Article published In: Narratives as Social Practice in Organisational Contexts
Edited by Dorien Van De Mieroop, Jonathan Clifton and Stephanie Schnurr
[Narrative Inquiry 32:1] 2022
► pp. 108–129
Clinicians’ narratives in the era of evidence-based practice
A sociolinguistic exploration of the role of narratives in staff meetings
Published online: 3 November 2020
https://doi.org/10.1075/ni.20057.laz
https://doi.org/10.1075/ni.20057.laz
Abstract
In evidence-based practices, narratives are the vehicle through which medical knowledge is shared and clinical
judgment is grounded. This paper explores narratives as a sanctioned social practice that help a group of clinicians in a
healthcare institution in New Zealand build and negotiate expertise and accountability, as they discuss clinical cases. To this
end, the paper investigates narratives in six staff meetings, which were video and audio recorded. The paper presents a discursive
analysis of the functions of narratives in this context to show how narratives are interactional achievements that are pivotal to
clinical decision-making and to building and contesting professional stances. Finally, the paper reflects on the value of
narratives as shared resources that are sometimes revisited and reframed over time and that help construct a common thread of
history that becomes part of the cultural capital of the organization and positions clinicians as core members of their
community.
Article outline
- 1.Introduction
- Medical case presentation in reflective practice
- Method and data
- Analysis
- Discussion and conclusions
- Notes
- Transcription conventions
References
References (51)
Baker, D. (2019). Using narrative to construct accountability in cases of death after police contact. Australian & New Zealand Journal of Criminology, 52(1), 60–75.
Barone, S. and Lazzaro-Salazar, M. (2015). ‘Forty bucks is forty bucks’: An analysis of a medical doctor’s professional identity. Journal of Language and Communication, 431, 27–34.
Bamberg, M., & Georgakopoulou, A. (2008). Small stories as a new perspective in narrative and identity analysis. Text & Talk, 28(3), 377–396.
Cappuccio, A., Latella, M., Pelaia, G., Menzella, F., Pellegrini, G., & Marini, M. G. (2017). Narrative medicine to evaluate the relationship between clinicians and patients living with severe asthma. Eur Respir J., 50 (suppl 61):A2779.
Castonguay, J., Filer, C., & Pitts, M. (2016). Seeking help for depression: applying the health belief model to illness narratives. Southern Communication Journal, 81(5), 289–303.
Charon, R. (2001). Narrative medicine: form, function, and ethics. Annals of Internal Medicine, 134(1), 83–87.
De Fina, A. (2003). Identity in Narrative: A study of immigrant discourse. Amsterdam: John Benjamins.
(2009). Narratives in interview – The case of accounts: For an interactional approach to narrative genres. Narrative inquiry, 19(2), 233–258.
Fook, J., Ryan, M., & Hawkins, L. (2000). Professional expertise: Practice, theory and education for working in uncertainty. London: Whiting & Birch.
Georgakopoulou, A. (2006). Thinking big with small stories in narrative and identity analysis. Narrative Inquiry, 16(1), 122–130.
Greenhalgh, T. (1999). Narrative based medicine in an evidence based world. British Medical Journal, 318(7179), 323–325.
Hardy, S., Garbett, R., Titchen, A., & Manley, K. (2002). Exploring nursing expertise: nurses talk nursing. Nursing Inquiry, 9(3), 196–202.
Hartwell, S. (2002). Classes and Collections: How Clinicians Feel Differently. Clinical Law Review, 91, 463–493.
Holmes, J., & Meyerhoff, M. (1999). The community of practice: Theories and methodologies in language and gender research. Language in Society, 28(2), 173–183.
Holmes, J., & Stubbe, M. (2003). Doing disagreement at work: A sociolinguistic approach. Australian Journal of Communication, 30(1), 53–77.
Holmes, J., Marra, M., & Vine, B. (2011). Leadership, Discourse, and Ethnicity. Oxford: Oxford University Press.
Holmes, J., Marra, M. and Lazzaro-Salazar, M. (2017). Negotiating the Tall Poppy Syndrome in New Zealand workplaces: women leaders managing the challenge. Journal of Gender and Language, 11(1), 1–29.
Hunter, K., & Montgomery, K. (1993). Doctors’ stories: The narrative structure of medical knowledge. Princeton: Princeton University Press.
Johnstone, B. (2016). ‘Oral versions of personal experience’: Labovian narrative analysis and its uptake. Journal of Sociolinguistics, 20(4), 542–560.
Khan, M. (2019). The Perspective of Medical Communication on the Biomedical Model of Practice and Patient Centeredness: A Review of the Language of Medical Case Presentation Genre. International Journal of Linguistics, Literature, and Translation, 2(3), 71–80.
Kjaerbeck, S. (2008). Narratives as a resource to manage disagreement: Examples from a parents’ meeting in an extracurricular activity center. Text & Talk, 28(3), 307–326.
Labov, W., & Waletzky, J. (1967). Narrative analysis: Oral versions of personal experience. In Jean Helm (ed.), Essays on the verbal and visual arts, (pp. 12–44). Seattle: University of Washington Press.
