152 R.P. Fitzgerald and M. Legge
which part of the IVF procedure, based on their levels of competency
and the difficulties of the sample being worked with. Senior scientists
spoke of observing small aspects of technique such as the handling of
pipettes, consistency in careful identification of specimens and atten-
tion to aseptic technique that indicated a new member ‘had a feel’ for
working in the area. Then, they would start to build up a collaborative
knowledge basis with the newcomer, as competency had to be acquired
in their judgement calls as well as their practical technique. Judgement
was just as important as manual dexterity in selecting which embryo
and sperm to use for ICSI, and to decide which embryos to freeze and
which should be discarded. One worker described it as ‘building up that
repertoire of knowledge so that you’re tapping into someone with more
experience for their initial decisions until you get to that point where
you are getting the same answers in the discussions and feeling more
confident’.
Scientists could also conceptually disassemble the magnitude of
the purpose of IVF (a live baby) into component parts that provided
stronger positive reinforcements for competencies achieved. Many
of the scientists regarded a result of ‘no fert[ilization]’ with more con-
cern than the vagaries of whether a live baby was eventually produced.
Several spoke of an unexplained run of ‘no ferts’ as a ‘bit of a hurdle
that you need to get past’. In such cases of apparently inexplicable
failure, using the system and ‘following the protocol’, along with the
mandatory second checking of steps of the procedure was a source of
comfort. However, as another experienced scientist noted, ‘the pro-
tocol is the minimum requirement for something—you need that feel
for the bigger situation as well’. Another mid-career worker said, with
some exasperation, that while it was possible to look up the protocols
to decide what to do at every decision point, this would take so much
time, that the laboratory would grind to a halt, and eventually you had
to learn to decide on your own.
Similar to the points addressed in Gawande’s work, staff spoke of
how the practice of repetition led to embodied competencies: ‘When
I tried to do embryo transfers I was shaking so hard that I could never
load the embryos up the catheter because I was so anxious. And I think
that was psychological but it was like if I muck up I am dropping
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