An analysis of the use of autobiographical narrative for teachers’ intercultural learning

The currency of intercultural education has risen worldwide in response to increased diversity within societies resulting from migration and global lows of populations. As intercultural education becomes a core responsibility of schooling, critical, detailed analysis of pedagogies for teachers’ own intercultural learning is largely absent in education research, in contrast to attention to developing students’ intercultural capabilities and theoretical and policy analyses. In beginning to address this limitation, this article offers a critical, reflexive analysis of our use and the efficacy of using autobiographical narrative for teachers’ intercultural learning. Framing theories include interculturality, autobiographical narratives for teachers’ professional learning, reflexivity, and the effects of silence and silencing in relation to diversity and intercultural relations in schools. Three instances of teacher autobiographical narrative elicited as part of a large-scale, longitudinal study of intercultural education in Australian schools are deconstructed to elucidate their explicit and hidden meanings and effects. The analysis reveals that while autobiographical narrative has productive potential as a strategy for stimulating teacher reflexivity about cultural identities and intercultural relations, it also contains hidden dangers and traps that caution against viewing it as a pedagogical cure-all in the development of teachers’ intercultural knowledge and skills.

Creating opportunities for interdisciplinary collaboration and patient-centred care: how nurses, doctors, pharmacists and patients use communication strategies when managing medications in an acute hospital setting.

AIMS AND OBJECTIVES: This paper examines the communication strategies that nurses, doctors, pharmacists and patients use when managing medications. BACKGROUND: Patient-centred medication management is best accomplished through interdisciplinary practice. Effective communication about managing medications between clinicians and patients has a direct influence on patient outcomes. There is a lack of research that adopts a multidisciplinary approach and involves critical in-depth analysis of medication interactions among nurses, doctors, pharmacists and patients. DESIGN: A critical ethnographic approach with video reflexivity was adopted to capture communication strategies during medication activities in two general medical wards of an acute care hospital in Melbourne, Australia. METHODS: A mixed ethnographic approach combining participant observations, field interviews, video recordings and video reflexive focus groups and interviews was employed. Seventy-six nurses, 31 doctors, 1 pharmacist and 27 patients gave written consent to participate in the study. Data analysis was informed by Fairclough's critical discourse analytic framework. FINDINGS: Clinicians' use of communication strategies was demonstrated in their interpersonal, authoritative and instructive talk with patients. Doctors adopted the language discourse of normalisation to standardise patients' illness experiences. Nurses and pharmacists employed the language discourses of preparedness and scrutiny to ensure that patient safety was maintained. Patients took up the discourse of politeness to raise medication concerns and question treatment decisions made by doctors, in their attempts to challenge decision-making about their health care treatment. In addition, the video method revealed clinicians' extensive use of body language in communication processes for medication management. CONCLUSIONS: The use of communication strategies by nurses, doctors, pharmacists and patients created opportunities for improved interdisciplinary collaboration and patient-centred medication management in an acute hospital setting. Language discourses shaped and were shaped by complex power relations between patients and clinicians and among clinicians themselves. RELEVANCE TO CLINICAL PRACTICE: Clinicians need to be encouraged to have regular conversations to talk about and challenge each other's practices. More emphasis should be placed on ensuring that patients are given opportunities to voice their concerns about how their medications are managed.