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Objective To explore the interactional implications of either/or-questions on the interaction between people who call out-of-hours services in primary care (OHS-PC) and triage nurses who use a decision support tool called the ‘Netherlands Triage Standard’ (NTS) during telephone triage. Methods A qualitative study of 68 triage conversations at six Dutch OHS-PC. Patients called the OHS-PC with symptoms, e.g. chest discomfort, suggestive of acute coronary syndrome. Using conversation analysis, we identified two categories of multiple-choice either/or-questions that indicated interactional difficulties, shown in hesitation markers within callers’ responses. Results Our analysis shows that interactional difficulties mainly arise when (i) questions are poorly designed by the triage nurse; or (ii) when the caller’s complaints are ambiguously presented reflecting patient’s difficulties to verbalize them (e.g. “not feeling well”). Conclusion The way NTS displays key diagnostic options encourages triage nurses to use multiple-choice either/or-questions. More awareness among triage nurses is needed on undesirable implications of either/or-questions on the interaction. Practice implications We recommend changing the NTS display of diagnostic options and to use questions with fewer options in order to decrease the chance of formulating ambiguous questions soliciting unclear responses. Furthermore, asking content questions when complaints are ambiguously formulated may specify the presentation of complaints.

Contains fulltext : 250304.pdf (Publisher’s version ) (Open Access) Police records drawn up during or after a suspect's police interrogation play a crucial role in judicial systems and should therefore be factual representations of what occurred in the spoken interrogation. Within the judicial domain, however, little is known about how style of reporting (i.e., the specific language used) affects the interpretation of these facts. Furthermore, the relationship between police record 'quality' and variations in judgment of guilt, credibility or reliability has not been studied to date. In three studies, we investigated the influence of three commonly used recording styles (i.e., monolog, recontextualized and question-answer style) on judgments of guilt, credibility, and reliability in fictitious criminal cases. We hypothesized that participants would (1) find records in the question-answer style more credible and reliable than those in the monolog or recontextualized style, and (2) consider the recontextualized style to be the least credible and reliable. Experiment 1 showed that the Q&A style was perceived as more reliable than the other two styles. Experiment 2, a replication in which we also tested new hypotheses based on explorative analyses of Experiment 1, showed no effects of reporting style. To investigate whether the discrepancy in results was due to different scenarios, a third experiment that made use of multiple scenarios was conducted. We found effects of reporting style on perceived accuracy, imageability, and understandability. In sum, this study showed that factors as subtle as reporting style might impact the processing of information in contexts where only factual information should be taken into account. 10 p.

Tijdens telefonische triage op de huisartsenpost maken triagisten gebruik van de Nederlandse Triage Standaard. Deze beslishulp beïnvloedt de interactie tussen triagisten en patiënten, en bevordert het gebruik van meerkeuze of-vragen (bijvoorbeeld ‘Is het een stekende of beklemmende pijn op de borst?’). Onze conversatieanalyse toont aan dat interactionele problemen kunnen ontstaan bij of-vragen wanneer die inadequaat zijn vormgegeven en wanneer de patiënt niet duidelijk is over zijn klachten. Inzicht in de ongewenste gevolgen van of-vragen is essentieel voor het verbeteren van de telefonische triage.

In 2020 nam een koppel in de Verenigde Staten chloroquinefosfaat in, vanwege desinformatie omtrent de effectiviteit van chloroquine voor de behandeling van COVID-19. De man stierf, de vrouw belandde in kritieke conditie in het ziekenhuis.1 Een dramatisch gevolg van fake news. Professionals in het gezondheidsdomein krijgen te maken met zorggerelateerde desinformatie en misinformatie. Het is essentieel dat zij deze informatie leren herkennen en er op de juiste manier mee leren omgaan.

Introduction: Workplace-based learning conversations can be a good opportunity for supervisors and trainees to learn from each other. When both professionals discuss their specific knowledge openly with each other, learning conversations may be a useful educational tool, for instance for learning how to apply evidence-based medicine (EBM) in the workplace. We do, however, need a better understanding of how the exchange of knowledge provides opportunities for such bidirectional learning. The aim of this study was therefore to analyse how trainees and supervisors currently handle bidirectional learning opportunities by describing in detail how supervisors respond to knowledge expressed by trainees during a learning conversation. Method: We video-recorded learning conversations between supervisors and trainees in general practice (GP). Within these learning conversations, EBM discussions on medical topics were selected and transcribed. We then identified, analysed using Conversation Analysis (CA) and categorised each expression of knowledge by the trainee and the supervisor's subsequent response. Results: We found that when a trainee expresses knowledge during the learning conversation, supervisors either (a) refute the expressed knowledge, (b) immediately suggest an alternative or (c) pose (additional) questions. These responses have consequences for the learning opportunities of both trainee and supervisor: it is only when supervisors pose further questions that trainees are encouraged to elaborate on their knowledge, leading to a bidirectional learning opportunity. Discussion: Improving EBM learning opportunities for both supervisors and trainees requires more than simply instructing trainees to express knowledge-based—for instance—on recent evidence more often. Inflexible institutional roles related to historical claims of supervisors’ epistemic authority hamper bidirectional learning. Posing open questions during learning conversations enhances the flexibility of institutional roles while also creating bidirectional learning opportunities.

