White Rose University Consortium logo
University of Leeds logo University of Sheffield logo York University logo

Explanations in consultations: the combined effectiveness of doctors' and nurses' communication with patients

Collins, S. (2005) Explanations in consultations: the combined effectiveness of doctors' and nurses' communication with patients. Medical Education, 39 (8). pp. 785-796. ISSN 0308-0110

Full text not available from this repository.



Multidisciplinary and interprofessional working is currently a priority in health care policy, in caring for patients and in health professional education. Realising multidisciplinary approaches presents challenges in the context of changes in doctors' and nurses' roles and the increased emphasis placed on communication with patients. In communication in consultations, explanations are employed in the service of numerous activities, including decision making, diagnosis and physical examination, but they have been little studied.


This paper presents findings from a comparative study of doctors' and nurses' communication with patients in multidisciplinary health care, focusing on diabetes in primary care.


Video- and audio-recorded consultations were subjected to conversation analysis. Output from discussion groups with patient representatives and health professionals underwent qualitative analysis.


Distinctive features of explanations in nurses' and doctors' consultations with patients were identified. These can be understood by reference to patterns of communication. Nurses' communication was mediated by patients' contributions; doctors' communication gave an overarching direction to the consultation as a whole. While nurses' explanations began from the viewpoint of a patient's responsibility and behaviour, doctors' explanations began from the viewpoint of biomedical intervention. Their consultations lent different opportunities for patients' involvement.


Nurses' and doctors' communications each exhibit their own distinct features. Specification of these features, when considered in the context of a particular consultation activity such as explanations, allows both recognition of the distinct contributions each profession can offer and identification of ways of combining these to maximum effect. This has implications for policy, for practice and for interprofessional education.

Item Type: Article
Institution: The University of York
Academic Units: The University of York > Health Sciences (York)
Depositing User: York RAE Import
Date Deposited: 27 Mar 2009 10:09
Last Modified: 27 Mar 2009 10:09
Published Version: http://dx.doi.org/10.1111/j.1365-2929.2005.02222.x
Status: Published
Publisher: Wiley-Blackwell
Identification Number: 10.1111/j.1365-2929.2005.02222.x
URI: http://eprints.whiterose.ac.uk/id/eprint/6990

Actions (repository staff only: login required)