Teamwork and Team Talk - Decision-making across the Boundaries in Health and Social Care - Srikant Sarangi

Teamwork and Team Talk - Decision-making across the Boundaries in Health and Social Care - Srikant Sarangi

The management of diagnostic uncertainty and decision-making in genetics case conferences

Teamwork and Team Talk - Decision-making across the Boundaries in Health and Social Care - Srikant Sarangi

Olga Zayts [+-]
The University of Hong Kong
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I arrived in Hong Kong in December 2003 after completing my PhD studies in St. Petersburg, Russia, and have researched and taught in this vibrant city ever since. My areas of expertise and research interests broadly include interactional approaches to professional communication, in particular in healthcare and business settings. In the past few years I have been working on a number of research projects studying social interactions in the genetic counselling and prenatal screening contexts in Hong Kong in collaboration with public hospitals and the Clinical Genetic Services of Hong Kong. I have also been studying business interactions in a number of large international corporations and privately-owned businesses.Currently I lead the Health Communication Research Cluster at the Center for the Humanities and Medicine, HKU where I also serve as a Board Member; and I am a member of the Consortium on Clinical Genetics and Genomic Medicine (Hong Kong West Cluster (HKWC)/HKU) that strives to improve genetic and genomic services in Hong Kong. Besides work, I also love spending time with my two sons and enjoy trail running around Asia.
Srikant Sarangi [+-]
Aalborg University
Srikant Sarangi is Professor in Language and Communication and Director of the Health Communication Research Centre at Cardiff University, Wales, UK (www.cf.ac.uk/encap/research/hcrc). He is also Professor in Language and Communication at Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Honorary Professor at the Faculty of Humanities, Aalborg University, Denmark; and Honorary Professor at the Centre for the Humanities and Medicine, The University of Hong Kong. His research interests are in discourse analysis and applied linguistics; language and identity in public life and institutional/professional communication studies (e.g., healthcare, social welfare, bureaucracy, education etc.). He has held several project grants (Funding bodies include The Wellcome Trust, The Leverhulme Trust, ESRC) to study various aspects of health communication, e.g., genetic counselling, HIV/AIDS and telemedicine. The other areas of healthcare research include communication in primary care, palliative care, with particular reference to assessment of consulting and communication skills. He is author and editor of 12 books, 5 journal special issues and has published nearly 200 journal articles and book chapters. He is the founding editor of Communication & Medicine, editor of TEXT & TALK: An Interdisciplinary Journal of Language, Discourse and Communication Studies (formerly TEXT) as well as co-editor (with C. N. Candlin) of Journal of Applied Linguistics and Professional Practice. He is also general editor (with C. N. Candlin) of three book series[es]: Studies in Applied Linguistics; Studies in Language and Communication; and Studies in Communication in Organisations and Professions. He serves as an editorial board member for other journals and book series[es], and as a consulting advisor at many national and international levels. His involvement in professional societies include membership of the Executive Committee of the British Association of Applied Linguistics (BAAL, 1997-2002) and Member-at-Large of the Executive Board of the International Association of Applied Linguistics (AILA, 1999-2002). He is also the founder of the annual interdisciplinary conference series, Communication, Medicine and Ethics (COMET) and Applied Linguistics and Professional Practice (ALAPP). Over the last ten years, he has held visiting academic attachments in many parts of the world.
Stephanie Schnurr [+-]
University of Warwick
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My main research interests are professional and medical communication. I am particularly interested in leadership, and the crucial role that communication plays in leadership performance. I have researched and published widely on various aspects of leadership discourse, gender, the multiple functions and strategic uses of humour, politeness and impoliteness, identity construction, the role of culture, decision making and advice giving, and other aspects of workplace discourse in a range of professional and medical contexts.

Description

In this paper we examine one type of intraprofessional collaborative activity, namely case conferences in a specialist genetics clinic. Our specific focus is on how clinical geneticists manage decision-making through team talk in the event of diagnostic uncertainty which is mainly attributable to limitations in the current state of genomic knowledge, ‘uncertain significances’ associated with genetic test results, and a lack of information/evidence pertaining to cases under discussion. The case conference then becomes a means to minimise the uncertainty and arrive at decisions that optimise the significance of the results in terms of clients’ life trajectories. Adopting theme-oriented activity analysis, we examine video-recorded data from five case conferences in Hong Kong. Beginning with a prototypical structural mapping of the case conference activity type, our analysis focuses on what we call ‘uncertain cases’. Our findings highlight three discourse types constitutive of team talk: pedagogic talk, diagnostic talk and decisional talk. In paying particular attention to how uncertainty is formulated and negotiated, we suggest that access to and assessment of different kinds of evidence as well as the activity-specific expert role-positions of the participants are crucial with regard to establishing a correct diagnosis and/or striving towards a minimisation of current uncertainties.

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Citation

Zayts, Olga; Sarangi, Srikant; Schnurr, Stephanie. The management of diagnostic uncertainty and decision-making in genetics case conferences. Teamwork and Team Talk - Decision-making across the Boundaries in Health and Social Care. Equinox eBooks Publishing, United Kingdom. p. Jun 2025. ISBN 9781845539054. https://www.equinoxpub.com/home/view-chapter/?id=25187. Date accessed: 21 Jul 2024 doi: 10.1558/equinox.25187. Jun 2025

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