title: Electronic medical records in diabetes consultations: participants' gaze as an interactional resource.
abstract: Two routine consultations in primary care diabetes clinics are compared using extracts from video recordings of interactions between nurses and patients. The consultations were chosen to present different styles of interaction, in which the nurse's gaze was either primarily toward the computer screen or directed more toward the patient. Using conversation analysis, the ways in which nurses shift both gaze and body orientation between the computer screen and patient to influence the style, pace, content, and structure of the consultation were investigated. By examining the effects of different levels of engagement between the electronic medical record and the embodied patient in the consultation room, we argue for the need to consider the contingent nature of the interface of technology and the person in the consultation. Policy initiatives designed to deliver what is considered best-evidenced practice are modified in the micro context of the interactions of the consultation.
authors.affiliation: Bradford Institute for Health Research, Royal Infirmary, Duckworth Lane, Bradford, West Yorkshire, United Kingdom. penny.rhodes@bradfordhospitals.nhs.uk
authors.forename: Penny
authors.initials: P
authors.lastname: Rhodes
authors.forename: Neil
authors.initials: N
authors.lastname: Small
authors.forename: Emma
authors.initials: E
authors.lastname: Rowley
authors.forename: Mark
authors.initials: M
authors.lastname: Langdon
authors.forename: Steven
authors.initials: S
authors.lastname: Ariss
authors.forename: John
authors.initials: J
authors.lastname: Wright
mesh_terms: D003920:Diabetes Mellitus / Q000628:therapy*; D006801:Humans; D016347:Medical Records Systems, Computerized / Q000706:statistics & numerical data*; D009633:Nonverbal Communication; D009723:Nurse-Patient Relations; D010358:Patient Participation; D011320:Primary Health Care; D014743:Videotape Recording