The interplay of argumentative dialogues and work observations in collective reflection for work transformation. Cross self-confrontations in a public health institution

This chapter is based on an intervention in cross self-confrontation (Clot et al. in Perspectives interdisciplinaires sur le travail et la santé 2(1):2--8, 2000), recently conducted in a French nursery home and home for disabled adults. It introduces the methodology of cross self-confrontation, as it was implemented in this institution, with the goal of "putting into debate complex questions related to work activity, health at work and work organisation, through discussing the question of the quality of work", according to the research agreement. It discusses how this methodology differs from the "best practice" approach. It shows how professional elaborations in the project were backed up by argumentations based on a careful observation of details of the work activity, and how the collaborative process of work co-analysis contributed to the development of the argumentation, dialogue and shared reflection. The research process therefore supports a "simple dialogue" among practitioners, expanded with the direction, which is important but nearly impossible in everyday work. The experiences made by the participants in the cross self-confrontation dialogical process impact the types of professional dialogues that are familiar within the institution, both horizontally and vertically: among frontline workers, within the direction of the institution and between the frontline workers and the direction of the institution.