The empirical papers in this special issue show that how knowledge is made relevant and negotiated in interaction is a complex matter. Traditionally, research on knowledge conceptualizes knowledge as being distributed across patients and health care providers, who respectively have access to experiential knowledge and medical knowledge of illness. In this view, both forms of knowledge then need to be transferred from one party to the other. However, our contributions show that interactions are more complex in many ways. First of all, there are more actors involved in medical interaction, such as translators and family members, who each uniquely contribute to what knowledge is constructed and how. Secondly, the forms and domains of knowledge cannot be reduced to medical and experiential knowledge, but for instance also concern knowledge on how health care interactions are structured. Thirdly, knowledge is not only about informing the other party in interaction but is for instance also used to account for decisions or to seek alignment. In this contribution we explore how these insights can inform future research and how it can help deepen our understanding of patient centredness and shared decision making in health care communication., The empirical papers in this special issue show that how knowledge is maderelevant and negotiated in interaction is a complex matter. Traditionally,research on knowledge conceptualizes knowledge as being distributedacross patients and health care providers, who respectively have access toexperiential knowledge and medical knowledge of illness. In this view, bothforms of knowledge then need to be transferred from one party to the other.However, our contributions show that interactions are more complex inmany ways. First of all, there are more actors involved in medical interaction,such as translators and family members, who each uniquely contribute towhat knowledge is constructed and how. Secondly, the forms and domainsof knowledge cannot be reduced to medical and experiential knowledge,but for instance also concern knowledge on how health care interactions arestructured. Thirdly, knowledge is not only about informing the other party ininteraction but is for instance also used to account for decisions or to seekalignment. In this contribution we explore how these insights can informfuture research and how it can help deepen our understanding of patientcentredness and shared decision making in health care communication.

This paper presents an analysis of human-human-computer triads (HHC triads) in institutional settings, more specifically of the way in which advisor, customer and computer cooperatively generate the maximum loan amount in mortgage orientation consultations (MOCs). HHC triads involve a participation framework in which three actors collaborate in order to fulfill a specific consultation goal. We argue that the computer, despite its restricted interactional repertoire, is a full participant in this framework, considered in terms of the turn-taking system . First, we will focus on the global organization of HHC triads, on how these triads emerge in the course of institutional interactions and how they are closed. Second, we analyze the interactional dynamics of HHC triads in the MOC. We demonstrate how turn-taking rules apply, how turn-taking is managed by the participants and how the participants, including the computer, collaborate to perform a task. In the final section we will describe the local sequential structure of HHC triads and identify the actions of the participants, including the computer. The use of HHC-triads not only facilitates easy transitions for the advisors between activities in the consultation, it also cleverly combines the advisor's computer use and customer-centeredness. As the computer becomes an actual “participant” in this institutional goal-oriented participation framework, both advisors and customers show that they make use of the interactional affordances the framework creates.

Drawing on Dutch mortgage orientation consultations, the present study uncovers how mortgage advisors communicate information packages to laypersons. These information packages are jointly constructed by advisors and customers as a distinct activity within a professional advisory setting. We name this activity ‘explicative telling’. Through a systematic analysis of 57 of such explicative tellings we will demonstrate that this explicative telling activity consists of (1) doing preliminary work; (2) a body in which (a) general, official information about a specific mortgage topic is given and (b) information is applied to the customer’s situation; and (3) (pre-)closing sequences. Essential to the explicative telling activity is the recipient orientation of mortgage information, and also the advisors’ display of accountability for providing eligible information. This is supported by the irreversibility of the preliminary phase and by the presence of news deliverer upshot formulations during the body of the telling.

In order to better understand literacy practices in high poverty L2 contexts, we use a conversation analytic approach to study two forms of chorusing in Grade 3 classrooms in South African township schools: choral reading and choral answering. Based on more than 6 hours of video recorded classroom interaction, we show that choral reading aloud is initiated by explicit and implicit instructions, combined with intonational cues. Choral answering is initiated by yes/no questions, designedly incomplete utterances or known-answer questions, producing short answers. Teacher feedback in both forms is extremely limited. Choral practices risk limited individual student engagement and restrict development of language and cognitive skills. However, we also show that students demonstrate a high awareness of the subtleties of a variety of interactional “rules”. They are occasionally encouraged to produce their own answers and are capable of reading new pieces of text aloud, showing potential learning opportunities through classroom engagement.

