The interaction order and clinical practice: Some observations on dysfunctions and action steps (original) (raw)

Intervening With Conversation Analysis: The Case of Medicine

In this article, we discuss the notion of a 'conversation analytic intervention,' focusing on the role of conversation analysis in the major stages of intervention research, epitomized by the randomized controlled trial, the gold standard for intervention in the medical sciences. These stages embrace development, feasibility and piloting, evaluation, and implementation. We describe how conversation analytic methods are used as part of the first two stages and how a conversation analytic skill base and sensibility must be deployed in managing the last two stages. Through a review of practical requirements for successful, externally-funded intervention research, we provide suggestions for how to maximize the potential for basic, conversation analytic research to eventuate in intervention. Data are in American English. The progressive expansion in the range, quality, and reliability of conversation analytic (CA) findings over recent years has increased confidence that these findings will find significance in real-world applications. These applications are, of course, various. As Antaki (2011) observed, there are numerous ways in which CA findings can be applied, such as toward the establishment of new areas of scholarship or toward a better understanding of macrosocial issues, communication problems, organic/psychological disorders, and the workings of social institutions. When CA is

CONVERSATION ANALYSIS AND THE STUDY OF SOCIAL INSTITUTIONS: METHODOLOGICAL, SOCIO-CULTURAL AND EPISTEMIC CONSIDERATIONS

Athenea Digital, 14(1), 303-331

The objective of this study is to show how conversation analysis, a sociological discipline, approaches the study of social institutions. Social institutions are conceived as the crystallization of members’ communicative, interactional practices. Two institutional domains—psychiatric interviews and broadcast news interviews —and a specific interactional practice—‘formulations’—are examined in this study. The results show that (1) in psychiatric interviews the psychiatrist uses formulations to transform the patients’ avowals and establish a psychiatric problem. (2) In broadcast news interviews, formulations might help the interviewer to clarify or transform the statements of the interviewee, or challenge his assertions. The comparison of formulations in two different institutional settings serves the purpose of (1) demonstrating how communicative conduct is adapted in particular settings in ways that invoke and configure distinct social institutions and (2) inspect the knowledge, practices, logic, etc., mobilized by members of the epistemic communities of psychiatry and journalism.

The medical consultation through the lenses of language and social interaction theory

Advances in Health Sciences Education, 2019

The well-structured medical communication models that are typically described in textbooks are relevant to practice, but the actual messy interactional realities of consultations are often a far cry away from them. As a result, medical trainees frequently encounter difficulties when applying communication skills acquired during training to medical practice. This paper reflects on how clinical communication research and courses can incorporate the growing need for context-bound communication skills training. This paper illustrates how concepts from the research field of language and social interaction can facilitate the description and analysis of communication in clinical encounters, drawing on a real-life example from an increasingly common clinical scenario: a consultation in the emergency department involving a patient who does not speak the same language as the clinician. The proposed way of looking at clinical communication can enrich clinical skills training as it provides a tool to study, analyze, visualize and discuss communication from a different perspective that simultaneously accounts for interactional and clinical reasoning aspects of medical consultations.

Conversation Analysis and Medicine

Oxford Research Encyclopedia of Communication

Beginning with phone calls to an emergency psychiatric hospital and suicide prevention center, the roots of Conversation Analysis (CA) are embedded in systematic analyses of routine problems occurring between ordinary persons facing troubling health challenges, care providers, and the institutions they represent. After more than 50 years of research, CA is now a vibrant and robust mode of scientific investigation that includes close examination of a wide array of medical encounters between patients and their providers. Considerable efforts have been made to overview CA and medicine as a rapidly expanding mode of inquiry and field of research. Across a span of 18 years, we sample from 10 of these efforts to synthesize important priorities and findings emanating from CA investigations of diverse interactional practices and health care institutions. Key topics and issues are raised that provide a unique opportunity to identify and track the development and maturity of CA approaches to ...