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Objective: This study addresses, for the first time, the effectiveness of receptionists handling incoming calls from patients to access General Practice services. Methods: It is a large-scale qualitative study of three services in the UK. Using conversation analysis, we identified the issue of 'patient burden', which we defined based on the trouble patients display pursuing service. We quantified instances of 'patient burden' using a coding scheme. Results: We demonstrate how 'patient burden' unfolds in two phases of the telephone calls: (i) following an initial rejection of a patient's request; and (ii) following a receptionist's initiation of call closing. Our quantitative analysis shows that the three GP services differ in the frequency of 'patient burden' and reveals a correlation between the proportion of 'patient burden' and independent national satisfaction scores for these surgeries. Conclusion: Unlike post-hoc surveys, our analysis of live calls identifies the communicative practices which may constitute patient (dis)satisfaction. Practice Implications: Through establishing what receptionists handle well or less well in encounters with patients, we propose ways of improving such encounters through training or other forms of intervention.
Drawing from Conversation Analysis (CA), we examine how the orientation towards progressivity in talk-keeping things movingmight help us better understand and design for voice interactions. We introduce progressivity by surveying its explication in CA, and then look at how a strong preference for progressivity in conversation works out practically in sequences of voice interaction recorded in people's homes. Following Stivers and Robinson's work on progressivity, we find our data shows: how non-answer responses impede progress; how accounts offered for non-answer responses can lead to recovery; how participants work to receive answers; and how, ultimately, moving the interaction forwards does not necessarily involve a fitted answer, but other kinds of responses as well. We discuss the wider potential of applying progressivity to evaluate and understand voice interactions, and consider what designers of voice experiences might do to design for progressivity. Our contribution is a demonstration of the progressivity principle and its interactional features, which also points towards the need for specific kinds of future developments in speech technology. CCS CONCEPTS • Human-centered computing → Natural language interfaces.
This article explores how to best deal with resistance during and beyond initial encounters with prospective mediation clients. The study is based on a large data set of intake calls to community and family mediation services in the United Kingdom. Using conversation analytic techniques, we studied instances where call takers invited prospective clients to make a first appointment. We found that questions or proposals addressing whether the caller would be willing to mediate generated stronger agreement from the caller than when other formats were used. We discuss how to best establish effective practice in order to develop better training for mediators.
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