Conversation Analytic Perspective Research Articles

Interprofessional meetings, organization, and interactive practices: the reflexive achievement of patient-centeredness

ABSTRACT Interprofessional meetings are crucial for achieving patient-centeredness in healthcare. Exactly how patient-centeredness is reached during these meetings remains underexamined. Adopting an Ethnomethodology and Conversation Analysis (hereafter EMCA) perspective, this contribution looks at video-recordings of interprofessional meetings in two distinct healthcare settings: rehabilitation and internal medicine. It aims to provide new insight into how investigations of patient-centeredness as a reflexive achievement allow us to better understand the organizational and relational efforts required to achieve it in practice. This contribution outlines how different healthcare contexts result in variety in the meeting frequency, duration, aims, participants, and agendas, which in turn means that the opportunities for patient-centeredness are not the same. But it also illustrates how patient-centeredness depends on the ways the various opportunities are seized and play out in the interprofessional interactions. It is therefore argued here that research on how patient-centeredness is reached in interprofessional meetings and the development of recommendations for enhancing it both require consideration of context-specific conditions and how participants adapt to and simultaneously modify them to achieve patient-centeredness in practice.

Analysis of the Characterization of Holden in The Catcher in the Rye from the Perspective of Conversation Analysis

The Catcher in the Rye, the only one full-length novel created by Jerome David Salinger, gains great popularity among people and even the whole literary world. The interlocutions in the novel are carefully designed by Salinger, which is also an important way to shape a character. This paper will analyze the conversations between Holden and other characters to discuss how the image of Holden is shaped. By rendering these theories of Conversation Analysis, the personalities of characters can be shown more vividly and comprehensively. Besides, the perspective of Conversation Analysis can also deepen themes and offer a new way for readers to tap into the inner world of characters.

The types of repairs, categories of repairs, repairs in doctor-patient communication, and repair strategies from the perspective of psycholinguistics

The nature of human spontaneous speech brings about speech errors and typical disfluencies such as hesitation, pause, silence, repetition, and repair. Recent studies in spoken dialects across many countries reported that speakers produce speech errors or unclear expressions in daily verbal communication. When speakers realize their utterances are erroneous or inappropriate, they frequently make pervasive, highly systematic, and measurable repairs in conversation. Some researchers claim that the repairs in conversation are ubiquitous. This occurrence reflects that individuals make great efforts to ensure their utterances are understandable and acceptable to the listeners. This also triggered the question of what role do speech repairs play in building mutual understanding and enhancing therapeutic relationships between doctors and patients during clinical interactions. Most of these studies have predominantly focused on first (L1) and second language (L2) acquisition, while limited studies have investigated repairs in clinical settings. Repair is a key mechanism for building mutual understanding in clinical interactions and contributes to better therapeutic relationships and treatment adherence. Doctors and patients attempt to make their utterances understandable and acceptable to attain their purposes in the clinical encounter. Nevertheless, some studies do not describe the categories of repair strategies and the trouble source, while only limited research mentioned the types of repair. This gives no insights into the specific strategies and trouble sources in the communication. This study, therefore, sets out to review the types of repairs, categories of repairs, repairs in doctor-patient communication, and repair strategies in attempting to explain the repair mechanism that works in the communication setting between doctor-patient interactions from the perspective of epistemic, pragmatics, conversation analysis, and psycholinguistics.

Repair as a practice and action in East Asian languages

The papers collected in this special issue explore ways in which repair/correction is organised in three East Asian languages, Chinese, Japanese, and Korean, from the perspective of conversation analysis (CA).

Overexposed other-initiated repair in Mandarin conversation

When the non-trouble-source speaker initiates and even repairs the repairable, s/he might extend the other-initiation or other-correction segment by rejecting or commenting on the trouble source, thus overexposing the trouble source. This study investigates the overexposed other-initiated repair in Mandarin talk-in-interaction. Overexposed other-initiated repairs in Mandarin are executed in a boldfaced manner for a certain interactional reason, which the current research explores from the conversation analytic perspective. Repairables in the current study fall into either error-based or non-error-based ones. Furthermore, the repairables are taken by the interactants as either a common-sense blunder or a moral blunder. In addition, other overexposures reveal the nuanced relation between interactants and their respective epistemic stance in the local interactional environment

