Narrative perspective, person references, and evidentiality in clinical incident reports

TY - JOUR

T1 - Narrative perspective, person references, and evidentiality in clinical incident reports

AU - Myketiak, Chrystie

AU - Concannon, Shauna

AU - Curzon, Paul

N1 - © 2017 The Authors. Published by Elsevier B.V. This is an open access article under the CC BY license (http://creativecommons. org/licenses/by/4.0/).

PY - 2017/7/15

Y1 - 2017/7/15

N2 - Clinical incident reporting provides opportunities for organisational learning, ideally leading to improved patient safety. However, this process requires healthcare professionals to record experiences where patients were harmed, or had the potential to be harmed. It also requires others to interpret the language used in order to make recommendations. We investigate the use of epistemic and evidential markers in incidents labelled as ‘user error’, in which a responsible individual is categorically implied, as opposed to other types of incidents where responsible individuals may not be tacitly assumed, such as ‘failure of sterilisation or contamination of equipment’ and ‘lack of suitably trained staff’. By analysing the frequency of various linguistic features related to authority and accountability, we provide insights into the pragmatics of clinical incident reporting. We find that user error reports differ from other categories of reports in that the identity of the narrator is obscured and the locus of agency is removed, and that this difference is irrespective to levels of patient harm. User error reports differ from other incident reports in the following statistically significant ways: they are more likely to be written using impersonal absent narration and feature significantly higher frequencies of epistemic markers of uncertainty and evidentiality.

AB - Clinical incident reporting provides opportunities for organisational learning, ideally leading to improved patient safety. However, this process requires healthcare professionals to record experiences where patients were harmed, or had the potential to be harmed. It also requires others to interpret the language used in order to make recommendations. We investigate the use of epistemic and evidential markers in incidents labelled as ‘user error’, in which a responsible individual is categorically implied, as opposed to other types of incidents where responsible individuals may not be tacitly assumed, such as ‘failure of sterilisation or contamination of equipment’ and ‘lack of suitably trained staff’. By analysing the frequency of various linguistic features related to authority and accountability, we provide insights into the pragmatics of clinical incident reporting. We find that user error reports differ from other categories of reports in that the identity of the narrator is obscured and the locus of agency is removed, and that this difference is irrespective to levels of patient harm. User error reports differ from other incident reports in the following statistically significant ways: they are more likely to be written using impersonal absent narration and feature significantly higher frequencies of epistemic markers of uncertainty and evidentiality.

U2 - 10.1016/j.pragma.2017.06.018

DO - 10.1016/j.pragma.2017.06.018

M3 - Article

VL - 117

SP - 139

EP - 154

JO - Journal of Pragmatics

T2 - Journal of Pragmatics

JF - Journal of Pragmatics

SN - 0378-2166

IS - 8

ER -