketed periods of time. These periods occurred before 1978
when
are:
during three
field
(1) a gestation period that
the cochlear technology lay dormant, (2) an institutionalization
period that occurred between 1978 and 1985, and (3) an inversion period that occurred
between 1985 and 1988. Each period
metaphors introduced
with reference to the evolutionary
will be discussed
earlier.
Gestation Period (before 1978). During the early years, a variety of technological
approaches were pursued by researchers the cochlear technology. difficult to
The
compare these
who were
direaly engaged in the development of
lack of testing, comparison
trajectories.
and reporting standards made
it
Consequently, claims made by researchers about
the efficacy of cochlear devices were considered to be just so
much
noise.
Media
sensationalized basic scientific findings thereby alienating the researcher
Simmons, of Stanford University, remembered miracle of the elearonic ear was like claiming:
that
reports
community.
one such advertisement about the
"Mom
gives birth to a 2 year old baby."'
Moreover, technology champions fueled controversy surrounding cochlear implantation by invading the domains of other researchers and by publishing controversial tides
such
as
"How
to
do your own implants." At the same time, audiologist gatekeepers
were skeptical about the efficacy of cochlear devices profoundly deaf
when
other substitutes had
NIH, had condemned human ^From
a talk given by Blair
monograms with
Simmons
at the
failed.
Most
in providing
speech cues to the
researchers, including those at the
cochlear implantation as being morally and theoretically
NIH/FDA
consensus development program held between
May
2 and
5,
1988.
technology remained unacceptable. Because of this adverse scleaion environment, cochlear
dormant
for a considerably long duration
Despite
this adverse
kept the technology
of time.
environment, the dedication of a few key technology champions
However, while necessary, persistence by technology champions
alive.
implants. Some was not sufficient to ensure concerted development of cochlear for this new serendipitous environmental changes provided the necessary impetus
NIH
technology. In particular, result
researchers decided to support cochlear implant
of unrelated research aaivities on neural cortex stimulation initiated
in
which was organized
in
incident led to the
first
international conference,
University of California, San Francisco with support from the researchers proposed that testing, comparison
NIH. At
work
as a
Europe. This
1973
at
the
this conference,
and reporting standards be developed.
formation of a Standards that began emerging subsequent to the conference represented the vocabulary and
grammar among
a core
group of researchers that legitimized the further
growth of cochlear implants. researchers directly engaged in die
The conviaion of
led to the creation of technological trajectories.
comparison and reporting standards during researchers
had no other choice but
based on dieir
own
this
development of the technology
Because of the lack of testing and stage of technology development,
to continue developing their particular trajectories
starting assumptions. For instance,
House of the House Ear
Institute
better (HEI) switched over from the multi-channel route to a single-channel route to researchers understand the cochlea before proceeding to develop more complex devices. As
model of the ear involved in the cochlear implant area reported, no panicular theoretical and pursued an direaed House's research. Rather, House proceeded largely by intuition empirical approach where he
House's approach was
would
let
the results of his efforts guide his future research.
in sharp contrast to the theoretical
assumptions that guided other
was a complex cochlear implant researchers. Their theories suggested that the cochlea multiple organ that could only be replicated by the insertion of a cochlear device with electrodes. In contrast to the empirical
approach pursued by House and
his
team, the
approaches pursued by these researchers had a "ring of science" attached to them.
In particular, Michelson of
multi-channel device the
same
level
as
he
felt
of performance
what Constant (1987) might
UCSF
switched over from a single-channel device to a
that the single-channel device
would not be able
to provide
as the
multi-channel device. That
call a
"presumptive anomaly" with respect to the single-
is,
Michelson identified
A
channel route.
system
still
presumptive anomaly
may
works, indeed
a situation
is
where the existing technological
development potential, but science
offer substantial
suggests that the leading edge of future practice will have a radically different foundation.
But
in
providing a symmetric account of the development of the different technological
of testing and comparison standards made
trajectories, the lack
clearly
conclude that the multi-channel device was superior
To
channel device.
devices
were
impossible for House to
comparison to the
in
complicate matters, the two devices aimed
While single-channel
characteristics.
it
at different
designed
to
single-
performance
provide
useful
environmental cues, multi-channel devices were designed to provide speech perception.