Reference repair in Korean conversation

This study examines, from a conversation-analytic perspective, the role of post-mortems following reference repair, whose organisational features exhibit the participants’ remedially motivated orientations towards managing their face and membership categories in accounting for a problematic reference. Post-mortems are predominantly organised as self-deprecating or other-supportive accounts, through which the troublesome character of a trouble source is downgraded, e.g., attributed to a momentary lapse. Their face-sensitive character is sometimes oriented via the repair-initiator’s abdication of correction, geared to pre-empting their generation, particularly when the repairable is an English word or its nativised version. In entertainment-oriented talk-shows, post-mortems, organised as mock-activities, are designedly promoted through exposed correction/reformulation. A case of problematic reference understanding is examined and accounted for as deriving from a tying-based mishearing, with the repair initiator being incorrectly primed to the trouble-source expression as continuative of the categorial flow of the preceding sequence, without recognising its sequence-organisational import in launching post-mortems.

Therapist's positive evaluation of children with hearing impairment: A conversation analysis perspective

In speech-language therapy, the evaluation of children with atypical speech embodies the practical expertise of the therapist and the therapeutic goal of facilitating rehabilitation by guiding these children toward more typical speech behaviors. This study aims to provide an interactional explanation of how positive evaluations given by speech therapists are sequentially formatted, constructed, and oriented in therapy practice and what interactional consequences they have on the interpretation and learning of children with hearing impairment. Adopting conversation analysis as a methodology, this empirical study delves into naturally occurring conversations between speech therapists and children with hearing impairment within the context of Chinese speech-language therapy, focusing specifically on instances of positive evaluations in the third-turn position. The analysis reveals a prevalent occurrence of positive evaluations during therapeutic interactions, showcasing a diverse range of formats employed, spanning from explicit to implicit expressions. A fine-grained conversation analysis demonstrates the delicate and intricate nature of therapists’ positive evaluations, in terms of their indexicality (the function of being referential), and sensitivity to local contingencies. Furthermore, these positive evaluations serve as a critical site for displaying the epistemic asymmetry and its negotiation in and through therapist-client interactions. By providing an empirical demonstration of the interactional skill involved in speech-language therapy and advocating for evaluations characterized by clear indexicality and recipient-orientedness, this study contributes to enhancing the efficiency and effectiveness of rehabilitation practices while shedding new light on the atypical interactions involving people with communicative impairments.

Differentiated use of Japanese interjective items 'eeto', 'sonoo' and 'anoo' in self-initiated, same-turn repair

This study examines the intricacies of Japanese interjective tokens eeto, anoo, and sonoo from a conversation analytic perspective, particularly focusing on their role in self-initiated, same-turn self-repair. This study reveals that these tokens can serve as repair prefaces, projecting the quintessence of the impending repair operation. Depending on the specific interactional concerns at any given juncture, distinct variations in self-initiated, same-turn repair operations emerge, and Japanese speakers adeptly indicate how their orientation toward specific interactional aspects of the upcoming repair solution should be heard at that particular conversational juncture by prefacing their self-repair operations with these tokens, each signaling a different nature for the repair. Furthermore, this study argues that the differentiated use of eeto, anoo, and sonoo as repair prefaces correlates with and extends findings from our previous studies, thereby establishing congruence between their varied workings across multiple situations.

Self-repair in Korean conversation

This paper analyses the practice of self-initiated (same-turn) self-repair in Korean conversation, from a conversation-analytic perspective, with the focus on “post-positionally” conducted morphological repair. Korean is a predicate-final language with an agglutinative system, where a case marker or a sentence-ending suffix post-positionally marking the root (e.g., noun or verb stem) may become a repairable, being replaced by another, rearticulated, or even suppressed or blurred (in the case of turn-finally occurring repair). The analysis suggests that post-positional repair of the root or suffixes (e.g., sentence-ending suffixes or turn-final clausal connectives) embodies the repairer’s orientation towards rendering the action more “normatively appropriate” in a way that is more recipient-designed, face-sensitive, or solidary. Explicating the reflexive relationship between the repairable and the repair solution is shown to be a useful comparative-analytic practice, illuminating the way post-positional morphosyntactic elements in Korean are deployed as paradigmatically related interactional resources managing action, face and relationships

