Body Part Highlighting: Exploring two types of embodied practices in two sub-types of showing sequences in video-mediated consultations
Consultations in healthcare settings involve an initial phase of “history-taking”, during which the healthcare professional examines the client for symptoms by asking questions, making the client show symptoms on his or her own body, and performing bodily examinations. But how can bodily symptoms be identified when the interaction is video-mediated and sensory access is limited? One key resource here is “body showings”. However, research suggests that video-mediated teleconsultations reduce body showings due to both technical difficulties and sensory obstruction. In this paper, we provide a contrary case that shows two types of practices employed for successful history-taking through body-part showings. Based on an analysis of an “evocative showing sequence” (Licoppe, 2017), we present two types of gestural highlighting practices, via two types of showing sub-sequences: 1) “mimicable body part highlighting”, which occurs in a sequence of “adapting-body-to-frame”; and 2) “direct body part highlighting”, which occurs in a sequence of “adapting-frame-to-body”. The paper uses a single case to discuss how gestures work in a video-mediated context and how sensory judgements are not just a property of the healthcare professional, but are distributed to clients who are able to creatively adapt to situated contingencies in order to accomplish common understanding about the symptoms. The data consist of video-recorded, video-mediated physiotherapy consultations in Denmark, analysed using ethnomethodological conversation analysis (EMCA). The paper contributes to EMCA research on mediated interaction and embodied, gestural and sensorial practices.
Byrne, P. S., & Long, B. E. L. (1976). Doctors Talking to Patients: A Study of the Verbal Behaviours of Doctors in the Consultation. London: Royal College of General Practitioners.
Cocksedge, S., George, B., Renwick, S., & Chew-Graham, C. A. (2013). Touch in primary care consultations: Qualitative investigation of doctors’ and patients’ perceptions. The British Journal of General Practice: The Journal of the Royal College of General Practitioners, 63(609), P. 283-290. https://doi.org/10.3399/bjgp13X665251
Deppermann, A. (2014). Multimodal participation in simultaneous joint projects: Interpersonal and intrapersonal coordination in paramedic emergency drills. In Multiactivity in Social Interaction Beyond multitasking (eds.) P. Haddington, T. Keisanen, L. Mondada, M. Nevile. Amsterdam: John Benjamins Publishing Co.
Due, B. L., Lange, S. B., Nielsen, M. F., & Jarlskov, C. (2019). Mimicable embodied demonstration in a decomposed sequence: Two aspects of recipient design in professionals’ video-mediated encounters. Journal of Pragmatics, 152, 13–27. https://doi.org/10.1016/j.pragma.2019.07.015
Due, B. L., Lehn, D. V., Webb, H., Heath, C., & Trærup, J. (2020). Servicing the body: Placing glasses on the client’s head at the opticians. Visual Studies, 35(2-3), 109–123. https://doi.org/10.1080/1472586X.2020.1763196
Due, B. L., & Toft, T. (forth.). Phygital Highlighting: Achieving joint visual attention when physically co-editing a digital text. Journal of Pragmatics.
Garfinkel, H. (1996). Ethnomethodology’s Program. Social Psychology Quarterly, 59(1), 5–21.
Gibson, W., & Vom Lehn, D. (2020). Seeing as accountable action: The interactional accomplishment of sensorial work. Current Sociology, 68(1), 77–96. https://doi.org/10.1177/0011392119857460
Goffman, E. (1974). Frame Analysis: An Essay on the Organization of Experience. New York: Harper & Row.
Goodridge, D., & Marciniuk, D. (2016). Rural and remote care: Overcoming the challenges of distance. Chronic Respiratory Disease, 13(2), 192–203. https://doi.org/10.1177/1479972316633414
Goodwin, C. (1994). Professional Vision. American Anthropologist, 96(3), 606–633.
Goodwin, C. (2000). Action and Embodiment Within Situated Human Interaction. Journal of Pragmatics, 32(10), 1489–1522.
Goodwin, C. (2017). Co-Operative Action. New York: Cambridge University Press.
Heath, C. (1986). Body movement and speech in medical interaction. New York: Cambridge University Press.