These discussions suggest
several insights
about
trajectories
and seleaion environments
during early stages of technology development. During early stages of technology
development when there standards,
it
a lack of a
is
commonly
pursuing different technological trajectories to
difficult for researchers
is
accepted set of comparison and testing
Researchers pursuing
clearly identify deficiencies in the approaches that they adopt.
different trajectories designed to provide different features will perceive their respective
trajeaory to be superior to others. Charges of exaggeration levied serve not as seleaion for researchers'
mechanisms that weaken
commitment
at
each other therefore
particular trajectories, but as reinforcement
to their respeaive trajeaories in their efforts to demonstrate
the validity of their claims.
Institutionalization Period (1978-1985).
The
pioneering researchers in cochlear implants
established collaborative relationships with different business firms between 1978 and
now began
1982. Researchers associated with firms trajeaories they
to influence the
had been previously chosen. For example, 3M's strategy
for developing
House
single-channel
cochlear implants was to begin with the relatively safe and simple device,
the
which would enable the firm
first
to create a market
to obtain regulatory approvals.
decided not to
development of the
make any
To
"window of opportunity" by being
accomplish
this objective,
3M
core design changes in the device as design changes
researchers
would take up
valuable development time. However, convinced of the need to establish the safety of the
device beyond any doubt,
3M
researchers reduced the depth of electrode insertion.
researchers in the industry
felt
that this design change reduced the efficacy of
3M's
Many single-
channel device.
This description provides a flavor of
how
business strategies influenced the direction of
particular trajectories. This period also witnessed firms' efforts at developing testing
and
10
reporting standards for their particular devices. Because each device features, testing
rather than
aa
the scientific
and reporting standards served more
embodied
different
to legitimize particular trajectories
seleaion mechanisms. Firms developed and used such standards to signal
as
community
that their panicular claims were legitimate. At the
same time,
these testing and reporting standards refleaed each firms' proprietary product attributes.
That
is,
testing
and reporting standards almost became tautological with the produas they
were supposed to
test
(Constant, 1987), with the two forming a self-reinforcing system. As
change took on
a result, technical
a life
of
own
its
as
multiple standards emerged, each
confirming the expectations of the different researchers while yet not possessing the power to
aa
as
The
seleaion mechanisms.
proliferation of tests
and the
difficulty in
comparing
test results are
statement that Gantz and his colleagues from the University of Iowa
made
in
refleaed in a
Laryngoscope
in 1985.
A
major obstacle preventing accumulation of comparative data is that each center has reported results based on different measures, and in some instances investigators have developed tests tailored to their implants. (Ganczetal., 1985)
program manager of Storz Corporation, one of the business
Similarly, the stated in the
firms,
1986 edition of The Hearing Journal: The
clinical trials allow the claims
it is
important that the
the
tests
of each manufacturer to be proven,
be standardized. That should include both
method used
by Bebout
in
to administer the tests and the type of tests used. (Quoted The Hearing Journal 1986)
Thus, unlike the gestation period where few standards during the institutionalization period. While hyperbole, they were
now ambiguous. These
relevant cues only to those
who understood
vague to others employing a different
set
earlier claims
existed, standards proliferated
had been so much noise and
claims were ambiguous as they possessed
or employed panicular standards while being
of standards. Each firm claimed that the other
was exaggerating. But given the lack of commonly accepted testing and reponing standards,
it
was not
clear
standards developed by
which firm was exaggerating. Claims made by firms against
them simply captured the
diverse business strategies they
had
employed. Researchers associated with these firms began interacting with other independent researches that entered the cochlear implant field.
On
the one hand, the frames of references
of these independent researchers were shaped by the
activities
of researchers directly
11
engaged
development of the products.
in the
On
the other, these independent researchers
technology as they became progressively more began shaping the development of the vocabulary and grammar consisting of testing, knowledgeable and began developing a
also
comparison and reporting standards. That
is.
1979) a process of "structuration" (Giddens.
between Belt and Rip. 1987) shaping the interaaions ensued, resulting in a "nexus" (van den trajeaories
and
selection environments.
While these imeraaions were proceeding,
results
of comparative
tests
conducted by the
et al., 1984). clinical journals in 1984 (e.g. McCabe University of Iowa began appearing in devices. devices were superior to single-channel These results suggested that multi-channel Iowa. results from the University of Over time, other anicles continued referencing
one of Iowa began having on their program, Refleaing upon the influence that University
3M
manager commented. People chink that
if
an
article
is
published,
it
But, actually, other people
couple of months. and it never really dies.
