Abstract
This chapter explores the role of repetition for expressing cognitive empathy during simulated primary care medical consultation between Japanese and non-Japanese student doctors and simulated patients (SPs) from different lingua-cultural backgrounds in English as a Lingua Franca (ELF), using conversation analysis. “Empathy” in medicine has been discussed in a number of extensive literatures, but empathy practice in doctor–patient communication in ELF has rarely been investigated. This chapter adopts the definition of empathy in patient care by Hojat (Empathy in Patient Care: Antecedents, Development, Measurement, and Outcomes. Springer, New York, 2007) and empathy categories by Duan and Hill (J Couns Psychol 43:261–274, 1996) and examines how the student doctors express cognitive empathy, that is, the student doctors’ understanding of the SP’s state by using repetition, which has been argued as the effective strategies for co-constructing mutual understanding and accommodation in ELF communication. The analysis section compares two cases of medical interview in ELF and provides an emic perspective on how cognitive empathy is delivered and received.
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Notes
- 1.
Simulated patients are those who play a role of patient in simulated medical interview during medical English classroom. Information about SPs such as educational background, age, nationality, L1 are not provided for protecting their privacy, following the ethical approval this research obtained.
- 2.
- 3.
Conversation analysis, the origin of which is in ethnomethodology, enables the microscopic and emic view of analysis of interaction (e.g. Heritage & Atkinson, 1984). This chapter uses conversation analysis for studying empathy in practice, as empathy is now widely understood as individually different and situation-specific (e.g. Hojat, 2007; Wynn & Wynn, 2006).
- 4.
Kupetz (2014) suggests the new conceptualisation of empathy, which is in line with cognitive empathy and affective empathy in psychology or psychotherapy, but her data is not institutional one, but everyday interaction.
- 5.
This chapter does not consider other categories of empathy related to partaking in patient’s emotion, but this project does not necessarily exclude the sharedness of emotion or feelings, as it understands emotive involvement is inherent to doctor–patient interaction overall (e.g. Kupetz, 2014), where the participants orient to the problem-solving communicative purpose.
- 6.
They are not necessarily conversation analytic approach.
- 7.
In this data, “sympathy” is not discussed as a distinct phenomenon from empathy. From medical education perspective, the author of this chapter understands it is used synonymously.
- 8.
Accommodation is known as adjusting one’s speech to the other’s in order to facilitate communication and make it more intelligible (e.g., Giles, Coupland, & Coupland, 1991).
- 9.
Data collection was approved by Academic Research Ethical Review Committee of the university. The names and identifying characteristics of the participants were anonymised.
- 10.
Through this programme, the students engage in clinical practice at their destination such as Thailand, Germany, Taiwan and USA.
- 11.
The nationalities of the participants have not been disclosed in order to protect their privacy.
- 12.
This class is mainly organised and taught by an English teacher. He is also a multilingual speaker and licensed as a doctor.
- 13.
In both sessions, the junior student doctor basically conducts the medical interview. At the end of the phase of history-taking, the senior student doctor asks some additional questions in order to support the junior student doctor’s information collection process.
- 14.
TRP: Transition Relevance Place refers to a point in a speaker’s turn where transitions of a speakership occur, such as the end of a sentence (e.g., Sacks, Schegloff, & Jefferson, 1978).
- 15.
In this case, empathy is not delivered in the form of repetition, but by verbalisation of the student doctor’s stance for the SP’s state.
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This is a part of my PhD project, which is partially supported by a Grant-in-Aid for Scientific Research: MEXT/JSPS KAKENHI Grant Number JP18K12469.
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Nozawa, Y. (2020). Co-construction of Cognitive Empathy between Student Doctors and Simulated Patients in English as a Lingua Franca. In: Konakahara, M., Tsuchiya, K. (eds) English as a Lingua Franca in Japan. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-33288-4_13
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