Heath, C. (1992). The delivery and reception of diagnosis in the general-practice consultation. In P. Drew and J. Heritage (eds.) Talk at work (pp. 235–268). New York: Cambridge University Press.
Heath, C., Luff, P., Sanchez‐Svensson, M., & Nicholls, M. (2018). Exchanging implements: The micro-materialities of multidisciplinary work in the operating theatre. Sociology of Health & Illness, 40(2), 297–313. https://doi.org/10.1111/1467-9566.12594
Heritage, J., & Clayman, S. (2010). Talk in action: Interactions, identities, and institutions. Malden (MA): Wiley-Blackwell.
Hunt, D. P. (2014). Do patients with advanced cancer value the physical examination? Cancer, 120(14), 2077–2079. https://doi.org/10.1002/cncr.28678
Kendon, A. (1988). Sign languages of Aboriginal Australia: Cultural, semiotic, and communicative perspectives. Cambridge: Cambridge University Press.
Koschmann, T., LeBaron, C., Goodwin, C., & Feltovich, P. (2011). “Can You See the Cystic Artery yet?” a Simple Matter of Trust. Journal of Pragmatics, 43(2), 521–541.
Liberman, K. (2013). The Phenomenology of Coffee Tasting: Lessons in Practical Objectivity. In K. Liberman (Ed.), More Studies in Ethnomethodology (pp. 215–262). New York: SUNY Press.
Licoppe, C. (2017). Showing objects in Skype video-mediated conversations: From showing gestures to showing sequences. Journal of Pragmatics, 110, 63–82. https://doi.org/10.1016/j.pragma.2017.01.007
Licoppe, C., Luff, P. K., Heath, C., Kuzuoka, H., Yamashita, N., & Tuncer, S. (2017). Showing Objects: Holding and Manipulating Artefacts in Video-mediated Collaborative Settings. Proceedings of the 2017 CHI Conference on Human Factors in Computing Systems - CHI ’17, 5295–5306. https://doi.org/10.1145/3025453.3025848
Licoppe, C., & Morel, J. (2014). Mundane Video Directors in Interaction: Showing One’s Environment in Skype and Mobile Video Calls. In M. Broth, E. Laurier, & L. Mondada (Eds.), Studies of Video Practices Video at Work. Abingdon, Oxon: Routledge.
Lupton, D., & Maslen, S. (2017). Telemedicine and the senses: A review. Sociology of Health & Illness, 39(8), 1557–1571. https://doi.org/10.1111/1467-9566.12617
Mandel, M. (1977). Iconic devices in American Sign Language. In L. Friedman (Ed.), On the other hand: New perspectives on American Sign Language research (pp. 57–107). New York: Academic Press.
Maslen, S. (2015). Researching the Senses as Knowledge. The Senses and Society, 10(1), 52–70. https://doi.org/10.2752/174589315X14161614601565
Maslen, S. (2016). Sensory Work of Diagnosis: A Crisis of Legitimacy. The Senses and Society, 11(2), 158–176. https://doi.org/10.1080/17458927.2016.1190065
Maslen, S. (2017). Layers of sense: The sensory work of diagnostic sensemaking in digital health. Digital Health, 3. https://doi.org/10.1177/2055207617709101
Meyer, C., Streeck, J., & Jordan, J. S. (2017). Intercorporeality: Emerging Socialities in Interaction. New York: Oxford University Press.
