Making the most of video recorded clinical encounters: Optimizing impact and productivity through interdisciplinary teamwork

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Description

Patient-clinician interactions are central to technical and interpersonal processes of medical care. Video recordings of these interactions provide a rich source of data and a stable record that allows for repeated viewing and analysis. Collecting video recordings requires navigating ethical

Patient-clinician interactions are central to technical and interpersonal processes of medical care. Video recordings of these interactions provide a rich source of data and a stable record that allows for repeated viewing and analysis. Collecting video recordings requires navigating ethical and feasibility constraints; further, realizing the potential of video requires specialized research skills. Interdisciplinary collaborations involving practitioners, medical educators, and social scientists are needed to provide the clinical perspectives, methodological expertise, and capacity needed to make collecting video worthwhile. Such collaboration ensures that research questions will be based on scholarship from the social sciences, resonate with practice, and produce results that fit educational needs. However, the literature lacks suggested practices for building and sustaining interdisciplinary research collaborations involving video data. In this paper, we provide concrete advice based on our experience collecting and analyzing a single set of video-recorded clinical encounters and non-video data, which have so far yielded nine distinct studies. We present the research process, timeline, and advice based on our experience with interdisciplinary collaboration. We found that integrating disciplines and traditions required patience, compromise, and mutual respect; learning from each other enhanced our enjoyment of the process, our productivity, and the clinical relevance of our research.

Date Created
2021-10-01
Agent

The role of modals in policies

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Description

The present study uses corpus-assisted discourse analysis to examine the role of modality in policy verb phrases, using California opioid policies as a case study. By tracking the behavior of permissive and restrictive modals across time, this study highlights two

The present study uses corpus-assisted discourse analysis to examine the role of modality in policy verb phrases, using California opioid policies as a case study. By tracking the behavior of permissive and restrictive modals across time, this study highlights two potential discourse functions of modals in policy drafting: (i) to reflect the gravity of the issues on the ground, and (ii) to express permission and restriction by highlighting and deemphasizing a policy's suggestive intent, respectively. This study shows that the increased use of restrictive modality has significant positive correlations with California's worsening opioid crisis and its rising fatalities. A closer examination of state policy amendments reveals that altering policy modals has the potential to either broaden or limit the terms of existing policies. Informed by Van Dijk's “context models,” this study provides a cogent applied corpus linguistics framework for analyzing policy text and offers both political and linguistic perspectives into our understanding of modals and how communities address epidemics, respectively.

Date Created
2021-12-15
Agent

Let's talk about pain and opioids: Low pitch and creak in medical consultations

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Description

In recent years, the opioid crisis in the United States has sparked significant discussion on doctor- patient interactions concerning chronic pain treatments, but little to no attention has been given to investigating the vocal aspects of patient talk. This exploratory

In recent years, the opioid crisis in the United States has sparked significant discussion on doctor- patient interactions concerning chronic pain treatments, but little to no attention has been given to investigating the vocal aspects of patient talk. This exploratory sociolinguistic study intends to fill this knowledge gap by employing prosodic discourse analysis to examine context-specific linguistic features used by the interlocutors of two distinct medical interactions. We found that patients employed both low pitch and creak as linguistic resources when describing chronic pain, narrating symptoms, and requesting opioids. The situational use of both features informs us about the linguistic ways in which patients frame fraught issues like chronic pain in light of the current opioid crisis. This study expands the breadth of phonetic analysis within the domain of discourse analysis, serving to illuminate discussions surrounding the illocutionary role of the lower vocal tract in expressing emotions.

Date Created
2019-12-19
Agent

Face-saving strategies and the burden of opioid policy enactments: When physicians' compliance makes patients non-compliant

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Description

The escalation of the opioid epidemic in the United States has sparked sweeping legislation meant to regulate physicians' opioid prescribing practices. The demands of such policies force physicians to initiate discussions that could jeopardize the collaborative doctor- patient relationships necessary

The escalation of the opioid epidemic in the United States has sparked sweeping legislation meant to regulate physicians' opioid prescribing practices. The demands of such policies force physicians to initiate discussions that could jeopardize the collaborative doctor- patient relationships necessary for curbing inappropriate opioid prescriptions. Drawing on sociopragmatics, this discourse analysis study of primary care interactions examines the face- saving linguistic features employed by physicians in negotiating the line between policy demands and maintaining collaborative relationships. The findings reveal several face-saving acts‚"pseudo requests, downtowners, broadening, redirection, tag questions, impersonalization, listing, and (negative) imagery‚"used by physicians when enacting the three most prominent policies: (1) monitoring opioid use, (2) prescribing anti-overdose medication, and (3) transitioning patients from opioids to alternative treatment. Informed by Goffman's concept of "face-work," this study provides evidence of the communicative burden placed on physicians implementing disagreeable opioid policies, as well as opening up discussions on how policymakers and medical institutions can support physicians in implementing opioid policies. Keywords: opioids, face-work, face threats, medical discourse, doctor-patient interaction, discourse analysis, sociopragmatics

Date Created
2023-01-18
Agent