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Body Movement and Speech in Medical Interaction

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... While the pioneering works in Conversation Analysis (CA) focused on the exclusive use of naturally occurring talk in conversation (Heath, 1986;Hutchby & Wooffitt, 2008;Mondada, 2006), more recent studies have benefitted from bringing participants' verbal as well as non-verbal interaction, e.g., gaze, gesture, and other resources, into analysis. Previously, Sacks (1972) had been working on recordings of telephone conversations from a suicide prevention center, which naturally did not give analytic access to modalities such as gaze, gesture, or bodily posture. ...
... Previously, Sacks (1972) had been working on recordings of telephone conversations from a suicide prevention center, which naturally did not give analytic access to modalities such as gaze, gesture, or bodily posture. Although Sacks made several observations regarding participants' visual behavior even in his early lectures (Heath, 1986), the lectures most often deal with the structure and order of conversation and how this is verbally accomplished, with themes such as rules of conversational sequence, correction and categorization (but see Sacks, 1995, Part 1, Fall 1964-Spring 1965, Lecture eleven: On exchanging glances). While these recordings could be listened to repeatedly, the lack of visual media meant that talk was studied in isolation, laying bare the sequential structure of talk in conversation but offered no insight into participants' use of e.g., gaze. ...
... While these recordings could be listened to repeatedly, the lack of visual media meant that talk was studied in isolation, laying bare the sequential structure of talk in conversation but offered no insight into participants' use of e.g., gaze. However, pioneering scholars Goodwin (1980) and Heath (1986) would soon follow up on those studies by analyzing "nonvocal" actions such as gaze when establishing mutual orientation within turns at talk, using video recordings of actual conversations in institutional settings (e.g., interaction between doctor and patient in medical consultations, Heath, 1986) and non-institutional settings (social gatherings such as family dinners, Goodwin, 1980) as their data source. ...
Thesis
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Drivers rely on vision to navigate and interplay with other road users. However, the experienced drivers use of vision differs considerably from the novice’s, with the former having developed what is essentially a “professional vision” (Goodwin, 1994). This compilation thesis seeks to investigate how the ability to see and act in methodic ways is taught and learned in driver training. It takes a special interest in trajectories of learning as displayed in and through participants’ interaction. Study I shows how the mirror routine, a standard procedure for visually checking the car’s surroundings, is taught and practiced during training. The analysis demonstrates the intractability of instructions and the prospective-retrospective character of members’ procedures for sensemaking as proposed by Garfinkel (1967). Study II shows how the blind spot check, essentially a component of the mirror routine, is introduced and later practiced during driving lessons. Results revealed how instructions are not only sensitive to changes in the surrounding, but also to the trainee’s developing levels of competence. Study III investigates participants’ work of establishing joint vision when deciding on an action point for an upcoming maneuver. It shows how seeing, as a social phenomenon, is an achievement that may require interactional work and coordination of embodied sensorial practices. The participants’ orientation to the trainee drivers’ progression can be seen in different ways of orienting to learning as shared interactional history, as mutual orientation displayed through explicitly oriented talk, and as changing participation in an ongoing activity. Becoming a member-driver in the community of road users involves a perceptual restructuring of the world as perceived through one’s senses (Nishizaka, 2006). Sensoriality may thus be seen as crucial to processes of learning. In order to develop necessary skills for looking and seeing in traffic, trainee drivers should be given ample opportunity to practice those skills in the setting where the instructed practice will actually be produced.
... Each two researchers watched the videos multiple times and coded interruptions and reactions independently. Since we were primarily interested in the action-by-action character of social interaction [39], the verbal content was not analyzed, and thus transcripts were not considered. For validation, identified interruptions and reactions were discussed and reached consensus during regular data analysis sessions within the research team and in a video data session outside with experts in video interaction analysis. ...
... HCPs received or made phone calls or had conversations with each other, whereupon participants shifted their gaze and thus their attention to the person speaking [39]. Therefore, participants may have missed important parts of the discussions. ...
... During MTCs with patient participation, the browsing of individual HCPs through their documents led to interruptions. Patients and companions turned their gaze, and thus attention, to the browsing person [39]. Even though HCPs are very busy, many patients must be discussed during MTCs, and re-reading is probably sometimes necessary, better preparation of HCPs could at least reduce the need to browse through documents. ...
... Das Beratungstool iKNOW benötigt zwar Informatio nen, die teilweise auch in Klinikinformationssyste men zu finden sind, ist aber ansonsten vom digita len Ökosystem der Klinik weitgehend unabhängig. Daher schließen wir an bisherige Arbeiten an, wel che die Informationen aus einer elektronischen Patient*innenakte und deren Verwendung in der Sprechstunde in den Blick nehmen (Engeström et al. 1988;Heath 1986), gehen jedoch insofern da rüber hinaus, als hier digitale Informationen und der Beratungsprozess dezidiert aufeinander abge stimmt sind (bzw. sein sollen). ...
... Curare 45 (2022) 1 Ärzt*in, Patient*in und ein digitaler dritter gen. Auch der thematische Fokus auf Brust und Eierstockkrebs und insbesondere die spezielle ge netische Disposition einer BRCA1/2Mutation, die maßgeblich für das von uns beforschte Beratungs tool iKNOW sind, wurde weitreichend -quantita tiv wie qualitativ -untersucht (Blakeslee et al. 2017;Gunn et al. 2019;Lock 1998 (Pelland et al. 2017;Heath 1986;Alku reishi et al. 2016). Engeström und Mitautor*in nen (1988) analysierten, basierend auf ethnogra fischempirischen Material, wie die Nutzung der Patient*innenakte zu inhärent widersprüchlichen Arbeitsroutinen führe -unter anderem zwischen Zeitdruck und Fokus auf Versorgungsqualität, zwi schen Kompartementalisierung in der elektroni schen Akte und einer ganzheitlichen Einschätzung der Patient*in. ...
... Christine sChmid, frauke mörike & markus a. feufel Unabhängig davon, ob eher ein solch kritischer Blickwinkel auf die Auswirkungen von digitalen Technologien eingenommen wird, oder vor allem die gegenseitige Konstitution von digitalem Arte fakt und Sozialität in den Blick genommen wird, ist man sich jedoch darin einig (und dies schon seit den 1980erJahren), dass Computer (und di gitale Technologien) Teil zukünftiger ärztlicher Konsultationen sein werden und beide Parteien sich an die Anforderungen der Technologie an passen werden müssen (Heath 1986). Teilwei se werden die digitalen Technologien aber auch als Ausgangspunkt gewertet, um Einfluss auf die Begegnung zwischen Ärzt*innen und Patient*in nen auszuüben, schlussfolgern Engeström et al. (1988: 83): ...
Article
t Computerbasierte Informationstechnologien, die zur Gestaltung von Inhalten und Abläufen ärztlicher Beratungsgespräche eingesetzt werden, erhalten bisher erstaunlich wenig sozialwissenschaftliche Aufmerksamkeit – trotz des generell sehr großen Forschungsinteresses sowohl an Digitalisierung im Bereich der Gesundheitsversorgung als auch an Ärzt*innen-Patient*innen-Interaktionen. Gerade Technologien, die für eine maßgeschneiderte Informationsvermittlung oder zur strukturierten Erklärung unterschiedlicher Therapiemaßnahmen genutzt werden, bleiben bisher nur ausschnitthaft untersucht. Unser Beitrag diskutiert, wie sich das traditionell dyadisch gedachte Ärzt*in-Patient*in-Gespräch durch digitale Informationssysteme verändert, wenn diese nicht nur zur Dokumentation, sondern zur inhaltlichen und strukturellen Unterstützung des Beratungsgesprächs und damit als dritter Akteur eingebunden sind. Anhand von empirisch ethnografischem Material zu einem online-gestützten, digitalen Beratungstool für die familiäre Krebsberatung – iKNOW – beschreiben wir, wie verschiedene Relationen zwischen Ärzt*innen, Ratsuchenden und dem Beratungstool entstehen. Wir führen insbesondere aus, wie durch das Beratungstool verschiedenes Wissen, verschiedene Akteurspositionen und verschiedene materielle Arrangements situativ relevant werden – und dadurch letztlich verschiedene Formen der Beratung durch das Tool als digitalem Dritten ko-produziert werden. Dabei wird deutlich, dass sich zwei scheinbar gegensätzlichen Motive durch die Beratungen mit digitalem Dritten ziehen: die Standardisierung der medizinischen Versorgung einerseits und deren Individualisierung bzw. Personalisierung andererseits. Das digitale Beratungstool aktiviert dabei verschiedene Formen von Standardisierung und Personalisierung und hilft diese im Sinne einer „situierten Standardisierung“ zu verknüpfen (Zuiderent-Jerak 2007: 316, Übersetzung CS). Das Tool fungiert somit als „wissenschaftlicher Sammelpunkt“ (Timmermans & Mauck 2005: 26, Übersetzung CS) über den die verschiedenen Formen und Prozesse von Standardisierung und Personalisierung durch die Moderationsleistung der Ärzt*innen situativ zusammengefügt und damit bedarfsgerecht und patient*innenzentriert in das Beratungsgespräch integriert werden können.
