Latest Issue: Vol 13, No 1 (2016): Teamwork and Team Talk in Healthcare Delivery RSS2 logo

Communication & Medicine

Editor Srikant Sarangi Aalborg University, Denmark

Since its inception in 2004, Communication & Medicine has been consistently interrogating the `black box’ of what is routinely characterised as `the communicative turn’ in healthcare practice in clinical and public health domains. It is now firmly established as a leading forum for these critical debates.

The journal is adopted by The COMET Society which hosts annual conferences every July. The editor is supported by an internationally acclaimed, interdisciplinary advisory board, selectively drawn to represent the well-established traditions of the medical, social and human sciences.

Aims and Scope
Communication & Medicine continues to abide by the following distinctive aims:

• To consolidate different traditions of discourse and communication research in its commitment to an understanding of psychosocial, cultural and ethical aspects of healthcare in contemporary societies.

• To cover the different specialities within medicine and allied healthcare studies.

• To underscore the significance of specific areas and themes by bringing out special issues from time to time.

• To be fully committed to publishing evidence-based, data-driven original studies with practical application and relevance as key guiding principles.

• To be targeted at an interdisciplinary audience, which will include healthcare professionals and researchers and students in the medical, social and human sciences.

• To promote a reader-friendly style and format, including engagements with debates and dialogues on crosscutting themes of topical significance.

Forthcoming Issue

CAM 13.2 (2016) [2017]

Table of Contents


LAnna W. Gustafsson

Shuya Kushida, Takeshi Hiramoto and Yuriko Yamakawa

Annabel Levesque and Han Z. Li

Elena Link, Daniela M. Schlütz and Stefan Brauer

Geoffrey M. Maina, Vera Caine, Judy Mill and Randolph Wimmer


Diana L. Awad Scrocco

Indexing and Abstracting
H-index: 14 (2015)
SJR: 0.176

Bibliography of Linguistic Literature / Bibliographie Linguistischer Literature (BLL)
EBSCO Communication and Mass Media Index
EBSCO Current Abstracts
IBZ International Bibliography of Periodical Literature in the Humanities and Social Sciences
IBR International Bilbiography of Book Reviews of Scholarly Literature in the Humanities and Social Sciences
Linguistics and Language Behaviour Abstracts
OCLC Electronic Collections Online
European Reference Index (ERIH Plus)

Publication and Frequency: 3 issues per year from 2011 (volume 8)
ISSN: 1612-1783 (print)
ISSN: 1613-3625 (online)

Professor Srikant Sarangi
Faculty of Humanities
Aalborg University
Kroghstræde 3
DK-9220 Aalborg Ø

Notice Regarding Volumes 1-4
For print copies of Volumes 1-4 as well as online access for those issues please contact the former publisher, Mouton De Gruyter.

Most Recent Articles


Discourse types and (re)distribution of responsibility in simulated emergency team encounters

Successful teamwork, constitutive of team talk, depends largely on shared responsibility in the coordination of tasks in a goal-oriented way. This paper examines how specific modes of talk or ‘discourse types’ are utilised by a healthcare team in simulated emergency care. The data corpus comprises six video-recorded simulation training sessions in an emergency department at a large Norwegian hospital. Our analysis focuses on the critical moment when the original healthcare team is joined by other specialists in an ad hoc manner, which necessitates the (re)distribution of expert responsibility in the management of the patient’s condition. We examine the interactional trajectories and, in particular, the discourse types surrounding the critical moment which marks the incorporation of the new team members. The analysis centres on three discourse types (online commentary, offline commentary and metacommentary) that are utilised in accomplishing the multiple tasks in a collaborative and coordinated fashion. We suggest that team talk overlays and overlaps with distributed medical work in highly charged decision-making contexts such as emergency care. The findings have relevance for how healthcare professionals and students are trained in multidisciplinary team talk and teamwork.
Posted: 2016-10-14More...

