An analysis of discourse strategies in pharmacy consultations: Novices and experts, L1 and L2

Face-to-face communication is crucial in pharmacy practice. Increasing numbers of novices in this field need to communicate in English as their second language. This dissertation focuses on the structural features of pharmacy consultations and the linguistic and social knowledge required of pharmacists in the United States. Four research questions are addressed: (a) What discourse strategies do pharmacists use in understanding and responding to clients' concerns about medication? (b) What do performance evaluations of novice pharmacists reveal about the effectiveness of their strategies? (c) How are current pharmacy guidelines put into operation in consultation discourse? (d) How do pharmacists with different levels of experience, performance ratings, and native languages compare in their handling of clients' concerns?; The pharmacy consultations of ten novices (four native speakers, six non-native speakers) and three experienced pharmacists (two native speakers, one non-native speaker) were videotaped. Transcription and analysis of the videotapes followed the approach of Gumperz and Berenz (1993) and Gumperz (1982; 1992). The participants also reflected on their strategies, strengths, and difficulties in playback interviews, which were summarized in profiles of the non-native speakers.; Results indicate that the consultations share a common underlying structure that includes predictable sequences for handling the clients' concerns. The strategies cluster into eight sets of options throughout the consultation. The experienced pharmacists and the more highly rated novices have the following discourse strategies in common: soliciting clients' concerns in the context of ongoing talk about medication problems; providing elaborated responses to the concerns; including reference to the physician during the consultation; and encouraging clients to intersperse contributions to the discourse throughout the consultation. Novices with lower ratings tend not to employ these strategies, and they omit some of the required parts of the consultation.; These findings suggest that investigations of professional consultations are incomplete and insubstantial unless they consider the contextual details of the conversations between clients and practitioners. The strategies needed in practice are both institutional and interactive. An understanding of how to improve and assess professional performance requires an explication of knowledge, skills, and communicative competence that discourse analysis can provide.