Two sources of miscommunication in oncology consultations: an observational study using conversation analysis

This paper investigates miscommunication in sequences of talk where an oncologist asks about patients’ comorbidities, that is, their other illnesses beyond cancer. Using conversation analysis, we examine ways in which the participants make observable and manage two sources of miscommunication: a divergence in the doctor’s and the patient’s understandings about the scope of the question; and a divergence in the doctor’s, the patient’s (and sometimes their companion’s) understandings about the matters that the question targets. Our findings have implications for practice, highlighting practices that clinicians and patients can use to manage these sources of miscommunication. These include practices to retrospectively or preemptively manage ambiguities and to check the accuracy of patients’ answers. Additionally, our study addresses some theoretical and methodological problems in the study of miscommunication. Our data consist of twenty-five outpatient first consultations video-recorded in an Italian hospital; the participants speak Italian