Let’s talk about discourse analysis for health professional education: What, why and how
DOI:
https://doi.org/10.11157/fohpe.v21i2.470Keywords:
discourse analysis, health professional education, genre analysis, communicationAbstract
Much of healthcare is facilitated through interactive talk and writing: diagnosing, collaboratively making treatment decisions, conducting treatment, coordinating care, handing over care. For junior health professionals, learning the valued patterns of talk and writing—the discursive practices of healthcare—is part of becoming a health professional. Discourse analysis of texts, written and spoken, can make visible to health professional educators what the valued interactional patterns are and how junior members learn the discursive practices through interaction with more senior colleagues. It can also illuminate “troubles” in communication, such as barriers, power imbalances and misalignment. Doing discourse analysis requires an understanding of how texts work and a meaningful, systematic approach to representing and analysing data. This paper introduces genre theory, a form of discourse analysis that distinguishes between text types according to their social purpose and contextual variables, including what the text is about, who is involved and how the text is organised. This paper outlines some principles of genre analysis and practical “how to” guidelines. It also provides suggestions about how findings of genre analysis can inform teaching in health professional education.
References
Bernstein, B. (1990). The structuring of pedagogic discourse: Class, codes, and control (Vol. 3). Routledge. https://doi.org/10.4324/9780203011263
Boyd, V. A., Whitehead, C. R., Thille, P., Ginsburg, S., Brydges, R., & Kuper, A. (2018). Competency-based medical education: The discourse of infallibility. Medical Education, 52(1), 45–57. https://doi.org/10.1111/medu.13467
Brown, J., Nestel, D., Clement, T., & Goldszmidt, M. (2018). The supervisory encounter and the senior GP trainee: Managing for, through and with. Medical Education, 52(2), 192–205. https://doi.org/10.1111/medu.13468
Brown, P., & Levinson, S. C. (1987). Politeness. Some universals in language usage. Cambridge University Press.
Christie, F. (1994). Developing an educational linguistics for English language teaching. Functions of Language, 1(1), 95–127. https://doi.org/10.1075/fol.1.1.06chr
Christie, F. (2002). Classroom discourse analysis: A functional perspective. Continuum.
de la Croix, A., & Skelton, J. (2013). The simulation game: An analysis of interactions between students and simulated patients. Medical Education, 47(1), 49–58. https://doi.org/10.1111/medu.12064
Dornan, T. (2014). When I say … discourse analysis. Medical Education, 48(5), 466–467. https://doi.org/10.1111/medu.12291
Eggins, S., & Slade, D. (1997). Analysing casual conversation. Cassell.
Eggins, S., & Slade, D. (2013). Clinical handover as an interactive event: Informational and interactional communication strategies in effective shift-change handovers. Communication & Medicine, 9(3), 215–227. https://doi.org/10.1558/cam.v9i3.215
Fairclough, N. (2001). Language and power. Pearson Education.
Goffman, E. (1981). Forms of talk. Unversity of Pennsylvania Press.
Halliday, M. A. K. (1978). Language as a social semiotic: The social interpretation of language and meaning. Edward Arnold.
Hodges, B. (2008). Discourse analysis. BMJ, 337, a879. https://doi.org/10.1136/bmj.a879
Howe, A., Barrett, A., & Leinster, S. (2009). How medical students demonstrate their professionalism when reflecting on experience. Medical Education, 43(10), 942–951. https://doi.org/10.1111/j.1365-2923.2009.03456.x
Imafuku, R., & Bridges, S. (2016). Guest editors' introduction: Special issue on analyzing interactions in PBL—Where to go from here? Interdisciplinary Journal of Problem-Based Learning, 10(2), Article 6. https://doi.org/10.7771/1541-5015.1648
Imafuku, R., Kataoka, R., Mayahara, M., Suzuki, H., & Saiki, T. (2014). Students’ experiences in interdisciplinary problem-based learning: A discourse analysis of group interaction. The Interdisciplinary Journal of Problem Based Learning, 8(2), Article 1. https://doi.org/10.7771/1541-5015.1388
Kärreman, D., & Levay, C. (2017). The interplay of text, meaning and practice: Methodological considerations on discourse analysis in medical education. Medical Education, 51(1), 72–80. https://doi.org/10.1111/medu.13212
Kurtz, S., & Silverman, J. (1996). The Calgary—Cambridge referenced observation guides: An aid to defining the curriculum and organizing the teaching in communication training programmes. Medical Education, 30(2), 83–89. https://doi.org/10.1111/j.1365-2923.1996.tb00724.x
Lave, J., & Wenger, E. (1991). Situated learning: Legitimate peripheral participation. Cambridge University Press. https://doi.org/10.1017/CBO9780511815355
Lingard, L. (2007). The rhetorical "turn" in medical education: What have we learned and where are we going? Advances in Health Sciences Education, 12(2), 121–133. https://doi.org/10.1007/s10459-006-9046-y
Lingard, L., Schryer, C., Garwood, K., & Spafford, M. (2003). "Talking the talk": School and workplace genre tensions in clerkship case presentations. Medical Education, 37(7), 612–620. https://doi.org/10.1046/j.1365-2923.2003.01553.x
Martin, J. R. (1993). Technicality and abstraction: Language for the creation of specialized texts. In M. A. K. Halliday & J. R. Martin (Eds.), Writing science: Literacy and discursive power (pp. 166–202). Falmer Press.
