My main research interest is the study of interaction between patients and health care providers. I specialise in the application of conversation analytic (CA) methods, to address important questions in relation to improving health care. I have studied patient requests and doctor offers for medical services, how treatment recommendations are formulated and responded to, and safety-netting practices in primary care. I am also interested in using CA alongside other methods to examine implementation fidelity in clinical trials.
I have recently worked alongside Dr Tanya Stivers, Professor John Heritage (UCLA), Professor Rose McCabe (Exeter University) and Dr Merran Toerien (York University) on a large collaborative CA study, the Treatment Recommendations Project, comparing the different ways that medications are recommended by doctors across different health care contexts.
I was PI for the One In a Million study about primary care consultations funded by the NIHR School for Primary Care Research where we investigated how what gets said in the consultation such as advice about medical and non-medical treatments can affect patients' subsequent decision-making. The consultations and other linked data collected in this study have been archived for re-use.
I recently led the development of a CA-grounded coding scheme on the UnPAC study, Understanding the causes of miscommunication in Primary care consultations for children with Acute Cough (UnPAC), also funded by the NIHR School for Primary Care Research (PI Dr Christie Cabral, UoB).
I am also currently PI on a feasibility study of a communication intervention for consultations with patients who attend primary care significantly more than the norm funded by the NIHR Research for Patient Benefit Programme. Here we are using CA to monitor the validity of the intervention implementation, and to inform the training of GPs.
I am interested in supervising postgraduate students in the following areas: patient-health care provider interaction, conversation analytic (CA) methods, prescribing, safety-netting, using mixed methods to assess implementation fidelity in trials.
My background is in social psychology and for the last 15 years I have been steadily building my research experience as a qualitative methodologist, specialising in applied conversation analytic (CA) methods with a particular interest in health care communication. CA is the dominant contemporary method for the analysis of social interaction. It has been extensively applied in primary care, particularly in North America where it has been used to successfully identify a wide range of important communication practices and dilemmas that recur in patient-provider consultations and that have substantive effects and outcomes. The field is rapidly evolving and in the UK, it is also beginning to find its way into various aspects of RCTs, complementing other qualitative methods used for process evaluations such as focus groups and interviews. Furthermore it can provide a theoretical resource for the content of interventions themselves, attracting researcher-clinician partnerships, NIHR funding and policy makers.
I conceived the idea for and organised (with Professor Nicky Britten, UoE) the 1st & 2nd ‘International Meeting on Conversation Analysis and Clinical Encounters’, sponsored by the Foundation for the Sociology of Heath and Illness, held July 16-18th 2007 at the Peninsula Medical School, University of Exeter and July 20-23rd 2009 at the Peninsula Medical School, University of Plymouth.
I am a member of the International Society for Conversation Analysis
I currently tutor on the MBChB Year 1: Society, Health & Medicine course, and organise and teach a short course at the School of Social and Community Medicine, 'Introduction to using Conversation Analysis to study Health Care Encounters'
View complete publications list in the University of Bristol publications system
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