Interactional Trouble Research Articles

Missing Responses as an Interactional Warning Sign

In this study, we aim to find out what happens in moments of collaborative situations when a response is treated as missing, irrelevant, or insufficient, how such moments are handled, and what underlying interactional trouble those instances can reveal. The data are video recordings from multinational military observer training. Using the method of ethnomethodological conversation analysis (EMCA), we examine a team of two people taking part in a simulated patrolling exercise. We focus on instances when one team member, the driver, attempts to get the other, the team leader, to verbalise or confirm some decision regarding a future (joint) action.

‘Troubling’ medication reviews in the context of polypharmacy and ageing: A linguistic ethnography

Healthy ageing is a global priority. Polypharmacy (the use of 5+ medicines) amongst older people is increasing, with over one-third of adults in England, aged 80–89, prescribed at least eight medications. Although sometimes necessary, polypharmacy can be harmful; the risk of harm increases with age and number of medicines prescribed. Medication reviews are recommended as one way of reducing the potential harms of polypharmacy although evidence of clinically significant benefit of medication reviews as currently delivered is limited. What happens in medication reviews in practice is poorly understood.We used a linguistic ethnography approach to explore how medication reviews proceed and what is accomplished during these consultations. We studied 18 video-recorded medication review consultations from three general practices in England. The consultations involved patients aged 65 or older, prescribed 10+ medications (‘higher risk’ polypharmacy), and primary care clinicians (general practitioner or clinical pharmacist). Video-recordings were gathered as part of a wider ethnographic study investigating practices of polypharmacy in primary care between 2017 and 2021. We conducted microanalysis of consultation data, drawing on our ethnographic knowledge of the organisational, institutional and domestic contexts of polypharmacy to inform our interpretation of these interactions.Consultations were time-consuming and involved lengthy stretches of interactional trouble: non-understandings; misunderstandings; misalignments. These stretches revealed profound uncertainties as to the effectiveness of medicines in the context of multimorbidity and polypharmacy. These uncertainties seeped further into ‘troubles talk’ concerning patients' existential concerns relating to enduring illness, ageing and mortality. Although these existential concerns were partially articulated, clinicians and patients left such troubles talk unelaborated, unresolved and unfinished. Participants succeeded in smoothing over interactional difficulties and maintaining respectful relationships but often fell short of addressing problematic polypharmacy more directly.

When Good News Falls Flat: Complications in the Delivery and Reception of Good News in Pediatric Neurology

This article considers interactional trouble that arises when the social distribution of knowledge and interpersonal relationships come together in the delivery and reception of good news in pediatric neurology visits for video-electroencephalography testing. Contrary to common perceptions of good news as easy to deliver and receive, I find that it is occasionally fraught with hesitancy in this context. Using conversation analysis, I explore what drives this trouble and argue that some of the difficulty associated with good news in this context arises from its structure: Physicians prioritize conveying “the facts” of the news over characterizing its valence. However, parents treat physicians’ assessments of the news as critical for the news delivery. When physicians fail to evaluate the information they present, parents tend to treat news deliveries as incomplete, which not only causes difficulties in their reception of the news but also leads to protracted news deliveries.

“We are just not sure what that means or if it's relevant”: Uncertainty when gathering family history information in South African prenatal genetic counseling consultations

Uncertainty impacts the process of health communication. The management and tolerance of uncertainty during healthcare discussions have gained renewed focus due to the growing challenge of obtaining and delivering complex health information, and the offer of health services in diverse contexts. Prenatal genetic counseling (GC) provides education, support and testing options for patients and couples facing a genetic or congenital diagnosis or risk during pregnancy. Gathering detailed and accurate family history information is essential to determine a patient's genetic risk. In South Africa, contextual factors such as patient literacy, language diversity, limited written patient health records, and a lack of familiarity with GC services may increase the potential for misunderstandings during GC consultations. This study uses a qualitative sociolinguistic approach to analyse 9 video-recorded South African prenatal GC consultations to understand the impact of uncertainty on the process of gathering family history information. The findings reveal uncertainty is introduced in different ways during family history taking. This includes when patients have no knowledge about their family history; when they have some knowledge but the details are unclear; or when patients have knowledge but the details are confusing. Uncertainty can lead to interactional trouble in the form of knowledge asymmetries, interrogative questioning, reversals in epistemic authority, and the potential for mistrust. Suggestions are made for how genetic specialists can manage uncertainty in GC family history taking. These include recognizing contextual sources of uncertainty, understanding how patients may respond to uncertainty and being aware of personal responses to moments of discomfort. Specific communication training recommendations and video-based sociolinguistic methods to enhance reflection and communication practice are highlighted. These approaches may enhance the effectiveness of GC communication and strengthen patient-specialist relationships, especially in diverse settings.