Inversion Period (1985-1988).
with a transition from what specific firms to shape
will
be forgotten after a keep on referencing this will
The emergence of an
be labeled
as
institutionalized field occurred
normative control, representing effons by
standards, emerging product testing/comparison
from the control, representing increasing inputs
FDA
to
coerc.ve
firms to regulate the activities of
moments of inversion, coercive control manifests (Meyer and Rowan, 1977). Representing itself in ever
pre-market approvals. tightening regulatory guidelines for
implants of evaluation criteria for cochlear Institutionalization led to a changing set
over time. Initially, researchers
at
approvals to single-channel devices
the as
FDA
regulatory feh comfortable in granting
facilitated their the simplicity of this device
the safest single-channel trajectory was potentially evaluation process. Moreover, the products. However, the demonstration provide legitimacy to the new class of
approach to
To gam
single-channel devices. to offer legitimacy to of device safety was not sufficient ability to prov.de demonstrate efficacy-in this case, the legitimacy, a device had to
speech discrimination. Thus, those
yeomanry of the
new
service for other class
of produa.
who pursued
more complex
a the single-channel route performed
the safety devices that followed by establishing
12
Another type of inversion occurred
in the laboratory sening. In 1987,
by independent testing institutions surfaced
carried out
results that
comparative
tests
were not congruent with
the theory that single-channel devices were too simplistic and could not provide speech discrimination. Based on these results, audiologists at
asked the researcher
mind.
"We
community
HE!
(Berliner
and Eisenberg, 1987),
more open
to re-examine the single-channel device with a
should be more open to possibilities and
less tied
to theory, at least until
have an objeaive basis for defining our expectations" suggested Berliner and Eisenberg their article published in 1987. In this article, Berliner
own
clinicians'
led
them
to
initial
and Eeisenberg
also stated that
we in
HEI
expeaations about the performance limits of the House device had
commit an
error in not exploring the full potential of the single-channel
cochlear implant. Thus, standards that had at one point in time legitimized particular trajeaories later served to imprison researchers to their
own
expecutions.
Examination of the aaivities of key independent evaluators demonstrate it
was
for
them
to
compare and evaluate the
assessing the different trajeaories for inclusion
of Health Technology Assessment stated
how
different technologies.
how
difficult
For instance,
in
under Medicare Feigenbaum of the Office
difficult
had been to evaluate
it
this
unique
"psycho-social" therapy:
One
fascinating issue in this area is the fact chat different aspects of the technology require different types of underlying methodologies to evaluate. For instance, there are speech pathologists, social scientists,
audiologists and other involved. Consequently,
it
is
very difficult to
pinpoint what an 'objective sciendfic' method should be to evaluate the
performance of a device such
What
as the
cochlear implant.^
provided multi-channel devices legitimacy over single-channel devices were:
the theoretical rationale underlying multi-channel devices that the
device lacked, and (2) the significantly
more
House
stringent testing standards
(1)
single-channel
employed by
researchers pursuing the multi-channel trajeaory.
As standards congruent with the multi-channel device became widely accepted, sent out
by various researchers began loosing
their ambiguity.
Key technology
signals
evaluators
began employing standards associated with the multi-channel device, thereby vesting them with the power to act
as selection
mechanisms. These commonly accepted standards
represented institutional selection mechanisms, which in turn triggered other seleaion
mechanisms. For instance, audiologists interfacing with patients gave media testimonials that increased the legitimacy of multirchannel devices.
9
^Discussions with Earnest Feigenbaum,
Because of these testimonials,
OHTA health science analyst held on May
12, 1988.
13
patients continued awaiting the availability of multi-channel devices even
approved 3M/House single-channel devices were commercially available
though FDA-
in the market.
Acceptance of standards congruent with multi-channel devices
also
triggered
administrative seleaion mechanisms. Despite signals from various sources suggesting the superiority of multi-channel devices,
channel device.
A
3M
transition from the
House single-channel device was made by
3M
3M
top
program only when challenged by
researchers directly associated with the
management
to
researchers continued developing the single-
demonstrate the commercial
While administrative
viability
of the House single-channel device.
pressures had the
selection
power
to
loosen the grip of
technological trajeaories over researchers within firms, institutional and market pressures
were not adequate to dissuade researchers such trajeaories. Despite various signals
Dr. House from abandoning their
institutional bodies
his single-channel device.
continued refining researchers
from
as
documented with single-channel
The
and the market, House
positive test results that independent
devices promised to re-start a confrontation
between researchers pursuing the single-channel route and those pursuing the multi-channel
performing their respective
roles, researchers at
the
FDA
and the
NIH
route.
However,
felt it
necessary to institutionally induce closure by organizing a consensus development
in
conference in 1988.
