Using Applied Conversation Analysis to Teach Novice Dietitians History Taking Skills

Human Studies ◽  
2000 ◽  
Vol 23 (3) ◽  
pp. 281-307 ◽  
Author(s):  
Linda Tapsell
Keyword(s):  
Conversation Analysis ◽  
History Taking

The use of ‘my side telling’ during history taking in psychiatric consultations

2021 ◽  
pp. 146144562110016
Author(s):  
Xueli Yao
Keyword(s):  
Empirical Study ◽  
Conversation Analysis ◽  
History Taking ◽  
Patients Rights ◽  
Outpatient Visits ◽  
Psychiatric Outpatient ◽  
Audio Recordings ◽  
Sense Of Reality ◽  
Psychiatric Conditions

Using the method of conversation analysis, this article examines an interactional practice through which psychiatric practitioners exhibit knowledge about their patients’ problems, symptoms, or experiences in psychiatric outpatient consultations. This practice is referred to as ‘my side telling’. The data were from audio recordings of 55 psychiatric outpatient visits to four psychiatrists in China. In the data, the psychiatrists employ ‘my side telling’ within larger sequences of talk where psychiatrists solicit their patients to elaborate on their problems or experiences, treating prior answers of the patients as unsatisfactory. Based on empirical study of the data, it is argued that ‘my side telling’ in psychiatry is not merely used to elicit information. Rather, through facing patients with facts or evidence which the psychiatrists got from other sources, it acquires a confrontative function and may be employed as a tool to test the patients’ sense of reality and willingness to talk about their experiences. Thus, it is shown to work towards assessing patients for possible psychiatric conditions and forming diagnostic hypotheses. I further argue that ‘my side telling’ allows the psychiatrists to achieve a balance between respecting the patients’ rights to report their own experiences and influencing the directions in which the information is reported.

scholarly journals Body Part Highlighting: Exploring two types of embodied practices in two sub-types of showing sequences in video-mediated consultations

2020 ◽  
Vol 3 (3) ◽  
Author(s):  
Brian Lystgaard Due ◽  
Simon Bierring Lange
Keyword(s):  
Healthcare Professional ◽  
Conversation Analysis ◽  
Initial Phase ◽  
Single Case ◽  
Body Part ◽  
History Taking ◽  
Healthcare Settings ◽  
Asking Questions ◽  
Common Understanding ◽  
Direct Body

Consultations in healthcare settings involve an initial phase of “history-taking”, during which the healthcare professional examines the client for symptoms by asking questions, making the client show symptoms on his or her own body, and performing bodily examinations. But how can bodily symptoms be identified when the interaction is video-mediated and sensory access is limited? One key resource here is “body showings”. However, research suggests that video-mediated teleconsultations reduce body showings due to both technical difficulties and sensory obstruction. In this paper, we provide a contrary case that shows two types of practices employed for successful history-taking through body-part showings. Based on an analysis of an “evocative showing sequence” (Licoppe, 2017), we present two types of gestural highlighting practices, via two types of showing sub-sequences: 1) “mimicable body part highlighting”, which occurs in a sequence of “adapting-body-to-frame”; and 2) “direct body part highlighting”, which occurs in a sequence of “adapting-frame-to-body”. The paper uses a single case to discuss how gestures work in a video-mediated context and how sensory judgements are not just a property of the healthcare professional, but are distributed to clients who are able to creatively adapt to situated contingencies in order to accomplish common understanding about the symptoms. The data consist of video-recorded, video-mediated physiotherapy consultations in Denmark, analysed using ethnomethodological conversation analysis (EMCA). The paper contributes to EMCA research on mediated interaction and embodied, gestural and sensorial practices.