Collaborative turn-construction practices of people with primary progressive aphasia and their family conversation partners

Background: Primary progressive aphasia describes a group of three rare language-led dementias: semantic, logopenic, and non-fluent. The small number of conversation analysis studies to date suggest that repair and turn-construction practices in primary progressive aphasia are similar to those seen in post-stroke aphasia. This study investigates the collaborative aspect of these practices between people with primary progressive aphasia and their conversation partners. Method: Conversation analysis was used to investigate collaboration in repair and turn-construction practices in 10-minute video recordings of natural conversation collected from two dyads, one with logopenic and one with mixed primary progressive aphasia. Results: This study demonstrates that people with primary progressive aphasia have a range of practices available to construct their turns, and that their conversation partners collaborate to co-construct talk. Discussion: Findings demonstrate that collaboration can support interaction or lead to further interactional trouble. Collaborative practices are important targets for speech and language therapy interventions.

Conversation Analysis Based Simulation (CABS): A method for improving communication skills training for healthcare practitioners.

Actors portraying simulated patients are widely used in communication skills training in healthcare, but debates persist over the authenticity of these interactions. However, healthcare professionals value simulation-based training because of the opportunity to think and react in real time, which alternatives cannot provide. To describe a method for the use of simulation which maximises authenticity by grounding training in real, observed, patterns of patient communication. Naturally occurring care interactions were video recorded and analysed using conversation analysis (CA) to identify communication patterns. We focused on sites of recurring interactional trouble as areas for training, and identified more and less effective ways of dealing with these. We used the CA findings to train actors portraying simulated patients, based on the observed interactional patterns. Patients living with dementia and healthcare practitioners (HCPs) on two acute healthcare of the elderly wards in the English East Midlands. One month later HCPs reported using the skills learned in clinical practice. Masked-ratings of before and after simulated patient encounters confirmed these self-reports in relation to one key area of training. The Conversation Analysis Based Simulation (CABS) method used in this setting showed positive results across a range of quantitative and qualitative outcome measures. What is significant for the transferability of the method is that qualitative feedback from trainees highlighted the ability of the method to not only illuminate their existing effective practices, but to understand why these were effective and be able to articulate them to others. While the CABS method was piloted in the dementia care setting described here, it has potential applicability across healthcare settings where simulated consultations are used in communication skills training. Grounding simulated interaction in the observed communication patterns of real patients is an important means of maximising authenticity. The VideOing to Improve dementia Communication Education (VOICE) intervention which piloted the CABS method was developed by a multidisciplinary team, including three carers of people with dementia. People living with dementia were involved in the rating of the before and after video simulation assessments.

O.15.2 - Interactional trouble and compassion during clinical assessments: A conversation analytic study.: Presenter(s): Rachael Drewery, University of Nottingham, United Kingdom

O.15.2 - Interactional trouble and compassion during clinical assessments: A conversation analytic study.: Presenter(s): Rachael Drewery, University of Nottingham, United Kingdom

Keeping the conversation going: How progressivity is prioritised in co-remembering talk between couples impacted by dementia.

This article explores how partners keep the conversation going with people living with dementia (PLWD) when speaking about shared memories. Remembering is important for PLWD and their families. Indeed, memory loss is often equated with identity loss. In conversation, references to shared past events (co-rememberings) can occasion interactional trouble if memories cannot be mutually recalled. This article analyses partners' interactional practices that enable progressivity in conversations about shared memories with a PLWD. In previous research, both informal and formal carers have reported that they can find interacting with PLWD difficult. Identifying practices used by partners is one way to begin addressing those difficulties. Analytical findings are based on over 26 hours of video data from domestic settings where partners have recorded their interactions with their spouse/close friend who is living with dementia. The focus is on 14 sequences of conversation about shared memories. We show how particular practices (candidate answers, tag questions and single-party memory of a shared event) structure the interaction to facilitate conversational progression. When partners facilitate conversational progressivity, PLWD are less likely to experience stalls in conversation. Our findings suggest the actual recall of memory is less relevant than the sense of shared connection resulting from the conversational activity of co-remembering, aiding maintenance of individual and shared identities. These findings have relevance for wider care settings.

