Movie dialogues as discourse data in the study of forecasting mechanisms in the delivery of medical bad news
Issued Date: 11 Mar 2014
Abstract
Understanding the communication skills for delivering bad news, an important daily task for medical professionals, presents a challenge for most discourse researchers due to methodological and ethical dilemmas. Movie dialogues, in which difficult communication of life-and-death issues are fundamental ingredients in creating dramatic effects, are often adopted in medical education and thus potential data for study. By applying the concept of ‘forecasting mechanism’ in bad news delivery (Schegloff 1988 and Maynard 2003), this study examines bad news delivery events depicted in three movie clips. My analysis demonstrates (1) how forecasting, as a ‘macro conversation mechanism,’ is observed in both natural and artificial discourses; (2) what two subtypes of forecasting are identified in movie dialogues: forecasting that directs the interaction to a ‘recipient-leading-the-telling’ pattern, and forecasting that constructs the delivery as one with shared agency; and (3) how the two subtypes may facilitate the deliverers’ task by minimizing the conflicting perspectives with the recipients, ensuring the recipients’ orientation to the bad news, and freeing the deliverers from the pressure of being blamed. These findings implicate the possibility of applying movie clips in discourse research and medical education in regarding to conversational strategies for difficult communication.
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References
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Schegloff, E. A. (1988) On an actual virtual servo-mechanism for guessing bad news: A single case conjecture. Social Problems 35 (4): 442–457. http://dx.doi.org/10.2307/800596
Schegloff, E. A. and Sacks, H. (1973) Opening up closings. Semiotica 8 (4): 289–327. http://dx.doi.org/10.1515/semi.1973.8.4.289
Schiffrin, D. (1987) Discourse Markers. Cambridge: Cambridge University Press. http://dx.doi.org/10.1017/CBO9780511611841
Taglicht, J. (2001) Actually, there’s more to it than meets the eye. English Language and Linguistics 5 (1): 1–16. http://dx.doi.org/10.1017/S1360674301000119
Tannen, D. and Lakoff, R. (1984) Conversational strategy and metastrategy in a pragmatic theory: The example of Scenes from a Marriage. Semiotica 49 (3–4): 323–346.
ten Have, P. (1993) Talk and institution: A reconsideration of the asymmetry of doctor–patient interaction. In D. Boden and D. Zimmerman (eds) Talk and Social Structure, 138–163. Berkeley: University of California Press.
Biber, D., Johansson, S., Leech, G., Conrad, S. and Finegan, E. (1999) Longman Grammar of Spoken and Written English. Harlow: Pearson Education Ltd.
Blasco, P. G., Moreto, G., Roncoletta, A. F., Levites, M. R. and Janaudis, M. A. (2006) Using movie clips to foster learners reflection: Improving education in the affective domain. Family Medicine 38 (2): 94–96.
Boden, D. and Molotch, H. L. (1994) The Compulsion of proximity. In R. Friedland and D. Boden (eds) Now Here: Space, Time and Modernity, 257–286. Berkeley: University of California Press.
Buckman, R. (1992) How to Break Bad News: A Guide for Health Care Professionals. Baltimore: Johns Hopkins University Press.
Buckman, R. (2005) Breaking bad news: The S-P-I-K-E-S strategy. Psychosocial Oncology 2 (2): 138–142.
Chafe, W. (1985) Linguistic differences produced by differences between speaking and writing. In D. R. Olson, A. Hildyard and N. Torrance (eds) Literacy, Language, and Learning, 105–123. Cambridge: Cambridge University Press.
Clark, R. E. and LaBeff, E. E. (1982) Death telling: Managing the delivery of bad news. Journal of Health and Social Behavior 23 (4): 366–380. http://dx.doi.org/10.2307/2136494
Coleridge, S. T. (1817) Biographia literaria, or, Biographical Sketches of my Literary Life and Opinions. New York: Kirk and Mercein.
Coupland, N. (2004) Stylized deception. In A. Jaworski, N. Coupland and G. Dariusz (eds) Metalanguage: Social and Ideological Perspectives, 59–74. Berlin: Mouton de Gruyter.
Culpeper, J. (2005) Impoliteness and entertainment in the television quiz show: The Weakest Link. Journal of Politeness Research: Language, Behavior, Culture 1 (1): 35–72. http://dx.doi.org/10.1515/jplr.2005.1.1.35
DiBartolo, M. C. and Seldomridge, L. A. (2009) Cinemeducation: Teaching end-of-life issues using feature films. Journal of Gerontological Nursing 35 (8): 30–36. http://dx.doi.org/10.3928/00989134-20090706-06
Ferri, A. J. (2007) Willing Suspension of Disbelief: Poetic Faith in Film. Lanham, MD: Lexington Books.
Forchini, P. (2012) Movie Language Revisited: Evidence from Multi-dimensional Analysis and Corpora. New York: Peter Lang.
Glaser, B. G. and Strauss, A. L. (1965) Awareness of Dying. Chicago: Aldine Pub. Co.
Labov, W. (1972) The transformation of experience in narrative syntax. In the author’s Language in the Inner City, 359–396. Philadelphia: University of Pennsylvania Press.
Maynard, D. W. (1993) The perspective-display series and the delivery and receipt of diagnostic news. In D. Boden and D. Zimmerman (eds) Talk and Social Structure, 164–192. Berkeley: University of California Press.
Maynard, D. W. (2003) Bad News, Good News: Conversational Order in Everyday Talk and Clinical Setting. Chicago: University of Chicago Press.
Quaglio, P. (2009) Television Dialogue: The Sitcom Friends vs. Natural Conversation. Amsterdam/Philadelphia: John Benjamins. http://dx.doi.org/10.1075/scl.36
Richardson, K. (2010) Television Dramatic Dialogue: A Sociolinguistic Study. New York: Oxford University Press. http://dx.doi.org/10.1093/acprof:oso/9780195374056.001.0001
Roter, D. (2010) Second sight: Extending insight into the patient experience of care. Paper presented at the Eighth Interdisciplinary Conference on Communication, Medicine, and Ethics, Boston University.
Schegloff, E. A. (1988) On an actual virtual servo-mechanism for guessing bad news: A single case conjecture. Social Problems 35 (4): 442–457. http://dx.doi.org/10.2307/800596
Schegloff, E. A. and Sacks, H. (1973) Opening up closings. Semiotica 8 (4): 289–327. http://dx.doi.org/10.1515/semi.1973.8.4.289
Schiffrin, D. (1987) Discourse Markers. Cambridge: Cambridge University Press. http://dx.doi.org/10.1017/CBO9780511611841
Taglicht, J. (2001) Actually, there’s more to it than meets the eye. English Language and Linguistics 5 (1): 1–16. http://dx.doi.org/10.1017/S1360674301000119
Tannen, D. and Lakoff, R. (1984) Conversational strategy and metastrategy in a pragmatic theory: The example of Scenes from a Marriage. Semiotica 49 (3–4): 323–346.
ten Have, P. (1993) Talk and institution: A reconsideration of the asymmetry of doctor–patient interaction. In D. Boden and D. Zimmerman (eds) Talk and Social Structure, 138–163. Berkeley: University of California Press.
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