In this paper, we investigate the communicative dynamics of tests administered in order to assess linguistic and cognitive abilities (e.g. the Mini-Mental State, Folstein & Folstein, 1975, or naming tests, Kaplan et al., 2001). By using the methodological and theoretical approach of Conversation Analysis, we consider testing as a form of social interaction and their results as a collaborative accomplishment between the patients and the clinicians/therapists who administer them (Marlaire & Maynard, 1990; Schegloff, 2003; Wilkinson, 2013). By focusing on the initial phase of testing activities, we analyze the way test instructions and questions are delivered by the health professionals and on how they are understood and responded by patients (for variability in interaction of standardized protocols, see Jones et al., 2020). The analyses are based on a 12-hours corpus of video-recordings of doctor-patient and speech-language therapist-patient interactions. The data was collected in Brazil and France as part of two projects investigating the dynamics of clinical and therapeutic interactions. The languages involved are Brazilian Portuguese and French. The interactions were transcribed following the multimodal transcription conventions developed by Mondada (2018). Through a detailed analysis of the sequential organization of these interactions, we identify moments in which the initial instructions and test questions are either repeated, reformulated or modified by the therapist, or checked and assessed by the patient him/herself. Moreover, we consider not only the verbal dimension of testing, but also their entire ecology - the setting, the material environment (objects), the embodied resources (postures, gestures, gazes) – and we show how these resources contribute to build the intelligibility of the test. The results pave the way for distinguishing difficulties of the patients in responding to the test contents from difficulties related to how instructions are designed and tests organized. Implications for how health professionals interpret patients’ results are finally discussed.

Merlino, S., da Cruz, F. (2021). Communicative dynamics of testing in clinical and therapeutic encounters.

Communicative dynamics of testing in clinical and therapeutic encounters

Sara Merlino
;
2021-01-01

Abstract

In this paper, we investigate the communicative dynamics of tests administered in order to assess linguistic and cognitive abilities (e.g. the Mini-Mental State, Folstein & Folstein, 1975, or naming tests, Kaplan et al., 2001). By using the methodological and theoretical approach of Conversation Analysis, we consider testing as a form of social interaction and their results as a collaborative accomplishment between the patients and the clinicians/therapists who administer them (Marlaire & Maynard, 1990; Schegloff, 2003; Wilkinson, 2013). By focusing on the initial phase of testing activities, we analyze the way test instructions and questions are delivered by the health professionals and on how they are understood and responded by patients (for variability in interaction of standardized protocols, see Jones et al., 2020). The analyses are based on a 12-hours corpus of video-recordings of doctor-patient and speech-language therapist-patient interactions. The data was collected in Brazil and France as part of two projects investigating the dynamics of clinical and therapeutic interactions. The languages involved are Brazilian Portuguese and French. The interactions were transcribed following the multimodal transcription conventions developed by Mondada (2018). Through a detailed analysis of the sequential organization of these interactions, we identify moments in which the initial instructions and test questions are either repeated, reformulated or modified by the therapist, or checked and assessed by the patient him/herself. Moreover, we consider not only the verbal dimension of testing, but also their entire ecology - the setting, the material environment (objects), the embodied resources (postures, gestures, gazes) – and we show how these resources contribute to build the intelligibility of the test. The results pave the way for distinguishing difficulties of the patients in responding to the test contents from difficulties related to how instructions are designed and tests organized. Implications for how health professionals interpret patients’ results are finally discussed.
Merlino, S., da Cruz, F. (2021). Communicative dynamics of testing in clinical and therapeutic encounters.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11590/388830
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