Managing uncertainty in healthcare interpreter-mediated interaction: On rendering question-answer sequences

This paper analyses healthcare interactions involving
doctors, migrant patients and ‘intercultural mediators’
who provide interpreting services. Our study is
based on a collection of 300 interactions involving two
language pairs, Arabic–Italian and English–Italian.
The analytical framework includes conversation
analysis combined with insights from social systems
theory. We look at question-answer sequences, where
(1) the doctors ask questions about patients’ problems
or history, (2) the doctors’ questions are responded
to and (3) the doctor closes the sequence, moving on
to another question. We analyse the ways in which
mediators help doctors design questions for patients
and patients understand and eventually respond to
the doctors’ design. While the doctor’s question design
aims at obtaining details which are relevant for the
patients’ care, it is argued that collecting such details
involves complex interactional work. In particular,
doctors need help in displaying their attention to their
patients’ problems and in guiding patients’ responses
into medically relevant directions. Likewise, patients
need help in reacting appropriately. Mediators help
manage communicative uncertainty both by showing
the doctor’s interest in what the patient says, and by
exploring and rendering the patient’s incomplete,
extended and ambiguous answers to the doctor’s
questions.