Lecture Sessions
Announced
Led by Professor
Srikant Sarangi (Cardiff University, UK), an internationally renowned
scholar in the field of health communication, each day will include lectures
introducing specific analytic frameworks, followed by hands-on data sessions
and plenary discussions. Professor Sarangi has announced the titles of his
lecture sessions:
Session 1: Healthcare communication research: an overview of themes and methodological/analytical
approaches
For quite some time health and social care has been the
locus of research across a number of disciplines in the human and social
sciences covering core themes, e.g., social psychological aspects of coping;
narratives of illness; cultural models of health belief; sociological studies
of medical ideology and power relations; media studies of health and disease
representations; public understanding of science and medical technology;
ethical issues surrounding decision-making; access to e-health; health inequalities
etc. Language/communication-based studies – concerned with talk, text and other
modalities – have been carried out over the past four decades, both within quantitative
and qualitative research paradigms. The shift to patient-centred healthcare
delivery has triggered interest in the centrality of the communicative and therapeutic
relationship between the healthcare provider and the client/patient. This has
led to the inclusion of communication skills teaching within the medical curricula
in many countries, but such educational programmes pay scant attention to the
dynamic ways in which language/communication mediates actions, expert/lay roles
and decisional outcomes in situated contexts where institutional, professional and
everyday spheres intersect.
This session offers an overview of different
communication research traditions which
engage with healthcare encounters. Building on
interaction process analysis, one can
undertake the coding of encounters between healthcare
professionals and
clients/patients using the Roter Interaction Analysis
System (RIAS). From a microinteractional perspective (Mishler 1984, Roberts and
Sarangi 2005), the RIAS codes may be seen as reducing the meaning of
conversational data to simplistic, pre-set categories devoid of contextual
richness (Sarangi 2010a). In adopting a discourse perspective, a proposal is
made to consider healthcare interaction as an expert system (Sarangi 2010a,
2010b), sensitive to different medical sub-specialties.
Session 2: Communication in the clinic: activity analysis
The notion of ‘activity type’ – which emphasises that our
use of language is goaldefined and socially constituted, with constraints on
who can say what to whom and the specific inferences that follow – is a useful
starting point for characterizing healthcare encounters (Sarangi 2000).
Activity types are made up of discourse types: while activity type is a means
of characterising settings (e.g., medical consultation, service encounter,
university seminar), discourse type is a way of characterising the forms of
talk (e.g., small talk, medical history taking, promotional talk,
crossexamination, troubles telling etc), thus contributing to interactional
hybridity.
Building on the original proposal for a theme-oriented
discourse analysis (Roberts
and Sarangi 2005), I propose a model of activity analysis
(Sarangi 2000, 2010a, 2010b) which is distinctive in at least three ways:
mapping of structural, interactional and thematic trajectories; relationality
concerning focal themes and analytic themes; and role performance vis-a-vis
participant structure. We will consider extended sequences of healthcare
encounters for purposes of mapping, with attention paid to
focal and analytic themes.
Session 3: Communicating health and illness: accounts analysis
Patients’ experience of illness is routinely elicited in
research interview settings. Within the framework of theme-oriented discourse
analysis, I consider research interview as a situated activity type with
identifiable interactional and rhetorical configurations (Briggs 1986, Mishler
1986) and as accounts comprising justifications and excuses (Scott and Lyman
1968). So, what kind of analytic lens should we use when representing and
interpreting interview data? As Mishler (1986: vii) rightly points out: `How we
make that representation and the analytic procedures we apply to it reveal our
theoretical assumptions and presuppositions about relations between discourse
and meaning’.
In adopting a rhetorical discourse approach
(Arribas-Ayllon, Sarangi and Clarke 2011), in this session we explore how
patients’ accounts of illness include justifications and excuses for allocating
blame and responsibility with regard to their subjective contextualisation of
illness on a cline from short-term interruption to long-term coping mechanisms.
We will examine illustrative illness experiential accounts to explore some of
the interpretive nuances surrounding any interview corpus.
Session 4: Health communication: cultural and ethical perspectives
Culture as a significant variable in the
conceptualisation of health and illness has long been the mainstay of medical
anthropology. Themes range from epidemiology to aetiology, from symptoms
description and pain management to decision-making and compliance behaviour.
Morris (1998) persuasively characterises illness as a ‘biocultural’ phenomenon
in our postmodern age, thus challenging the biomedical view which juxtaposes
objective and subjective knowledge (cf. Mishler’s [1984] distinction between ‘the
voice of medicine’ and ‘the voice of the lifeworld’). This holistic view is
epitomised in Good and Good’s (1981) ‘cultural hermeneutic model’ which claims
that ‘human illness is fundamentally semantic or meaningful’. From a discourse/communication
perspective, linguistically and culturally diverse clients and healthcare
professionals manage interpreter-mediated and unmediated encounters differently,
with the additional interactional complexity of participation-structure.
In addition to the cultural imperative, in this
session we consider the moral and ethical dimensions of professional practice
by drawing on the dynamics of self-other relations via role-sets and
responsibility. By a similar token, it is arguable that individual patients
present moral/responsible selves in healthcare encounters. (Shared) decision
making becomes a crucial site for the articulation of ethical and moral values
vis-a-vis individual autonomy and other-oriented role-responsibilities. We will
examine real-life data from healthcare settings such as genetic counseling and
end-of-life consultations where such concerns become more pronounced.
Stay tuned in for
more updates!
Updated Schedule of 2nd Annual Winter School on Health Communication:
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