Chapter 14 Inter-Professional Clinical Handovers in Surgical Practice
Peter Roger [+]
Maria R Dahm [+]
John A. Cartmill [+]
Lynda Yates [+]
Department of Linguistics Macquarie University
Much of the professional communication that takes place in hospitals involves members of different professional groups sharing clinical information. This is a crucial element of surgical practice, where surgeons and resident medical/surgical staff need to be able to communicate effectively with other health professionals to achieve optimal patient care outcomes, particularly in the post-operative phase. This chapter focuses on a clinical handover scenario involving a paediatric surgical case. In a series of role-played interactions, six medical practitioners with different levels and types of experience assumed the role of a resident hospital doctor receiving handover information from a registered nurse. Drawing on the concept of interactive framing in discourse (cf. Goffman 1974; Tannen 1993), analysis focuses on the ways in which doctors’ expectations and perceptions of team-based versus individual practice affect the way in which they approach the handover. Findings highlight the potential for effective clinical communication in cases where doctor and nurse share similar perceptions of their respective roles and responsibilities, as well as the potential for conflict and misunderstanding where mismatches exist in the ways in which the two professionals ‘frame’ the handover interaction. It is argued that an understanding of the ways in which such encounters are framed has important practical applications in the design of communication training and professional development programs in surgical practice. The ways in which the findings can be practically applied are outlined in detail.