In this special issue, different kinds of medical interactions are taken into consideration: among healthcare professionals striving to coordinate their efforts to meet patients’ demands; between generalists and specialists treating patients with specialty care needs; caregivers encountering mentally suffering children, or oncologists interacting with their patients. The effects of racially discordant medical interactions (with the physician being non-Black and the patient Black) are also analyzed. Cultural contexts, in which these interactions took place, and methods of analysis of interactions vary across contributions.
In the first part of the special issue, potentialities and affordances of different video-based methods for analyzing interactions in medical settings are presented and discussed. In their paper, O’Brien, Little, Rivera, and Wiedinmyer examine about 100 groups of health professionals and students, while participating at the UCSF Medical Center in a simulated patient exercise (IPE), aimed at preparing to effective interprofessional communication. The video-based interaction analysis emerges as a research method well suited to investigate the learning contribution of this exercise; interaction analysis may also be used to design curricula aimed to enhance interprofessional practice in medical settings.
Using ethnographic and interactional methods, Koenig, Wenger, Graham, Asch, and Rongey analyze 32 video consultations in which generalists and specialists co-manage patients with chronic liver disease at two U.S. medical centers. The analysis identifies a four-phase consultation structure and three distinct consultation types (full cases, updates, and summaries). Such knowledge can help physicians to diversify specialty care opportunities and, ultimately, to improve health outcomes for patients.
In the framework of applied conversation analysis, Fasulo and Sterponi examine three points, focusing on autism as case in point: 1) how mental health difficulties can affect the interaction between professionals and children, but interactional dynamics can influence the manifestation of mental conditions; 2) how psychological assessment could be conceived as a set of institutional practices; 3) how professionals interact with children according to different psychological approaches. Results show that conversation analysis can help to deepen our understanding of children’s mental suffering; it can also enhance children’s and caregivers’ well-being.
In their contribution, Zucchermaglio, Alby, and Fatigante highlight three main points when they analyze a corpus of 35 videorecordings of cancer consultations (in an Italian hospital): 1) anamnesis is a challenging collaborative activity; 2) physicians and patients show different classification practices of what “counts” as illness; 3) anamnesis is a suitable site for patient’s socialization to the oncological domain. Patient’s competence favors compliance to care and allows a more informed participation in the “journey” through the disease.
The second part of the special issue considers intergroup relations in medical contexts, and patient dehumanization. In the domain of racially discordant medical interactions, Dovidio, Eggly, Albrecht, Hagiwara, and Penner, working in the USA, examine the effects of physician’s racial bias on Black patients’ responses to care. These authors identify several interventions which can limit the negative consequences of physician’s prejudice. Hagiwara and Dent note that, in order to advance research on patient-physician communication, new coding systems of racially discordant medical interactions should be evaluated. The aim is to assess what physician’s behaviors are perceived as positive or negative by Black patients. Racial/ethnic disparities in psychotherapy are investigated by Drinane, Owen, and Kopta in a study conducted on a large sample of therapists.
Capozza, Falvo, Boin, and Colledani consider patient dehumanization and its antecedents. They note that patient dehumanization is a dysfunctional way to cope with job-related stress: it can hinder caregiver-patient communication and impair patients’ self-evaluation. The crucial role of physician’s empathetic attitudes is emphasized.
Finally, De Carlo, Dal Corso, Falco, Girardi, and Piccirelli propose organizational measures which can improve work engagement and job satisfaction among caregivers. In a study, performed on a sample of healthcare employees working in a healthcare organization, the following were found as antecedents of work engagement and job satisfaction: perceived organizational support, job autonomy, and perceived supervisor’s responsibility.
The authors involved in this special issue indicate paths to follow: to favor the communication between caregivers and patients; to increase the cooperation between health professionals, and improve practices of medical education. Their common goal is to identify conditions that can enhance patients’ and caregivers’ psychological and physiological well-being.
