1887
image of Clinicians’ narratives in the era of evidence-based practice
USD
Buy:$35.00 + Taxes

Abstract

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.

Loading

Article metrics loading...

/content/journals/10.1075/ni.20057.laz
2020-11-03
2020-11-27
Loading full text...

Full text loading...

References

  1. 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. doi:  10.1177/0004865818767227
    https://doi.org/10.1177/0004865818767227 [Google Scholar]
  2. 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, 43, 27–34. doi:  10.1016/j.langcom.2015.04.002
    https://doi.org/10.1016/j.langcom.2015.04.002 [Google Scholar]
  3. Bamberg, M., & Georgakopoulou, A.
    (2008) Small stories as a new perspective in narrative and identity analysis. Text & Talk, 28(3), 377–396. doi:  10.1515/TEXT.2008.018
    https://doi.org/10.1515/TEXT.2008.018 [Google Scholar]
  4. 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. doi:  10.1183/1393003.congress‑2017.PA2779
    https://doi.org/10.1183/1393003.congress-2017.PA2779 [Google Scholar]
  5. 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. doi:  10.1080/1041794X.2016.1165729
    https://doi.org/10.1080/1041794X.2016.1165729 [Google Scholar]
  6. Charon, R.
    (2001) Narrative medicine: form, function, and ethics. Annals of Internal Medicine, 134(1), 83–87. doi:  10.7326/0003‑4819‑134‑1‑200101020‑00024
    https://doi.org/10.7326/0003-4819-134-1-200101020-00024 [Google Scholar]
  7. De Fina, A.
    (2003) Identity in Narrative: A study of immigrant discourse. Amsterdam: John Benjamins. doi:  10.1075/sin.3
    https://doi.org/10.1075/sin.3 [Google Scholar]
  8. (2009) Narratives in interview – The case of accounts: For an interactional approach to narrative genres. Narrative inquiry, 19(2), 233–258. doi:  10.1075/ni.19.2.03def
    https://doi.org/10.1075/ni.19.2.03def [Google Scholar]
  9. Fook, J., Ryan, M., & Hawkins, L.
    (2000) Professional expertise: Practice, theory and education for working in uncertainty. London: Whiting & Birch.
    [Google Scholar]
  10. Georgakopoulou, A.
    (2006) Thinking big with small stories in narrative and identity analysis. Narrative Inquiry, 16(1), 122–130. doi:  10.1075/ni.16.1.16geo
    https://doi.org/10.1075/ni.16.1.16geo [Google Scholar]
  11. Goffman, E.
    (1959) The Presentation of Self in Everyday Life. New York: Doubleday Anchor Books.
    [Google Scholar]
  12. Greenhalgh, T.
    (1999) Narrative based medicine in an evidence based world. British Medical Journal, 318(7179), 323–325. doi:  10.1136/bmj.318.7179.323
    https://doi.org/10.1136/bmj.318.7179.323 [Google Scholar]
  13. Hardy, S., Garbett, R., Titchen, A., & Manley, K.
    (2002) Exploring nursing expertise: nurses talk nursing. Nursing Inquiry, 9(3), 196–202. doi:  10.1046/j.1440‑1800.2002.00144.x
    https://doi.org/10.1046/j.1440-1800.2002.00144.x [Google Scholar]
  14. Hartwell, S.
    (2002) Classes and Collections: How Clinicians Feel Differently. Clinical Law Review, 9, 463–493. doi:  10.2174/092986708784872393
    https://doi.org/10.2174/092986708784872393 [Google Scholar]
  15. Holmes, J., & Meyerhoff, M.
    (1999) The community of practice: Theories and methodologies in language and gender research. Language in Society, 28(2), 173–183. doi:  10.1017/S004740459900202X
    https://doi.org/10.1017/S004740459900202X [Google Scholar]
  16. Holmes, J., & Stubbe, M.
    (2003) Doing disagreement at work: A sociolinguistic approach. Australian Journal of Communication, 30(1), 53–77.
    [Google Scholar]
  17. Holmes, J., Marra, M., & Vine, B.
    (2011) Leadership, Discourse, and Ethnicity. Oxford: Oxford University Press. doi:  10.1093/acprof:oso/9780199730759.001.0001
