Conversation Analytic Research Research Articles

Halt for Speaking

Conversation analytic (CA) research on multimodality has mostly focused on the “movement” rather than the “freezing” of such movement, except for a small body of work on gesture holds mostly in sign language and several European languages. Based on two large corpora of video-recorded family interactions and adult ESL classroom interactions in American English, this conversation analytic study demonstrates how halts of eating and drinking are carefully configured to preserve contiguity by facilitating completion and repair. Findings expand our understanding of the interdependence between multimodality and sequence organization within the larger context of managing multiactivity and materiality.

Making new technology understandable through multimodal orientations: A digital exercise stick in customer training interaction

With a variety of smart technologies on the market, health technologies have become an increasingly everyday phenomenon. This paper focuses on customer training in the use of a new technological device, a digital mobility stick, which is an exercise stick with a built-in haptic component. It can be used as a measuring and training tool to analyze the body’s ability to balance, bend, and rotate and to guide the trajectory of one’s exercise movements. We focus on the mobility stick as a training tool, investigating how the haptic technology is introduced to the customer in instructional interaction, and what roles the technology obtains in the process. The paper uses video-recorded customer training interaction data from a health technology company. It draws on multimodal conversation analytic research on instructions and instructed actions, objects, technologies, and touch in interaction. We show that the company representative’s specific orientation to the mobility stick was consequential to the instructed actions of the customers and their learning. The analyzed cases also illustrate that the mobility stick gained different roles in the interaction, ranging from a technological and sensorial object to a technology representing information to an active participant in interaction guiding human action. The study thus contributes to our understanding of the multimodality of instructional interaction and the potentially varied roles of technology in such interaction.

“Atypical Interactions” in Healthcare: A State-of-the-Art Literature Review of Conversation-Analytic Research, with Reflections on Equity, Diversity, and Inclusion

ABSTRACT Our state-of-the-art review examines conversation-analytic (CA) research on healthcare encounters in which the patient has a disability that can affect their communication, using the lens of the social relational model of disability. We report findings via the following themes: where (and why) interactional challenges arise, practitioner barriers and facilitators to effective communication, how behaviors interpreted medically as symptoms can be understood as interactional competencies, and understanding the role of companion. We reflect on equity, diversity, and inclusion in CA research, arguing that labeling interactions as “atypical” can lead to assumptions that findings are circumscribed and have no wider applicability. Existing research has focused on specialist settings created for people with one particular condition, overlooking their healthcare interactions with other healthcare services. We argue that CA research on healthcare and beyond should include a more diverse range of interactants and also discuss why. Data in examples are in multiple languages.

Communication in Outpatient Secondary Care: A State-of-the-Art Literature Review of Conversation-Analytic Research

ABSTRACT Our review highlights state-of-the-art conversation analytic (CA) research within adult outpatient secondary care settings and how this research has been applied to clinical practice, provides reflections, and considers fruitful areas for future research. Findings from 128 articles were synthesized according to five clinical activities that have been the focus of CA research thus far: (1) information gathering and patients’ descriptions of their symptoms/condition; (2) information delivery, including test results and diagnosis; (3) decision making about goals, treatment, and future care; (4) interacting about sensitive issues, including patients’ emotions and psychosocial concerns; and (5) managing the interactional role of companions accompanying patients in adult outpatient secondary care appointments. Research in these settings has been used in healthcare policy/guidelines and designing training interventions for clinical practice. Within future CA research in outpatient secondary care, there is scope for more longitudinal studies and further exploring interactions in multidisciplinary care. Data examples are in multiple languages.

Communication in Primary Healthcare: A State-of-the-Art Literature Review of Conversation-Analytic Research

ABSTRACT We report the first state-of-the-art review of conversation-analytic (CA) research on communication in primary healthcare. We conducted a systematic search across multiple bibliographic databases and specialist sources and employed backward and forward citation tracking. We included 177 empirical studies spanning four decades of research and 16 different countries/health systems, with data in 17 languages. The majority of studies originated in United States and United Kingdom and focused on medical visits between physicians and adult patients. We generated three broad research themes in order to synthesize the study findings: managing agendas, managing participation, and managing authority. We characterize the state-of-the-art for each theme, illustrating the progression of the work and making comparisons across different languages and health systems, where possible. We consider practical applications of the findings, reflect on the state of current knowledge, and suggest some directions for future research. Data reported are in multiple languages.