... The patient's body is not only a site of the patient's physiological, cognitive, sensory, and affective perceptions and experiences of health and illness (Agarwal, 2018) but also an object for clinical inspection transformed by patients in the physical examination activity (Heath, 1986). The observations and findings generated from examining patients' bodies lay the foundations for managing patients' pain and suffering and treating their illnesses (Heath, 2006). ...
... Patient participation is crucial for conducting and completing physical examinations (Heath, 2006). In physical examinations, patients not only transform their bodies into objects for inspection (Heath, 1986) but have opportunities for active participation. Patients cooperate with clinicians to complete examining activities, displaying their orientation to the intersubjective understandings and the joint construction and accomplishment of social actions and activities (McArthur, 2018). ...
... Concurrently, patients actively monitored and participated in the physical examination activity, as evidenced by the temporal and sequential mobilization of their multimodal resources (Goffman, 1957(Goffman, , 1964Peräkylä et al., 2021). First, patients not only showed voluntary compliance to clinicians' guiding touch and adjusted their body posture as requested but also agentively monitored and participated in the ongoing examination by verbally instructing clinicians to painful locations and physically showing particular locations (Extracts 1, 3, 4), and verbally presenting the problems to clinicians without being inquired (Extract 2), thus displaying patients as active participants rather than passive clinical objects for inspection (Heath, 1986). The knowledge about subjective sensations of pain and experiential knowledge about painful locations provided patients with specific ways of expressing expert knowledge about painful locations. ...
Article
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Touch is a fundamental resource mobilized by clinicians in physical examinations in outpatient clinical consultations. However, few studies have been conducted to explore the sequential organization of touch in the interactional process of physical examinations where clinicians’ touch is launched and responded to in Chinese medical settings. Based on a collection of video recordings of naturally occurring clinician-patient interaction in an orthopedic outpatient clinic in China, we observed four types of clinicians’ touch in the physical examination framework: the guiding touch, the diagnostic touch, the demonstrative touch, and the therapeutic touch. Together with clinical expertise, the sensorial knowledge obtained through touch enables clinicians to professionally evaluate patients’ physical conditions and diagnose their illnesses. We also demonstrated that patients do not merely put themselves into clinicians’ hands as clinical objects for inspection and defer to clinicians’ medical authority. Instead, they actively and agentively participate in physical examinations to jointly accomplish social actions and activities through the temporal and sequential mobilization of their multimodal resources. This study not only adds to an emerging body of research on touch in medical settings but also sheds some light on the understanding of the clinician-patient interaction in Chinese outpatient clinics.
... Discourse-based interactional approaches generally follow the basic CA principles claiming that participants organize their speech in a systematic way (Sacks et al., 1974) and that that utterances and actions can only be understood within the context in which they occur (Heath, 2004(Heath, / 1986). According to CA principles, conversations are sequentially organized, that is, interlocutors coordinate their interaction by building on previous utterances. ...
... Discourse-based interactional approaches generally follow the basic CA principles claiming that participants organize their speech in a systematic way (Sacks et al., 1974) and that that utterances and actions can only be understood within the context in which they occur (Heath, 2004(Heath, / 1986). According to CA principles, conversations are sequentially organized, that is, interlocutors coordinate their interaction by building on previous utterances. ...
... Over the years, the seminal work by Sacks et al. (1974) that constitutes the basis of the discourse-based interactional approach has been further complemented and refined, especially by means of ever-more fine-grained accounts of the multimodal character of dialogue. Studies on interaction management in monolingual conversation such as Bavelas et al. (2002), Heath (2004Heath ( / 1986), Kendon (1967), Kress and Van Leeuwen (2001), Mondada (2016) and Rossano et al. (2009) have increasingly focused on the role of participants' nonverbal behaviour in conversation, for example, to steer the interaction. Moreover, the introduction of innovative research methods such as mobile eye-tracking (Vranjes, 2018;Vranjes et al., 2019) has led to more fine-grained accounts of the role of gaze, gesture, body posture, proxemics, the handling of artefacts and spatial arrangement in interaction (Davitti & Pasquandrea, 2017), taking into account the multimodal character of conversation. ...
Book
The increasing practice of remote interpreting (RI) by telephone and video link has profoundly changed the ways in which interpreting services are being delivered. Although clinical research on RI has reported positive results, empirical research in other settings, such as legal contexts, has demonstrated that RI can affect the quality of interpreter-mediated communication. This book investigates the possible effects of using RI on the quality of healthcare interpreting. Central to the research design are three series of simulated interpreter-mediated doctor–patient encounters, each involving a different interpreter and using three different interpreting methods: face-to-face interpreting, telephone interpreting and video interpreting. These sessions were video recorded, transcribed and annotated according to categories previously established in interpreting studies. First, quantitative analyses of miscommunication and interaction management were carried out to identify potential relationships between message equivalence issues and interactional issues and to establish the possible influence of environmental and technological factors. These data were submitted to comparative, qualitative analyses, which were triangulated with the findings from the participants’ perceptions, collected by means of thirty post-simulation interviews. The insights generated by this work are highly relevant for all users of RI to anticipate and overcome communication problems.
... Early, and influential, studies on intimate work in medical and nursing practice (cf. Emerson, 1970;Heath, 1986) have shown how professionals and their clients, through routines and social interaction, create 'frames for interaction' that provide a distance that regulates and characterises the interaction between participants. Other identified strategies of framing, as means to create professional distance, is 'objectification', which refers to the way a person's body might be seen as a set of typical features rather than as unique to the individual (cf. ...
... Other identified strategies of framing, as means to create professional distance, is 'objectification', which refers to the way a person's body might be seen as a set of typical features rather than as unique to the individual (cf. Heath, 1986). ...
... By referring to the dementia diagnosis, a professional distance is created that can be referred to as objectification (cf. Heath, 1986). This does not necessarily imply an emotional distance towards the care recipients. ...
Article
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Sweden, as a welfare state, has a long tradition of providing formal home care and support to their citizens in their own homes, either through home care services or personal assistance. A large percentage of frail elderly and persons with disability who receive formal home care require personal and intimate care, such as help with eating, showering, getting dressed and personal hygiene. Managing intimacy and safeguarding the care recipient’s integrity pose particular challenges for staff. The aim of this qualitative interview study is to describe and analyse care workers’ (CWs) and personal assistants’ (PAs) strategies for managing situations and challenges related to provision of personal and intimate care in the context of formal home care. Semi-structured interviews with eleven CWs and nine PAs were conducted. Our analysis reveals a complex repertoire of relational and communicative strategies, within an overall approach—which we labelled ‘empathetic attuning’—of relating to the current situation and task at hand whilst safeguarding integrity. These strategies were intertwined with dimensions of time. The possibility to accomplish satisfactory personal and intimate care rests on structural and organisational conditions that promote sustainable working conditions, where relations characterised by continuity, integrity and respect can be realised.
... This ethnomethodological research uses the video-recordings of events as its principal data source, courtrooms comprising one amongst a range of institutional domains through which ethnomethodologists have explored the interactional assembly of social memory (see studies of institutional talk, Drew and Heritage 1992). Other studies investigate how accounts of individual memory emerge in medical interactions (Heath 1986). These studies contend that accounts of individual memory, biographical stories and the medical history of a patient are co-produced in interaction between medical professionals and patients (Boyd and Heritage 2006;Tapsell 2000;Heath 1982). ...
... For example, cameras are positioned in places where they do not obstruct participants' exploration of the museums, and camera recording lights are switched off. In this regard, it is noteworthy that research in medical settings has shown that people rarely, if at all, orient to the camera in a noticeable way (Heath 1986). If they react to the camera, this is visibly responsive to the ongoing recordings; for example, people waving to or smiling into the camera. ...