    https://doi.org/10.1093/acprof:oso/9780199730759.001.0001 [Google Scholar]
  18. 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. doi:  10.1558/genl.31236
    https://doi.org/10.1558/genl.31236 [Google Scholar]
  19. Hunter, K., & Montgomery, K.
    (1993) Doctors’ stories: The narrative structure of medical knowledge. Princeton: Princeton University Press. doi:  10.1001/jama.1991.03470090109047
    https://doi.org/10.1001/jama.1991.03470090109047 [Google Scholar]
  20. Johnstone, B.
    (2016) ‘Oral versions of personal experience’: Labovian narrative analysis and its uptake. Journal of Sociolinguistics, 20(4), 542–560. doi:  10.1111/josl.12192
    https://doi.org/10.1111/josl.12192 [Google Scholar]
  21. 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.
    [Google Scholar]
  22. 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. doi:  10.1515/TEXT.2008.015
    https://doi.org/10.1515/TEXT.2008.015 [Google Scholar]
  23. Labov, W., & Waletzky, J.
    (1967) Narrative analysis: Oral versions of personal experience. InJean Helm (ed.), Essays on the verbal and visual arts, (pp.12–44). Seattle: University of Washington Press.
    [Google Scholar]
  24. 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.
    [Google Scholar]
  25. (2016) Downscaling culture in intercultural communication: The case of nurses’ professional values in New Zealand. InDorottya 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.
    [Google Scholar]
  26. (2017) Ingroups and outgroups in complaints: Exploring politic behaviour in nurses’ discourse. Logos: Revista de Lingüística, Filosofía y Literatura, 27(2): 319–333. doi:  10.15443/RL2725
    https://doi.org/10.15443/RL2725 [Google Scholar]
  27. (forthcoming). Advice-giving in nursing teams: Managing face threats while promoting collaborative work in (inter?)cultural contexts. InGillian Martin & Jonathan Crichton Eds. The Handbook of Intercultural Communication in Health Care (Section 5: Teams and Collaboration). Berlin: De Gruyter.
    [Google Scholar]
  28. 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. doi:  10.1075/ps.6.3.06laz
    https://doi.org/10.1075/ps.6.3.06laz [Google Scholar]
  29. Lazzaro-Salazar, M., & Zayts, O.
    (forthcoming). Migrant doctors’ narratives about patients: A study of professional identity in Chile and Hong Kong.
    [Google Scholar]
  30. Marra, M., & Lazzaro-Salazar, M.
    (2018) Ethnographic methods. InAndreas Jucker, Klaus Schneider and Wolfram Bublitz (Eds.), De Gruyter Handbook of Methods in Pragmatics (pp.343–366). Berlin: de Gruyter.
    [Google Scholar]
  31. Mønsted, T., Reddy, M., & Bansler, J.
    (2011) The use of narratives in medical work: A field study of physician-patient consultations. InECSCW (Ed.), Proceedings of the 12th European Conference on Computer Supported Cooperative Work, 24–28 September 2011, Aarhus Denmark (pp.81–100). London: Springer. doi:  10.1007/978‑0‑85729‑913‑0_5
    https://doi.org/10.1007/978-0-85729-913-0_5 [Google Scholar]
  32. 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. doi:  10.1111/j.1467‑9841.2006.00298.x
    https://doi.org/10.1111/j.1467-9841.2006.00298.x [Google Scholar]
  33. Norrick, N.
    (2013) Narratives of Vicarious Experience in Conversation. Language in Society, 42(4), 385–406. doi:  10.1017/S0047404513000444
    https://doi.org/10.1017/S0047404513000444 [Google Scholar]
  34. Orr, J. E.
    (1996) Talking about machines: An ethnography of a modern job. Ithaca, NY: Cornell University Press. doi:  10.7591/9781501707407
    https://doi.org/10.7591/9781501707407 [Google Scholar]
