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Understanding communication between surgeon and patient in outpatient consultations
Author(s) -
White Sarah J.,
Stubbe Maria H.,
Dew Kevin P.,
Macdonald Lindsay M.,
Dowell Anthony C.,
Gardner Rod
Publication year - 2013
Publication title -
anz journal of surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.426
H-Index - 70
eISSN - 1445-2197
pISSN - 1445-1433
DOI - 10.1111/ans.12126
Subject(s) - medicine , primary care , conversation , similarity (geometry) , conversation analysis , outpatient clinic , proposition , nursing , medical education , family medicine , psychology , communication , philosophy , epistemology , artificial intelligence , computer science , image (mathematics)
Background There is an assumption that there is a similarity between surgeon‐patient and primary care consultations. Yet, surgeon communication has had far less analytic attention than its primary care counterparts. Therefore, this assumption of similarity (and the proposition here of dissimilarity) has yet to be evidenced through detailed interactional analysis. Methods Conversation analysis ( CA ) is a methodology used to understand both mundane and institutional interactions. Using CA , we have developed an understanding of surgeon‐patient interactions in outpatient clinic settings in N ew Z ealand. Rather than attempting to determine what ‘bad’ communication is, we describe and analyse what occurs routinely in surgeon‐patient consultations, particularly how these interactions are built up by both patient and doctor. Results This research shows that while surgeon‐patient consultations share some similarities to the overall structure of primary care consultations, there are two unique structures that occur in surgical consultations. These structures follow a logical progression of activities and are influenced by the type of visit (referred versus follow‐up). Discussion This article summarizes the first comprehensive description of the overall interactional structure of surgeon‐patient consultations. It demonstrates that surgeon‐patient consultations are structurally distinct from primary care consultations. This key finding has implications for surgeon‐specific research and education, highlighting the need to question current assumptions in communication training and in clinical practice.