Effective teamwork is a critical feature of surgical practice and is based on shared expectations and understandings between team members. These shared understandings are intimately tied to a hierarchy of expertise pertaining to role, responsibility and participation status, and it has been suggested that this can sometimes negatively impact trainees’ experience of intraoperative surgical training. This paper examines this issue, exploring how surgeons and their trainees collaboratively manage decision making amidst the hierarchy of expertise. Our data set consists of audio and video recordings of surgical procedures, which are examined using conversation analysis. Our findings indicate that implicit in the interactions between consultant surgeons and trainees is the expectation that the lead surgeon is the authoritative expert and will therefore direct decision making. Trainees actively acquiesce to that order. Notwithstanding this, the analysis underscores some of the interactional practices used by surgeons and trainees which preserve, and on rare occasions, challenge that hierarchical relation. The paper concludes by considering the implications of the findings within the broader context of patient safety.
{"title":"‘Hm no-one says anything, did you notice?’","authors":"G. Murtagh, J. Bezemer","doi":"10.1558/CAM.15138","DOIUrl":"https://doi.org/10.1558/CAM.15138","url":null,"abstract":"Effective teamwork is a critical feature of surgical practice and is based on shared expectations and understandings between team members. These shared understandings are intimately tied to a hierarchy of expertise pertaining to role, responsibility and participation status, and it has been suggested that this can sometimes negatively impact trainees’ experience of intraoperative surgical training. This paper examines this issue, exploring how surgeons and their trainees collaboratively manage decision making amidst the hierarchy of expertise. Our data set consists of audio and video recordings of surgical procedures, which are examined using conversation analysis. Our findings indicate that implicit in the interactions between consultant surgeons and trainees is the expectation that the lead surgeon is the authoritative expert and will therefore direct decision making. Trainees actively acquiesce to that order. Notwithstanding this, the analysis underscores some of the interactional practices used by surgeons and trainees which preserve, and on rare occasions, challenge that hierarchical relation. The paper concludes by considering the implications of the findings within the broader context of patient safety.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2021-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78512291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ernisa Marzuki, H. Rohde, C. Cummins, H. Branigan, G. Clegg, A. Crawford, L. Macinnes
Training for effective communication in high-stakes environments actively promotes targeted communicative strategies. One oft-recommended strategy is closed-loop communication (CLC), which emphasises three components to signal understanding: call-out, checkback and closing of the loop. Using CLC is suggested to improve clinical outcomes, but research indicates that medical practitioners do not always apply CLC in team communication. Our paper analyses a context in which speakers’ linguistic choices are guided by explicit recommendations during training, namely out-of-hospital cardiac arrest (OHCA) resuscitation. We examined 20 real-life OHCA resuscitations to determine whether paramedics adopt CLC in the critical first five minutes after the arrival of the designated team leader (a paramedic specially trained in handling OHCA resuscitation), and what other related communication strategies may be used. The findings revealed that the standard form of CLC was not consistently present in any of the resuscitations despite opportunities to use it. Instead, we found evidence of non-standard forms of CLC and closed-ended communication (containing the first two components of standard CLC). These findings may be representative of what happens when medical practitioners communicate in time-critical, real-life contexts where responses to directives can be immediately observed, and suggest that CLC may not always be necessary for effective communication in these contexts.
