The interactional organization of pharmacist consultations in a hospital setting: a putative structure

Abstract

The long term, complex drug regimes prescribed for oncology patients create specific opportunities for pharmacists to play an advisory role in their care, and this kind of ‘extended’ advisory role is being seized upon by the profession as the way forward. However, there is little published research on the nature of these interactions, or the kinds of communicative competencies that they require of pharmacists. This paper presents transcripts of audio data collected from a hospital outpatient clinic, where patients and/or carers are given an opportunity to discuss with a pharmacist questions or problems arising from their therapy. The data are taken from a wider study of advice-giving by pharmacists in this setting. Taking a single encounter as a ‘typical’ case, the data is analyzed and presented in the light of the Conversation Analysis (CA) literature concerned with interactional organization, and specifically the descriptions of overall structures or sequences which recur in particular kinds of interaction (e.g. Zimmerman, 1992; Jefferson, 1988). Drawing on these sequences, a putative ‘template’ structure for the pharmacist/patient/carer encounter is proposed. It is suggested that this mapping begins to establish the interactional contingencies of encounters in this setting, and hence the kinds of communicative competencies required of the ‘extended role’.