The management of diagnostic uncertainty and decision-making in genetics case conferences

In this paper we examine one type of intraprofessional collaborative activity, namely case conferences in a specialist genetics clinic. Our specific focus is on how clinical geneticists manage decision-making through team talk in the event of diagnostic uncertainty which is mainly attributable to limitations in the current state of genomic knowledge, ‘uncertain significances’ associated with genetic test results, and a lack of information/ evidence pertaining to cases under discussion. The case conference then becomes a means to minimise the uncertainty and arrive at decisions that optimise the significance of the results in terms of clients’ life trajectories. Adopting theme-oriented activity analysis, we examine video-recorded data from five case conferences in Hong Kong. Beginning with a prototypical structural mapping of the case conference activity type, our analysis focuses on what we call ‘uncertain cases’. Our findings highlight three discourse types constitutive of team talk: pedagogic talk, diagnostic talk and decisional talk. In paying particular attention to how uncertainty is formulated and negotiated, we suggest that access to and assessment of different kinds of evidence as well as the activity-specific expert role-positions of the participants are crucial with regard to establishing a correct diagnosis and/or striving towards a minimisation of current uncertainties.
Posted: 2016-09-13More...

How language shapes psychiatric case formulation

The aim of this paper is to describe, analyse, and discuss the process of formulation in the specific context of mental health (MH). Formulation is a fundamental element of the work of psychiatrists and other MH clinicians that is expected to be mastered during training. The literature, however, shows that formulation is rarely explicitly addressed in the psychiatric curriculum; rather, it is implicitly developed through modelling, and/or clinical practice. This paper focuses on case formulation in one MH context in Australia. It tracks the iterative formulation of one patient in a hospital emergency department. The analysis uses resources from systemic functional linguistics (SFL) situated within a broader framework of discourse analysis. It highlights patterns of lexical relations and nominalisation as well as the range of conjunctions. These make explicit how the clinicians talk about the patient’s illness and shape their developing understanding into a logical formulation. We see applications of this work for the training of mental health professionals. These data make explicit the ways in which the participating clinicians use language in the process of formulation. By bringing this process to the level of consciousness, it can be discussed and evaluated and become a pedagogic resource.
Posted: 2016-09-13More...

A collective clinical gaze: Negotiating decisions in a surgical ward

This article explores collaborative aspects of clinical decision-making, based on a focused ethnography and video recordings of meetings in clinical practices in two wards for gastro-intestinal diseases at the surgical department of a large Norwegian university hospital. By studying clinicians’ communication during patient introduction, handling uncertainties and surprises, collecting information, and negotiating acceptance, we elaborate on how collaborative teamwork in the hospital ward is developed. Further, by drawing on detailed studies of meetings, in which patients are not physically represented, we explore ways in which a ‘collective clinical gaze’ of each patient is constructed on the basis of documents, memory, and a consensus-directed discussion among clinicians who are present. Although electronic patient record systems and the like are expected to produce firm bases for clinical decision-making, our analysis suggests that more emphasis should be put on how clinicians in their daily practice establish collectively based validity of any decision being made.
Posted: 2016-09-13More...

Team talk and problem solving in thoracic medicine

The topic of this article is collaborative problem solving conducted as talk and social interaction in a particular team in the thoracic ward of a Norwegian hospital. The problems to be solved were complex and required a team consisting of participants from diverse medical specialties that met regularly to discuss examination procedures, formulate diagnoses, and decide forms of treatment. Data for the article come from field notes and audio recordings made while the author observed this meeting regularly over more than one year. The aim of the paper is to investigate how team discourse was regulated in ways that served the reproduction of institutional medical standards for problem solving, and also how the meeting had to deal with deviations from institutional standards and attempted to reproduce a certain form of normative orderliness and interaction order
Posted: 2016-09-13More...

Most Viewed Articles


The use of abbreviations in medical records in a multidisciplinary world -- an imminent disaster

Abbreviations are commonly used in the medical world to save time and space whilst writing in the patients’ medical records. As various specialties have evolved, each has developed a collection of commonly used abbreviations within its practice, which may not be recognizable to those not working within the same field. The purpose of this study was to assess whether we, the multidisciplinary team members, correctly interpret the abbreviations used in the medical records. We analysed one week of orthopaedic surgical medical records for the use of abbreviations and assessed their appreciation by other members of the multidisciplinary team by means of a standardized questionnaire. We found great variability in the understanding of these abbreviations by different groups of health care professionals. As expected, the orthopaedic surgeons produced significantly more right answers when compared to the other groups, but even they could correctly interpret just over half (57.24 per cent) of the abbreviations. There were many misinterpretations of the abbreviations across the specialties posing imminent clinical risk. Whilst abbreviations may indeed save time, the observed inter-group variation in correct interpretation of these abbreviations is unacceptable. We recommend that the abbreviations have no place in the multidisciplinary world and their continued use will only lead to eventual clinical error.
Posted: 2008-11-25More...