Lazzaro-Salazar, M. (2013). Investigating Nurses’ Professional Identity Construction in Two Health Settings in New Zealand (Unpublished doctoral dissertation). Victoria University of Wellington, New Zealand.
(2016). Downscaling culture in intercultural communication: The case of nurses’ professional values in New Zealand. In Dorottya Cserző, Argyro Kantara & Jaspal Singh (Eds.), The journey is its own reward: Downscaling culture in Intercultural Communication Research (pp. 114–140). Cambridge: Cambridge University Press.
(2017). Ingroups and outgroups in complaints: Exploring politic behaviour in nurses’ discourse. Logos: Revista de Lingüística, Filosofía y Literatura, 27(2): 319–333.
(forthcoming). Advice-giving in nursing teams: Managing face threats while promoting collaborative work in (inter?)cultural contexts. In Gillian Martin & Jonathan Crichton (Eds.), The Handbook of Intercultural Communication in Health Care (Section 5: Teams and Collaboration). Berlin: De Gruyter.
Lazzaro-Salazar, M., Holmes, J., Marra, M., & Vine, B. (2015). Doing power and negotiating through disagreement in public meetings. Pragmatics and Society, 6(3), 444–464.
Lazzaro-Salazar, M., & Zayts, O. (forthcoming). Migrant doctors’ narratives about patients: A study of professional identity in Chile and Hong Kong.
Marra, M., & Lazzaro-Salazar, M. (2018). Ethnographic methods. In Andreas Jucker, Klaus Schneider and Wolfram Bublitz (Eds.), De Gruyter Handbook of Methods in Pragmatics (pp. 343–366). Berlin: de Gruyter.
Mønsted, T., Reddy, M., & Bansler, J. (2011). The use of narratives in medical work: A field study of physician-patient consultations. In ECSCW (Ed.), Proceedings of the 12th European Conference on Computer Supported Cooperative Work, 24–28 September 2011, Aarhus Denmark (pp. 81–100). London: Springer.
Moore, E. (2006). ‘You tell all the stories’: Using narrative to explore hierarchy within a Community of Practice 1. Journal of Sociolinguistics, 10(5), 611–640.
Norrick, N. (2013). Narratives of Vicarious Experience in Conversation. Language in Society, 42(4), 385–406.
Orr, J. E. (1996). Talking about machines: An ethnography of a modern job. Ithaca, NY: Cornell University Press.
Patterson, E., McIntire, A., Beecroft, N., Happ, M., & Moffatt-Bruce, S. (2019). Nursing Handovers in Critical Care: A Retrospective Analysis of Information Content and Function. In Proceedings of the International Symposium on Human Factors and Ergonomics in Health Care (Vol. 8(1), pp. 4–8). Sage, Los Angeles, CA: SAGE Publications.
Peterkin, A. (2011). Primum non nocere: on accountability in narrative-based medicine. Literature and Medicine, 29(2), 396–411.
Pomata, G. (2014). The medical case narrative: Distant reading of an epistemic genre. Literature and Medicine, 32(1), 1–23.
Robertson, P., Barnao, M., Ward, T., Birgden, A., Casey, S., & Guardagno, B. (2020). Clinicians’ perspectives of forensic rehabilitation. Psychiatry, Psychology and Law, 27(1), 138–154.
Sarangi, S., & Roberts, C. (1999). Talk, work and institutional order: Discourse in medical, mediation and management settings. (Vol. 1). Berlin: De Gruyter Mouton.
Schiffrin, D. (1996). Narrative as self portrait: The sociolinguistic construction of identity. Language in Society, 25(2), 167–203.
Schuck, P. (2008). “Tort Reform, Kiwi-Style”. Faculty Scholarship Series. Paper 1679. [URL]
Shaw, S., Russell, J., & Greenhalgh, T. (2011). Shaping healthcare planning in England: front stage and back stage language play. Conference Proceedings, The Impact of Applied Linguistics, 109. Proceedings of the 44th Annual Meeting of the British Association for Applied Linguistics, University of the West of England.
Taylor, B. (2006). Reflective Practice: A Guide for Nurses and Midwives. Maidenhead: Open University Press.
van Leeuwen, T. (2008). Discourse and practice: New tools for critical discourse analysis. Oxford: Oxford University Press.
Wallace, I., Barratt, H., Harvey, S., & Raine, R. (2019). The impact of Clinical Nurse Specialists on the decision making process in cancer multidisciplinary team meetings: A qualitative study. European Journal of Oncology Nursing, 431, 101674.
Wenger, E., McDermott, R., & Snyder, W. (2002). Cultivating communities of practice: A guide to managing knowledge. Cambridge: Harvard Business Press.
Wittich, C. M., Szostek, J. H., Reed, D. A., Kiefer, J. L., Mueller, P. S., Mandrekar, J. N., & Beckman, T. J. (2013). Measuring Faculty Reflection on Medical Grand Rounds at Mayo Clinic: Associations With Teaching Experience, Clinical Exposure, and Presenter Effectiveness. Mayo Clinic Proceedings, 88(3), 277–284.
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