Computer based simulated patient for teaching history-taking

1973 ◽  
Vol 37 (8) ◽  
pp. 27-31
Author(s):  
HA Brody ◽  
LF Lucaccini ◽  
M Kamp ◽  
R Rozen
Keyword(s):  
Simulated Patient ◽  
History Taking ◽  
Teaching History ◽  
Computer Based

Observer Variation in Clinical Diagnosis - A Computer-Aided Assessment of its Magnitude and Importance in 552 Patients with Abdominal Pain

1973 ◽  
Vol 12 (02) ◽  
pp. 108-113 ◽  
Author(s):  
P. W. Gill ◽  
D. J. Leaper ◽  
P. J. Guillou ◽  
J. R. Staniland ◽  
J. C. Horhocks ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Clinical Diagnosis ◽  
Error Rate ◽  
Diagnostic System ◽  
Diagnostic Error ◽  
Observer Variation ◽  
History Taking ◽  
Computer Aided ◽  
Computer Based ◽  
Initial Survey

This report describes an evaluation of »observer variation« in history taking and examination of patients with abdominal pain. After an initial survey in which the degree of observer variation amongst the present authors fully confirmed previous rather gloomy forecasts, a system of »agreed definitions« was produced, and further studies showed a rapid and considerable fall in the degree of observer variation between the data recorded by the same authors. Finally, experience with a computer-based diagnostic system using the same system of agreed definitions showed the maximum diagnostic error rate due to faulty acquisition of data to be low (4.7°/o in a series of 552 cases). It is suggested as a result of these studies that — at least in respect of abdominal pain — errors in data acquisition by the clinician need not be the prime cause of faulty diagnoses.

Computerization of the Patient History -Patient Answers Compared with Medical Records

1986 ◽  
Vol 25 (04) ◽  
pp. 222-228 ◽  
Author(s):  
M. J. Quaak ◽  
R. F. Westerman ◽  
J. A. Schouten ◽  
A. Hasman ◽  
J. H. Bemmel
Keyword(s):  
Internal Medicine ◽  
Medical Records ◽  
Patient Record ◽  
Frequency Of Occurrence ◽  
History Taking ◽  
Patient History ◽  
Patient Complaints ◽  
Computerized Patient Record ◽  
Extensive Information ◽  
Experienced Physician

SummaryComputerized medical history taking, in which patients answer questions by using a terminal, is compared with the written medical record for a group of 99 patients in internal medicine. Patient complaints were analysed with respect to their frequency of occurrence for all important tracts, such as the respiratory, the gastro-intestinal and the uro-genital tracts. About 36% of over 3,200 patient answers were identical in the patient record and the written record, but a considerable percentage of complaints (56%), that were present in the patient record, were missing in the written record; the reverse was true for 4.5%. A computerized patient record appears to contain more extensive information about patient complaints, still to be interpreted by the experienced physician.

Counseling and new media technologies: A comparison of problem presentations in e-mail and in chat

2016 ◽  
Vol 12 (2-3) ◽  
Author(s):  
Wyke Stommel ◽  
Fleur Van der Houwen
Keyword(s):  
New Media ◽  
Conversation Analysis ◽  
Online Counseling ◽  
Counseling Program ◽  
Media Technologies ◽  
Email Counseling ◽  
Counseling Clients ◽  
E Mail ◽  
Shed Light ◽  
New Media Technologies

In this article, we examine problem presentations in e-mail and chat counseling. Previous studies of online counseling have found that the medium (e.g., chat, email) impacts the unfolding interaction. However, the implications for counseling are unclear. We focus on problem presentations and use conversation analysis to compare 15 chat and 22 e-mail interactions from the same counseling program. We find that in e-mail counseling, counselors open up the interactional space to discuss various issues, whereas in chat, counselors restrict problem presentations and give the client less space to elaborate. We also find that in e-mail counseling, clients use narratives to present their problem and orient to its seriousness and legitimacy, while in chat counseling, they construct problem presentations using a symptom or a diagnosis. Furthermore, in email counseling, clients close their problem presentations stating completeness, while in chat counseling, counselors treat clients’ problem presentations as incomplete. Our findings shed light on how the medium has implications for counseling.

