Self-Repeats-as-Unit-Ends: A Practice for Promoting Interactivity During Surgeons’ Decision-Related Informings

ABSTRACT

Although information provision is a prerequisite of informed decision making in surgical consultations, research has shown that patients’ understanding of such information is often limited. We use conversation analysis to illustrate patients’ and surgeons’ management of interactivity, intersubjectivity, and progressivity during information provision, which frequently takes the form of extended tellings. In the midtelling phase of extended tellings, the surgeon is the primary speaker and patients orient to the temporary suspension of the usual turn-taking system. On the rare occasions that patients do take the floor midtelling, it is overwhelmingly following surgeons’ self-repeats-as-unit-ends, which include gist formulations. We argue that surgeons’ self-repeats-as-unit-ends are a practice for encouraging interactivity during extended tellings and as a consequence for facilitating shared understanding of decision-relevant information. Data are in English.

Data availability statement

The data used in this study are not publicly available as they include identifiable images and information that could compromise the privacy of research participants.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Notes

¹ We are grateful to Reviewer B for pointing out that the patient’s question could relate to the left lung spot having different implications for the patient on learning that the whole of the right lung might need to be removed.

² This 0.4-second silence was timed using ELAN software. However, because this surgeon has a fast speech cadence, it is perceptibly shorter than four Jeffersonian “beats” (Hepburn & Bolden, 2017).

³ This patient does occasionally display strong intersubjective alignment with the surgeon via choral completions (Lerner, 2002). However, our focus is on patients’ floor-taking turns.

⁴ Surgeons do, however, invite questions to mark the completion of ID/ETSs (e.g., Excerpt 1).