Programme no. 125-OP
Linguistic choices and evidence based practice
Gritt Overbeck*1, Ole Olsen2
1Research Unit for General Practice,København K,Denmark, 2Research Unit for General Practice,København K,Denmark
* = Presenting author
To explore how clinicians’ linguistic choices reflect their perception of new evidence when this challenges current perceptions and clinical practice.
Background: The discourse of medicine is associated with rationality and disembodied reasoning. However, conflicts between the best available evidence and current clinical practice are not uncommon and it has been recommended to study the process of dissemination of evidence in more detail using qualitative methods. The present analysis is nested in a larger qualitative study of dissemination and implementation of evidence.
Results: The study is on-going and results will be presented at the conference. Preliminary results show that linguistic choices are particularly prominent with respect to (i) sound, (ii) grammar and words, and (iii) interaction. In relation to sound intonation and speech pace shows how the speaker chose a dramatic discourse style; in relation to grammar the speaker’s choices show how the issue is highly personal for the speaker; on an interactional level, the speaker switches between different discourse identities when formulating the utterances: as a debater on health progress in general, as GP and as a woman giving birth.
A particularly illustrative section of text was selected from 8 hours of transcribed audiotaped verbal exchanges at 20 sessions involving more than one hundred GPs presented to new evidence. The selected text was transcribed using detailed linguistic notation in order to capture sound variations as well as discourse organization. After transcription the text was analyzed using two complementary approaches applicable for spoken language: Systemic Functional Analysis to explore the grammatical choices the speakers make and Conversation Analysis to explore the interactional perspectives of the utterance.
Conclusion: Analyses of speech pace, grammatical choices, and interactional identity-work show that presentation of evidence that conflicts with existing perceptions in this case does not only cause professional skepticism but also causes emotional distress.
Points for discussion:
1. Given that feeling emotional distress or discomfort towards specific evidence may hinder implementation of evidence, what should be done to overcome this in general practice?
2. Would you inform pregnant woman about the available evidence?