Abstract
ABSTRACT This paper explores the fine-grained interactional minutiae involved in promoting health literacy in medical interactions. More specifically, it explores the multimodal interactional resources (verbal and nonverbal) that health professionals and lay participants mobilize in order to make sense of fetal ultrasound images. We adopt the ethnomethodological perspective of Multimodal Conversation Analysis (SACKS; SCHEGLOFF; JEFFERSON, 1974; GOODWIN, 1981; 2010; MONDADA, 2018) to investigate 10 audio and video interactions that were recorded during fetal ultrasound exams that took place at a moderate and high-risk pregnancy ward in a public hospital in Brazil. Our aim is to ‘make visible’ the multimodal ethnomethods that interactants employ in order to render ultrasound images intelligible ‘texts’. Among the various semiotic resources mobilized to achieve intersubjectivity in this complex setting, special focus is given to the healthcare professionals’ use of similes, and the fundamental importance of the temporality in which verbal and nonverbal resources are mobilized in the process of making images intelligible. In that sense, we hope to bring to this special thematic issue the methodological advantages that a Multimodal Conversation Analytic perspective can afford to the discussion about multiliteracies and, in practical terms, to the advancement of health literacy. In medical contexts, health literacy can (and perhaps should!) be a concern ‘at all points.’ There might be no ‘borders’ to what constitutes a health literacy source or resource. Our claims, thus, are the following: (i) ultrasound images do constitute materials to be ‘read’ and understood - also by lay participants; (ii) healthcare professionals can (and perhaps should) promote health literacy among patients by employing efforts to make images ‘readable’; and, finally, (iii) social interaction is one of the constitutive loci for the promotion of multiliteracy events.
Highlights
Consider the following fetal ultrasound image (Fig. 1) – an image that is projected on a computer screen and that becomes visually available both to the healthcare professional and to the patient while an exam unfolds
This paper explores the fine-grained interactional minutiae involved in promoting health literacy in medical interactions
It investigates the multimodal interactional resources that health professionals and lay participants mobilize in order to make sense of fetal ultrasound images
Summary
The expression “pedagogy of multiliteracies” was first used in September 1994, during a week of meetings and debates held by the New London Group (COPE; KALANTZIS, 2000). In order to tackle these demands, Cope and Kalantzis (2009) propose to consider everyday experiences and their inherent features as some of the fundamental aspects of multiliteracies, and to actively engage literacy agents (here understood as not restricted to agents in educational contexts) in designing their future, choosing new ways of interacting in society, and critically analyzing them. It becomes a premise that in order to be able to take a more active role over one’s health, one must understand health information (CONNELLY; SPEER, 2017) This brings us to the fact that getting health-informed is largely accomplished (despite not being restricted to) in social interaction between healthcare professionals and laypersons (OSTERMANN; PEROBELLI, 2019). Doctor-patient interaction becomes an important locus for doing health literacy – or, to put it differently, doctor-patient interactions (might) become actual literacy events in themselves, as we hope to demonstrate
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