Abstract：
The effectiveness of work performed through interprofessional practice is contingent on the nature and extent of communication between professionals. To date, there is little research exploring how the patterns of communication may impact interprofessional work. This study focused on communication during interprofessional meetings to better understand the interprofessional work performed through these encounters. Specifically, it examined how interactional discourse, that is, the patterns of language, influenced work performed during interprofessional meetings. A series of four interprofessional meetings in a rehabilitation unit were observed. Twenty-one participants were observed, including medical, nursing, allied health clinicians, and health professions students. Follow-up stimulated-recall interviews were conducted with five meeting participants. The data collection consisted of video and audio recordings and detailed field notes. Data were analyzed using a combination of genre analysis, a form of discourse analysis, and activity system analysis, drawing on Cultural Historical Activity Theory. This facilitated an in-depth examination of the structure of discourse and its influence on meeting outcomes. The meeting structure was defined and predictable. Two distinct forms of discourse were identified and labeled scripted and unscripted. Scripted discourse was prompted by standardized documents and facilitated the completion of organizational work. In contrast, unscripted discourse was spontaneous dialogue used to co-construct knowledge and contributed to collaboration. There was constant shifting between scripted and unscripted discourse throughout meetings which was orchestrated by experienced clinicians. Rather than fragmenting the discussion, this shifting enabled shared decision making. This research provides further insights into the interprofessional work performed during interprofessional meetings. The scripted discourse was highly influenced by artifacts (communication tools) in meetings, and these were used to ensure organizational imperatives were met. Unscripted discourse facilitated not only new insights and decisions but also social cohesion that may influence work within and outside the meeting.
摘要：
通过跨专业实践进行的工作的有效性取决于专业人员之间沟通的性质和程度。迄今为止,很少有研究探索沟通模式如何影响跨专业工作。这项研究的重点是在跨专业会议期间进行沟通，以更好地了解通过这些相遇进行的跨专业工作。具体来说,它研究了互动的话语，也就是说,语言的模式，影响在跨专业会议期间执行的工作。观察到在一个康复股举行了一系列四次跨专业会议。观察到21名参与者，包括医疗,护理,联合卫生临床医生，和健康专业的学生。对五名与会者进行了后续刺激召回访谈。数据收集包括视频和音频记录以及详细的现场注释。数据采用体裁分析相结合的方法进行分析，一种语篇分析的形式，和活动系统分析，借鉴文化历史活动理论。这促进了对话语结构及其对会议成果的影响的深入审查。会议结构是明确和可预测的。确定了两种不同形式的话语，并将其标记为脚本和非脚本。脚本化的话语是由标准化文件推动的，并促进了组织工作的完成。相比之下,无脚本话语是自发的对话，用于共同构建知识并有助于合作。在经验丰富的临床医生精心策划的整个会议中，脚本化和非脚本化的话语之间不断变化。与其分散讨论，这种转变使共享决策成为可能。这项研究为在跨专业会议期间进行的跨专业工作提供了进一步的见解。脚本化的话语受到会议中的工件（交流工具）的高度影响，这些被用来确保满足组织要求。无脚本的话语不仅促进了新的见解和决策，而且还促进了可能影响会议内外工作的社会凝聚力。
