‘Reassuring’ during clinical examinations

Abstract

Novices and experts alike must engage in the interactional complexities of clinical consultations as a form of institutional talk. This includes reconciling the demands of task completion with those of effective patient communication in order to achieve successful outcomes. This paper reports a study that identifies ‘giving reassurance’ as an area of relative communicative weakness for undergraduate student dentists (novices) and examines the mechanisms by which an experienced dentist (expert) interactionally accomplishes ‘reassurance’ during a single consultation in a multilingual Asian dental education clinic. Two stages of data gathering and analysis were adopted within a multivariate framework (Heritage and Maynard, 2006). First, 51 student dentists were rated using a 360° approach during a single clinical consultation. Interactants and observers rated each student’s communicative performance using an established scale in dentistry (Theaker, Kay, and Gill, 2000). Descriptive statistical analysis identified areas of relatively lower communication performance with ‘giving reassurance’ during the ‘examination’ stage consistently rated as the least accomplished skill. Second, an experienced dentists’ consultation was audio recorded and transcribed. Using conversational analysis (CA) as the method of analysis, strategies are identified in the process of an experienced dentist and a patient co-constructing ‘reassurance’ as a two-way process.