Learning to talk and talking about talk - Medical Technologies and the Life World - page 26

One group member, often the supervisor or the student who conducted the
interview, then stopped the tape at a point that they thought illustrated the
initially formulated problem, or some other critical aspect of the interview
situation. Then discussion started and often focused on two aspects. First the
student's problem had to be identifi ed and formulated into a learning need,
and secondly some form of remedial action had to be suggested. These two
foci formed the basis of the group discussion.
Interaction problems discussed in the groups
A wide range of recurring problem areas connected with interviewing
patients in a professional way was discussed in the groups. The identifi cation
of the problem and the specifi cation of an appropriate remedial action
were embedded in a dynamic process that recurred on several sources -
the videotape, the student's perceptions, and impressions by other group
members - and were interwoven with the discussion of possible solutions. It
was common for several problems from different areas to be formulated in
the course of the discussion, before they were discussed in an exhaustive way
and before solutions were found. Some problems remained unanswered or
were reacted to with a long time delay.
The degree of active involvement by the peer group and the supervisors
also varied with the kind of problem, and the discussion level oscillated
between the student's own diffi culties and general refl ections about the
topic.
Basically three different types of problems tended to recur in the
discussions. The fi rst type was problems related to communicative skills , like
being able to organize and lead the interview, keep to the agenda, and so on.
The second type of problem had to do with the transformation of identity ,
that is, learning to differentiate between the private and personal on the
one hand and the professional on the other hand. This includes learning
to see both oneself and the patient within the framework of a professional
relationship. It also includes learning self-refl ection ; i.e. how to talk about
talk in a group of colleagues.
The communicative technologies used in medical practice as well as in
other settings all take everyday talk and communicative practices as their
- often implicit - foundation. Learning to develop new ways of talking with
patients is then basically about using everyday practices in new ways (see the
discussion in Drew and Heritage 1992).
In everyday talk, both parties contribute to and negotiate the situation of
what they are doing, what they are talking about, etc. Talk between doctor
and patient, on the other hand, is defi ned by institutional and professional
norms and constraints, tasks and goals, and imposes certain expectations
and roles on both doctor and patient. In everyday talk, the interaction
between the participants is negotiated and in most cases turns are fairly
even distributed in terms of who talks the most or who decides what to talk