Laughter, communication problems and dementia

This article investigates how the elderly with dementia and their professional caregivers use laughter as a device to deal with problems related to language production and comprehension. The data consist of two game-playing situations, used to engage the elderly people in memory work. The article shows how the elderly patients recurrently laugh to acknowledge communication difficulties and to show awareness of their potential non-competency. The professional caregivers are shown to use slightly different strategies for responding to laughter segments initiated by the patients, either making the shortcomings part of the conversation or avoiding referring to the lapse explicitly. The laughter strategies used by the patients are compared to those reported in the CA-literature on laughter. It is well known that laughter is used in sequences of trouble and delicacy in both ordinary and institutional contexts, but my study shows that speakers with dementia laugh when they encounter problems related to language production and comprehension. This functional expansion in relation to premorbid occurrence is evidence that laughter fits the definition of compensatory behaviour utilized to overcome communication barriers. Certain conversational skills are preserved in individuals with dementia, but due to their cognitive impairment these resources are utilized in a slightly different way than by healthy speakers.
Posted: 2008-11-25More...

The negotiation of the problem statement in Cognitive Behavioural Therapy

Cognitive behavioural therapy (CBT) is a form of psychotherapy which is characterized by being highly structured, outcomes focused and time limited. The literature concerning CBT is extensive but it has primarily focused on the outcomes of therapy with limited qualitative studies investigating the process of CBT. In this present study we investigate how the CBT model is implemented in therapeutic interaction through a focus on the conversion of the client’s problem into CBT terms and its ultimate articulation as the problem statement. The problem statement is an integral part of the form of CBT studied from which the subsequent therapy is derived. Drawing on theme-oriented discourse analysis we examine the first two sessions of the treatment of one client using a number of tools derived from discourse and conversation analysis. This case study was drawn from a larger corpus of the CBT treatment of ten clients. The expertise of the therapist in applying the generic CBT model of therapy to the client’s particular problem is a focus of this study.
Posted: 2010-10-22More...

Moral accounts and membership categorization in primary care medical interviews

Although the link between health and morality has been well established, few studies have examined how issues of morality emerge and are addressed in primary care medical encounters. This paper addresses the need to examine morality as it is (re)constructed in everyday health care interactions. A Membership Categorisation Analysis of 96 medical interviews reveals how patients orient to particular membership categories and distance themselves from others as a means of accounting (Buttny 1993; Scott and Lyman 1968) for morally questionable health behaviours. More specifically, this paper examines how patients use membership categorisations in order to achieve specific social identity(ies) (Schubert et al. 2009) through two primary strategies: defensive detailing and prioritizing alternative membership categories. Thus, this analysis tracks the emergence of cultural and moral knowledge about social life as it takes place in primary care medical encounters.
Posted: 2012-02-24More...

Establishing mutual understanding in interaction: An analysis of conversational repair in psychiatric consultations

The therapeutic relationship is the greatest predictor of treatment outcome, yet its relationship to communication is largely unevaluated. This study explored how psychiatrists and people with a diagnosis of schizophrenia establish mutual understanding in naturalistic communication, and associations with the therapeutic relationship, patient satisfaction and symptoms. In conversation analysis, the concept of repair focuses on how participants in interaction create mutual understanding and address misunderstanding. A standardized protocol measuring the frequency of repair was applied to 15 outpatient consultations. Correlations between repair and the therapeutic relationship, patients’ experience of the consultation and symptoms were explored. Patients made most effort to make their contribution understandable, whereas psychiatrists made most effort to repair misunderstandings. The more positively psychiatrists rated the relationship, the more effort they made to understand patients. Although psychiatrists’ efforts were not associated with patients’ overall view of the relationship, patients felt better emotionally, despite, feeling less understood. Psychiatrists used fewer repairs when patients were more symptomatic. Both parties prioritized understanding similar topics but psychiatrists focused more on medication and patients on voices. Quantifying repair offers a new way of analyzing how mutual understanding is established in interaction, and links communication processes with treatment outcomes.
Posted: 2010-01-16More...



COMET 2017

15th International and Interdisciplinary Conference
"Communication, Medicine and Ethics"
June 26-28, 2017
Hosted by Indiana University-Purdue University Indianapolis (IUPUI), USA
Posted: 2016-10-21 More...

COMET 2016

COMET 2016 is hosted by Danish Institute of Humanities and Medicine, Aalborg University, from 4-6 July 2016. Please click here for more details  
Posted: 2016-05-06
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