On Facebook brands create pages to facilitate interaction with their (potential) customers, or fans. Brands publish content on these pages which often contain rhetorical figures. Facebook's technological affordances allow fans to respond to these posts leading to multiple participation framework levels that were initiated and can be seen by the brand, but may – at some point – no longer involve the brand. In this study, we uncovered how brands initiate interaction by posting content in an artfully divergent way by collecting 62 Dutch Facebook posts from 12 brands and fans' reactions they evoked. Using a mixed-methods approach, the posts' rhetorical figures and how fans responded to them were analyzed. The results showed that brands' posts often contain a deviation in meaning which enabled fans to respond in various ways: they responded to the actions posts generated, such as answering questions, but also responded by evaluating the brands. Despite the post's rhetorical type (trope or scheme), format (visual, verbal, or verbo-pictorial), or relevant next action projected, rhetorical posts on brand pages secure responses and thus participation from fans.

Images such as photographs, drawings, animations and videos are everywhere in modern society and are playing an ever-increasing role in court. This general shift from written and spoken language to “visual language” in society has been of interest to language and communication researchers for years. Within the domain of law, however, a lot of the language and communication literature is traditionally focused on written and spoken language. In the first part of this paper we provide a theoretical background in which we discuss how people understand images, what visual literacy means, how images can have persuasive power and can influence people in terms of their emotions, attitudes, and decision-making, and we talk about how this can play a role in court. Furthermore, we illustrate some gaps in the literature. In the second part of the paper we show, based on a small scale ethnographic study and systematic observation, how often visualizations are part of the case file in Dutch hearings, what types of images are talked about and/or shown, and by whom they are introduced during the hearing. We conclude by discussing what communication scholars find interesting about these observations and we also suggest a number of research opportunities that may be of interest for interdisciplinary research amongst law and communication scholars.

In the bachelor course Face-to-Face Communication, students receive an introduction to pragmatics, specifically “talk in interaction.” Students learn (1) about pragmatic theories concerning how we get things done in talk; (2) how one’s cultural background and speaking in a second language influence interactional understanding; and (3) how to do research on intercultural interaction in formal and informal settings. This chapter includes the syllabus of the course, including a list of topics discussed, reading materials, course assignments (such as preparatory assignments for class and reflective diary assignments), and a step-by-step explanation of the various phases of the research project in which students learn to do research on intercultural interaction. Through carefully choosing literature, guiding students through a research project for which they gather real conversations in both a local and international setting, encouraging students to reflect on their own and other people’s (intercultural) interaction in diary assignments, and designing interactive seminar activities focusing on intercultural communication, the face-to-face communication curriculum can be “internationalized.” Through this curriculum design, students learn about, experience, and do research on face-to-face communication beyond their own culture, language and context.

Inleiding Triagisten op huisartsenposten voeren triagegesprekken met behulp van de Nederlandse Triage Standaard (NTS), die hen helpt vast te stellen wat de medische urgentie van de hulpvraag van de beller is. In de praktijk heerst het idee dat de NTS over- en ondertriage in de hand werkt. Afhankelijk van de manier waarop de gebruiker met de NTS omgaat kan de vraagstellingstructuur leiden tot een defensieve urgentiebepaling of tot het missen van relevante informatie. Methode Conversatieanalyse is een methode waarmee vanuit talig perspectief de effectiviteit van triagegesprekken kan worden onderzocht. Uit deze vorm van analyse blijkt dat de veiligheid en doelmatigheid van triage niet alleen worden bepaald door de vragen die triagisten stellen, maar ook door de manier waarop zij dit doen en hoe deze vraagstelling van invloed is op de reactie van de beller. De NTS spoort triagisten aan om de beller voortdurend te vragen een keuze te maken tussen opties, waarbij de ene optie leidt tot een hogere urgentie dan de andere. Triagisten formuleren deze opties door middel van een ‘of-vraag’: ‘Is de pijn drukkend, of stekend, of heel scherp?’ Resultaten Uit de analyse blijkt dat bepaalde ‘of-vragen’ effectiever zijn dan andere. Een conversatieanalyse van de effectiviteit van de communicatie tijdens triagegesprekken levert kennis op waarmee we de kwaliteit van de triagegesprekken kunnen vergroten. Conclusie Op grond van ons onderzoek bevelen we triagisten aan aanvullende communicatietrainingen te volgen.