{"title":"Closed-loop communication during out-of-hospital resuscitation","authors":"Ernisa Marzuki, H. Rohde, C. Cummins, H. Branigan, G. Clegg, A. Crawford, L. Macinnes","doi":"10.1558/cam.37034","DOIUrl":"https://doi.org/10.1558/cam.37034","url":null,"abstract":"Training for effective communication in high-stakes environments actively promotes targeted communicative strategies. One oft-recommended strategy is closed-loop communication (CLC), which emphasises three components to signal understanding: call-out, checkback and closing of the loop. Using CLC is suggested to improve clinical outcomes, but research indicates that medical practitioners do not always apply CLC in team communication. Our paper analyses a context in which speakers’ linguistic choices are guided by explicit recommendations during training, namely out-of-hospital cardiac arrest (OHCA) resuscitation. We examined 20 real-life OHCA resuscitations to determine whether paramedics adopt CLC in the critical first five minutes after the arrival of the designated team leader (a paramedic specially trained in handling OHCA resuscitation), and what other related communication strategies may be used. The findings revealed that the standard form of CLC was not consistently present in any of the resuscitations despite opportunities to use it. Instead, we found evidence of non-standard forms of CLC and closed-ended communication (containing the first two components of standard CLC). These findings may be representative of what happens when medical practitioners communicate in time-critical, real-life contexts where responses to directives can be immediately observed, and suggest that CLC may not always be necessary for effective communication in these contexts. ","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82697100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Thomas Spranz-Fogasy, Eva Graf, J. Ehrenthal, C. Nikendei
As part of a larger research project on understanding change in helping professions, this paper investigates into therapists’ requesting examples and their interactional and sequential contri-bution to clients’ change. Requesting examples by therapists in psychodiagnostic interviews explicitly or implicitly criticize the patient’s prior turn as insufficient, i.e. as unclear, vague, or as too general. Such a request opens a retro-sequence (Schegloff 2007) and in the following provides for a description that both helps clarify the semantic vagueness and evinces psychic or relational aspects of the topic at hand. While the patient’s insufficient presentation is initi-ated by a prior request of the therapist, the patient’s example presentation is regularly fol-lowed by the therapist’s summarizing comments or by further requests focusing on the pa-tient’s problem. Requesting examples thus are a particular case of requests that follow ‘ex-pandable responses’ as described by Muntigl & Zabala (2008); they follow the same sequential organization, yet, given that they make examples conditionally relevant, they are more specif-ic. With the help of this sequential organization both participants co-construct elements of common knowledge. Such an ‘interplay of understanding’ (Voutilainen & Peräkylä 2014) al-lows the therapist to pursue the overall aim of therapy, i.e. to increase the patients’ awareness of their distorted perceptions, and thus to pave the way for change. The data comprises of 16 videotaped first interviews following the manual of the Operationalized Psychodynamic Di-agnostics (OPD Task Force 2009). It was collected in cooperation with the Clinic for General Internal Medicine and Psychosomatic at the University Clinic of Heidelberg.
{"title":"Requesting Examples in Psychodiagnostic Interviews","authors":"Thomas Spranz-Fogasy, Eva Graf, J. Ehrenthal, C. Nikendei","doi":"10.1558/cam.34112","DOIUrl":"https://doi.org/10.1558/cam.34112","url":null,"abstract":"As part of a larger research project on understanding change in helping professions, this paper investigates into therapists’ requesting examples and their interactional and sequential contri-bution to clients’ change. Requesting examples by therapists in psychodiagnostic interviews explicitly or implicitly criticize the patient’s prior turn as insufficient, i.e. as unclear, vague, or as too general. Such a request opens a retro-sequence (Schegloff 2007) and in the following provides for a description that both helps clarify the semantic vagueness and evinces psychic or relational aspects of the topic at hand. While the patient’s insufficient presentation is initi-ated by a prior request of the therapist, the patient’s example presentation is regularly fol-lowed by the therapist’s summarizing comments or by further requests focusing on the pa-tient’s problem. Requesting examples thus are a particular case of requests that follow ‘ex-pandable responses’ as described by Muntigl & Zabala (2008); they follow the same sequential organization, yet, given that they make examples conditionally relevant, they are more specif-ic. With the help of this sequential organization both participants co-construct elements of common knowledge. Such an ‘interplay of understanding’ (Voutilainen & Peräkylä 2014) al-lows the therapist to pursue the overall aim of therapy, i.e. to increase the patients’ awareness of their distorted perceptions, and thus to pave the way for change. The data comprises of 16 videotaped first interviews following the manual of the Operationalized Psychodynamic Di-agnostics (OPD Task Force 2009). It was collected in cooperation with the Clinic for General Internal Medicine and Psychosomatic at the University Clinic of Heidelberg.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87152567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Therapeutic alliance is often posed as an explanation for why therapy works, and there seems to be a consistent finding that the stronger the alliance, the greater the therapeutic change. Although extensively documented in the professional literature as an essential aspect of therapeutic alliance, the concept of emotional presence and its actualization in moment-by-moment interaction have not been adequately described. This paper applies integrative qualitative methodology, including tools and insights from discourse analysis and conversation analysis, to five extracts of Relationship-focused Integrative Psychotherapy sessions with three different clients. It examines the concept of emotional presence operationalized in terms of the therapist’s invoking the client’s immediate experience. The analytical focus falls on an interactive sequence involving the therapist’s topicalization of the client’s (proffered) non-verbal cues aiming at eliciting emotion talk in the interactional here-and-now and the latter’s orientation to it. The psychotherapist’s strategy of emotional presence is proposed to play a salient role in promoting the client’s (gradual) change by focusing the talk on the client’s here-and-now experience. Thus clients are prompted to project their emotions and/or engage in overt self-reflexive examination of emotional and relational patterns in the immediate context of their concrete trouble-telling. By being regularly exposed to such practices in therapy, clients are instilled with a sense of being in touch with how they feel about a particular situation or person.