Discursive Interaction and Agency in Transitional Justice: A Conversation Analysis Perspective

ABSTRACT The article presents discursive interaction as an analytical framework for capturing agency in transitional justice (TJ). Embedded in the paradigm of Conversation Analysis, which foregrounds the interactive nature of communication, the framework sets out how the exercise of agency is facilitated or constrained at the micro level of talk in conversational sequences. The article shifts attention to the mechanics of interactions in TJ, which are demonstrated empirically with patterns of interactions in the Croatian Parliament. The reconceptualization of agency based on the systematic analysis of how speakers engage with each other advances emerging theories of interactive TJ both conceptually and methodologically.

Collaborative character searches in L2 Chinese peer writing: sequential design and object affordances

ABSTRACT In light of the growing field of research on writing-in-interaction within an ethnomethodological (EM) and conversation analytic (CA) perspective, which peer writing as a situated activity unfolded by participants, this study investigates how L2 Chinese learners accomplish collaborative character searches during a peer writing task. The analysis shows that learners’ collaborative character search follows a three-phase sequential design: problem-displaying, attention-drawing, and problem-resolving phases, during which they employ various multimodal resources to achieve interactional goals. By using different objects, participants demonstrate their agency in coordinating resources while collaboratively searching for the correct character(s). Furthermore, participants’ interactions with objects provide affordances for a particular point for noticing, transferring the writership, displaying epistemic stance, re-directing attention, and exploring the emergent learnable. This study unveils how L2 Chinese learners do collaborative character searches during peer writing and extends our understanding of the intricate coordination of multimodal resources in collaborative character search work. It contributes to ongoing discussions on (hand)writing-in-interaction within the EM/CA field by illustrating how participants navigate the intricacies of logographic writing while doing writing.

Schisming as an Interactional Resource for Learning at the Frontiers of Work and Vocational Training — A Secondary Publication

This paper examines the sorts of interactional competencies and institutional demands required from students as they engage in complex forms of participation combining work and training purposes. It focuses on a series of empirical cases, recorded through video data and analyzed from a conversation analytic perspective, in which mentors make the decision to intervene during work sessions moderated by students. Such interventions do not interrupt the student’s activity and lead to the emergence of two distinct but not impermeable interactional spaces. This complex participation framework, known as “schisming,” contributes to overcoming practical issues within multiparty settings. Our study shows how schisming constitutes a particular sequential phenomenon where participants reorganize the interaction and co-construct a social and cognitive interactional space, thus enabling a shared understanding of the specific training context. Empirical data from the practical training of medical radiographers are used to illustrate how schisming may contribute to learning in the conditions of guided practice.

‘I know what it is’. An interactional study of sex discovery in prenatal ultrasound examinations

One of the most exciting moments in a prenatal ultrasound session is learning the sex of the baby.Following a conversation analysis perspective, we present a multimodal analysis of sequences of interaction between patient and practitioner at the time the foetus’ sex is the focus of attention. Based on video data collected from maternity wards and private practitioners, we report on two types of sequences, which illustrate the different ways of responding to the perceptually-occasioned formulation of the foetus’ sex: as a telling or as a noticing (in which case participants orient towards jointly seeing). While the possibility of both response is inherent to the sequential properties of noticing-based claims in general, we will discuss how the production of both types of sequences is sensitive and articulated to the distribution of epistemic authority as a practical achievement in this medical setting, along two dimensions: expert versus ordinary knowledge, and professional vision versus lay gaze.

How diabetes forum-users complain about others’ expectations: Troubles-telling and troubles-receiving

This article offers a qualitative analysis of two instances of troubles-telling threads on a diabetes forum, with a specific focus on how these instances contribute to constructing a way to manage others’ expectations concerning how persons diagnosed with diabetes control their condition. From the perspective of conversation analysis and discursive psychology, this article shows some recurrent features of both troubles-telling (namely announcement, stake inoculation and self-deprecation) and of troubles-receiving (namely appreciation, second stories, escalation). Our analysis furthermore shows how inadequate expectations from family members are judged differently from those of health professionals. The latter are judged more harshly for what seems a lack of professional competence, whereas the former are more easily pardoned but pose a particular challenge in that patients do not wish to remove these persons from their lives. Through this analysis, we contribute to showing a particularly important function of patient fora, namely allowing patients to tell troubles about others’ expectations and to receive support and advice for these circumstances that put a heavy emotional burden.

