Understanding decision-making in interprofessional team meetings through interpretative repertoires and discursive devices

Abstract

ABSTRACT Health practitioners of the geriatrics ward in a teaching hospital participate in interprofessional team meetings to agree on treatment and discharge care plans for their patients suffering from chronic illnesses and co-morbidities and in need of coordinated assessments and care. We turn to the ideas in critical discursive psychology to grow a much-needed research area of examining the language-in-use and its effects in team decision-making. Specifically we explore how healthcare team members use language to perform collaboration or disengagement, creating different subject positionings for themselves and others out of a backcloth of discursive resources and practices. We observed and transcribed 108 case discussions and analyzed them for interpretative repertoires and discursive devices. During the first half of the team discussions, the members of various health professions employed the empiricist and lifeworld interpretative repertoires and the discursive strategy of perspective-taking, articulating these through formulations and questions. We use the notion of argumentative texture to better understand why an administrative structural support like protected turn-taking in team meetings is not enough to promote interprofessional collaboration. We conclude that health practitioners can improve their contributions and subject positionings at team meetings and consequently patient-care, by identifying habitually deployed linguistic resources depicting professional knowledge, and augmenting these with Other-oriented perspectives in their repertoires. By expanding their range of discursive repertoires and recognizing that discursive practices are embedded in the bigger context or argumentative texture of institutional and societal discourses, norms, values, beliefs and practices, interprofessional teams can work to improve communication and knowledge-sharing.