Multi-dimensional interaction analysis: a collaborative approach to the study of medical discourse.

This paper reviews the conceptual frameworks of several research approaches to the study of medical interactions. Two methods are discussed: process analysis and microanalysis. Adapted from Robert Bales's study of the behavior of small groups, process analysis sorts and tallies such interviewing processes as questioning and informing, achieving analysis of large numbers of interviews at the expense of attention to the content or context of the interview. When used in medical interaction research, process analysis seeks correlation between processes documented in the interview and outcomes of the interview. The methods of conversation analysts and discourse analysts, microanalyses subject medical conversations to close linguistic study and contextualization. This review focuses on the underlying assumptions, generalizability of findings, and the types of subjective judgment applied by the methods. It then describes the Multi-Dimensional Interaction Analysis (MDIA) system, a linguistic analytic instrument that combines features of process analysis and microanalysis to capture content, process, and context of medical conversations. The MDIA's validity and reliability are reported and implications for future research are outlined.