Formulating another’s report of troubles in peer support

2020 ◽  
Vol 16 (1) ◽  
Author(s):  
Christopher Pudlinski
Keyword(s):  
Mental Health ◽  
United States ◽  
Community Mental Health ◽  
Conversation Analysis ◽  
Peer Support ◽  
Mental Health System ◽  
The United States ◽  
Telephone Support ◽  
Healthcare Settings ◽  
Professional Perspective

This study stems from an interest in peer support talk, an underexplored area of research, and in how supportive actions such as formulated summaries function in comparison to more professional healthcare settings. Using conversation analysis, this study explores 35 instances of formulations within 65 calls to four different ‘warm lines’, a term for peer-to-peer telephone support within the community mental health system in the United States. Formulations can be characterized across two related axes: client versus professional perspective, and directive versus nondirective. The findings show that formulations within peer support were overwhelmingly nondirective, in terms of meeting institutional agendas to let callers talk. However, formulations ranged from client-oriented ones that highlight or repeat caller reports to those which transform caller reports through integrating past caller experiences or implicit caller emotions. These tactics are found to have similarities to how formulations function in professional healthcare settings.

Managing uncertainty in healthcare interpreter-mediated interaction

2020 ◽  
Vol 15 (2) ◽  
pp. 150-164
Author(s):  
Claudio Baraldi ◽  
Laura Gavioli
Keyword(s):  
Systems Theory ◽  
Conversation Analysis ◽  
Social Systems ◽  
Analytical Framework ◽  
Social Systems Theory ◽  
Intercultural Mediators ◽  
Or History

This paper analyses healthcare interactions involving doctors, migrant patients and ‘intercultural mediators’ who provide interpreting services. Our study is based on a collection of 300 interactions involving two language pairs, Arabic–Italian and English–Italian. The analytical framework includes conversation analysis combined with insights from social systems theory. We look at question-answer sequences, where (1) the doctors ask questions about patients’ problems or history, (2) the doctors’ questions are responded to and (3) the doctor closes the sequence, moving on to another question. We analyse the ways in which mediators help doctors design questions for patients and patients understand and eventually respond to the doctors’ design. While the doctor’s question design aims at obtaining details which are relevant for the patients’ care, it is argued that collecting such details involves complex interactional work. In particular, doctors need help in displaying their attention to their patients’ problems and in guiding patients’ responses into medically relevant directions. Likewise, patients need help in reacting appropriately. Mediators help manage communicative uncertainty both by showing the doctor’s interest in what the patient says, and by exploring and rendering the patient’s incomplete, extended and ambiguous answers to the doctor’s questions.

Patients’ practices for taking the initiative in decision-making in outpatient psychiatric consultations

2017 ◽  
Vol 13 (2) ◽  
pp. 169-184 ◽  
Author(s):  
Shuya Kushida ◽  
Takeshi Hiramoto ◽  
Yuriko Yamakawa
Keyword(s):  
Decision Making ◽  
Conversation Analysis ◽  
Treatment Decision ◽  
Close Inspection ◽  
Important Resource ◽  
Treatment Decision Making ◽  
The Way

In spite of increasing advocacy for patients’ participation in psychiatric decision-making, there has been little research on how patients actually participate in decision-making in psychiatric consultations. This study explores how patients take the initiative in decision-making over treatment in outpatient psychiatric consultations in Japan. Using the methodology of conversation analysis, we analyze 85 video-recorded ongoing consultations and find that patients select between two practices for taking the initiative in decision-making: making explicit requests for a treatment and displaying interest in a treatment without explicitly requesting it. A close inspection of transcribed interaction reveals that patients make explicit requests under the circumstances where they believe the candidate treatment is appropriate for their condition, whereas they merely display interest in a treatment when they are not certain about its appropriateness. By fitting practices to take the initiative in decision-making with the way they describe their current condition, patients are optimally managing their desire for particular treatments and the validity of their initiative actions. In conclusion, we argue that the orderly use of the two practices is one important resource for patients’ participation in treatment decision-making.

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