Article
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In this article we will explore how people’s memories of past experiences and events are evoked through their interaction with, and around museum objects. By examining naturally-occurring interactions which emerge at exhibits, we investigate how people draw upon material objects within the museum- texts and exhibits, when vocalising their rememberings of past experiences and events, and address the role of the body in animating these occasioned memories. Thus, we can observe how memories are brought to life at exhibits- these past encounters supplying a means through which to engage in the present, and address how people’s aesthetic encounters are shaped by these vocal and bodily animated rememberings. We also examine a case in which a participant’s remembering is questioned, exploring how participants resolve the contested status of memory to arrive at a concerted way of remembering and experiencing an exhibit. The analysis contributes to discussions within the sociology of memory and memory studies, as well as to museology and related areas of research. It is based on field observations and video-recordings of interaction in museums and other exhibitions in Great Britain and Europe, adopting ethnomethodology and conversation analysis as its analytic attitude.
... In service encounters, epistemic rights are divided between professionals, who are supposed to possess expert knowledge concerning the institutional task at hand, and clients, who are considered to have primary rights to knowledge on their personal experiences. For example, physicians are expected to have primary access to the medical knowledge required to solve the patient's presented health problems, while patients are expected to share their lay experiences of their felt symptoms (Heath, 1986). In different types of interview situations, such as research or media interviews, the interviewer usually assumes the role of the not-knowing participant, while the interviewee has the information that is being sought (Clayman, 2013). ...
... There is a silence of 2.0 seconds during which the recruiter gazes at the test (Line 37), while the candidate gazes at the recruiter (except at the end of the pause, when he quickly glances toward the test and right after turns his gaze back to the recruiter). Thus, the candidate displays recipiency to the recruiter, who next gazes at the test and produces a description of the candidate (see Heath, 1986). With the pronoun "for that," she refers to the candidate's preceding statement, indicating that she is talking about a similar thing, albeit using different terminology. ...
Article
Personality testing is an elementary part of recruitment. The test results are increasingly considered a necessary means of obtaining information about candidates’ personalities and suitability. This has raised questions about who has the right to define a candidate’s personality in recruitment interviews. Here, we use conversation analysis to describe two strategies through which recruiters evaluate candidates’ personalities based on the personality test results and show how these methods are linked to different interactional affordances. We recommend the candidate-driven strategy that attends to the candidates’ fundamental right to define their personality in a situation where their career is at stake.
... A nemzetközi szakirodalomban már a nyolcvanas évek közepétől kezdve jelen vannak azok az empirikus kutatások, amelyek az orvos-beteg kommunikációt a konverzációelemzés eszközeivel vizsgálják (Frankel 1983;Heath 1982Heath , 1986. A kutatások elsősorban az alapvető és általános orvosi ellátások körében folytak (Maynard-Heritage 2005;Heritage-Maynard 2006), de az egészségügy olyan speciális területeire is kiterjedtek, mint a sürgősségi ellátás (Mondada 2003) vagy az AIDS-betegek vizsgálata (Peräkylä 1995;Silverman 1997). ...
... IZMEĐU BABICA I PORODILJA U međunarodnoj stručnoj literaturi su od osamdesetih godina prisutna empirijska istraživanja koja komunikaciju između lekara i pacijenata ispituju sredstvima konverzacijske analize (Frankel 1983;Heath 1982Heath , 1986. Istraživanja su pretežno vršena u okviru opšte prakse (Maynard-Heritage 2005), ali su se proširila i na specijalističke oblasti. ...
Article
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A nemzetközi szakirodalomban már a nyolcvanas évektől jelen vannak azok az empirikus kutatások, amelyek az orvos-beteg kommunikációt a konverzációelemzés eszközeivel vizsgálják. A kutatások elsősorban az általános orvosi ellátások körében folytak, de az egészségügy speciális területeire is kiterjedtek. Kutatásomban az orvos-beteg kommunikáción belül szülésznő-szülő nő interakciót vizsgálom a konverzációelemzés eszközeivel együttműködési stratégiák tükrében. A vizsgálat korpuszát szülésznő-szülő nő közötti beszélgetések diktafonos rögzítés után az ALRITE szoftverrel átírt párbeszédei alkotják. Az elvégzett szakirodalmi kutatás tanúsága szerint még nem volt az együttműködés elemzés fókusza a szülésznő-szülő nő párbeszédek vizsgálatának, ezért remélhetőleg hozzájárul majd az egészségügyi kommunikáció egy speciális területének alkalmazott nyelvészeti elemzéséhez. A tervezett kutatás további célja, hogy a vizsgálatok révén kapott eredmények segítséget nyújtsanak egy az Egészségtudományi Karon alkalmazandó MID szaknyelvi tananyag kidolgozásához.
... The problem of availability for interaction is a matter of "sizing up" another person with respect to their preparedness or inclination to enter into focused interaction. Practices used at this stage are largely to do with persons' "body idiom" (Goffman 1959(Goffman , 1963Heath 1986), or what can be apperceived regarding what each person is attending to, whether they are stationary or mobile, what objects they are wielding or acting upon, with whom they are engaged, etc. Studies of walking, for instance, have argued for the constitutive accountability of navigational practices in partitioning shared social spaces into legible streams of movement and pockets of activity, and in rendering mobile persons into vehicular units of various sizes (Goffman 1971;Ryave and Schenkein 1974;Livingston 1987;Watson 2005). ...
... The notion of an interactional space draws attention to the spatial distribution and configuration of participants' bodies relative to one another and to their material environment, to the collaborative emergence of those arrangements, and to the ongoing constitution of a dynamic "here and now" through participants' orchestration of multimodal resources. The emergence of this space typically involves the (re-)configuration of participants' bodies into reciprocal or vis-à-vis orientations (Goodwin 1981(Goodwin , 2000Heath 1986;Kendon 1990;Schegloff 1998). Such configurations display availability and preparedness for interaction and may be accompanied by practices like putting away items (Mortensen and Hazel 2014) or adopting a "waiting" posture (Svinhufvud 2018). ...
Chapter
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This chapter shows how workers initiate interactions in a complex workplace setting: a construction site. It focuses on encounters involving an ambulatory party and a (generally) stationary party. Three practices for approaching and initiating interaction are described—direct, oblique, and restricted approaches—each of which has particular implications for the interactions that they precede. Participants are shown orienting to trajectory and proximity as constitutive features of ambulatory openings. This chapter also considers “anticipatory openings”: opening turns issued by a party who sees that they are being approached, and which anticipates the likely reason for their being approached. The analysis is based on 80 openings in English and Spanish, identified in 10+ hours of video recordings of construction site activities.KeywordsOpeningsMobilityWorkplaceConstruction
... The body is not only a resource or a site for implementing practices but there is an interactive relation between bodies, something that is part and parcel of interactive bodywork previously noticed in professional practices (cf. Twigg, 2000; see also Heath, 1986Heath, , 2006. In such activities, the bodies in collaboration are what Merleau-Ponty called expressive bodies that are constitutive of ongoing actions (Merleau-Ponty, 2014, chapter 6). ...
... 389). Heath (1986Heath ( , 2006 stressed bodywork as an "ontological endeavour": the construction and constitution of the body as "the site for clinical activity," that is, as a medical object for the doctor to examine (1986: 187). Our analysis highlights the collaborative aspect of bodywork, namely what we can be called interactive bodywork: interacting with a body rather than working on a body and thus working with the lived body rather than a body as an object. ...
Article
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This study shows how concerted bodily movements and particularly intercorporeality play a central role in interaction, particularly in joint activities with people with late-stage dementia. Direct involvement of bodies in care situations makes intercorporeal collaboration the basic form for engaging with people with late-stage dementia. By detailed analysis of a videorecording of a joint activity involving a person with late-stage dementia as an example, we show that the process of concerted bodily movements includes not only an interactive bodywork but also a reconfiguration of the routine activities and actions in situ. Reconfigurations often require, and are the outcome of, particular practices for the systematic modification of the embodied conducts of the participants and their use of artifacts in the surrounding environment. These practices, that we highlight in our study, are (1) staging activities through organization and re-organization of body parts, as well as artifacts (rather than using verbal descriptions of activities); (2) decomposing (parsing) activities into smaller parts possible for the person with dementia to perform (rather than using verbal action descriptions); and (3) providing embodied directions and bodily demonstrations of actions (rather than using verbal directives). As a result, we point to these practices for their reflexive roles in the change of the use of modalities in interaction: from mainly using verbal language to the prominence of visual depiction and bodily demonstration as necessary methods to facilitate the participation of people with latestage dementia in joint activities.