It
was
at this
two-day meeting that the evidence and impressions,
which the researcher sub-communities had accumulated over time, were quickly
crafted
into a consensus statement that supported the superiority of the multi-channel device over
the single-channel device.
A
researcher at
researcher, theory
3M
had
offered an explanation for this outcome. According to this
initially
driven research. However, incongruities between theoretical
had not
led to a re-examination of the strongly held theoretical
beliefs
and
biases,
but rather a re-interpretation of the
clinical results
results. In
explaining the
NIH/FDA
consensus
statement supporting the superiority of the multi-channel device, Berliner of
HEI
suggested that otologists were "converging to the multi-channel device in order to reduce cognitive dissonance on the choice of the most appropriate device."
DISCUSSION
AND CONCLUSION
This paper began with a description of researchers embedded
in a social context.
study the roles of researchers in the commercial development of a
To
new technology,
14
orienting concepts such as trajectories and seleaion environments were introduced (Nelson
& Winter,
1982; Dosi (1982).
To
apply these concepts to the study of a technology and
provide a symmetric account of both failures and successes, a longitudinal design was suggested with a focus on researchers' frames of references to
methods were suggested
as
.
Multiple sources and
an approach for gathering information on what researchers say
and do that influence the development of a new technology. Application of these methods to study the commercial development of cochlear implants suggest several theoretical insights that build upon received theory (Nelson and
Winter, 1982; Dosi, 1982. The following table summarizes these
insights:
15
Institutional,
market and administrative selection
mechanisms were
socially
negotiations between these different types constituted through a process of interaaions and
activated of researchers. These selection mechanisms were
at
different periods
of
differential power to reinforce or technology development. Each environment possessed mechanisms became important selea out particular technologies. Institutional selection
with a transition from normative to coercive control
as
standards developed to legitimize
and developed the panicular technological trajectories and then became institutionalized
power
to select out other trajectories.
These
institutional seleaion
mechanisms triggered
former did not loosen the market and administrative selection mechanisms. While the researchers, administrative hold of particular technological trajectories over independent
selection
mechanisms forced researchers associated with firms and explore new ones. Eventually, closure was
ti;ijeaories
These observations form the
i:
z:
earlier
institutionally induced.
field:
institutionalized field emerges, the lack of any testing the standards create adverse selection mechanisms that threaten
Before
an
survival of the
PROPOSITION
abandon
process basis for the following propositions that reflea the
of institutionalization of a technological
PROPOSITION
to
new
During
the process
multiple
and
class
of technology.
of institutionalization, the existence of
conflicting testing standards creates ambiguity.
leading to These testing standards legitimize specific trajectories reinforcing the
commitments of researchers
to their respective
trajectories.
PROPOSITION
3:
widely accepted testing After an institutionalized field emerges, while trajectories some out standards differentially select reinforcing others.
What
are the implications of the
methodology developed and the
studying the development of cochlear implants?
An
insights gained
understanding of researchers
the theoretical rationale scientists raises a critical issue regarding
as social
behind the choice of
While, as in the cochlear implant case, trajectory that researchers choose to pursue.
make
intuitive sense to stan off
build
more complex
prove
critical in
it
its
may
experience to with a simple trajeaory and then learn from
rationale for a trajeaory ones, the lack of a strong theoretical
esublishing
from
may
legitimacy within a researcher community.
mechanisms raise questions about Discussions relating to trajectories and seleaion
when
it is
most appropriate
trajeaories to tests for researchers to expose dieir particular
by
16
independent testing institutions.
A
may
trajectory,
prematurely offered to an independent
not be able to withstand the adverse seleaion pressure.
group of researchers for
testing,
On
timely independent testing
the other hand,
if
is
not carried out, researchers
danger of loosing legitimacy for their trajectory,
and more important,
risk the
lose
the
opportunity to determine the performance capabilities of their respective trajectories.
The most important
implication for the
basic premise of this paper
— that
management of innovation
follows from the
different types of researchers play varied roles in
determining the success or failure of a new technology or specific trajectories. researchers say or
do can
either legitimize or trigger off adverse seleaion
then become key determinants of success or researchers often have also
know
equations.
little
failure.
as
mechanisms
these that
As MacKenzie (1987:198) suggests,
time for sociology and other social sciences. Yet researchers
that to be successful they have to be able to engineer
Or
What
more than metal and
Whitley (1974) suggests, researchers must not only manage the research
context, but also the social context of legitimacy. In particular, researchers directly
engaged
in the
development of new technologies have
researchers with diverse motivations
to
what extent
particular researchers
to deal with different types of
and recognize the temporal dynamics such
become important.
as
when and
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