You people: Membership categorization and situated interactional othering in BigBank

AbstractThis paper offers an ethnomethodological membership categorization analysis (MCA) of an episode of argumentative talk in a bank, between a recent Indian migrant and her white British area manager. MCA examines how members use categorizations in the course of their everyday practical activities including workplace meetings. Our analysis shows how the “interactional trouble” between an employee and manager leads to the manager racially Othering the employee by invoking attributes resonant with what researchers call coloniality. Although theories of everyday racism and microaggression focus on everyday interactions, attention is not usually given to the moment‐by‐moment, turn‐by‐turn interactions and racial categorizations. In contrast, the MCA of our case study enables us to explicate the complexities of racializing and re‐colonizing work in specific organizational encounters. Racist interactions in organizations are complex, contestable, and draw on various shared categories, resources, and knowledges deployed to achieve situated institutional aims. In our in‐depth, close analysis of a relatively short interaction, we are able to reveal the institutional, gendered, racial, and colonial categories, and institutional and colonial devices that were made relevant; enabling us to explicate how racism works in the organizational every day. Studies of racist interactions stress there are specificities to the categories mobilized in organizational settings for example, parents, neighbors, race, and ethnicity and therefore the forms of racism produced. Our article contributes to studies of everyday racism in the workplace by showing the specific categories and devices―such as English, Indian, English Economy―mobilized turn‐by‐turn which led to a racially minoritized member of staff being interactionally Othered by the white manager in ways which not only does interpersonal harm but leads to her exclusion and dehumanization. We show how ethnomethodology and MCA are very useful, but somewhat neglected approaches, for learning about racism, coloniality, and gender in mundane, everyday workplace interactions.

Teacher epistemic stance as a trouble in foreign language classroom interaction

In foreign language learning, students are commonly encouraged to share their experiences, opinions and beliefs. Such actions position the teacher as an interactant with no access to this knowledge unless the student makes it publicly available. At the same time, it is normatively expected that teachers have primary access to knowledge related to their responsibilities as language experts. Such contextual constraints shape classroom interaction within which moments of epistemic incongruence may arise as, for example, when an epistemic stance is not in line with the assumed epistemic status. Taking a conversation analytic approach, this study aims to investigate teacher epistemic stance as a source of trouble that emerges during episodes of meaning-and-fluency foreign language classroom interaction. The analysis reveals that incongruent teacher epistemic stance unfolds in two ways: 1) when students have initiated a word-search that must be repaired by the teacher, and 2) when the teacher inaccurately anticipates some information pertaining to the students' territory of knowledge. In both cases, the teacher displays an epistemic stance that is seen to be incongruent with the participants’ epistemic statuses. Findings also indicate that these episodes require certain repair work to resolve the resulting dissonance to which the interactants orient.

“I don’t have an address”: Housing instability and domestic violence in help-seeking calls to a support service

Increasing recognition of the long-term negative impacts of gendered violence has led to the establishment of a variety of social support services. Feminist research has examined the barriers that prevent women from accessing these services and the problems women report getting the help they need. However, little is known about what happens in situ when women interact with support services. This paper is a novel empirical investigation of naturalistic social interactions where women seek help with problems resulting from violence at home. We used conversation analysis to examine how problems of housing instability and help-seeking unfolded in recorded telephone calls to a victim support service. We found that the routine institutional practice of asking for an address posed interactional trouble for women who were seeking to leave violence, had left a violent home, or were homeless as a result of violence. When answers could not be provided, callers’ responses included disclosures of violence or challenges to the meanings of address. Our findings point to an interactional burden that women confront in institutional interactions. We suggest institutions should carefully consider how routine practices such as asking for an address might pose unintended problems for service users in vulnerable circumstances.

When people living with dementia say 'no': Negotiating refusal in the acute hospital setting.

