Introduction to e-Lectures


This website is a series of 5 e-Lectures that have been developed in the Department of Biochemistry at King's College London.

  • The e-lectures are audio narrated presentation files, so you will need to make sure that you have audio set up on your computer, tablet or smartphone, with speakers or headphones connected and check that the volume is turned up.
  • Press the PLAY button to play MP4's of the e-lectures.
  • Work through the e-Lectures in the order that they appear in the menu on the left, and then start with Part A for each e-Lecture.
  • The e-Lectures are intended as the main resource on this website for you to use. There are also links to Additional Resources for each e-Lecture, some of which are only available in Flash format. PDFs and MP3s of the presentation slides are also provided. The MP3's can be downloaded and copied/transferred to mobile devices, eg, mobile phones or MP3 players. Some mobile devices may also read PDF's.
  • Each e-Lecture has been split into 3 parts, each approximately 15-20 minutes in length. If you are leaving an e-lecture before it has finished, make a note of where you are in the presentation. Navigation buttons are also provided at the bottom of the window.
  1. Contextualization cues are the subtle signs a speaker gives the listener during conversation. For example, small facial movements may reveal that the speaker is happy, or sad, or whether they have finished speaking and are now silent to allow the listener to take their turn in speech. A speaker may change their tone or emphasise are word or use their body language to show the listener what they mean. It is up to the listener to pick these up accurately and to respond accordingly.
  2. Framing determines how you, as a doctor, communicate with others and influences how you choose your turn or allow others to speak, in a specific phase or a topic during the consultation. The possible phase frames within a medical consultation may include (Silverman et al., 2013): 
    1. Opening frame: greeting, introduction, checking physical comfort, etc.
    2. Eliciting frame: eliciting initial complaints, history taking, exploring concerns, etc.
    3. Examination frame: oral or physical examinations
    4. Explanation frame: either doctor or patient explains issues or gives information to the other
    5. Planning frame: shared decision making for treatment plans
    6. Closing frame: summarising, safety-netting, final check, etc.
  3. Positioning is the taking on of different roles during an interaction, for example, a doctor has different roles from a patient and thus also different positions. Positioning can change during the conversation and people may take up multiple positions.
  4. Repair is a conversational strategy in which a speaker corrects his/her own or others’ unintended errors. The repair is done either by repeating their speech, correcting it, or asking the previous speaker to clarify their speech in order for it to be better understood. 
  5. Register is the type of language a speaker chooses to use during conversation with others. For example a doctor may choose to use a low register to talk to one patient; but with a well-informed patient the doctor may prefer to use a higher register.
  6. Facework has to do with the social image a person presents and/or is thought to present to another during conversation. A speaker maintains their own face as well as that of the other people in the conversation, through being polite.   
    1. Negative politeness: Makes a request less infringing, such as "If you don't mind..." or "If it isn't too much trouble...” it respects a person's right to act freely. In other words, deference. 
    2. Positive politeness: Seeks to establish a positive relationship between parties; respects a person's need to be liked and understood.
  7. Talk as Social Action: When we talk, we are performing social actions aimed at fulfilling certain social functions. In the context of a clinical consultation, the doctor and the patient may be performing different actions through their language.  For example, the doctor’s actions may include: building rapport, eliciting information, facilitating information giving, empathising, comforting, counselling, discussing, negotiating, diagnosing and treating. The patient’s actions may include: giving and seeking information, seeking emotional support, discussing and negotiating.

For further details in the meaning of these word, please see pages 12-17 in the handbook.

  1. Identify the contextualisation cues of both the doctor and the patient
  2. Distinguish the frames that the contextualisation cues signal (e.g. various phases of the consultation, clinical topic or supportive topic)
  3. Examine the positions/roles that the participants take in the frames
  4. Analyse the actions embodied in the participants’ language (e.g. advice giving, building rapport)
  5. Confirm how the overall meaning is evident in the interaction
    1. note that meaning of actions is the meaning understood by the participants which is manifested in the interaction;
    2. You are analysing how the participants understand each other’s meanings not how you understand the meanings.
    3. There is a difference between your meaning and participants’ meaning although they may overlap, if you analyse correctly.
    4. Meaning confirmed in interaction is an objective understanding of the communication between the participants.