Communication in Palliative Care and About End of Life: A State-of-the-Art Literature Review of Conversation-Analytic Research in Healthcare

ABSTRACT I review conversation analytic research on healthcare interactions in palliative care, and end-of-life preferences and plans conversations in other settings. The review process drew on established systematic review methods. Twenty-two publications were included. Key themes were initiating and managing the topics of dying, of prognosis, and of advance care planning, and interactionally managing emotions. There is substantial, cumulative evidence about patterns and practices for initiating sensitive conversations, managing emotions, and indirectly referring to death. Two of 22 studies examined interactional consequences of companions accompanying patients, and two examined pain assessment. Current evidence is restricted: 21 of 22 studies were in secondary/tertiary care and all were in high-income countries, and most involved specialist physicians. Nevertheless, findings contribute to conversation analytic scholarship on delicacy, emotion in interaction, and indirect reference. Healthcare applications include contributions to training in communicating about sensitive topics and to policy on talking about dying. Data presented are in British English, U.S. English, Canadian English, Swiss-French, and Japanese.

Communication in Pediatric Healthcare: A State-of-the-Art Literature Review of Conversation-Analytic Research

ABSTRACT Communication is central to pediatric care. Conversation analytic (CA) studies of recorded naturally occurring pediatric interactions contribute distinctive understandings; however, to date there has been no detailed review of CA’s unique contributions. We searched Medline, PsychINFO, Sciencedirect, Google Scholar, and the EM/CA Wiki database, identifying 74 empirical articles across diverse areas of pediatrics. Our state-of-the-art review highlights CA of clinician and caregiver conversations about a child patient, in addition to those involving the child. The findings have the potential to enhance clinical practice by illuminating how healthcare tasks are practically accomplished and enrich our knowledge of children’s participation in consultations by revealing the mechanisms that constrain and enable their involvement. We call for better synthesis of findings with broader CA literature (e.g., nonclinical child interactions, adult triadic clinical encounters, and fundamental knowledge of social interaction). We appeal for increased support for scholarly work in non-Western settings, and emphasize scope for applied initiatives. The data reported are in multiple languages.

Using conversation analysis to identify unresponsiveness in peer interactions in inclusive groups

Background: Previous research regarding unresponsiveness in peer interaction, including participants on the autism spectrum (AS), is mainly based on predefined categorizations of unresponsiveness; thus, there is a need for conversation analytic research to examine unresponsiveness from participants’ perspectives. Method: Multimodal conversation analysis (CA) was applied to examine unresponsiveness in task-focused multiparty peer interactions of an inclusive group, including one participant on the AS. Results: The results showed that it was not meaningful to analyze unresponsiveness in situations where there was no (aligning) response and all participants’ orientations revealed that a response was (not) needed. Instead, participants’ discrepant orientations to the response relevance made unresponsiveness a meaningful issue for participants to negotiate. Discussion/conclusion: The CA approach can be useful for examining unresponsiveness accurately. The combination of both the speaker and recipient(s) orientations to response relevance can be used as a conceptual tool to identify unresponsiveness when it is relevant for the participants.

Conversation analysis, institutions, and rituals.

By relating conversation analysis (CA), in particular CA research on institutional interaction to such research traditions as sociological institutionalism, new materialism, and ritual theory, the article illustrates how CA scholarship can contribute to macrosociological theorizing. This argument is illustrated by how national parliaments are organized as institutions. The main point made in the article is that occasions of what CA calls institutional interaction should be considered as rituals. Although those occasions are scripted ceremonial performances wherein social pressure, material conditions, or avoidance of punishment make actors conform, they still play a role in constituting social order by making participants honor the rules and principles codified in an organization's frontstage events. The article also underlines that organizational arrangements do not determine what actors can say or do, but they impose limits and conditions on people's conduct. Finally, the paper suggests that it is through such arrangements of institutional interaction that social structure is created, maintained, and naturalized.

Reporting racism in broadcast interview

AbstractThis study examines invited reports of racism in broadcast interviews. Guided by discursive psychology (DP) and conversation analysis (CA), the investigation focuses on the interactional moments wherein the interviewee (is invited to) describe a racist incident. Expanding existing DP and CA research on complaints of racism, this analysis shows how reported speech is treated by speakers as an indispensable device in reproducing the incident and providing evidence for the racism reported. This investigation provides further evidence for how speakers treat reporting racism as a sensitive business. This is reflected in the interviewee's accounts as they begin by describing the circumstance of the incident, and the interviewer's collaboration in co‐constructing the interviewee's accounts and co‐managing the trajectory of the interview. Overall, the analysis spotlights how an auspicious environment for victims to talk about their experiences of racism is created and fostered at both institutional and interactional levels.

