Programme no. 124-OP
Professional Development
Decision making may be painful when new evidence challenges previous clinical practice: a linguistic study
Ole Olsen*1, Gritt Overbeck2
1The Research Unit for General Practice,University of Copenhagen,Copenhagen,Denmark, 2The Research Unit for General Practice,University of Copenhagen,Copenhagen,Denmark
* = Presenting author
Objectives: To explore decision making in real life through its linguistic expressions.
Background: Conflicts between the best available evidence and current clinical practice are not uncommon. But there is no comprehensive understanding as to how choices are made by physicians nor has the subject of choice and decision making in general received proper scholarly attention among anthropologists. This presentation invites you to follow a clinician’s decision making process.
Results: The study is on-going and results will be presented at the conference. Preliminary results show that 1: The decision taker experiments with different degrees of responsibility for the decision to be made. 2: Orients towards what others will think of her decision. 3: Reveals physical discomfort when imagining the decision being made.
Material/Methods: Seven GPs were presented to new evidence, and from three hours of transcribed audiotaped dialogues sections of text were selected where a general practitioner elaborates on her decision making as it progresses. The selected text was transcribed in details using linguistics notation and analysed with interaction analysis.
Conclusion: Not knowing which decision to make can be painful. Decisions can be aided by emotions, in the form of bodily states that are elicited during the deliberation of future consequences. Every significant vital sign - body temperature, heart rate, oxygen consumption, hormone level, brain activity, and so on – are said to alter the moment a decision is made, and this study shows that emotional arousal in real life is reflected in breathing, laughing, odd linguistic choices (e.g. irrealis and dis-preferred design) as well as reflections on self-perception.
Points for discussion: 1. Do you recognize the presented bodily and linguistic reactions from other clinical decision making experiences?

2. How do you best support patients facing similarly challenging choices?