Clinicians’ narratives in the era of evidence-based practice

Abstract

In evidence-based practices, narratives are the vehicle through which medical knowledge is shared and clinical judgment is grounded. This paper explores narratives as a sanctioned social practice that help a group of clinicians in a healthcare institution in New Zealand build and negotiate expertise and accountability, as they discuss clinical cases. To this end, the paper investigates narratives in six staff meetings, which were video and audio recorded. The paper presents a discursive analysis of the functions of narratives in this context to show how narratives are interactional achievements that are pivotal to clinical decision-making and to building and contesting professional stances. Finally, the paper reflects on the value of narratives as shared resources that are sometimes revisited and reframed over time and that help construct a common thread of history that becomes part of the cultural capital of the organization and positions clinicians as core members of their community.

Expert Claims in Clinical Meetings: Analysing the Relational Role of Medical Jargon

“…Though these contributions are very valuable and widely acknowledged in the sociolinguistic literature, this exploration of expert knowledge has often been approached as a continuum of professional development, even when investigated from a discursive perspective (consider Philip, Woodward-Kron & Manias, 2019), and, as a consequence, its underlying assumptions of rather fixed categories and stages of expertise have commonly been questioned (Lazzaro-Salazar, 2013;Dall'Alba & Sandberg, 2006). As a result of this scholarly focus of nursing talk, the way expert stances may serve purposes other than transactional ones, for instance, relational purposes (as proposed by Fletcher, 1999), in nurse-nurse communication has seldom been addressed (consider McDowell, 2015(consider McDowell, , 2018Lazzaro-Salazar, 2022).…”