Asymmetry in Medical Interview
|1.||The asymmetry in doctor-patient interaction||5|
|1.1.||The concept of Asymmetry||5|
|1.2.||How the Asymmetry can be produced in doctor-patient interaction||6|
|2.1.||Gesture Types: Symbolic, Deictic, Motor and Lexical||9|
|3.||Examining the linguistic and gestural level of Asymmetry||11|
The two patterns of interruption were observed in analyzed videorecordings: interruptions without a pause and interruptions with a pause. Interruptions without a pause occured when one speaker broke in on the current speaker in midspeech; interruption with a pause occured when one speaker paused briefly before completing the thought, and during this pause, the second speaker interrupted.
Only in one case the interruption was patient-initiated, in other cases interruptions were initiated by physician.
It is assumed (Realini, 1995) that when patient interrupts doctor, he or she probably considers the content of the interruption to be important to the medical interaction; at the same time physicians interrups patiens to refocus them, because it is the responsibility of the doctor to maximize efficiency and effectiveness while interacting with patients in a busy practise.
Doctor’s interruptions may have also undesirable effects; for patient they could be a reminder that the physician controls the interview, and this may leave the patients with a sense that their input in communication is not important for the physician (Realini, 1995).
The goals of present study were to define the interruption in data extracts and the gestural expression of interruption; to define the type of gestural expression and to determine the proportion of each of gestural types in occured interruptions.
During the analysis no deictic or symbolic gestures accomoponied interruptions were identified. The absence of symbolic gestures can be explained with specific conditions in which such gestures usually occur. As Krauss (Krauss, 2001) notes, this kind of gestures frequently occurs in the absence of speech; they often are used to communicate when distance or noise makes vocal communication impossible. Since the interaction between physicians and patients occurred in closed silent rooms, there was no need for symbolic gestures. The lack of deictic gestures can be explained with short distance between doctor and patient, which didn’t required pointing to something.
Analysis was limited by five examples of interruption, that is not enought for making clear conclusions concerning how the asymmetry on linguistic and non-linguistic level is connected. But since the purpose of this study was to make suggestions about relatedness of both levels of asymmetry, I can assume that there are two types of gestures that seem to be close related to non-linguistic level of asymmetry: motor and lexical gestures, by which interruptions were more often accompanied.
More clear conclusions concerning how the linguistic and non-linguistic level of asymmetry are connected can be made after analyzing larger number of samples that could be a proposal for future studies of asymmetry.
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