Recent publications and current projects on medical interactions by Prof. Paul Drew

Posted on 10 March 2020

Prof. Paul Drew (University of York) illustrates the impact of research in conversation analysis

Paul Drew (Dept. Language and Linguistic Science, University of York) has recently published a number of articles in a series of medical journals. The articles focus on the communicative processes and practices of interactions in such medical settings as neonatology; memory clinics (dementia); and the NHS’s delivery of IAPT (Improving Access to Psychological Therapies) project with Dr Annie Irvine, also in the Department of Language & Linguistic Science.

Initiating end-of-life decisions with parents of infants receiving neonatal intensive care, Chloe Shaw, Kathrina Connabeer, Paul Drew, Katie Gallagher, Narendra Aladangady, Neil Marlow, Patient Education and Counselling (February 2020) (Neonatology)
Are there interactional differences between telephone and face-to-face psychological therapy? A systematic review of comparative studies, Irvine, A., Drew, P. et al, J. (2020) Affect Disord., 265:120-131. (NHS IAPT programme)
Variation and Interactional non-standardization in neuropsychological tests: The case of the Addenbrooke¹s Cognitive Examination. Jones, D., Drew, P., Wilkinson, R. and Jackson, C. (2019) Qualitative Health Research. (Dementia research)

Of particular note, ‘Initiating end-of-life decisions with parents of infants receiving neonatal intensive care’ investigates whether parent-initiated or doctor-initiated decisions about limiting life-sustaining treatment in neonatal care has consequences for how possible courses of action.

The paper is the most recent to emerge from a research project ‘Parents and Neonatal Decisions Study: Improving communication during conversations about limiting life-sustaining treatment in neonatal intensive care’, funded by a charity Sands (Stillbirth and neonatal death charity), led by one of the UK's leading neonatologists Neil Marlow (Centre for Women's Health, UCL). As part of the research team, Prof Paul Drew provides a Conversation Analysis input, analysing the conversations between doctors and parents of (usually) very premature babies who may not survive.

“This is a challenging area of research, emotionally as well as intellectually. However, the experience of our recent workshop (see below) suggests that the results of our research can help neonatal doctors in what is such a difficult - and again, challenging - aspect of their work. We are intending to run further workshops of this kind.” - Prof. Paul Drew, Dept. Language and Linguistic Science

The paper is also closely connected with the multi-disciplinary training NeoAsk workshop ‘Advanced communication skills in neonatal decision making’. The workshop took place at Nottingham Hospital (27th and 28th January 2020) and was run by the research team. Among the comments made by Neonatologists who attended the workshop:
“Focuses mind on the importance of language and simple words that can have a significant impact.”
“Very much appreciated the linguistic aspect. Learnt a lot. It was very thoughtful and provoking of reflection.”

Evidence presented in ‘Initiating end-of-life decisions with parents of infants receiving neonatal intensive care’, suggests that when parents initiate the decision point, doctors subsequently tend to refer to or list available options. Instead, when doctors initiate, they tend to use ‘recommendations’ or ‘single-option’ choice that did not include multiple treatment options. As a result, in the article are illustrated practice implications to medical professionals: explicitly proposing treatment options may provide parents with opportunities to be involved in treatment decisions for their critically ill babies, thereby fostering shared decision-making.