Opportunities and Challenges

CA is a valid and reliable method of qualitative research (see (Peräkylä, 1997), in that it sidesteps problems associated with the gap between what people say they do and what they actually do.

By capturing what people actually do, on video, we have an indisputable record of actual behaviour. The method of analysis enables the researcher to find patterns in these behaviours, and it is these patterns that constitute the key findings. Results can often be communicated effectively to clients for whom the recorded data offer the opportunity for reflective practice.

Using recordings to provide feedback to clients can, however, pose ethical concerns. This is particularly true in large organisations, where clients may include front-line service providers, their managers, and even high-level policy makers. Ensuring that appropriate measures of anonymity are in place (e.g. pixelating video data, deleting personal references) can be time-consuming and technically demanding; this can also make the recordings more difficult to watch. It is also common for organisations to expect feedback more quickly than is possible using CA.

CA is a specialised and resource-intensive methodology and should be used only when appropriate, and when the research question merits it. Questions about how people behave are appropriate to CA; questions about how they think or feel are not. It can be difficult for clients to appreciate the appropriate range of questions to which CA can provide answers. Sometimes CA may be combined appropriately with other methods in order to address different kinds of question. In the research on electronic guidebooks, for example, CA research was used to establish how people behaved when using guidebooks while looking around a historic attraction. Interviews, meanwhile, were used to establish their subjective impression of how much they enjoyed the experience.

Some primary CA studies have been supplemented, very effectively, with follow-up quantitative research. For example, conversation analysts noticed that patients seemed more likely to reveal an additional health concern when asked at the end of a GP consultation whether they had “something else” they wanted to address, than whether they were asked if there was “anything else”. Subsequently a randomised controlled trial was conducted and showed that these two formats were in fact statistically significantly different in terms of eliciting patients’ concerns.

Another research project offering a good example of a multi-method approach explored how doctors might resist pressure for antibiotic prescriptions in paediatric consultations. A statistically significant association was shown between what parents said and the likelihood of the doctor prescribing antibiotics inappropriately (i.e. inappropriate prescriptions were more likely if the parent questioned the doctor’s initial treatment plan for the child).

In this kind of applied CA research, the use of statistical measures is important because they allow us to demonstrate a significant relationship between an interactional practice and a relevant outcome (e.g. soliciting unmet concerns or appropriate prescribing). However, it is important to recognise that these statistics do not replace the fine-grained qualitative approach offered by CA but are based on it.

CA’s specific focus on interaction is, then, not simply a limitation, but also a unique strength. After all, in so many instances, it is talk that gets the job done. Taking a medical history, cross-examining a witness, lecturing students, counselling a new mother, advising Jobcentre Plus claimants – these are all tasks that are done through talk. In using CA’s empirical findings to understand what is happening in talk-in-interaction we eliminate the gap between what people say they do and what they actually do, and gain access to the heart of human action.