Team talk and the evaluation of medical guidance documentation

Abstract

This article looks at team talk in a validation committee meeting assessment of a guidance document text item. The item assessment was not evidence-based in terms of Evidence Based Medicine (EBM) criteria; instead, the item was assessed via the committee members present drawing on their clinical practitioner members’ knowledge and professional experience. Analysis of the meeting reveals such apparently ‘mere opinion’ to be a systematic evaluation of professional knowledge and personal experiences, in ways ‘compatible’ with thought experiments. Thought experiments are argued to be a members’ resource as well as an analyst’s one, although their detailed occasionedness is not reducible to a constructivist formalisation. The article’s approach is informed by ethnomethodology and conversation analysis, and while the use of thought experiments as a heuristic device in the analysis is controversial, a warrant for this is attempted. The research was undertaken to locate ways of understanding and supporting team members’ work of robust and useful guidance content production. ‘Validating’ guidance is shown in-and-as the emergent collaborative work of the committee members themselves.