Professor Merran Toerien

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Profile

Biography

PhD (York)
BA(Hons) (Psychology, KwaZulu-Natal)

Having grown up in South Africa, Merran Toerien completed her BA(Hons) in Psychology and Gender Studies at the University of KwaZulu-Natal, Pietermaritzburg. She was awarded the Emma Smith Overseas Scholarship to pursue her PhD studies in the UK. Additional funding was also provided by the Sir Richard Stapley Educational Trust.

Merran began her PhD at Loughborough University and completed it at the University of York. Titled, Hair Removal and the Construction of Gender: A Multi-method Approach, the PhD was supervised by Celia Kitzinger and Sue Wilkinson. The thesis consists of a series of projects, including a study of interaction in the beauty salon using conversation analysis (CA). At York, Merran trained extensively in CA and this is now her methodology of choice.

On completing the PhD, Merran worked as a researcher in the Department of Social Medicine at the University of Bristol, focusing on health professional-patient interaction in recruitment to trials and neurology clinic appointments.

She then returned to York to work with Paul Drew, Roy Sainsbury and Annie Irvine on a two-year Department for Work and Pensions-funded project. This examined meetings between claimants of social security benefits and Personal Advisers (PAs) in Jobcentre Plus. During the course of this project, Merran was awarded an RCUK Research Fellowship at York in “Communication and Language Use in Interaction”. This allowed her to focus on developing her research portfolio for a period of five years, after which she transferred to a lectureship in Sociology (also at York).

Since then, her research has focused on understanding how doctors and patients make choices together in UK neurology clinics. This has been collaborative work with, among others, Markus Reuber (University of Sheffield) and Clare Jackson (University of York), bringing together neurologists, social scientists, medical educators and an elearning specialist. She is active in medical education and training researchers in the methods of conversation analysis (CA), around the UK and internationally (including in Brazil, China, the Netherlands, and South Africa). Her collaborative research has led to two 4* impact case studies (REF 2014, 2021).

Merran is Director of Research in Sociology and Director of the Centre for Advanced Studies in Language & Communication.

She is also a member of the University of York's Research Committee.

Research

Overview

Merran’s primary research interest is the application of conversation analysis (CA) to the study of talk in institutional settings. This has included studies of:

Consultant-patient interaction during neurology clinic appointments, with a focus on how (and whether) neurologists offer patients choice about their treatment and/or further investigations.
Claimant-adviser interaction during ‘work-focused interviews’ in Jobcentre Plus, with a focus on what constitutes ‘effective practice’.
Nurse-patient interaction during recruitment appointments, with a focus on how nurses ask if patients are willing to take part in a medical trial.
Client-beauty therapist interaction during salon hair removal sessions, with a particular interest in the emotional labour performed by beauty therapists.

Merran has a track record of securing research funding, including two National Institute for Health and Care Research (NIHR) grants, which supported her work on patient choice in practice.

Reports of the findings are available, open access, in the Health Services and Delivery Research journal:

Delivering patient choice in clinical practice: a conversation analytic study of communication practices used in neurology clinics to involve patients in decision-making
Evaluating nuanced practices for initiating decision-making in neurology clinics: a mixed-methods study

Impact

Merran's 2023 YorkTalk provides an accessible summary of the impact achieved by the Patient Choice in Practice research.

For more detail, please see Sociology at York's 'Impact and Engagement' and the REF 2021 Impact Case Study database.

Are you interested in signing up for the free to access Patient Choice in Practice elearning package? You can do this via the NICE Shared Decision-making online training (scroll down to 'decision talk').

Publications

Selected publications

Merran's publications can be found by visiting her profile in the York Research Database (above). Recent highlights include:

Toerien, M. (2021). When do patients exercise their right to refuse treatment? A
conversation analytic study of decision-making trajectories in UK neurology
outpatient consultations. Social Science & Medicine, 290:114278.
Toerien, M., Jackson, C. and Reuber, M. (2020). The normativity of medical tests:
test ordering as a routine activity in ‘new problem’ consultations in secondary
care. Research on Language and Social Interaction, 53(4): 405-424
Toerien, M., Reuber, M., Shaw, R. and Duncan, R. (2018). Generating the perception
of choice: the remarkable malleability of option-listing. Sociology of Health &
Illness, 40(7): 1250-1267
Chappell, P., Toerien, M., Jackson, C., Reuber, M. (2018). Following the patient’s orders? Recommending vs. offering choice in neurology outpatient consultations. Social Science & Medicine, 205: 8-16.
Toerien, M. (2017). Deferring the decision point: treatment assertions in neurology outpatient consultations. Health Communication, 33(11): 1355-1365