Noticing-based actions and the pragmatics of attention in expository live streams. Noticing ‘effervescence’ and noticing-based sequences

This paper focuses on live streams as interactional phenomena from an ethnomethodology and conversation analysis (EMCA) perspective. It discusses how streamers and viewers manage attention and engagement and how noticing-based actions constitute a powerful and crucial resource to produce and display these, finely tuned to the asymmetric communicative affordances of live streams, which, in the case of expository live streams, enact a streamer on display for the perceptual consumption of remote viewers. It discusses how streamers and viewers may produce noticing sequences and noticing-based sequences. It also discusses how the orientation towards noticing in expository live streams may become contagious and lead to a ‘noticing effervescence.’

Framing offer-related actions as assistance at jewelry stores in Japan

While most of the studies on assistance in talk-in-interaction from the conversation analytic perspective presuppose that the actor who receives assistance already has or is expected to have problems, issues, needs, or demands, assistance can be offered without the expression or existence of plausible expectations of problems, issues, needs, or demands. Using the methodology of conversation analysis, this study explores how service providers frame their offer-related actions as assistance without the customer’s expression of concrete needs or demands or their expected emergence by analyzing the sequences in which salespersons offered customers to try the jewelry. The results of the analysis show that salespersons were motivated to execute pull-based offer-related actions in which assistance is provided in response to the expression or anticipation of customer needs, as they could lead to successful sales outcomes. Salespersons employed various techniques to frame their offer-related actions as assistance.

A Conversation Analytic Study on Clicks in Mandarin Chinese

From the perspective of Conversation Analysis, this paper analyzes clicks in daily Chinese communication. Data analysis shows that clicks generally appear in negative contexts and play an important role in conveying the speaker’s negative attitudes or feelings. This article first discusses the main ways that the linguistic resource of clicks helps the speaker convey his/her negative attitudes: presupposing the click-producer’s disdain, presupposing the speaker’s dissatisfaction, presupposing the speaker’s impatience, and strengthening the speaker’s negative attitude. On this basis, the author explores the main two functions of clicks in Chinese conversation, that is serving as a signal of topic transition and maintaining harmonious social relations.

Review of Wong & Waring (2021): Review of Storytelling in multilingual interaction: A conversation analysis perspective

Review of Wong & Waring (2021): Review of Storytelling in multilingual interaction: A conversation analysis perspective

Classroom interaction in an online context: A translanguaging informed conversation analysis perspective

This study aims to investigate the mode-divergent practices of pre-service teachers in an online context. Firstly, 16 h of classroom interaction is analyzed via Conversation Analysis utilizing the Classroom Interactional Competence framework. Then, the translanguaging pedagogy perspective complements this analysis by focusing on linguistic, social, and psychological aspects. The conversation-analytical findings demonstrate the failures in constructive alignment, and an inordinate amount of wasted time with no satisfying results has been observed. It is shown that translanguaging pedagogy may support the creative, critical, and strategic utilization of bilingual students' entire repertoires in classroom practices. Overall, the analysis demonstrates how translanguaging pedagogies can inform mode-divergent practices in classrooms by which teachers’ interactional competence may be improved.

Analyzing L2 Classroom Dynamics: A Conversation Analysis Perspective

This paper explores the reflexive relationship between pedagogy and interaction in second language (L2) classrooms, employing Seedhouse’s (2004) model and Conversation Analysis (CA) methodology. The analysis covers three contextual dimensions: form-and-accuracy, meaning-and-fluency, and task-oriented contexts. The study reveals the dynamic interplay between pedagogical focus and interactional organization, showcasing how participants negotiate linguistic forms, repair sequences, and engage in turn-taking to accomplish pedagogical goals. Despite critiques emphasizing the emic perspective’s limitations, the paper underscores CA’s contribution to understanding language use in teaching, offering pedagogical insights for language educators.