Pronunciation, Grammar, and Vocabulary Explanations in Pedagogical Interaction

This article reviews conversation analytic research on explanations in pedagogical interaction, particularly in language learning classrooms. In reviewing this literature, this paper aims to provide a comprehensive account of what is interactionally involved when giving pedagogical explanations so that future research investigating the effectiveness of these kinds of explanations can be appropriately measured. The paper first discusses characteristics of explanation as interactional phenomena, namely that they are sequentially organized, either planned or unplanned, and either monologically or dialogically organized. Then, the paper details how explanations in three particular linguistic domains (i.e., pronunciation, grammar, and vocabulary) are accomplished interactionally. In doing so, this paper highlights similarities and differences across linguistic domains that are frequently found in language learning classrooms. The paper ends by identifying patterns across pedagogical explanations and by suggesting directions for future research.

Directives to read for self-correction in peer-tutoring consultations for L2 writing

This study examines tutor-initiated error-correction sequences in one-to-one consultations for second language (L2) writing. Using conversation analysis (CA), the paper presents three examples illustrating what the tutor does to help tutees come up with solutions to grammar problems in their essays. The detailed analysis demonstrates how the tutor's directives to read in order to find and solve an L2 grammar issue, along with the tutees’ alignment, create opportunities for the tutees to self-correct. The study explores: (1) how the tutor's directive to read leads a tutee to self-correct; (2) how the tutor manages a tutee's resistance to a directive to read and trouble display through “narrowed-down support”; and (3) how the tutor manages a tutee's trouble display through multiple directives to read. The findings suggest pedagogically useful practices, and contribute to CA research on L2 writing consultations in general and the understanding of tutor-initiated error-correction sequences specifically.

A multimodal perspective on adult learners’ vocabulary explanations in the beginner-level L2 classroom

ABSTRACT Following the current research in conversation analysis in the field of second language (L2) learning, the present study demonstrates that beginner-level adult learners actively contribute to vocabulary explanation sequences by mobilising multimodal resources including depictive gestures, gaze, and short verbal turns. The data consist of video-recordings of whole-class interactions in a beginner-level L2 French classroom for adults with migrant backgrounds. The analysis shows how the depictive gestures deployed by learners serve either to represent concrete words, directly depicting the target item, or, combined with a short verbal explanation, to make more abstract concepts visible by contextualising the target word and associating it with a larger context of use. The findings contribute to a deeper understanding of the functioning of vocabulary explanations in the L2 classroom and, in particular, of the specific participatory dynamics in language classes for beginner-level adult learners.

The Priority Structure behind Overlap of Multi-Person Conversation

This article explores the priority structure underlying overlapping speech in multi-person conversations. While most research on overlapping talk has focused on resolution and management, there remains a gap in understanding multi-party conversations. Drawing on a self-collected corpus of dialogue materials, the author analyzes existing data to examine the influence of underlying priority structures on overlapping phenomena. By delving into the observable implicit communicative structure and regular characteristics, this study sheds light on the prioritization dynamics in multi-person conversations. The findings contribute to conversation analysis research and enhance our comprehension of the complexities involved in managing overlaps in communication.

Differentiating between epileptic and functional/dissociative seizures using semantic content analysis of transcripts of routine clinic consultations

The common causes of Transient Loss of Consciousness (TLOC) are syncope, epilepsy, and functional/dissociative seizures (FDS). Simple, questionnaire-based decision-making tools for non-specialists who may have to deal with TLOC (such as clinicians working in primary or emergency care) reliably differentiate between patients who have experienced syncope and those who have had one or more seizures but are more limited in their ability to differentiate between epileptic seizures and FDS. Previous conversation analysis research has demonstrated that qualitative expert analysis of how people talk to clinicians about their seizures can help distinguish between these two TLOC causes. This paper investigates whether automated language analysis - using semantic categories measured by the Linguistic Inquiry and Word Count (LIWC) toolkit - can contribute to the distinction between epilepsy and FDS. Using patient-only talk manually transcribed from recordings of 58 routine doctor-patient clinic interactions, we compared the word frequencies for 21 semantic categories and explored the predictive performance of these categories using 5 different machine learning algorithms. Machine learning algorithms trained using the chosen semantic categories and leave-one-out cross-validation were able to predict the diagnosis with an accuracy of up to 81%. The results of this proof of principle study suggest that the analysis of semantic variables in seizure descriptions could improve clinical decision tools for patients presenting with TLOC.

