A brief conversation analytic communication intervention can change history-taking in the seizure clinic

Jenkins, Laura, Cosgrove, Jeremy, Ekberg, Katie, Kheder, Ammar, Sokhi, Dilraj and Reuber, Markus (2015) A brief conversation analytic communication intervention can change history-taking in the seizure clinic. Epilepsy and Behavior, 52 Part A: 62-67. doi:10.1016/j.yebeh.2015.08.022

Author Jenkins, Laura
Cosgrove, Jeremy
Ekberg, Katie
Kheder, Ammar
Sokhi, Dilraj
Reuber, Markus
Title A brief conversation analytic communication intervention can change history-taking in the seizure clinic
Journal name Epilepsy and Behavior   Check publisher's open access policy
ISSN 1525-5050
Publication date 2015-11
Sub-type Article (original research)
DOI 10.1016/j.yebeh.2015.08.022
Open Access Status Not Open Access
Volume 52
Issue Part A
Start page 62
End page 67
Total pages 6
Place of publication Maryland Heights, MO, United States
Publisher Academic Press
Collection year 2016
Language eng
Formatted abstract
Question design during history-taking has clear implications for patients' ability to share their concerns in general and their seizure experiences in particular. Studies have shown that unusually open questions at the start of the consultation enable patients to display interactional and linguistic markers which may help with the otherwise challenging differentiation of epileptic from nonepileptic seizures (NES). In this study, we compared the problem presentation approach taken by trainee neurologists in outpatient encounters with new patients before and after a one-day conversation analytic training intervention in which doctors were taught to adopt an open format of question design and recognize diagnostically relevant linguistic features. We audio/video-recorded clinical encounters between ten doctors, their patients, and accompanying persons; transcribed the interactions; and carried out quantitative and qualitative analyses. We studied 39 encounters before and 55 after the intervention. Following the intervention, doctors were significantly more likely to use nondirective approaches to soliciting
patient accounts of their presenting complaints that invited the patient to describe their problems from their own point of view and gave them better opportunity to determine the initial agenda of the encounter. The time to first interruption by the doctor increased (from 52 to 116 s, p b .001). While patients were given more time to describe their seizure experiences, the overall appointment length did not increase significantly (19 vs 21 min, n.s.). These changes gave patients more conversational space to express their concerns and, potentially, to demonstrate the interactional and linguistic features previously found to help differentiate between epilepsy and NES, without impacting the length of the consultations.
Keyword Epilepsy
Nonepileptic seizures
Doctor–patient communication
Conversation analysis
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Non HERDC
School of Health and Rehabilitation Sciences Publications
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Citation counts: Scopus Citation Count Cited 2 times in Scopus Article | Citations
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Created: Mon, 28 Sep 2015, 09:17:08 EST by Katie Ekberg on behalf of School of Health & Rehabilitation Sciences