研究成果概要：This research has analysed how student doctors and simulated patients from overseas communicate in primary care his...This research has analysed how student doctors and simulated patients from overseas communicate in primary care history-taking in English as a Lingua Franca. Special focuses are as follows; 1) how student doctors deliver the diagnosis and suggest the treatment and 2) how simulated patients disagree with or resist the diagnosis and suggestion. The conversation data were audio-visual recorded and transcribed for subsequent conversation analysis. Conversation analysis has found three types of delivering diagnosis and suggestion by the student doctors and two types of disagreement or resistance by the simulated patients. In this data, the student doctors tend to deliver their decisions by using hedging expressions such as auxiliary verbs and stance markers when referring to the process of inference such as characteristics of the symptoms. Some however use more direct expressions when delivering strong need and necessity by clearly explaining the evidence of diagnosis. The former leads to immediate and smooth agreement of the treatment phase, while the latter invites more disagreement by the patients. For showing disagreement, the patients are found to use both question-formulation and repetition. The former facilitates immediate transition to the negotiation phase, while the latter requires multiple turns for the doctors to understand their disagreement.
研究成果概要：This study has analysed how student doctors and simulated patients pre-empt and repair non-understanding in doctor-...This study has analysed how student doctors and simulated patients pre-empt and repair non-understanding in doctor-patient interactions at primary care medical consultations in English as a Lingua Franca. It specifically focuses on clarifying conversation strategies during history-taking used by student doctors and simulated patients to achieve their communicative purposes successfully, co-constructing mutual understanding and collaboratively producing a diagnosis. Throughout the current history-taking data, student doctors conscientiously engaging in achieving mutual understanding with simulated patients in information-gathering process at history-taking. They pursue this goal by repeating and rephrasing simulated patients’ utterances as well as their own and never let the trouble sources or signs of non-understanding pass. They use the following strategies extensively; simply repeating, reformulating the whole utterance, by observing simulated patients’ response and reaction very carefully. As a result, these efforts pre-empted non-understanding and triggered immediate repair of the trouble sources. This attitude can contribute to the embodiment of patient-centred care. It is expected that future research contributes to supporting student doctors and developing their communicative skills for dealing with non-understanding in doctor-patient interaction by collaborative effort.