{"title":"therapist’s emotional presence and its interactional functions in promoting client change in relationship-focused integrative psychotherapy","authors":"Joanna Pawelczyk","doi":"10.1558/cam.33823","DOIUrl":"https://doi.org/10.1558/cam.33823","url":null,"abstract":"Therapeutic alliance is often posed as an explanation for why therapy works, and there seems to be a consistent finding that the stronger the alliance, the greater the therapeutic change. Although extensively documented in the professional literature as an essential aspect of therapeutic alliance, the concept of emotional presence and its actualization in moment-by-moment interaction have not been adequately described. This paper applies integrative qualitative methodology, including tools and insights from discourse analysis and conversation analysis, to five extracts of Relationship-focused Integrative Psychotherapy sessions with three different clients. It examines the concept of emotional presence operationalized in terms of the therapist’s invoking the client’s immediate experience. The analytical focus falls on an interactive sequence involving the therapist’s topicalization of the client’s (proffered) non-verbal cues aiming at eliciting emotion talk in the interactional here-and-now and the latter’s orientation to it. The psychotherapist’s strategy of emotional presence is proposed to play a salient role in promoting the client’s (gradual) change by focusing the talk on the client’s here-and-now experience. Thus clients are prompted to project their emotions and/or engage in overt self-reflexive examination of emotional and relational patterns in the immediate context of their concrete trouble-telling. By being regularly exposed to such practices in therapy, clients are instilled with a sense of being in touch with how they feel about a particular situation or person.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83977614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
When investigating intercultural communication in healthcare settings, interprofessional communication has received very little scholarly attention compared to doctor–patient interactions. Interactions among doctors, however, are an important locus for the organizational life of a hospital as the way these professionals communicate will promote (or hinder) professional effectiveness and efficiency. This paper presents the findings of a study that explores the perceptions concerning the degree and frequency of communicative conflict of 61 migrant doctors working in public healthcare institutions in the central region of El Maule in Chile. Drawing on data from a survey on communicative conflicts, the study analyses the perceptions of the migrant doctors in relation to one particular style of conflict management, namely, adaptability. Findings show that although communicative conflicts seem to occur only occasionally, moderate scores are reported for how such perceptions are believed to affect work performance. Also, the demands of communicative adaptability are perceived to be met largely by migrant doctors alone. The paper then offers considerations about the possible impact that these adaptability efforts could have on migrant doctors’ integration processes.
{"title":"Conflict in migrant doctor–local doctor communication in public healthcare institutions in Chile","authors":"M. Lazzaro-Salazar, Lucas Pujol-Cols","doi":"10.1558/cam.36271","DOIUrl":"https://doi.org/10.1558/cam.36271","url":null,"abstract":"When investigating intercultural communication in healthcare settings, interprofessional communication has received very little scholarly attention compared to doctor–patient interactions. Interactions among doctors, however, are an important locus for the organizational life of a hospital as the way these professionals communicate will promote (or hinder) professional effectiveness and efficiency. This paper presents the findings of a study that explores the perceptions concerning the degree and frequency of communicative conflict of 61 migrant doctors working in public healthcare institutions in the central region of El Maule in Chile. Drawing on data from a survey on communicative conflicts, the study analyses the perceptions of the migrant doctors in relation to one particular style of conflict management, namely, adaptability. Findings show that although communicative conflicts seem to occur only occasionally, moderate scores are reported for how such perceptions are believed to affect work performance. Also, the demands of communicative adaptability are perceived to be met largely by migrant doctors alone. The paper then offers considerations about the possible impact that these adaptability efforts could have on migrant doctors’ integration processes.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79785846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Research suggests that doctors are failing to make use of technologies designed to optimize their decision-making skills in daily clinical activities, despite a proliferation of electronic tools with the potential for decreasing risks of medical and diagnostic errors. This paper addresses this issue by exploring the cognitive basis of medical decision making and its psychosocial context in relation to technology. We then discuss how cognitive-led technologies – in particular, decision support systems and artificial neural networks – may be applied in clinical contexts to improve medical decision making without becoming a substitute for the doctor’s judgment. We identify critical issues and make suggestions regarding future developments.
