Conversation analysis, doctor–patient interaction and medical communication
Article first published online: 24 MAR 2005
Volume 39, Issue 4, pages 428–435, April 2005
How to Cite
Maynard, D. W. and Heritage, J. (2005), Conversation analysis, doctor–patient interaction and medical communication. Medical Education, 39: 428–435. doi: 10.1111/j.1365-2929.2005.02111.x
- Issue published online: 24 MAR 2005
- Article first published online: 24 MAR 2005
- Received 17 February 2004; editorial comments to authors 16 June 2004, 24 November 2004; accepted for publication 30 November 2004
- *physician−patient relations;
- interpersonal relations;
Introduction This paper introduces medical educators to the field of conversation analysis (CA) and its contributions to the understanding of the doctor−patient relationship.
The conversation analysis approach Conversation analysis attempts to build bridges both to the ethnographic and the coding and quantitative studies of medical interviews, but examines the medical interview as an arena of naturally occurring interaction. This implies distinctive orientations and issues regarding the analysis of doctor−patient interaction. We discuss the CA approach by highlighting 5 basic features that are important to the enterprise, briefly illustrating each issue with a point from research on the medical interview. These features of conversation analytic theory and method imply a systematic approach to the organisation in interaction that distinguishes it from studies that rely on anecdote, ethnographic inquiry or the systematic coding of utterances.
Conversation analysis and the medical interview We then highlight recent CA studies of the ‘phases’ of the internal medicine clinic and the implications of these studies for medical education. We conclude with suggestions for how to incorporate CA into the medical curriculum. It fits with biopsychosocial, patient-centred and relationship-centred approaches to teaching about medical communication.