... )e a análise da conversação (GOODWIN, 1986;SCHEGLOFF, 1984;HEATH, 1984HEATH, , 1986MONDADA, 2006;2007). McNeill (BUTTERWORTH;HADAR 1989;FEYEREISEN 1987;McNEILL1985, 1987McNEILL1985, , 1989. ...
Article
Este artigo tem por intuito apresentar um panorama dos estudos acerca da multimodalidade na linguística, com ênfase no período da aquisição da linguagem, tomando por base os trabalhos clássicos de Kendon (1988; 2009) e McNeill (1985; 1992; 2000). Nos situamos em oposição a uma concepção de primitivismos gestual e de uma proposta de continuidade estrutural entre o gesto e a fala e defendemos a inserção da criança na língua a partir de um arcabouço prosódico-gestual (FONTE; CAVALCANTE, 2016; CAVALCANTE, 2015; CAVALCANTE et al, 2016). Ilustramos a proposta com dados quantitativos e qualitativos de de uma díade mãe-bebê, ao longo de 18 meses de vida.
... However, a dedicated methodology was first developed in the last several decades, which has since established itself internationally. For example, Goodwin (1980) studied everyday interactions by means of video recordings, Erickson and Shulz (1982) used video to analyze school counseling sessions, and Heath (1986) carried out video analyses of medical treatments. Reflection on the methodology began in the 1980s and is still documented to this day in various anthologies (Knoblauch et al. 2006;Kissmann 2009;Corsten et al. 2010). ...
Chapter
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Listening, experiencing, drawing or interpreting spaces: narratives, experiences, visualizations and discourses can be helpful for the empirical investigation of spaces. This interdisciplinary handbook presents a broad spectrum of established methods and innovative method development to capture and understand different facets of spaces. Instructive explanations and concrete examples make the varied qualitative methods of spatial research understandable and applicable across disciplines. The theoretical and methodological aspects of qualitative spatial research form the framework of this handbook.
... Rather, the focus has been on how the technology features in social interaction. The field of technology-supported and humancomputer interaction goes back to Garfinkel's interest in workplace studies (Rawls, 2008), and especially the line of research that grew out of Suchman's (1987) work, as well as research by Heath, Luff and Hindmarsh (Heath, 1986;Heath and Luff, 1992;Luff et al., 2000). Research focusing on interactions using mobile phones includes, among others, Hutchby and Barnett's (2005) study of aspects of the sequential organization of mobile phone conversation; Brown et al. 's (2013) study of phone use while being mobile; Licoppe and Figea's (2018) study of gaze patterns and the temporal organization of multiple activities; and Arminen and Weilemann's (2009) study of the specifics of mobile social actions. ...
Article
What does it mean to see and look? Can seeing and looking be done without using the eyes? This article contributes to studies in visual communication through empirical visual research into human vision, visual impairment and computer vision technologies, using video-ethnographic methods. These topics essentially enable a respecification of the concept of vision, the role of visual and material culture, and the exploration of visual means of communication in social and cultural worlds. In this article, the authors advance the understanding of visuality and vision by showing empirically how ‘seeing’ and ‘looking’ are not uniquely human abilities, but rather informational phenomena that can be achieved through distribution with a technological, nonhuman sensing AI. This study draws on video-recorded data in which visually impaired persons (VIPs) use a smartphone with a computer vision-based app while grocery shopping in a supermarket. Based on video ethnography, ethnomethodology and conversation analysis (EMCA), they show the orderly, practical organization of four specific practices: (1) fleeting glancing; (2) searching; (3) identifying; and (4) locating. In the examples, these ordinary human practices for achieving visual information are done while using the technology as a handheld ‘eye’. This research contributes to studies in visual impairment, visuospatial organization and the use of AI consumer products in a context of cultural practices for accomplishing the act of looking at and picking up grocery products. The article contributes new knowledge on visuality by expanding the concept of distributed perception and by suggesting a praxeological respecification of achieving visuospatial perception as an action in the world.
... Additionally, physicians might overlook expressed and embodied demonstrations of patients' suffering, impacting patient health but seemingly having no repercussions for the clinical relationship. In contrast, patients who ignore physicians may pose a threat to that relationship (Heath 1986). A comprehensive understanding of medical authority necessitates attention to discourse histories extending beyond individual clinical encounters, encompassing entire sequences of discursive interactions (Atkinson 1999), which may include discourse involving only care receivers or familial discussions. ...
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We review the literature on medical discourse and attempt to build a computational model of it. Medical discourse sheds a light on communication structure of patient-doctor and other communication scenarios in healthcare and should be leveraged to facilitate and automate this communication when it is possible and practical. We propose a unified framework to represent communication discourse at the meta-level, where the subject of the communication is expressed in a language object. So far, the broad range of work on medical discourse is detached from computational discourse analysis, and we explore the possibilities of filling this gap and computationally treat the peculiarities of how information is passed between the agents in a hospital setting. We select the domain of question answering (QA) against a corpus of medical documents of diverse nature to evaluate our computational model of medical discourse. It turns out that applying specific structures obtained in medical discourse studies improves the relevance and efficiency of question answering.
... Early conversation analysis emphasized talk and telephone conversations (Schegloff, 1968;Sacks et al., 1974), and as such was highly oriented to that which is hearable in interaction. However, since the beginning of the 1980s, EM/CA has developed in a multimodal direction (Goodwin, 1979(Goodwin, , 1981Heath, 1982Heath, , 1986. The multimodal, visual, and embodied turn (Nevile, 2015), as facilitated by the easier use of smaller video cameras (Erickson, 2011), caused a boom in the study of the visually available and tangible world. ...
Chapter
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People with impairments can be studied in practical and interactional contexts without a priori focusing on the identity of being/not being disabled, competent, or experiencing social problems and social exclusion. Following Maynard (2005), the marking of problems (of any kind in practice and interaction) is, in any case, a member’s designation, not an analytic one: “ethnomethodological and conversation analysis asks about what exactly and precisely goes on in interaction whether or not participants perceive or sense deviance and disability then and there” (Maynard, 2005, p. 520). This requires that it is shown precisely how – if at all, and for all practical purposes (Garfinkel, 1967; Psathas, 1980) – disability and impairment are made relevant within unfolding situations. This means that contrary to most of the research within disability studies, which is concerned with criticism and political programmes, an EM/CA approach seeks, as its primary aim, not to solve anything, but to treat each and any instance as a phenomenon to be investigated in detail. This should enable an analytical precision from within, which does not presuppose any form of either identity, biological marker, competence, (dis)abilities, or other forms of membership categories to be of relevance a priori (Sacks, 1989; Schegloff, 1997). https://www.taylorfrancis.com/chapters/oa-edit/10.4324/9781003156819-1/practical-accomplishment-living-visual-impairment-brian-due?context=ubx&refId=101d7da1-cfa2-461d-a191-b0a889db67e1
... ' This work reflects widespread interest in better understanding the constraints and possibilities for advancing quality health care. Early work such as Heath's (1986) Body Movement and Speech in Medical Interaction, Drew and Heritage's (1987) Talk at Work, and Peräkylä's (1995) All rights reserved AIDS Counseling launched extensive efforts designed to take stock of how diverse actions shape and are consequential for health across primary, pediatric, secondary (e.g., oncology, dementia, rehabilitation, counseling), and many specialty areas. The four chapters in this volume focusing on physiotherapists (Udvardi), pediatric visits (Ranzani), and triadic medical visits (Caronia et al.) exemplify these research areas. ...
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This volume addresses the issue of pragmatic meaning and interpretation in communication contexts regarding health and does so by combining a series of diverse and complementary approaches, which together highlight the relevance of successfully shared understanding to achieve more accessible, inclusive, and sustainable healthcare systems. The volume is divided into five thematic sections: 1) Analytical approaches to health communication, 2) Intercultural and mediated communication, 3) Negotiation and meaning construction, 4) Expertise and common ground, 5) Uncertainty and evasive answers, bringing together a group of top scholars on the much-debated issue of shared understanding both at the micro-level of dialogues between professionals and patients, and the macro-level of institutional communication. In the variety of its contributions, it represents an ambitious attempt at setting pragmatics at the core of healthcare communication research and practice, by combining conceptual reflections on core topics in the field of pragmatics (among which are speech acts, common ground, ambiguity, implicitness), with discourse and linguistic analysis of real-world examples exploring various problems in health communication.
