Agenda navigation in consultations covering multiple topics. A qualitative case study from general practice

Area of Science:

• Medical Communication
• Linguistics
• General Practice

Background:

• General practitioner (GP) consultations frequently address multiple patient issues, diverging from traditional single-problem models.
• Effective management of these complex consultations requires adept agenda navigation strategies.

Purpose of the Study:

• To investigate the communicative strategies employed by a GP for agenda navigation during consultations involving multiple topics.
• To analyze how GPs manage topic transitions and maintain focus in complex patient encounters.

Main Methods:

• A qualitative observational case study utilizing linguistic microanalysis of a single GP-patient consultation.
• Speech act theory was applied to identify specific communicative actions indicative of agenda navigation across ten distinct topics.

Main Results:

• GP agenda navigation was achieved through distinct speech acts used to open and close topic-specific episodes.
• Episode openings involved accepting patient requests, informing, or requesting information.
• Episode closings primarily consisted of instructions, appraisals, agreements, or planning.

Conclusions:

• Skilful agenda navigation, particularly the distinct opening and closing of episodes, is crucial for managing multi-topic consultations.
• These communication strategies enhance patient-centered care and consultation focus, offering valuable insights for medical education.