The non-Verbal Structure of Patient Case Discussions in Multidisciplinary Medical Team Meetings

Meeting analysis has a long theoretical tradition in social psychology, with established practical rami?cations in computer science, especially in computer supported cooperative work. More recently, a good deal of research has focused on the issues of indexing and browsing multimedia records of meetings. Most research in this area, however, is still based on data collected in laboratories, under somewhat arti?cial conditions. This paper presents an analysis of the discourse structure and spontaneous interactions at real-life multidisciplinary medical team meetings held as part of the work routine in a major hospital. It is hypothesised that the conversational structure of these meetings, as indicated by sequencing and duration of vocalisations, enables segmentation into individual patient case discussions. The task of segmenting audio-visual records of multidisciplinary medical team meetings is described as a topic segmentation task, and a method for automatic segmentation is proposed. An empirical evaluation based on hand labelled data is presented which determines the optimal length of vocalisation sequences for segmentation, and establishes the competitiveness of the method with approaches based on more complex knowledge sources. The effectiveness of Bayesian classi?cation as a segmentation method, and its applicability to meeting segmentation in other domains are discusse

Knowledge and practice in multidisciplinary teams : Struggle, accommodation and privilege

The importance of translating knowledge across occupational boundaries is frequently identified as a means of generating innovation and improving performance. The creation of the multidisciplinary team is an institutional response to enable such translation and synergy, yet few studies examine the processes of knowledge generation and translation in such teams. This article offers a case study that analyses these processes in decisions about the diagnosis and treatment of patients. Polanyi’s concept of tacit integration is used to reveal how meaning is developed and manifest in team decisions and to examine how the discursive resources embedded in tacit knowledge shape clinical practice. We highlight the foundations and dynamics that privilege the knowledge of some team members to be reconstituted as multidisciplinary group practice. Privileged knowledge then becomes embedded in the practices of the group. We conclude that the creation of a multidisciplinary structure may support rather than challenge existing power hierarchies