The hybridization of human-robotic workplace. The case of pediatric robotic surgery.

Robotics is an area of digital innovation that has important implications for organizational practice in many occupational settings. The increasing use of robots in the workplace has renewed the interests of organizational scholars for studying human-robot interactions and how work is changing in high-tech workplaces. Automation is going along with more nuanced processes of hybridization/transformation that reshapes the contribution of humans and nonhumans in organizations. Starting from an explicit critique of technological reductionism, recent developments in organization studies challenge the traditional ontological separation between technology, work and organization, arguing for a relational ontology that focus on human and nonhuman agencies. In such a view, human or technological entities do not have intrinsic properties, but acquire form, attributes, and capabilities through their relation. The present research shares this view and maintains that technology is a condition and a consequence of process development. In order to study human-robot work processes, this dissertation presents a qualitative study of work transformation in a pediatric robotic surgery setting. The thesis is structured into four chapters. The first conceptualizes the operating room as a technologically dense environment, presenting the evolution of surgical techniques—from open surgery to laparoscopic and robotic-assisted procedures—and examining how different technologies shape spatial configurations, roles, and work processes. This chapter also includes a non-systematic review of organizational studies on robotic surgery, highlighting key research themes such as coordination, communication, learning, and adoption processes. The second chapter constructs the theoretical framework, presenting a tripartite epistemological distinction in organizational research on technological change—entitative, mutually dependent, and sociomaterial—drawing on the model proposed by Orlikowski and Scott (2008). It introduces Andrew Pickering’s dance of agency as the analytical lens adopted in the study, enabling a dynamic reading of human-technology interaction grounded in emergent patterns of resistance and accommodation (Pickering 1993). The third chapter outlines the research methodology, detailing the qualitative approach that combines ethnography, participant observation, and semi-structured interviews. It also presents the research settings, including a pediatric hospital (the main site of the research), two pediatric units, and one adult surgery department. The chapter further describes the iterative development of the codebook and the abductive logic used to analyze the data. The final chapter presents the analysis, exploring how surgical work processes are reconfigured across different surgical techniques through the lens of the dance of agency. It describes the interplay between human and nonhuman actors and the shifting dynamics of work processes within the surgical team. The results highlight the multifaceted nature of both human and material components, showing how they may simultaneously act as accommodation and resistance depending on the specific fragment of the work process observed. The complex environment, with multiple actors involved, demonstrates how, although work processes pursue a shared outcome, the dance of each actor may accommodate some while resisting others. The findings also reveal that human and material resistances are perceived and legitimized differently. Human resistances are often naturalized within team dynamics, while material resistances introduced by new technologies are more likely to be problematized—especially by those who experience them without direct benefit. The research further illustrates the role of disciplinary agency in shaping what is perceived as resistance or accommodation. Technological innovation does not simply resolve pre-existing material resistances but rather redistributes them through new sociomaterial arrangements, implying that how technologies are introduced and organized profoundly shapes their legitimization. The study thus contributes to sociomaterial theories of organization by offering a nuanced account of hybrid work processes, where human and nonhuman components are entangled in an ongoing, complex dance of agency.