A quarter of UK acute hospital beds are occupied by people living with dementia (PLWD). Concerns have been raised by both policy makers and carers about the quality of communication between hospital staff and PLWD. PLWD may experience communication impairments such as word finding difficulties, limited ability to construct coherent narratives and difficulties understanding others. Since much healthcare delivery occurs through talk, healthcare professionals (HCPs) and PLWD are likely to experience increased communication barriers. Consistent with this, HCPs report stress and reduced job satisfaction associated with difficulty communicating with PLWD. HCPs face these challenges whilst striving to deliver person-centred care, respecting the autonomy and wishes of the patient before them. However, best practice recommendations in the field tend not to be based on actual interactional evidence. This paper investigates recurring interactional difficulties around HCP requests to carry out health and social care tasks and subsequent reluctance or refusal on the part of PLWD. Using conversation analysis, we examined 41 video recordings of HCP/PLWD interactions collected across three acute inpatient wards. We identify both the nature of the refusals, and any mitigation offered, and explore the requests preceding them in terms of entitlement and contingency. We also explore the nature of HCP requests which precede PLWD agreement with a course of action. We conclude that several features of requests can be seen to precede acceptance, principally the use of higher entitlement requests, and the lowering of contingencies. Our findings underline the importance of examining the contextual interactional detail involved in the negotiation of healthcare, which here leads to an understanding of how design of HCP requests can impact on an important healthcare activity being carried out. They also emphasise the power of conversation analytic methods to identify areas of frequent interactional trouble in dementia care which have not previously been articulated.

Resolving interactional troubles and maintaining progressivity in paired speaking assessment in an EFL context

Any form of talk-in-interaction is organized in relation to progressivity (Schegloff, 2007; Hosoda & Aline, 2013). Progressivity of interaction may involve resolving interactional troubles and producing subsequent talk, and it is endemic to the organisation of conversation at the level of turn construction (Schegloff, 1979). In testing speaking skills, as progressivity of talk between peers is central for teachers to be able to assess students’ performances, troubles that halt progressivity and the resolution of such troubles by the students deserve close analyses. Against this background, this paper focuses on how paired L2 (i.e., English) speaking assessment interactions unfold in a Turkish higher education context. Using multimodal conversation analysis, we investigated the interactional resources that are deployed to maintain progressivity when there is a halt in the unfolding interaction, an under-researched phenomenon in L2 speaking assessment contexts. We used transcriptions of 100 video-recorded paired test interactions, each of which were approximately four minutes long. We identified and described the ways interactional trouble was flagged, paying close attention to how embodied resources, such as hand and other gestures, gaze direction, posture and body orientation, and facial expressions (Nevile, 2015), are used by the interactants. Based on 100 paired assessment interactions our findings reveal that in moments of interactional trouble participants make transitions to a sub-topic, formulate understandings, and engage in collaborative completions to maintain progressivity, using a variety of interactional resources as part of their interactional repertoires. The ways such troubles unfold in interaction and how they are resolved by L2 users to maintain progressivity of test-talk have potential to inform research on the assessment of Interactional Competence.

An Automated Approach to Examining Pausing in the Speech of People With Dementia.

Dementia is a common neurodegenerative condition involving the deterioration of cognitive and communication skills. Pausing in the speech of people with dementia is a dysfluency that may be used to signal conversational trouble in social interaction. This study aimed to examine the speech-pausing profile within picture description samples from people with dementia and healthy controls (HCs) within the DementiaBank database using the Calpy computational speech processing toolkit. Sixty English-speaking participants between the ages of 53 and 88 years (Mage = 67.43, SD = 8.33; 42 females) were included in the study: 20 participants with mild cognitive impairment, 20 participants with moderate cognitive impairment, and 20 HCs. Quantitative analysis shows a progressive increase in the duration of pausing between HCs, the mild dementia group, and the moderate dementia group, respectively.

“Context collapse” on a small island

Abstract Commentators and analysts in new media studies have taken inspiration from Goffman’s ‘dramaturgical’ approach to interaction as performance, as well as his concepts of ‘face’ and ‘impression management’. Goffman is specifically invoked in discussions of a particular source of interactional trouble that is seen as generated in and by the structure of mediated communication in digital spaces: so-called “context collapse.” Context collapse represents “a crisis of self-presentation” (Wesch, 2008) that is brought about by the ability of digital platforms like Twitter and Facebook to “flatten multiple audiences into one” (Marwick & boyd, 2010, p. 9). Returning to Goffman’s unpublished PhD dissertation (Goffman, 1953) – based on fieldwork on the remote island of Unst in the Shetlands – presents an opportunity to understand more fully both the online phenomenon of “context collapse” and the promise and limitations of Goffman’s work for the study of interaction in digital environments.