... 30: Kompetenzhäufigkeiten in Videodaten codiert mit act4learning . (Heath, 1986;Kauffeld, 2006 Lernenden künftig selbstständig mithilfe einer Tablet-App sowie einer Augmented Reality-Anwendung (AR) mit der Experimentierfabrik und der Lernfabrikhalle, in der sich diese befindet, vertraut machen können. Hierfür wurden die zwei Szenarien "Einführung in die Experimentierfabrik" und "Sicherheitsunterweisung" konzipiert und umgesetzt, welche zusammen im Verlauf dieses Kapitels als Einführungsszenarien bezeichnet werden. ...
... Nevertheless, as the main objective of CA was never to study language per se, but social action (Sacks, 1984;Sacks & Schegloff, 2002), the focus soon also embraced multimodal aspects of interaction. As the possibilities for collecting and playing video recordings developed in the early 1980s, pioneering researchers, such as Charles Goodwin ( , 1981, Marjorie , and Christian Heath (1982Heath ( , 1986, began to study bodily conduct as an equally important resource for the accomplishment of joint action in face-to-face encounters. ...
... Damit umfasst das Display-Konzept sowohl sprachliches Anzeigen einer Teilnehmendeninterpretation (etwa als Verstehensinferenz im Rahmen einer Antwort, vgl. Deppermann/Helmer 2013) als auch multimodal organisierte embodied displays (Heath 1986;Mondada 2013). Deppermann (vgl. ...
... Allgemein formuliert interessieren sich Ethnomethodologie und (ethnomethodologische) Konversationsanalyse für die Kunstfertigkeit des Handelns in den vielfältigen alltagsweltlichen Praktiken von Mitgliedern: Geschworenen (Garfinkel 1967, S. 104-115) und Labor-Wissenschaftlerinnen (Garfinkel et al. 1981;Lynch 1985), Tibetischen Mönchen (Liberman 2004) und Mathematikern (Livingston 1986), Polizisten (Meehan 1989) und Ärztinnen (Heath 1986), Lehrerinnen (Mehan 1979a) und Autofahrern (Brown und Laurier 2005). Diese Praktikenvom Anstehen in Warteschlangen über das Schachspiel bis hin zum Führen eines mathematischen Beweisessind für diejenigen, die sie versiert beherrschen, normalerweise uninteressant und werden von ihnen ignoriert. ...
Chapter
Der Beitrag gibt einen Überblick über die grundlegenden methodologischen Prämissen der Ethnomethodologie und Konversationsanalyse und empirische Entwicklungen des ethnomethodologisch-konversationsanalytischen Ansatzes im Bereich der Bildungsforschung. Eine zusammenfassende Darstellung der wichtigsten Forschungsthemen und Ergebnisse exemplarischer ethnomethodologischer und konversationsanalytischer Arbeiten in diesem Bereich zeigt die Mannigfaltigkeit ethnomethodologischen Interesses an Phänomenen im Kontext formaler Bildung und veranschaulicht die ethnomethodologische Perspektive.
... Especially since the turn of the last century, research in EMCA multimodal interaction analysis (e.g., Goodwin 2000;Heath 1986;Mondada 2006) has developed rapidly. This approach builds on the idea that when we make sense of each other's behavior and accomplish actions and activities together, we orient to more than just talk. ...
Article
This study demonstrates how interpreters in a Swedish video relay service (VRS) between deaf and hearing users can simultaneously accomplish two different actions, each directed to a particular user of the service. The study takes a multimodal, ethnomethodological conversation analysis (EMCA) perspective and is empirically based on a corpus of 25 recordings from authentic video calls. Our analysis shows how interpreters, through what we call dual action design, are able to: (1) offer the floor to one party while informing the other party, (2) refer to one of the participants using different forms of deictic reference for the two users of the service, and (3) request confirmation of a source statement from one party while rendering a statement to benefit the other party. The study contributes to current discussions relating to sequentiality, simultaneity, and positioning in interpreting studies and multimodal interaction research.
... mimisch-gestische Verhaltensweisen (C. Goodwin 1981;Heath 1986) in der sprachlichen Interaktion spielen. In den anderen Bereich gehören Arbeiten, die sich mit kommunikativen Großformen, also etwa mit dem Erzählen von Geschichten -oder Witzen -innerhalb von Unterhaltungen, mit Problemgesprächen ("trouble talk") sowie mit kommunikativen Gattungen (Kinderspielen, Abzählversen, Klatsch etc.) beschäftigen. ...
... Without forgetting the centrality of language, research on social interaction can be seen to have undergone an 'embodied turn' (Nevile 2015), in which analytical foci, concepts and tools have developed to take into (better) account the various bodily, material and spatial resources that participants may draw on (for seminal early work, see, e.g. Goodwin 1980;Goodwin 1981;Heath 1986). Recent research has indeed explored how the different dimensions of materiality (e.g. ...
... While closings constitute a basic routine organizing social interaction, a detailed analysis of its local organization shows that it is accomplished by participants through a complex interplay of linguistic and embodied resources. Pioneering the "embodied turn" in CA (Nevile, 2015), early video-based studies of face-to-face interaction show how closings are organize in ordinary and institutional settings, for example, how participants locally manage transitions toward disengagement (Goodwin, 1981) or how, in medical consultations, patients' leave-taking is coordinated with topic completion (Heath, 1985(Heath, , 1986. Further research on the multimodal organization of closings has shown how these are projected and negotiated by participants on a moment-by-moment basis and at different levels of organization, (i.e. ...
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Interactional closings constitute a crucial aspect of social interaction and, in social work practice, are organized around participants’ orientation to an asymmetrical distribution of tasks between professional and client, informed by a “dialectics of care and control.” Proceeding from a conversation analytic framework, and grounded on video recordings of encounters between social workers and clients in diverse institutional settings in Portugal, the present paper investigates how the routine of closing social work encounters is carried out through professionals’ and clients’ joint and progressive orientation toward bringing the encounter to an end, and examines some of the interactional and embodied practices mobilized by them for accomplishing this task. By providing a detailed analysis of participants’ audible and visible conduct and their interactional practices, this study shows how social workers orchestrate clients’ leave-taking through the concerted mobilization of linguistic, bodily and material resources, shedding light into how the dialectics of care and control are managed in the everyday exercise of social intervention.
... Conversation Analytic (CA) research on activity transitions and topic shifts has examined different settings, namely everyday conversation (Mondada, 2006;Schegloff & Sacks, 1973), medical interaction (Frankel, 1983;Heath, 1986;Robinson 2001;Robinson & Stivers, 2001), interviews (Mikkola & Lehtinen, 2014), classroom interaction (Icbay, 2011;Jacknick, 2011;Park, 2014), and even a dance class (Broth & Keevallik, 2014). However, there are very few microanalytic studies on the ways classroom activity transitions are brought into being, especially transitions from an activity that has not originally been the pedagogical focus of the classroom, e.g., impromptu storytelling. ...
Chapter
Research on stories as pre-packaged instructional tools in second language (L2) instruction, where stories may function to develop language competence, has a long tradition (e.g., Huang in Engl Teach Learn 30:51–74, 2006; İnal and Cakir in Procedia-Soc Behav Sci 98:675–679, 2014). However, the ways in which stories emerge as naturally occurring activities in L2 classroom interaction remain an understudied research topic. Drawing on multimodal conversation analysis (Burch in Lang Learn 64:651–684, 2014), this chapter focuses on the interactional resources that make transition from storytelling to other instructional matters possible. The chapter explicates how teachers’ and students’ stories in Persian language classrooms are closed down and how the shifts to the next instructional activity are achieved. The data are drawn from two corpora of video and audio recorded interactions in intermediate and advanced Persian language classes at two different North American universities. The analysis shows that the way the stories are received and responded to become consequential for the story closings and transitions. The participants made use of a variety of semiotic resources in multifaceted ways to close down a storytelling and to navigate to the next relevant activity. Such resources included shifts of embodiment and prosodic features, attending to the pedagogical artifacts (e.g., textbook, computer) and using lexical exit devices. By adding to the scant conversation analytic literature on storytelling practices in L2 classrooms in the higher education context (Hellermann in Social actions for classroom language learning, Multilingual Matters, 2008; Lee and Hellermann in TESOL Q 48:763–788, 2013), this chapter illuminates aspects of L2 storytelling in a less commonly taught language and has practical implications for teaching story closing methods in L2 learning in general and in Persian language instruction in particular.
