Wish I'd said that but I said this

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Originally uploaded by angie cat

I'm always on the lookout for writing that describes what EM and CA work is about. Today I found some in an article by Pilnick et al., (2009) who provide an overview of the CA work in the field of medical encounters. Here are a couple that I circled as I read:

"In particular, CA notes that in all interaction, people are ongoingly attentive to the talk and visible conduct of their co-participants. Indeed, they rely on each other to make sense of emergent conduct by virtue of what has happened immediately before; that is in light of the sequential context." (p. 788)

So, those familiar with CA will recognise that the ideas here are not new and in fact are central to doing CA, however, the way the ideas are put is particular and specific to the authors on this occasion of its use.


"A related aspect of the collaborative nature of interaction is that actions are typically accomplished via sequences, where one participant initiates a sequence (e.g. asks a question, makes an offer, presents a proposal), making it relevant for the recipient to produce the second part (e.g. to answer the question, accept or decline the offer, agree or disagree with the proposal (Schegloff and Sacks, 1973)." (pp. 788-789)

I liked the sound of "systematic study of medical interactions and detailed specification of recurrent international processes ... " (p. 788)


The article was written to introduce a themed issue in Sociology of Health and Illness. For me, it provides a very good example of how guest editors would do such work. So, there is a long-ish introduction which introduces EM and CA using some of the ideas I have quoted above, and concluding with implications for the application of CA to medical encounters. The article then provides a paragraph that draws out major themes of thirty years of CA work in medical encounters, and then considers key issues addressed in the work such as:
* how patients are able to put their concerns into talk
* "how to direct the doctor's attention toward and away from certain diagnostic possibilities" (p. 789)

The authors then extend the consideration of issues beyond doctor-patient interactions to those encompassing other medical personnel (so, practitioner-patient, including healthcare practitioners). The authors then consider new technologies and healthcare interactions.

After this scene setting, the authors introduce and briefly consider the contributions of each of the articles that form the themed issue.
"The papers that we have selected for this special issue build on the established tradition of applying CA to medical interaction, and many draw heavily on the key themes and findings that we have summarised above. Critically, they advance this work by unpacking some of the distinctive practical problems or institutional dilemmas that arise in different healthcare settings. The authors of these papers also reflect upon the practical relevance of their work, and the ways in which the understandings they present may be used to address these dilemmas. As the title of the collection suggests, the themes of policy, participation and new technologies are at the forefront of the analyses presented here, just as they are at the forefront of many recent developments in healthcare." (pp. 793-794).

I was surprised to see policy etc described as being "at the forefront of the analyses", however, I am also interested by this way of describing and presenting CA work. By that, I mean that I've always shied away from "the bigger picture" aspects that I can't find in the data (even though I might suspect they are there). There were a number of examples in my PhD work for example. The analysis of classroom talk provided a number of illustrations of encounters where interactions might have been influenced by literacy policies, professional development or ideas. However, I struggled over how much could be made in relation to those. For example, I had a number of sequences of talk where the teacher avoided providing specific information when it was was requested by students ("How do you write like?"). The insertion of a question ("What does it start with?") enabled the teacher to direct the student to a way of working out the spelling of the word, without spelling it for him/her by naming the letters. I also noted that a number of older children never asked the teacher how to spell words. Was it possible for me to claim that over time these children had learnt not to ask for the spelling of words? Further, were these interactional encounters linked to policies and understandings about literacy education that sought to promote children's working out of spelling as an aspect of independent activity during writing lessons?

Today, I'm back to thinking about some of those questions -promoted in part by the article I've been reading this morning. I've produced this working (rough) abstract:

Studies have established the restricted interactional activity that occurs during teacher-led lessons in classrooms (Freebody et el., 1995; McHoul, x). However, little attention has been given in conversation analysis to the interactional accomplishment of classroom activities during lessons when children work alone or in small groups. This paper presents an analysis of restricted interactional activity during an independent writing lesson where young children aged between five and seven years of age produced individual written texts. During this time, the children frequently needed help and sought help from others; some children asked the teacher for help. The analysis of these interactions during an independent writing lesson establishes two related interactional dilemmas managed by the teacher and children and illustrates how institutional activity may be constrained by institutional representatives orientations to policies and perspectives, in this case by curriculum guidelines that inform teaching and learning in classrooms.

Initiating help from the teacher presents one interactional dilemma that is managed and mutually resolved by the teacher and children during occurrences: the teacher avoids providing specific information that would help, and the individual children seek other means for working out how to write words they don’t know. The recurrence of these sequences of interaction illustrates one way that the teacher’s activity during independent writing was restrained so that children would learn to solve their own writing problems; that is; they will seek other solutions rather than ask the teacher. Some children never asked the teacher for help or information, although they did ask each other. A second dilemma resulted when the teacher directed what children should do during interactions with each other. When children complied with the teacher’s directive, they systematically withheld information in many of the same ways as the teacher herself did during her helping activity with individuals. Constraining help by not telling produced interactional trouble for the children and resulted in sequences of talk that extended over many turns at talk when providing information by telling would have addressed the trouble in talk.

Discussion considers how the teacher’s orientations restricted the interactional activity of helping and reflected institutional policies about instruction including: learning by working out rather than learning through telling. Although children oriented to restricted activity when directed by the teacher or interacting with her, their other interactions during independent writing establish their practice of telling when not in range of the teacher. It is concluded that interactional encounters with the teacher during independent writing produced interactions and activity that were restricted and produced the practical accomplishment of more extraneous institutional objectives.