Introduction: This paper reports on research conducted within a Hong Kong (HK) accident and emergency department (AED), which investigated the effectiveness of health care worker-patient communication over the course of patients' journeys from triage to disposition. Methods: The research combined qualitative and quantitative ethnographic methods with linguistically-oriented discourse analysis of audiotaped interactions between patients and health care workers. It involved: (1) observations, (2) semi-structured interviews with management and health care workers, (3) surveys with AED staff, (4) audio-recordings of 10 patients' journeys, and (5) follow-up interviews with patients. Results: The paper described the typically complex communication networks involved in AED care. It then exemplified how certain communicative strategies, balancing the communication of medical knowledge with interpersonal communication, could be used to achieve positive healthcare outcomes. This was illustrated by a case study of one patient's journey through the AED, pinpointing health care workers' effective use of communication strategies, their effect on the patient's participation and subsequently the patient's understanding and evaluation of the care he received. Conclusion: The high stress nature of AEDs inevitably poses challenges to communication. The results of this study, however, strongly suggest a correlation between health care workers' use of effective, interpersonally sensitive communication strategies and positive patient outcomes. Health care worker-patient communication that effectively balances interpersonal communication with the communication of medical expertise is integral to ensuring patients' participation in, understanding of, and satisfaction with their healthcare. These communication strategies should be required components in health care worker communication training.
In this article, we apply methods under development in socio-functional semiotics to explore the transfer of resources originally developed for comics to the medium of film. We illustrate this concretely with respect to extracts taken from Ang Lee’s Hulk (2003), a film we consider unique in its particular appropriation of expressive resources from the comic medium. Hulk is often been singled out in discussions of the relations between comics and film because many of the design decisions taken in the film evoke aspects of the comic page. Here, we argue that its use of the resources of comics goes substantially beyond ‘evocation’: Hulk is best considered a highly experimental hybrid, taking resources that were initially essentially comics based and ‘translating’ these filmically in order to extend the medium of film in interesting ways. We show this in two respects: first, we consider the filmic deployment of comicbook conventions for expressing movement; second, we establish that the film’s use of split-screen techniques extends the ability of film to express narrative continuity and connection between perspectives.
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