... 99). Heath (1986), in his discussion of medical interaction, also described the potential embarrassment inherent in 'the revelation of intimate parts of the body, the feel of another's hands and the attention of his look' (p. 125), noting how 'it is the mutual recognition that may give rise to embarrassmentseeing another see you in a certain fashion' (p. ...
Article
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Sweden has a long tradition of providing social care and support to its citizens in their own homes through formal home care, delivered either by home care services or personal assistance. A majority of people given support by formal home care need assistance with personal and intimate care. The focus of this interview study was on exploring care recipients', care workers', personal assistants' and care unit managers' perceptions and experiences of intimate and personal care in the context of formal home care in Sweden. In total, 57 interviews were conducted with 42 persons. Three themes emerged in the analysis: Personal Hygiene, Personal Sphere, and The Contextual Variability of Intimacy. Interviewees described intimate care as being inseparable from a person's service needs as a whole. Highlighted was how caring for and washing intimate body parts, intrusion into recipients' personal spheres, and the need to preserve integrity vary depending on situational, temporal and relational aspects. To safeguard the care recipient's influence, integrity and dignity in the reception/provision of care work, home care services and personal assistance, it is important to raise awareness of the variation in perceptions of intimate and personal care in education and inhouse training.
... Dans le courant des années 1980, l'analyse de conversation s'est enrichie d'études sur la contribution de la prosodie et de la gestuelle dans la production et l'interprétation du sens en contexte (de Fornel et Léon, 2000 : 150). Goodwin (1981) et Heath (1986 ont été les premiers à introduire la dimension visuelle et corporelle dans l'analyse conversationnelle. Cette approche multimodale a ensuite été prolongée par Schegloff (1984) et Mondada (2005 ;, qui ont étudié la gestuelle, Rossano (2012), les mimiques faciales et les regards, Mondada (2009), le corps dans l'espace interactionnel. ...
Article
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Devant le caractère particulièrement polysémique de la « communauté », cette contribution vise à proposer une esquisse typologique à partir de quatre conceptions compréhensives de la notion : 1/ La communauté locale, comme milieu de vie et d’interrelation ; 2/ La communauté associative, comme organisation institutionnalisée ou regroupement militant autour d’un problème ; 3/ La communauté identitaire, centrée autour d’un trait définitionnel prioritaire qui permet de caractériser et de rassembler des individus divers ; 4/ La communauté englobante, le plus souvent territorialisée, à la fois politique et culturelle, assimilée à la nation dans ses traits les plus saillants. La seconde partie du texte s’attelle à mettre cette typologie à l’épreuve en examinant les différentes formes que peut prendre la communauté des Sourds à travers la large diversité de ses expressions et de ses revendications.
... Gaze is a significant non-verbal factor in organising face-to-face interaction, yet eye contact is in fact impossible in video interactions. 38 However, due to the compactness of handheld technology, the camera and screen are positioned very close to each other, thus enhancing the impression that the patient is looking directly at the GP. On the other hand, the greater distance between the GPs' full-size computer screens and the externally fitted cameras was a material constraint that made it more difficult for the GPs to create the illusion of meeting the patient's gaze. ...
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Objective To analyse how the patient's use of handheld technology in video consultations with their general practitioner affects communication and the possibilities for the delivery of quality healthcare. Focusing on the visually communicated aspects of the video consultation, we present three episodes from our recordings of eight video consultations between Danish general practitioners and patients. Methods Using a multimodal social semiotic framework to conduct a micro-level analysis, we present episodes from our data in which the hardware's affordance of mobility gave rise to salient events in the interactions of patients who used handheld devices to carry out their video consultations. Results Patients’ use of technology plays a significant role in the interactions between general practitioner and patient and is thus an important factor to consider in how practice is shaped when using handheld video consultation technology. Conclusions Our findings demonstrate that the mobility of handheld devices (smartphone, tablet) can be used to augment sensing and embodiment and enhance the delivery of healthcare in video consultations. However, mobility may also disrupt the interaction. As a result, possibilities for the delivery of quality healthcare lie quite literally in the patients’ hands.
... Beginnend mit den Arbeiten von Frankel (1984), Heath (1986) und West (1984 entstand innerhalb der Gesprächsanalyse ein prosperierender Forschungszweig, der sich zunächst allein mit ÄPI in der Primärversorgung beschäftigte (Heritage/Maynard 2006a;Ijäs-Kallio/Ruusuvuori/Peräkylä 2010;Peräkylä 1998), seinen Gegenstandsbereich im Laufe der Zeit aber sowohl auf andere Settings 30 als auch auf andere Akteu-rInnen des Gesundheitswesens 31 ausdehnte und sich in den letzten Jahren verstärkt für die interprofessionelle Kommunikation zwischen VertreterInnen verschiedener Berufsgruppen innerhalb medizinischer Institutionen zu interessieren beginnt (Arber 2016;Måseide 2011Måseide , 2016Seuren et al. 2019). Gill/Roberts (2013: 575) (Beach/Anderson 2003;Beach et al. 2005;Schaepe/Maynard 2014;Günthner 2019b;Imo 2017a), in der AIDS-Beratung (Peräkylä 1995), der HIV-Sprechstunde (Groß 2018), der Psychiatrie (Bolden/Angell 2017;Speer/Parsons 2007) sowie der Pädiatrie (Stivers 2002a(Stivers , 2002b(Stivers , 2006 (2010: 227f.) in seiner Metastudie zwischen Visiten-, Anamnese-, Erst-/Aufnahme-, 35 Paradoxerweise -oder sollte man eher sagen nachvollziehbarerweise? -verhalten sich Pa-tientInnen gegenüber ÄrztInnen zumeist dennoch auf eine Weise, die das traditionelle Rollenverständnis mit seinen deontischen sowie epistemischen Asymmetrien zementiert und in der die ärztliche Expertise über die eigene Erfahrungsexpertise gestellt wird. ...