Mondada, L. (2014). The local constitution of multimodal resources for social interaction. Journal of Pragmatics, 65, 137–156. https://doi.org/10.1016/j.pragma.2014.04.004
Mondada, L. (2019). Contemporary issues in conversation analysis: Embodiment and materiality, multimodality and multisensoriality in social interaction. Journal of Pragmatics, 145, 47–62. https://doi.org/10.1016/j.pragma.2019.01.016
Mondada, L. (2020). Orchestrating Multi-sensoriality in Tasting Sessions: Sensing Bodies, Normativity, and Language. Symbolic Interaction. https://doi.org/10.1002/symb.472
Nielsen, S. B. (2016). How Doctors Manage Consulting Computer Records While Interacting With Patients. Research on Language and Social Interaction, 49(1), 58–74. https://doi.org/10.1080/08351813.2016.1126451
Nishizaka, A. (2014). Instructed perception in prenatal ultrasound examinations. Discourse Studies, 16(2), 217–246. https://doi.org/10.1177/1461445613515354
Nishizaka, A. (2017). The Perceived Body and Embodied Vision in Interaction. Mind, Culture, and Activity, 24(2), 110–128. https://doi.org/10.1080/10749039.2017.1296465
Parry, R. (2004). The interactional management of patients’ physical incompetence: A conversation analytic study of physiotherapy interactions. Sociology of Health and Illness, 26(7), 976–1007. https://doi.org/10.1111/j.0141-9889.2004.00425.x
Parry, R. (2009). Practitioners’ accounts for treatment actions and recommendations in physiotherapy: When do they occur, how are they structured, what do they do? Sociology of Health & Illness, 31(6), 835–853. https://doi.org/10.1111/j.1467-9566.2009.01187.x
Parry, R. (2010). Practitioners’ Accounts for Treatment Actions and Recommendations in Physiotherapy: When do they Occur, how are they Structured, what do they do? In Pilnick, A., Hindmarsh, J., Gill, V.T. (eds.) Communication in Healthcare Settings: Policy, Participation and New Technologies (pp. 48–65). John Wiley & Sons, Ltd.. Chichester : Wiley‐Blackwel. https://doi.org/10.1002/9781444324020.ch4
Parry, R. (2013). Giving Reasons for Doing Something Now or at Some Other Time. Research on Language and Social Interaction, 46(2), 105–124. https://doi.org/10.1080/08351813.2012.754653
Robinson, J. D. (2003). An Interactional Structure of Medical Activities During Acute Visits and Its Implications for Patients’ Participation. Health Communication, 15(1), 27–59. https://doi.org/10.1207/S15327027HC1501_2
Ruusuvuori, J. (2001). Looking means listening: Coordinating displays of engagement in doctor–patient interaction. Social Science & Medicine, 52(7), 1093–1108. https://doi.org/10.1016/S0277-9536(00)00227-6
Schegloff, E. A. (1968). Sequencing in Conversational Openings. American Anthropologist, 70(6), 1075–1095.
Schegloff, E. A. (1987). Analyzing Single Episodes of Interaction: An Exercise in Conversation Analysis. Social Psychology Quarterly, 50(2), 101–114. https://doi.org/10.2307/2786745
Schegloff, E. A., & Sacks, H. L. (1973). Opening up closings. Semiotica, 8(4), 289–327.
Scott Kruse, C., Karem, P., Shifflett, K., Vegi, L., Ravi, K., & Brooks, M. (2018). Evaluating barriers to adopting telemedicine worldwide: A systematic review. Journal of Telemedicine and Telecare, 24(1), 4–12. https://doi.org/10.1177/1357633X16674087
Stommel, W. J. P., Goor, H. van, & Stommel, M. W. J. (2020). The Impact of Video-Mediated Communication on Closed Wound Assessments in Postoperative Consultations: Conversation Analytical Study. Journal of Medical Internet Research, 22(5), e17791. https://doi.org/10.2196/17791
Streeck, J. (2008). Depicting by gesture. Gesture, 8(3), 285–301.
Streeck, J. (2009). Gesturecraft: The manu-facture of meaning. Philadelphia: John Benjamins
Svennevig, J. (2018). Decomposing Turns to Enhance Understanding by L2 Speakers. Research on Language and Social Interaction, 51(4), 398–416. https://doi.org/10.1080/08351813.2018.1524575
Weissert, W. G., & Silberman, S. (1996). Health care on the information highway: The politics of telemedicine. Telemedicine Journal: The Official Journal of the American Telemedicine Association, 2(1), 1–15. https://doi.org/10.1089/tmj.1.1996.2.1
Copyright (c) 2020 Author and Journal
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
We follow the Budapest Open Access Initiative's definition of Open Access.
The journal allows the author(s) to hold the copyright without restrictions.
The journal allows software/spiders to automatically crawl the journal content (also known as text mining)
The journal provides article level metadata to DOAJ
The journal allows readers to read, download, distribute, print, search, or link to the full texts of its articles and allow readers to use them for any other lawful purpose.