  35. 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. InProceedings of the International Symposium on Human Factors and Ergonomics in Health Care (Vol.8(1), pp.4–8). Sage, Los Angeles, CA: SAGE Publications. doi:  10.1177/2327857919081001
    https://doi.org/10.1177/2327857919081001 [Google Scholar]
  36. Peterkin, A.
    (2011) Primum non nocere: on accountability in narrative-based medicine. Literature and Medicine, 29(2), 396–411. doi:  10.1353/lm.2011.0322
    https://doi.org/10.1353/lm.2011.0322 [Google Scholar]
  37. Pomata, G.
    (2014) The medical case narrative: Distant reading of an epistemic genre. Literature and Medicine, 32(1), 1–23. doi:  10.1353/lm.2014.0010
    https://doi.org/10.1353/lm.2014.0010 [Google Scholar]
  38. Prince, G.
    (1983) Narrative pragmatics, message, and point. Poetics, 12(6), 527–536. doi:  10.1016/0304‑422X(83)90007‑4
    https://doi.org/10.1016/0304-422X(83)90007-4 [Google Scholar]
  39. 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. doi:  10.1080/13218719.2019.1695685
    https://doi.org/10.1080/13218719.2019.1695685 [Google Scholar]
  40. Sackett, D.
    (1997) Evidence-based medicine. Seminars in Perinatology, 21(1), 3–5. doi:  10.1016/S0146‑0005(97)80013‑4
    https://doi.org/10.1016/S0146-0005(97)80013-4 [Google Scholar]
  41. Sarangi, S., & Roberts, C.
    (1999) Talk, work and institutional order: Discourse in medical, mediation and management settings. (Vol. 1). Berlin: De Gruyter Mouton. doi:  10.1525/ae.2001.28.1.252
    https://doi.org/10.1525/ae.2001.28.1.252 [Google Scholar]
  42. Schiffrin, D.
    (1996) Narrative as self portrait: The sociolinguistic construction of identity. Language in Society, 25(2), 167–203. doi:  10.1207/S15327973RLSI3502_2
    https://doi.org/10.1207/S15327973RLSI3502_2 [Google Scholar]
  43. Schuck, P.
    (2008) “Tort Reform, Kiwi-Style”. Faculty Scholarship Series. Paper 1679. digitalcommons.law.yale.edu/fss_papers/1679
  44. 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.
    [Google Scholar]
  45. Taylor, B.
    (2006) Reflective Practice: A Guide for Nurses and Midwives. Maidenhead: Open University Press. doi:  10.1046/j.1365‑2648.2000.1662c.x
    https://doi.org/10.1046/j.1365-2648.2000.1662c.x [Google Scholar]
  46. Trudgill, P.
    (2003) A glossary of sociolinguistics. Oxford: Oxford University Press. doi:  10.1590/S0102‑44502003000100014
    https://doi.org/10.1590/S0102-44502003000100014 [Google Scholar]
  47. van Leeuwen, T.
    (2008) Discourse and practice: New tools for critical discourse analysis. Oxford: Oxford University Press. doi:  10.1093/acprof:oso/9780195323306.001.0001
    https://doi.org/10.1093/acprof:oso/9780195323306.001.0001 [Google Scholar]
  48. 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, 43, 101674. doi:  10.1016/j.ejon.2019.101674
    https://doi.org/10.1016/j.ejon.2019.101674 [Google Scholar]
  49. Wenger, E., McDermott, R., & Snyder, W.
    (2002) Cultivating communities of practice: A guide to managing knowledge. Cambridge: Harvard Business Press. doi:  10.5465/amle.2009.41788855
    https://doi.org/10.5465/amle.2009.41788855 [Google Scholar]
  50. 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. doi:  10.1016/j.mayocp.2012.11.014
    https://doi.org/10.1016/j.mayocp.2012.11.014 [Google Scholar]
  51. Zayts, O., & Lazzaro-Salazar, M.
    (2020) Healthcare communication in multicultural contexts: Exploring professional mobility. InZsófia Demjén (Ed.), Applying Linguistics in Illness and Healthcare Contexts (pp.299–325). London: Bloomsbury.
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.1075/ni.20057.laz
Loading
This is a required field
Please enter a valid email address
Approval was successful
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error