Book
In der Palliativmedizin, die sich an Menschen mit unheilbaren, bereits weit fortgeschrittenen Krankheiten richtet, hat gelungene Kommunikation zwischen den professionellen AkteurInnen und den PatientInnen bzw. Angehörigen aufgrund des palliativen Anspruchs, PatientInnen in der Endphase ihres Lebens die größtmögliche Lebensqualität zu bieten, einen so zentralen Stellenwert wie in kaum einer anderen medizinischen Subdisziplin. ÄrztInnen und Pflegekräfte, die das Kernteam von Palliativstationen bilden und von allen AkteurInnen des interprofessionellen Stationsteams den meisten Kontakt zu den PatientInnen und Angehörigen haben, sehen sich daher mit einer besonderen ethischen Verantwortung konfrontiert. In der Philosophie der Palliative Care ist hinsichtlich der interprofessionellen Zusammenarbeit von ÄrztInnen und Pflegekräften dezidiert die Maxime verankert, deren Arbeit als gleich wichtig und deren Zusammenarbeit als egalitär und somit hierarchiefrei anzusehen. Trotz dieses Ideals sind aber auch die auf der Palliativstation tätigen Pflegekräfte und ÄrztInnen an die Vorgaben hinsichtlich des Zuständigkeits- und Verantwortungsbereichs ihrer jeweiligen Berufsgruppe sowie an die damit verbundenen Rechte und Pflichten gebunden. Vor diesem Hintergrund gilt das Erkenntnisinteresse der Studie der Frage, welche Gemeinsamkeiten und Unterschiede sich im pflegerischen und ärztlichen Sprechen mit PatientInnen und deren Angehörigen auf der Palliativstation zeigen und wie sich die institutionellen Rollenvorgaben der beiden Professionen in deren jeweiligem Interaktionsverhalten manifestieren. Für den Vergleich der verschiedenen kommunikativen Praktiken von Pflegekräften und ÄrztInnen werden die drei Gesprächsthemen herangezogen, die sowohl in den Interaktionen zwischen Pflegenden und PatientInnen/Angehörigen als auch in den Interaktionen zwischen ÄrztInnen und PatientInnen/Angehörigen am häufigsten relevant gesetzt werden. Es handelt sich hier um die Themen ‚Schmerzen‘, ‚Medikamente‘ und ‚psychosozial-affektives Krankheitserleben‘. Neben dem primären Analysevorhaben, einen Vergleich zwischen pflegerischem und ärztlichem Sprechen mit PalliativpatientInnen und deren Angehörigen durchzuführen, fokussiert die Studie sekundär auch einen weiteren Aspekt: das Sprechen über Sterben und Tod. Angesichts der Tatsache, dass es sich bei der Arbeit um die erste breit angelegte, deutschsprachige, gesprächsanalytische Untersuchung handelt, die Interaktionen auf der Palliativstation zum Gegenstand hat, bleibt diese für den Palliativbereich zentrale Thematik nicht unberücksichtigt. Allerdings ist hierbei kein Vergleich zwischen pflegerischem und ärztlichem Sprechen möglich, da Sterben und Tod, abgesehen von einem Beleg aus einer Interaktion zwischen einer Pflegerin und einem Patienten, lediglich in ÄrztIn-PatientIn/Angehörigen-Gesprächen interaktiv relevant gesetzt und bearbeitet wird. Insgesamt kann empirische Evidenz dafür erbracht werden, dass die institutionellen Vorgaben bzgl. der berufsbedingten Rechte und Pflichten der beiden Akteursgruppen ‚Pflegekräfte‘ und ‚ÄrztInnen‘ im sozialen Feld ‚Palliativstation‘ ihre Spuren in den Praktiken hinterlassen, die Bestandteil des kommunikativen Haushalts der jeweiligen Berufsgruppe sind. Dementsprechend ist die Verteilung der kommunikativen Ressourcen insofern eng mit den jeweiligen sozialen Verhältnissen verwoben, als die Zugehörigkeit zu einer der beiden Berufsgruppen einen Einfluss auf das kommunikative Repertoire einzelner Mitglieder, d. h. – mit Bourdieu gesprochen – auf deren Habitus hat. Ihre Typik haben die kommunikativen Praktiken dabei durch Rekurrenz erworben, wobei sie sich in situ stets in einem dialektischen Spannungsfeld aus lokaler Emergenz einerseits und Routinisierung andererseits bewegen. Die getrennten Verantwortlichkeits- und Zuständigkeitsbereiche von PflegerInnen und ÄrztInnen werden folglich nicht nur beständig aktualisiert, sondern auch fortlaufend neu hervorgebracht.
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Turn beginning is a crucial location for establishing speakership and gaining recipiency. It is one of the most challenging tasks for an individual learner. This study used a corpus-based approach to investigate how Chinese EFL learners employ multimodal resources to successfully execute turn beginnings, with a specific focus on potential variances between intermediate and advanced proficiency levels. The findings revealed a hierarchy in the allocation of linguistic resources, with feedback being the most prevalent, followed by demonstrative, connective, and syntactic relevance. This suggested that learners prioritized feedback on the previous turn at the outset of a turn, often serving an interactional function to convey acknowledgement and recognition. Interestingly, intermediate learner group used more demonstrative to provide a cue for utterance-interpretation. However, the advanced learner group preferred to establish logical relevance between each turn through the use of connective. In terms of non-linguistic resources, learners predominantly employed gaze and head movement to project turn beginning intention, demonstrating their capacity to harness multimodal resources to a certain extent. Moreover, the advanced learner group’s increased use of hand gesture suggested that as language proficiency improved, learners were more inclined to engage the hearer’s attention at the commencement of turns. This study contributes to the scholarly understanding of multimodal turn-taking by elucidating the distinct characteristics that learners exhibit when initiating conversational turns. It offers insights into how learners navigate the complex interplay of linguistic and non-linguistic resources in the pursuit of effective communication.
Chapter
This volume addresses the issue of pragmatic meaning and interpretation in communication contexts regarding health and does so by combining a series of diverse and complementary approaches, which together highlight the relevance of successfully shared understanding to achieve more accessible, inclusive, and sustainable healthcare systems. The volume is divided into five thematic sections: 1) Analytical approaches to health communication, 2) Intercultural and mediated communication, 3) Negotiation and meaning construction, 4) Expertise and common ground, 5) Uncertainty and evasive answers, bringing together a group of top scholars on the much-debated issue of shared understanding both at the micro-level of dialogues between professionals and patients, and the macro-level of institutional communication. In the variety of its contributions, it represents an ambitious attempt at setting pragmatics at the core of healthcare communication research and practice, by combining conceptual reflections on core topics in the field of pragmatics (among which are speech acts, common ground, ambiguity, implicitness), with discourse and linguistic analysis of real-world examples exploring various problems in health communication.
Article
This study uses discourse analysis to investigate the connectedness between embodiment and the politics of orthography. Drawing on a video-recorded conversation from a large sociolinguistic dataset on Amazigh/Berber, the study examines the role of embodied acts not only as semiotic resources that elaborate talk but also as consequential discursive entities that organize political arguments about script. The participants use multimodal utterances that extend beyond meaning to iconize social orientation as well as power in conversation. Analysis of the video reveals the way participants map their social perceptions of the language and its script onto their talk and embodied actions. Analysis also shows how script arguments mirror larger political debates in Morocco, in which script preferences are based on ideological and political orientations.
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This article introduces the notion of interspecies pragmatics and suggests that embodied CA studies can inform such pragmatics. The aim of the study was to investigate how dogs provide embodied responses to human utterances when a human is about to throw a ball for them to catch. Studying dogs' recipiency in interaction requires that multimodal approaches be taken into consideration. The data were collected with GoPro cameras attached to two dogs: each dog brought a first-person camera perspective to the analysis and, when they looked at each other, they also provided a third-person camera angle. The findings based on this multi-camera CA approach demonstrate that when dogs produce embodied responses to human utterances, they can distinguish Goffman's addressed recipient from the unaddressed recipient. Compared to human response production planning time (600-1200 ms), dog response planning time proved much faster (a maximum of 200 ms in this context). Another interesting methodological finding was that the distance between the speaker and recipient influenced the transcription of reaction times in turns-of-talk, as sound travels at only 0.3 m/ms. By contrast, embodied actions observed from video material contained no such transcription-related limitations due to the far higher speed at which light travels.
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Dans cet article, nous allons examiner une pratique peu étudiée dans la littérature scientifique : l’annonce du sexe dans les échographies prénatales. En nous inspirant des travaux menés en anthropologie linguistique, nous allons proposer une vision des énoncés annonçant le sexe au prisme de leur performativité sans pour autant faire l’économie de la vérité. Nous considérerons l’annonce du sexe comme une pratique présentant des formats séquentiels spécifiques dans lesquels l’annonce proprement dite est systématiquement suivie ou précédée d’une séquence identifiant les modes d’identification visuelle du sexe. De ce fait, nous appréhenderons la vérité du sexe par sa visibilité et sa reconnaissabilité vis-à-vis des parents ainsi que comme l’un des traits constitutifs de la pratique médicale.
Chapter
In this chapter, we will investigate smartphone-based showing sequences in everyday social encounters, that is, moments in which a personal mobile device is used for presenting (audio-)visual content to co-present participants. Despite a growing interest in object-centred sequences and mundane technology use, detailed accounts of the sequential, multimodal, and material dimensions of showing sequences are lacking. Based on video data of social interactions in different languages and on the framework of multimodal interaction analysis, this chapter will explore the link between mobile device use and social practices. We will analyse how smartphone showers and their recipients coordinate the manipulation of a technological object with multiple courses of action, and reflect upon the fundamental complexity of this by-now routine joint activity.KeywordsMultiparty settingParticipation frameworkCollocated smartphone useShowing sequences
Thesis
This thesis seeks to contribute, through field work, to linguistics and interactional studies focused on healthcare workers. We have employed the theoretical approach of ethnomethodological conversation analysis and we acknowledge the multimodal dimension of the resources mobilized to organize simulated healthcare interactions. We have observed and recorded multiple high-fidelity simulation trainings addressed to multi-disciplinary teams of anaesthetics in intensive care. This thesis proposes a type of methodology which enquires on the pertinence of the phaenomena highlighted by the analysis. Indeed, our data shows that the participants accomplish their work but also they draw on it in order to identify issues. One may ask how this work can be problematized by them. In our first section, we start with a critical survey of several studies conducted in healthcare and ergonomics; we notice, in fine, the scarceness of concern for interactional dimension in didactic resources. Thus, we propose a new methodology that functions through “trajectories”, which we set in motion in the second part of our work. Through two trajectories, we reconstruct the steps that conduct the team’s members and trainers to identify two issues that they topicalize during the observation and debriefing : the lack of treatment of a dropping blood pressure and the delayed infusion of a drug. The accountability of those issues are both re-specified through the following interactional objects: a) asymmetries in the participatory framework, b) the medical exam as a sequential and multimodal accomplishment, c) the interactional work of producing accounts of activities as tasks, d) multi-activity management and e) enacted remedies of action. This approach sheds light on the analysis of specific interactional segments thanks to the identification of recurrent techniques in the whole encounter of a teamwork medical intervention.