Martin, J. R. (1997). Analysing genre: Functional parameters. In F. Christie & J. R. Martin (Eds.), Genre and institutions: Social processes in the workplace and school (pp. 3–39). Continuum.
Martin, J. R. (2001). Language, register and genre. In A. Burns & C. Coffin (Eds.), Analysing English in a global context. Routledge.
Mehan, H. (1979). Learning lessons: Social organization in the classroom. Harvard University Press.
Pryor, E., & Woodward-Kron, R. (2014). International medical graduate doctor to doctor telephone communication: A genre perspective. English for Specific Purposes, 35, 41–53. https://doi.org/10.1016/j.esp.2013.12.001
Rees, C., & Monrouxe, L. (2008). "Is it alright if I-um-we unbutton your pyjama top now?" Pronominal use in bedside teaching encounters. Communication and Medicine, 5(2), 171–181. https://doi.org/10.1558/cam.v5i2.171
Roberts, C., Wass, V., Jones, R., Sarangi, S., & Gillett, A. (2003). A discourse analysis study of "good" and "poor" communication in an OSCE: A proposed new framework for teaching students. Medical Education, 37(3), 192–201. https://doi.org/10.1046/j.1365-2923.2003.01443.x
Rose, D. (2014). Analysing pedagogic discourse: An approach from genre and register. Functional Linguistics, 1(1), Article 11. https://link.springer.com/article/10.1186/s40554-014-0011-4
Sinclair, J., & Coulthard, M. (1975). Towards an analysis of discourse. Oxford University Press.
Tai, S., Barr, C., & Woodward-Kron, R. (2019). Towards patient-centred communication: An observational study of supervised audiology student-patient hearing assessments. International Journal of Audiology, 58(2), 97–106. https://doi.org/10.1080/14992027.2018.1538574
Whitehead, C., Kuper, A., Freeman, R., Grundland, B., & Webster, F. (2014). Compassionate care? A critical discourse analysis of accreditation standards. Medical Education, 48(6), 632–643. https://doi.org/10.1111/medu.12429
Woodward-Kron, R. (2004). "Discourse communities" and "writing apprenticeship": An investigation of these concepts in undergraduate education students' writing. Journal of English for Academic Purposes, 3(2), 139–161. https://doi.org/10.1016/j.jeap.2003.09.001
Woodward-Kron, R. (2007). Negotiating meanings and scaffolding learning: Writing support for non-English speaking background postgraduate students. Higher Education Research and Development, 26(3), 139–161. https://doi.org/10.1080/07294360701494286
Woodward-Kron, R. (2008). More than just jargon:The nature and role of specialist language in learning disciplinary knowledge. Journal of English for Academic Purposes, 7(4), 234–249. https://doi.org/10.1016/j.jeap.2008.10.004
Woodward-Kron, R., & Remedios, L. (2007). Classroom discourse in problem-based learning classrooms in the health sciences. Australian Review of Applied Linguistics, 30(1), 9.1–9.18. https://doi.org/10.2104/aral0709
Downloads
Published
How to Cite
Issue
Section
License
On acceptance for publication in FoHPE the copyright of the manuscript is signed over to ANZAHPE, the publisher of FoHPE.