{"title":"role of cognitive science and artificial intelligence in supporting clinical diagnosis","authors":"C. Lucchiari, M. E. Vanutelli, R. Folgieri","doi":"10.1558/cam.36184","DOIUrl":"https://doi.org/10.1558/cam.36184","url":null,"abstract":"Research suggests that doctors are failing to make use of technologies designed to optimize their decision-making skills in daily clinical activities, despite a proliferation of electronic tools with the potential for decreasing risks of medical and diagnostic errors. This paper addresses this issue by exploring the cognitive basis of medical decision making and its psychosocial context in relation to technology. We then discuss how cognitive-led technologies – in particular, decision support systems and artificial neural networks – may be applied in clinical contexts to improve medical decision making without becoming a substitute for the doctor’s judgment. We identify critical issues and make suggestions regarding future developments.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83265325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tensions between nurses and physicians have been linked to differences in power, hierarchy, education, compensation and gender. Less attention has been paid to the underlying values on which these differences are predicated. Likewise, little is known about how frequently values conflicts are resolved, and the threats to patient safety unresolved conflicts pose. Our aim was to compare the values embedded in affirming and challenging narratives elicited from nurses and physicians from a large health system. We used thematic analysis and descriptive statistics to assess goodness-of-fit of observed differences in themes. Narratives were coded into eight values categories. Nurses felt affirmed by emotional investment, altruism, humanism, and being of service; for physicians, it was humanism and teamwork. Nurse challenges involved respect, altruism/kindness and emotional investment. For physicians it was also respect and, in addition, professionalism, being of service, humanism and teamwork. Some values affirming narratives, e.g., humanism, were indistinguishable, while for some values challenging narratives e.g., respect, there was virtually no overlap. Participant narratives provide important insights into work-life satisfaction and tensions arising from differences in the underlying values of close working professional groups. Unresolved values conflicts are a potential threat to quality, safety and effective relationships.
{"title":"Values at work","authors":"R. Frankel, O. Karnieli-Miller, T. Inui","doi":"10.1558/cam.35227","DOIUrl":"https://doi.org/10.1558/cam.35227","url":null,"abstract":"Tensions between nurses and physicians have been linked to differences in power, hierarchy, education, compensation and gender. Less attention has been paid to the underlying values on which these differences are predicated. Likewise, little is known about how frequently values conflicts are resolved, and the threats to patient safety unresolved conflicts pose. Our aim was to compare the values embedded in affirming and challenging narratives elicited from nurses and physicians from a large health system. We used thematic analysis and descriptive statistics to assess goodness-of-fit of observed differences in themes. Narratives were coded into eight values categories. Nurses felt affirmed by emotional investment, altruism, humanism, and being of service; for physicians, it was humanism and teamwork. Nurse challenges involved respect, altruism/kindness and emotional investment. For physicians it was also respect and, in addition, professionalism, being of service, humanism and teamwork. Some values affirming narratives, e.g., humanism, were indistinguishable, while for some values challenging narratives e.g., respect, there was virtually no overlap. Participant narratives provide important insights into work-life satisfaction and tensions arising from differences in the underlying values of close working professional groups. Unresolved values conflicts are a potential threat to quality, safety and effective relationships.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2020-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78568689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mei-hui Tsai, Huan-Fang Lee, Shuen-Lin Jeng, Sheng Che Lin, Li-Wei Hsieh, Jen Pin Chuang, E. Jacobs
Background: While language barriers between healthcare providers and minority-language-speaking patients often lead to miscommunication and jeopardize patient safety, language audits of the former have received little attention.Goal: Based on the context in Southern Taiwan, where the elderly population mainly speaks the local dialect Taiwanese, this study examines nurses' perceptions of their proficiency in and need for medical Taiwanese (‘MED-TW'), and attitudes toward it. Method: A questionnaire survey was conducted among 859 nurses from three levels of healthcare units: primary care stations (H1), a regional hospital (H2) and a medical center (H3). Results: Nurses from the rural-based H1 unit displayed significantly stronger needs for Taiwanese (TW) than those from urban-based H2 and H3. Specifically, H1 nurses reported encounters with the largest proportion of TW-speaking clients (p<0.001) and the highest frequency of using TW with clients (p<0.001). However, H1 nurses' self-evaluation of their TW proficiency revealed a lower score than those of the H2 and H3 nurses, especially with regard to medical TW proficiency (p<0.05). Finally, while nurses with a high command of TW felt it helped their work, those with a low level did not feel this impacted their performance. Conclusion: Nurses working in locations where the use of the minority language is prevalent would benefit more from learning this language.