The Expert EFL Teachers" Language Operation in and beyond Third-turn Feedback

This paper investigated how experienced English as Foreign Language (EFL) teachers adapt language when giving feedback, especially in large class sizes where learners have low language proficiency. Particular attention was paid to how teachers use language to extend learning opportunities and interactions to the whole class after completing the one-to-one Initiation-response-feedback (IRF) sequence. With the use of classroom videos and Conversation Analysis (CA) research methods, the feedback of three experienced EFL teachers was analyzed intensely. The results revealed that experienced EFL teachers were flexible in adjusting the tone and content of the feedback and, crucially, that in large classes of beginners in language learning. Teachers mostly offered another one-to-many question or interactive invitation immediately after the one-to-one IRF, which extended the learning opportunities and participation to the whole class, i.e., somehow enhancing the learning opportunities and participation of the whole class. Throughout this article, it is hoped that the language used by teachers in large classes mentioned therein will provide some reference and practical techniques for instructors in comparable situations, particularly in providing effective feedback.

Talking about the experiences of racism: A study of reporting racism in broadcast interviews.

This study examines how experiences of racism are talked about during broadcast interviews. Inspired by discursive-psychological and conversation-analytic investigations on experience in interactions, this study approaches experience as a 'loose term' and as a participant's issue in the unfolding sequence of talks. The analysis documents a range of interactional moments wherein experiences are invoked and negotiated over the course of reporting racism in the interviews. The findings align with the existing discursive-psychological and conversation-analytic research on experiences, and provide further evidence on how speakers jointly orient to and manage the issues of who knows and owns an experience, and has the premier authority to claim an experience, in relation to reporting racism. The analysis unveils the intricacy of inquiring and talking about a victim's experience of racism. People's (use of) common sense understanding of the detrimental nature of racism is met and complicated by an orientation to our unlevelled access to an experience of racism, which is a category-based societal problem.

Consultations Preliminary to Interdisciplinary Chronic Pain Rehabilitation

Before patients with chronic pain enter an interdisciplinary chronic pain rehabilitation programme, a team of various healthcare professionals performs a biopsychosocial analysis of their pain problem. To enhance patients’ engagement, the problem analysis is thoroughly discussed with them in order to gain a shared understanding of the nature of their pain problem. This study explores how patients and practitioners talk through their rehabilitation team’s hypotheses regarding the psychosocial factors involved in these patients’ health situation. Nine consultations were recorded at various Dutch interdisciplinary chronic pain rehabilitation units. The recordings were transcribed and analysed, combining an applied conversation analytic research approach with discursive psychology. Patients and practitioners are found to orient to ensuring consensus on the problem analysis as a relevant activity and tend to avoid or minimize the articulation of differences in perspectives. This study also shows that this orientation to consensus involves a delicate management of issues of accountability and blame. Findings can be used by practitioners to consider communication practices that are more likely to encourage patients to voice potential concerns regarding their rehabilitation team’s findings.

A conversation analysis of therapist repeats in open dialogue network meetings.

Writings on Open Dialogue approaches to working with families experiencing mental distress emphasize the importance of the therapist repeating the family's words back to them verbatim. Repeats are theorized to display the therapist's listening and to encourage elaboration without imposing the therapist's own interpretations or conclusions on the family. These recommendations have not been subjected to rigorous interactional investigation. In this study, we used conversation analysis to analyze 160 examples of therapists repeating the prior talk of the family from 14h of video-recorded Open Dialogue sessions. We found that these repeats had similar functions to those previously described in conversation analysis research such as initiating repair, marking receipt, and requesting elaboration as well as examples of therapist repeats occurring in overlap with the talk of the client. Open Dialogue writings thus present an oversimplified account of how repeats are utilized in clinical Open Dialogue sessions. Consistent with dialogical writings, repeats can elicit elaboration with limited input from the therapist, however repeats reflect selectivity and function to direct and guide the conversation to some extent. So, while therapist authority can be mitigated by repeating clients' words, when a therapist chooses to employ a repeat actively shapes the direction of the interaction.

”SO YOU’RE TELLING ME . ”: PARAPHRASING (FORMULATING), AFFECTIVE STANCE, AND ACTIVE LISTENING

ABSTRACT Paraphrasing is one of the core practices associated with active listening. While its use is widely advocated, research on its efficacy shows limited results. Paraphrasing-like actions have been studied extensively in conversation analytic research under the term formulations. Building on that tradition, this article features a conversation analysis of the affective stance that paraphrasing turns display toward their referents. Primary data drawn from a podcast series, Conversations with People Who Hate Me, are supplemented with instances drawn from mediation and a medical interview. Affiliative paraphrases feature components such as positive assessments, empathy displays, and shared laughter. Neutral paraphrases withhold markers of positive or negative orientation to their referents. Disaffiliative paraphrases restate what was said before in ways that convey skepticism or leave the prior talk vulnerable to criticism. Ambiguous paraphrases may reflect both affiliative and disaffiliative components; responses provide evidence for how recipients orient to their stance. Affiliative and neutral paraphrases may most closely approach the spirit of active listening. Greater understanding of how stance shapes paraphrasing can enrich research and practice in active listening.