A Conversation Analytic Intervention to Help Neurologists Identify Diagnostically Relevant Linguistic Features in Seizure Patients’ Talk

Abstract

Recent conversation analytic work has revealed that there are systematic differences between the ways in which patients with epilepsy and patients with “psychogenic” nonepileptic seizures describe their seizure experiences. But these differences may not become apparent if patients are exposed to traditional fact-oriented questioning. This article describes a one-day intervention workshop, informed by conversation analysis, which was designed to help doctors change their questioning style and solicit diagnostically useful narrative features. A comparison of video recordings of 38 routine consultations before the intervention, and 20 consultations after it, showed that the intervention had the desired effect. Doctors’ problem-presentation solicitation changed, and the patient responses were better suited to revealing diagnostically relevant features of their talk. Data are in British English.

The authors would like to thank Dr. Ammar Kheder, Dr. Jeremy Cosgrove, and Dr. Dilraj Sokhi for their tireless efforts that made data collection possible, and the participants, particularly the doctors, for making time for the intervention and seeing patients for this study. Thanks to Dr. Katie Ekberg for her valuable work in the first stage of this project, including designing the intervention. We are also grateful for insightful analytic comments in data sessions at the University of Sheffield and Loughborough University Discourse and Rhetoric Group.

Notes

2. ¹One doctor withdrew from the study (as he moved overseas) prior to recording consultations in the postintervention stage, one doctor recorded postintervention consultations after this article had been completed, and one doctor was unable to record consultations following the intervention.