Biomedical Engineering Reference
In-Depth Information
about. In the doctor/patient talk, it is the doctor who sets the agenda, who
conducts the interview and decides when and what to talk about. That is,
asymmetric relations in the medical professional context replace the more
or less symmetrical relations between participants in everyday conversations
(cf. Drew and Heritage 1992; Sarangi and Roberts 1999).
This means that medical students have to learn to interact in new ways
in the medical interview situation. The symmetrical relation has to be
developed into an asymmetrical one. This is not a simple cognitive task of
just learning to think and act differently; rather it involves a changed self- and
role-perception on the part of the medical student. As a consequence it also
means developing a new kind of relationship to persons as patients. It also
implies learning to
violate
certain fundamental interactional rules. Instances
of this rule violation include not telling a story about your own medical
problems in response to the patient telling his/her story, or being able to
interrupt patients in order to get specifi c kinds of answers to your questions,
or being able to ask about sensitive topics, like family life or sexual matters.
If some everyday practices are violated others are
overemphasized
. This
may include being very careful about the opening and the closing of the
encounter in order to give the patients or clients the opportunity to express
their concerns and questions and check if they want to bring up something
more. Being aware of and using non-verbal communicative resources is
another example. This includes everything from the way the physical setting
is organized and how the participants face each other, to the way eye contact
and intonation are handled (see Heath 1986; Hydén and Baggens 2004).
Some of the problems that surfaced in the group discussion had to do
with the fact that the medical students had to redefi ne their relationships
with other persons in the medical context - especially with patients, but
also with other types of medical professionals. They are no longer just one
person meeting another person, being able to talk about things like physical
problems, but rather a medical doctor encountering a patient who expects
and demands professional help. Learning to become a medical doctor
involves changing situational defi nition and interactional format in talk.
Finally, a central aspect of learning to communicate professionally is
developing a professional
identity
that is refl exive and is different from one's
private identity. This is accomplished in many ways (cf. the classical study
by Becker
et al
. 1961/1977), but most importantly through the way talk
is organized (Hydén 2000). Learning, for instance, to distinguish between
the professional and personal voice, and listening to and interacting with
patients not as fellow human beings but as patients, means developing a
new professional identity. Learning modern communicative techniques also
means learning to be self-refl ective about interaction and language use, and
developing skills for discussing these issues with other colleagues. In other
words, the identity that is developed not only has the classical attributes of
professional identity but is also, most importantly, self-refl ective.
In the following we give some examples from the group discussions.
