“Atypical Interactions” in Healthcare: A State-of-the-Art Literature Review of Conversation-Analytic Research, with Reflections on Equity, Diversity, and Inclusion

Abstract

Our state-of-the-art review examines conversation-analytic (CA) research on healthcare encounters in which the patient has a disability that can affect their communication, using the lens of the social relational model of disability. We report findings via the following themes: where (and why) interactional challenges arise, practitioner barriers and facilitators to effective communication, how behaviors interpreted medically as symptoms can be understood as interactional competencies, and understanding the role of companion. We reflect on equity, diversity, and inclusion in CA research, arguing that labeling interactions as “atypical” can lead to assumptions that findings are circumscribed and have no wider applicability. Existing research has focused on specialist settings created for people with one particular condition, overlooking their healthcare interactions with other healthcare services. We argue that CA research on healthcare and beyond should include a more diverse range of interactants and also discuss why. Data in examples are in multiple languages.