The use of narratives in medical work: a field study of physician-patient consultations

Troels Mønsted, Madhu Reddy, Jørgen P. Bansler

Publikation: Bidrag til bog/antologi/rapportKonferencebidrag i proceedingsForskningpeer review

Abstract

Medical reasoning involves more than just summarizing clinical data and
guidelines. Illness trajectories of chronic patients are often long, complex and full of uncertain information that requires interpretation. Understanding the complex interrelations is an important aspect of medical reasoning that displays narrative rather than scientific characteristics. While the qualities of the medical record as a repository of information or as a coordinative tool are well known, the role it plays in the unfolding of narratives in medical reasoning is less discussed. This paper examines this issue through a case study of patient consultations that take place as part of a distributed treatment of chronic heart patients. We found that the record, even though fragmented and to some extent incomplete, enables the physician to construct an ad hoc narrative.
During the actual consultation, physicians and patients unfold a more detailed narrative, which we refer to as the re-emplotted narrative, that includes additional information and entails a collaborative exploration of uncertainties. While this may point to some inadequacies of the medical record as a supportive tool for the process of unfolding narrative, we suggest that is it in fact a crucial component of the medical reasoning activity that must be considered in design of supportive systems.
OriginalsprogEngelsk
TitelECSCW 2011 : Proceedings of the 12th European Conference on Computer Supported Cooperative Work24-28 September 2011, Aarhus, Denmark
RedaktørerSusanne Bødker, Niels Olof Bouvin, Volker Wulf, Luigina Ciolfi, Wayne Lutters
Antal sider20
ForlagSpringer
Publikationsdato2011
Sider81-100
ISBN (Trykt)978-0-85729-913-0
DOI
StatusUdgivet - 2011
Begivenhed12th European Conference on Computer Supported Cooperative Work - Århus, Danmark
Varighed: 24 sep. 201128 sep. 2011
Konferencens nummer: 12

Konference

Konference12th European Conference on Computer Supported Cooperative Work
Nummer12
Land/OmrådeDanmark
ByÅrhus
Periode24/09/201128/09/2011

Citationsformater