Using Applied Conversation Analysis to Teach Novice Dietitians History Taking Skills
This paper presents an applied approach to conversation analysis in a setting comprising student dietitians and patients attending an outpatient clinic for heart disease and related disorders. In the first phase of the study interactions involving students deemed competent by supervisors were closely examined for distinctive configurations which could be attributed to satisfactory entry level practice. Reference was made to studies in similar settings and a particular emphasis was placed on the narrative structure for producing the diet history account. In the second phase a different group of students were taught history taking skills using findings and materials from the initial analysis. This focused on how to introduce the history and how to support its progression to achieve the outcomes required by the professional. In the final phase, interactions involving this second group of students were studied in detail to determine whether the interactional patterns taught were displayed in subsequent interactions. A further application of conversation analysis demonstrated that the second group of students co-constructed history phases which befitted the preferred narrative structure. These findings displayed the way in which conversation analysis could be applied in the teaching setting, bearing in mind that there is no escape from the situated order of professional interaction (nor indeed of the teaching context). The perspective presented of the interaction was one of 'professional medicine', that is it exposed issues of accountability and practical circumstances, when, in this case, novice dietitians 'do' nutrition counselling.