PRP018: Coordinated cooperation or inappropriate intrusion? A quantitative analysis of interruptions in primary care interactions.

Ilona Plug, MA, MSc

Abstract

Context: Interruptions have often been negatively associated with the exertion of power in interaction and breaking into the other’s conversational turn, in particular within the institutionalized context of medical interactions. However, linguistic studies have shown that interruptions often characterise interactions as a joint activity. It is yet unknown how and when physicians and patients in different sex dyad compositions use various forms and functions of interruptions in interactions in primary care. The study adds to existing literature and knowledge for primary care by focusing on (1) various forms and functions of interruptions, (2) speaker’s role and speaker’s sex, and (3) two important phases of the consultation. Objective: The present study aims to examine how and when physicians and patients in different sex dyad compositions use various forms and functions of interruptions in interactions in primary care. Study Design: A systematic and detailed quantitative analysis of interruptions by means of a developed and tested codebook. Setting or Dataset: Videorecorded primary care consultations, including all four sex dyad compositions (e.g., a female general practitioner and a male patient). Population studied: Consultations of 80 patients with common somatic symptoms, matched on patient’s age, assessment of symptoms (i.e., (un)explained), and first visits vs. follow-up consultations. Outcome Measures: The form and function of general practitioners’ and patients’ interruptions during the phase of problem presentation and anamnesis, and the phase of diagnosis and treatment. Utterances prior to the interruptions are coded on topic and content. Outcomes to be reported: It is expected that most interruptions will be cooperative, e.g., providing assistance or asking for clarification, which is in contrast with the idea of interruptions as intrusive acts. It will be reported to what extent the form and function of the interruptions differ depending on speaker’s medical role, speaker’s sex, sex dyad composition, and consultation phase. The findings will presumably demonstrate that interruptions are not necessarily a tool to exert power or dominance, and that GPs and patients – independent of their sex – use various forms and functions of interruptions for the purpose of particular interactional goals in the different phases of the consultation.
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Tim olde Hartman
tim.oldehartman@radboudumc.nl 11/19/2021

Great research and important to every health care professional. I always viewed interruptions as negative, now I learned that most interruptions are cooperative.

Ilona
11/22/2021

:D Thanks Tim!

Jack Westfall
jwestfall@aafp.org 11/21/2021

Very interesting research. Great work. Thanks for sharing it at NAPCRG

Ilona
11/22/2021

Thank you for your positive feedback Jack Westfall!

Diane Harper
harperdi@med.umich.edu 11/22/2021

Very cool work! Please keep up the work to help us communicate with patients in a more informative and congenial manner! Thank you for sharing your work with NAPCRG!

Ilona
11/23/2021

Thank you for your comment Diane Harper!

M B Murphy
melmurph202@gmail.com 11/22/2021

Interesting research. I am curious as to the results and how they will compare to the data here in the US where in recent times  our team has learned the phrase "respectful interruption" which suggests that interruptions are usually viewed negatively. Thanks for sharing. 

Ilona
11/23/2021

Thank you M.B. Murphy! I am very interested in the definition and use of respectful interruptions in practice!

Deborah
deborah.mccahon@bristol.ac.uk 11/23/2021

Very interesting work Ilona, thank you for sharing.

William Hogg
whogg@uottawa.ca 12/31/2021

Interesting and important work.

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