The community of Black women physicians, 1864-1941: Trends in background, education, and training

We identified nearly 180 Black women who earned medical degrees prior to the start of the Second World War and found information regarding their family and social connections, premedical and medical educations, and internship experience or lack thereof for many of these women. Through their collective history, we observed large-scale trends, especially regarding the importance of "separatist" medical education and declining medical school attendance among African American women in the 1910s as medicine became an increasingly exclusionary profession. While our research uncovered trends specific to Black women physicians, the implications of our research can be applied far more widely to other historically marginalized scientific practitioners. This research reminds us of the longstanding and shifting presence of Black women in science and medicine, despite the enduring popular belief that white men represent who participates in science, both historically and today.

Working at the boundary: Making space for innovation in a NASA megaproject

This study shows how occupational, organizational and institutional boundaries can be reworked to enable innovation. Based on an historical case study of NASA's Spitzer Space Telescope, which spanned three decades and two dozen organizations, I show how megaproject members made boundaries a target of strategic action. Megaprojects, in particular, require us to think about boundaries at multiple levels as they commonly draw on expertise and resources from different disciplines, organizations, and institutional domains. This case reveals several mechanisms by which boundaries can be modified to coordinate diverse innovation partners, from reconfiguring the ways members relate to one another (splicing, fitting and channeling) to reshaping the environment they work in (softening, fusing and corralling). Overall, this study contributes to our understanding of how actors make room for new ideas and cause institutional change as part of innovation processes. By treating boundaries as malleable and multiplex, I extend organizational theory, which tends to view boundaries as given and things to be spanned. I extend the STS literature that takes boundaries as fluid, identifying several mechanisms of making and unmaking them. A more dynamic treatment of boundaries is called for in both innovation research and practice, and this study opens a path for research that looks not only at boundary objects but also boundary actions, and moves from boundary organizations to boundary organizing.

Historical investigation of medical treatment for adult congenital heart disease: A Canadian perspective

OBJECTIVE

The number of adults with congenital heart disease (CHD) has increased substantially because of medical advances that are extending life expectancy beyond childhood. A historical investigation is timely not only because of this significant demographic shift, but also because stakeholder engagement is increasingly important in shaping research directions. The study questions were: From the perspective of stakeholders, what is known about the medical treatment for the adult CHD cohort in Canada and how has it changed over time?

DESIGN/METHODS

We harnessed the use of historical research methods and conducted interviews with 21 key informants in order to articulate a contextualized understanding of the evolution of adult CHD treatment in Canada. The informants recruited were currently or previously located in and/or involved in treatment in seven provinces and two territories across Canada including patients, families, advocates, researchers, and practitioners located in disciplines that included cardiology, cardiovascular surgery, nursing, psychology, dietetics, and kinesiology.

RESULTS

Alongside findings that highlighted the significant demographic shift, the findings highlight key themes related to temporal shifts in treatment, emergence of organizational structures and use of evidence, comprehensive approaches to care, and future directions. A critical finding that requires immediate attention is the significantly disproportionate resources to the number of adults living with CHD, and as a result, the real risk of premature death for this population.

CONCLUSIONS

The insights provided behoove the community of stakeholders to think creatively on how to draw attention to the inadequacy of resources and the unique and diverse needs of this population.