How to Disengage: Suspension, Body Torque, and Repair

ABSTRACTThis article uses conversation analysis to study other-initiated repair in multiactivity situations. The article focuses on two aspects of the repair initiator’s embodied conduct directly connected to the initiator’s involvement in multiactivity: body torque and the suspension of a parallel manual activity. The analysis reveals how the body torque and suspension of manual activity, when co-occurring with other-initiations of repair, display the OIR-speaker’s temporary disengagement from the manual activity and how this embodied conduct communicates downward prioritization of the manual activity and increased involvement in the interaction. This article shows that, to participants in a conversation and simultaneously involved in multiactivity, solving interactional trouble is prioritized over the progression of the parallel manual task and that this hierarchization of activities displays a strong preference toward restoration and maintenance of intersubjectivity. Data are in English and in French with English translation.

Reconsidering self-deprecation as a communication practice.

‘Self‐deprecation’ (SD) is widely understood within social psychology and popular culture as a form of self‐talk that reflects a cognitive state, such as low self‐esteem or negative self‐regard. However, most research on SD suffers theoretical and methodological problems that fail to account for how its cognitive and linguistic aspects can be reconciled. We know little about SD as it occurs in interactional settings. Utilizing a conversation analytic (CA) perspective that brackets cognitive explanations for linguistic phenomena, this paper draws on more than 100 hours of transcribed recordings of interactions from diverse settings to systematically examine the form and function of a common class of SD: critical comments by a speaker on their current talk or actions (self‐deprecatory meta‐comments; SDMCs). Analyses demonstrate that SDMCs are used in environments of possible or actual interactional trouble, and manage this trouble in different sequential positions. The paper shows that SDs can be treated as a communication practice. Rigorous analysis of SDMCs can enrich understanding of the construction of ‘identities’ in talk. It advances a CA understanding of the ascription of social actions, and the preference for self‐criticism over criticism by others. Findings suggest that widespread advice to self‐deprecate less may be invalid.

‘Well let me put it uhm the other way around maybe’: Managing students’ trouble displays in the CLIL classroom

ABSTRACTThis study is concerned with repair practices that a teacher and students employ to restore intersubjectivity when faced with interactional problems in a Content and Language Integrated Learning (CLIL) classroom. Adopting a conversation analytic (CA) approach, it examines the interactional treatment of students’ verbal and embodied trouble displays in a video-recorded, teacher-fronted geography lesson held in English at a German high school. At the same time, it explores to what extent the repair practices employed are fitted to this specific interactional context. The analysis shows that students’ verbal trouble displays often result in extensive repair sequences, whereas students’ embodied trouble displays are usually met with teacher self-repair in the transition space. In this way, the latter are resolved much earlier and more quickly. The study further reveals practices like reformulation and translation to be especially useful for repairing interactional problems in classrooms in which a foreign language is used as the medium of instruction. The findings may be of interest for prospective as well as practicing teachers in that they provide relevant insights into how interactional trouble can be successfully managed in (CLIL) classroom interaction.

Negotiating the terms of engagement: Humor as a resource for managing interactional trouble in after-school tutoring encounters

This paper examines how tutors and tutees negotiate the terms of their engagement within the context of an after-school program in the United States of America that pairs university students with immigrant children from Bangladesh for the purpose of working through the children's homework assignments. Drawing on insights and approaches from linguistic ethnography, it argues that humor plays a meaningful yet overlooked role both in managing the transactional and interpersonal dimensions of homework help sessions and in illuminating the ongoing tensions and uncertainties at various levels of social organization that tutors and tutees encounter as they engage with one another. Likewise, it shows how a focus on humorous talk can illuminate aspects of tutees’ communicative repertoires as emergent bilinguals that may go unnoticed when only serious talk is considered. The paper ends with a discussion of the implications of this study's findings for the preparation of tutors working in bi/multilingual settings.

Solo or shared laughter in coparticipant criticism in Japanese conversation

This study employs conversation analysis to examine solo production and sharing of laughter in the delivery and reception of coparticipant criticism in Japanese conversation. I argue that whilst laughter is routinely used by either the deliverer or recipient of criticism, it may be dispreferred for laughter to be shared by both parties with reference to a given criticism. Moreover, whereas solo laughter by either the deliverer or recipient of criticism tends to lead to a relatively speedy resolution of a criticism sequence, shared laughter between deliverer and recipient may signal interactional trouble and take considerable work to resolve. Such patterns suggest that even though criticising is itself a dispreferred action, shared laughter by both parties is potentially markedly dispreferred. Preliminary results of this investigation point to the possibility that interactional work performed by laughter may be more widely shared across different cultural and linguistic environments than previously assumed