Establishing emergent common ground: Chinese doctors’ use of metapragmatic expressions in oncological consultations

Chengtuan Li, Jing Han and Zhiwei Zhao
Guangdong University of Foreign Studies | South China Business College, Guangdong University of Foreign Studies

In the framework of the socio-cognitive approach, this article investigates how Chinese doctors’ use of metapragmatic expressions (MPEs) facilitates the construction of emergent common ground (ECG) in oncological consultations. Based on extracts from our medical corpus, this paper reveals that doctors primarily employ eight types of MPEs as ECG construction builders in interactions, i.e., commentaries, message glosses, evidentials, hedges, performatives, stance displayers, signaling expressions, and rapport indicators. It is found that oncologists use them to (1) construct ECG of information for clarifying the patients’ life-threatening condition, correcting patients’ misconceptions, and justifying treatment recommendations; and (2) construct ECG of (dis)affiliation for preemptively or retrospectively reconciling their institutional needs with the addressees’ emotional needs. This article aims to shed light on our understanding of the functioning mechanism of MPEs in ECG construction for the accomplishment of communicative tasks in highly sensitive Chinese oncological consultations.

Publication history

Date received: 17 May 2024

Date accepted: 27 December 2024

Published online: 18 August 2025

Table of contents

In medical encounters, successful communication is mostly contingent upon shared or mutual understanding achieved through the negotiation and co-construction of meaning (Bigi and Rossi 2023). Metapragmatic expressions (MPEs) that contribute to effective communication have received increasing attention from pragmatic researchers (e.g., Liu and Liu 2021; Liu et al. 2022). They are linguistic expressions that overtly reveal the speaker’s metapragmatic awareness regarding language use and their intentions to monitor and manage the ongoing communication to accomplish communicative goals (Liu et al. 2022). Previous studies have illustrated the role of MPEs in promoting mutual understanding by constructing common ground (CG) in intercultural project work (Penz 2007), BELF meeting interactions (Liu and Liu 2017), and complaint responses (Liu et al. 2022). Yet, this topic has received little attention in medical interactions, and even less in Chinese cancer consultations.

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