Social and Behavioral Sciences Commons^™

Co-Management In Healthcare: Negotiating Professional Boundaries, Catherine Schryer, Olga Gladkova, Marlee Spafford, Lorelei Lingard

Lorelei Lingard

This article investigates discursive practices associated with the co-management of patients between healthcare providers. Specifically, we focus on two genres (38 referral letters and 37 consultant reports) written by optometrists and ophthalmologists — two groups who are experiencing interprofessional tension over their scopes of practice. In our analysis we foreground four kinds of modality associated with verbs — epistemic, deontic, phatic and subjective. We found that these healthcare providers shared in the epistemic resources used to hedge their sense of clinical certainty, and that ophthalmologists used deontic resources to control future action. However, we also noted that both professions used …

Negotiating The Politics Of Identity In An Interdisciplinary Research Team, Lorelei Lingard, Catherine Schryer, Marlee Spafford, Sandra Campbell

Lorelei Lingard

This article explores the politics of identity in an interdisciplinary health research team that has been engaged in a qualitative research program for over five years. We draw on sociological theories of power and knowledge to explore our experiences of identity conflict, team socialization, and knowledge production. Structurally, our article integrates individual and group perspectives through personal narratives and collaborative critique as we explore the complex negotiations required to realize and maintain our team dynamic. These negotiations take place not only with one another as particularly positioned individuals, but also with the ideological and organizational forces that structure our scholarly …

Questioning Competence: A Discourse Analysis Of Attending Physicians' Use Of Questions To Assess Trainee Competence, Tara Kennedy, Lorelei Lingard

Lorelei Lingard

BACKGROUND: Attending physicians (APs) must constantly assess trainees' competence to act independently, to promote learning while ensuring quality of care. This study aimed to explore, through discourse analysis of case presentations, the process of competence assessment for case-specific clinical independence.

METHOD: Twenty-six case presentations in emergency medicine were observed and audiorecorded. A discourse analysis was conducted, focusing on APs' use of questioning strategies.

RESULTS: Questioning strategies involved clarifying questions (to ensure APs' understanding of the case), probing questions (to probe trainees' understanding of a case or their underlying knowledge), and challenging questions (to challenge presuppositions). Case-related probing questions and challenging …