Beyond the 'dyad': a qualitative re-evaluation of the changing clinical consultation.

Détails

Ressource 1Télécharger: BIB_B37F79B97A7C.P001.pdf (2319.62 [Ko])
Etat: Public
Version: Final published version
ID Serval
serval:BIB_B37F79B97A7C
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Institution
Titre
Beyond the 'dyad': a qualitative re-evaluation of the changing clinical consultation.
Périodique
Bmj Open
Auteur⸱e⸱s
Swinglehurst D., Roberts C., Li S., Weber O., Singy P.
ISSN
2044-6055 (Electronic)
Statut éditorial
Publié
Date de publication
2014
Peer-reviewed
Oui
Volume
4
Numéro
9
Pages
e006017
Langue
anglais
Notes
Publication types: Journal ArticlePublication Status: epublish
Résumé
OBJECTIVE: To identify characteristics of consultations that do not conform to the traditionally understood communication 'dyad', in order to highlight implications for medical education and develop a reflective 'toolkit' for use by medical practitioners and educators in the analysis of consultations.
DESIGN: A series of interdisciplinary research workshops spanning 12 months explored the social impact of globalisation and computerisation on the clinical consultation, focusing specifically on contemporary challenges to the clinician-patient dyad. Researchers presented detailed case studies of consultations, taken from their recent research projects. Drawing on concepts from applied sociolinguistics, further analysis of selected case studies prompted the identification of key emergent themes.
SETTING: University departments in the UK and Switzerland.
PARTICIPANTS: Six researchers with backgrounds in medicine, applied linguistics, sociolinguistics and medical education. One workshop was also attended by PhD students conducting research on healthcare interactions.
RESULTS: The contemporary consultation is characterised by a multiplicity of voices. Incorporation of additional voices in the consultation creates new forms of order (and disorder) in the interaction. The roles 'clinician' and 'patient' are blurred as they become increasingly distributed between different participants. These new consultation arrangements make new demands on clinicians, which lie beyond the scope of most educational programmes for clinical communication.
CONCLUSIONS: The consultation is changing. Traditional consultation models that assume a 'dyadic' consultation do not adequately incorporate the realities of many contemporary consultations. A paradox emerges between the need to manage consultations in a 'super-diverse' multilingual society, while also attending to increasing requirements for standardised protocol-driven approaches to care prompted by computer use. The tension between standardisation and flexibility requires addressing in educational contexts. Drawing on concepts from applied sociolinguistics and the findings of these research observations, the authors offer a reflective 'toolkit' of questions to ask of the consultation in the context of enquiry-based learning.
Pubmed
Open Access
Oui
Création de la notice
03/10/2014 10:50
Dernière modification de la notice
20/08/2019 16:22
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