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The COVID-19 pandemic has brought telemedicine into mainstream medical practice (although questions remain over its role in a post-pandemic world). Research suggests that most patients and providers are satisfied with the flexibility and convenience of teleconsultations. However, there is continuing uncertainty about whether this shift has a clinically relevant impact on the quality of doctor-patient interaction. We conducted a systematic search of studies comparing communication in medical face-to-face consultations and teleconsultations. We included only studies which examined communication directly using recordings, excluding studies which used questionnaires or interviews. Studies were appraised using modified versions of the Critical Appraisal Skills Programme (CASP) checklists. Our search yielded 25,348 records, of which 22 were included in the final review. These studies were conducted in various medical specialties. Methodologies included approaches based on quantified communication behaviors using coding systems and qualitative studies using microanalytic methods. Except for duration (where there was evidence of face-to-face consultations being longer), no differences between the two modes of communication were consistently identified. In the aggregate, however, statistically significant differences were more prominent in primary care and more likely to favor face-to-face consultations. Qualitative studies also highlighted differences in how communication behaviors were manifested in each modality. Because much of the examined research was conducted in selected or non-routine settings, its applicability to the less selective use of telemedicine during and after the pandemic is limited.
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There is an increasing interest in using authentic doctor–patient consultations as teaching materials for courses of languages for medical purposes. However, what is the effect of the instruction? How does the instruction adopt authentic consultations advance students' interpersonal communicative competence in medical settings? This paper aims to answer these questions. This study investigates the effect of an instructional design for medical Chinese, which incorporates research findings from Conversation Analysis (CA) and uses authentic doctor–patient consultations in primary‐care visits as teaching materials. The goal of the instruction is to develop students' interpersonal communicative competence in medical settings, especially doctor–patient consultations. Twelve pre‐med college students in the course Chinese for Healthcare Professions participated in this study. They first participated in five 50‐min classes using a chapter from a medical Chinese textbook. Then, they participated in an additional set of five 50‐min instructional sessions introducing CA‐informed instruction using authentic consultations. The pedagogical effects were measured with paired roleplays administered at three different times: at the beginning of the course, after the regular instruction sessions, and, finally, after the CA‐informed instructional period. The results show that the CA‐informed instruction for using authentic doctor–patient consultations has a positive effect on improving students' communicative performance in simulated medical settings.
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Context: For medical students and doctors, capturing the patient's perspective is critical if the consultation is to be meaningful for both parties. Medical students are taught the import of this in their communication skills training aided by inquiring into the patient's ideas, concerns, and expectations (ICE) during the consultation. Ensuring the effectiveness of those inquiries can be a challenge for different reasons. Yet apart from a handful of papers on the subject, there is little guidance on the efficacy of ICE as a communication technique and specifically how to successfully blend questions about ICE within the interaction between doctor and patient. Proposal: This paper takes a closer look at this communication technique and explores some of the interactional features of inquiries into ICE. First, the background to ICE and its emergence within the field of medical education is considered. Next the argument considers some of the contextual and pedagogical issues which ICE gives rise to. The discussion then goes on to explore some conceptual underpinnings drawing on findings from Conversation Analysis which provide some direction in approaching questions about what the patient thinks. Finally, the implications of the argument presented are considered in relation to the teaching and assessment of medical students with a short proposal for next steps. Conclusion: Capturing the patient's perspective through an exploration of their ideas, concerns and expectations remains a valuable approach in communication skills training in medical education. It is important, however, that inquiries into ICE are used carefully and responsively if it is to be used to improve communication with patients.
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Neste artigo investigaremos a participação de uma criança com diagnóstico de Transtorno do Espectro do Autismo (TEA) em dois episódios de interação de brincadeiras familiares. Inscrevemo-nos em uma perspectiva corporificada para análise da interação social (STREECK, GOODWIN, LEBARON, 2011; MONDADA, 2016). Para a análise, nos voltamos para os recursos interacionais corporais mobilizados durante a interação. Discutimos o problema das relações entre língua, corpo e mundo material na agenda dos estudos linguísticos. Como resultado, demonstramos como essa perspectiva apresenta ganhos, principalmente, para análise de interações em que a linguagem verbal encontra-se ausente ou alterada, como alguns caos de TEA.
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Although requests constitute a type of action that have been widely discussed within conversation analysis-oriented work, they have only recently begun to be explored in relation to the situated and multimodal dimensions in which they occur. The contribution of this paper resides in the integration of bodily-visual conduct (gaze and facial expression, gesture and locomotion, object manipulation) into a more grammatical account of requesting. Drawing on video recordings collected in two different hair salons located in the French-speaking part of Switzerland and in France (23 h in total), this paper analyzes clients’ negative requests by exploring how they interface with the participants’ embodied conducts. Contrary to what the literature describes for positively formulated requests, with negative requests clients challenge an expectable next action (or ongoing action) by the hairdresser. One linguistic format constitutes the focus of this article, roughly glossable as ‘You don’t do [action X] too much (huh)’. Our analysis of a consistent collection of such formatted turns will show that clients present them (and hairdressers tend to treat them) in different ways, depending on how they relate to embodied conduct: When these turns are used by the client as instructions, they are accompanied by manipulations of the client’s own hair and tend to occur toward the initial phase of the encounter, at a stage when hairdressers and clients collaboratively negotiate the service in prospect. When uttered as directives, these turns are not accompanied by any touching practices from the client and are typically observable in subsequent phases of the encounter, making relevant an immediate linguistic or/and bodily response from the professional, as shown by the client who is actively pursuing mutual gaze with him/her. Therefore, an action cannot be distinguished from another on the basis of the turn format alone: Its sequential placement and the participants’ co-occurring embodied conduct contribute to its situated and shared understanding. By analyzing the clients’ use of a specific linguistic format conjointly with the deployment of specific embodied resources, this study will advance our understanding of how verbal resources and embodiment operate in concert with each other in the formation and understanding of actions, thereby feeding into new areas of research on the grammar-body interface.
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Introduction Eye contact is generally considered a beneficial non-verbal behavior in patient-physician communication. Physicians are advised to simulate eye contact during video consultations by gazing at the camera, although we lack evidence that doing so is beneficial. This work is a cross-cultural experiment that aims to answer: “Are physicians who gaze at the camera during video consultations perceived as making eye contact, and are their communication skills rated higher?” Methods 43 Japanese and 61 Lebanese participants watched videos of physicians providing the same video consultations while gazing at the camera and screen. After watching each video, they rated the physicians’ communication skills using six items from the GCRS and the MAAS-G scales. They also picked and justified their preferred physician gaze direction. Results When physicians gazed at the camera, they were perceived as making more eye contact and received higher communication and interpersonal skills ratings, both in Japan and Lebanon. The effect of gazing at the camera was consistently positive but varied by country and consultation content. In Japan, simulating eye contact improved the ratings of the attentive and caring physician, whereas in Lebanon, it improved the ratings of the tired and inattentive physician. When asked to choose their preferred gaze direction, 88.4% of Japanese and 90.2% of Lebanese participants chose camera gaze over screen gaze due to its positive effect on patient feelings and physician perception. Participants who chose screen gaze noted the unnaturalness of gazing at the camera and its potential negative impact on care quality. Conclusion Physicians providing video consultations can simulate eye contact by gazing at the camera. Doing so improves their communication and interpersonal skills ratings and could potentially enhance their communication with their patients. Mainstream video conferencing platforms could implement gaze correction methods to simulate eye contact without affecting the physicians’ experience and capacity to provide quality care.
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