{"title":"Perceptions of the need for minority languages by nurses in Southern Taiwan","authors":"Mei-hui Tsai, Huan-Fang Lee, Shuen-Lin Jeng, Sheng Che Lin, Li-Wei Hsieh, Jen Pin Chuang, E. Jacobs","doi":"10.1558/CAM.33283","DOIUrl":"https://doi.org/10.1558/CAM.33283","url":null,"abstract":"Background: While language barriers between healthcare providers and minority-language-speaking patients often lead to miscommunication and jeopardize patient safety, language audits of the former have received little attention.Goal: Based on the context in Southern Taiwan, where the elderly population mainly speaks the local dialect Taiwanese, this study examines nurses' perceptions of their proficiency in and need for medical Taiwanese (‘MED-TW'), and attitudes toward it. \u0000Method: A questionnaire survey was conducted among 859 nurses from three levels of healthcare units: primary care stations (H1), a regional hospital (H2) and a medical center (H3). \u0000Results: Nurses from the rural-based H1 unit displayed significantly stronger needs for Taiwanese (TW) than those from urban-based H2 and H3. Specifically, H1 nurses reported encounters with the largest proportion of TW-speaking clients (p<0.001) and the highest frequency of using TW with clients (p<0.001). However, H1 nurses' self-evaluation of their TW proficiency revealed a lower score than those of the H2 and H3 nurses, especially with regard to medical TW proficiency (p<0.05). Finally, while nurses with a high command of TW felt it helped their work, those with a low level did not feel this impacted their performance. \u0000Conclusion: Nurses working in locations where the use of the minority language is prevalent would benefit more from learning this language.","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76225597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This article seeks to establish the educational and social significance of narrative and affect in anaesthetic training. Data were obtained from focus group discussions involving three groups of eight (total 24) young anaesthetists from around Australia held at an Australian and New Zealand College of Anaesthetists (ANZCA) residential conference. Analysis applied to transcripts of the discussions revealed the prominence of narratives used among trainees and supervisors as a medium for explaining and nurturing anaesthetic expertise. Nurturing expertise was accomplished by sharing narratives about extreme circumstances that highlighted a need for constant vigilance directed towards not just clinical circumstances but also colleagues. The article suggests that the narrative emphasis on remaining vigilant and maintaining personal resourcefulness may explain graduands' tendency towards social exclusivity (avoidance of non-colleague others), and contribute to a better understanding of medicine's professional inclusivity (strong in-group bonding).
{"title":"Nurturing anaesthetic expertise","authors":"R. Iedema, C. Jorm","doi":"10.1558/CAM.32897","DOIUrl":"https://doi.org/10.1558/CAM.32897","url":null,"abstract":"This article seeks to establish the educational and social significance of narrative and affect in anaesthetic training. Data were obtained from focus group discussions involving three groups of eight (total 24) young anaesthetists from around Australia held at an Australian and New Zealand College of Anaesthetists (ANZCA) residential conference. Analysis applied to transcripts of the discussions revealed the prominence of narratives used among trainees and supervisors as a medium for explaining and nurturing anaesthetic expertise. Nurturing expertise was accomplished by sharing narratives about extreme circumstances that highlighted a need for constant vigilance directed towards not just clinical circumstances but also colleagues. The article suggests that the narrative emphasis on remaining vigilant and maintaining personal resourcefulness may explain graduands' tendency towards social exclusivity (avoidance of non-colleague others), and contribute to a better understanding of medicine's professional inclusivity (strong in-group bonding).","PeriodicalId":39728,"journal":{"name":"Communication and Medicine","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-07-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83430005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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