"I Surrendered": Metaphors in Residents' Stories about Communication Challenges

Area of Science:

• Medical Education
• Linguistics
• Discourse Analysis

Background:

• Physician communication with patients is a known challenge for residents.
• Existing research often focuses on residents' experiences rather than the language used to describe them.
• Metaphor analysis is a valuable tool for understanding conceptualizations in health-related fields.

Purpose of the Study:

• To explore the metaphors Danish residents employ when recounting challenging patient communication scenarios.
• To understand how these metaphors illuminate the perceived nature of communication difficulties.
• To apply metaphor-led discourse analysis to gain insights into resident experiences.

Main Methods:

• Utilized metaphor-led discourse analysis for systematic identification and analysis of metaphors.
• Analyzed 259 narratives from 138 Danish residents detailing communication challenges.
• Identified and categorized over 700 metaphors used in descriptions of these challenges.

Main Results:

• A significant number of metaphors were identified in residents' accounts of communication challenges.
• The dominant metaphorical themes were categorized into four main groups: Location, Movement, Games and play, and Battle and warfare.
• These metaphors provide insight into how residents conceptualize and frame communication difficulties.

Conclusions:

• Metaphorical language plays a crucial role in how residents articulate and understand communication challenges with patients.
• The identified metaphorical categories (Location, Movement, Games, Battle) highlight specific conceptualizations of these difficulties.
• Understanding these metaphors can inform strategies for improving communication skills training for medical residents.