An overview of research presented on healthcare interactions at ICCA 2026
I recently returned from the International Conference on Conversation Analysis (ICCA). This is the conference for the field, occurring every four years and offering the opportunity to share research developments, connect and re-connect with other researchers, and participate in workshops. There are different themes and panels, and, as usual, I mainly attended those relating to conversation in healthcare. I couldn’t make all the presentations, but drawing on those that I did attend, I aim to provide a small update on the state-of-the-art of research on healthcare (though nothing so comprehensive as the reviews published in 2024).
What initially stood out to me was the variety of different clinical disciplines represented. Historically, there has been more of a focus on medical interactions, particularly in primary care. While this has been slowly changing, this year there seemed to be a more marked shift into other disciplines. There were talks across the entire lifespan, from antenatal care to end of life care, with disciplines including: emergency care, genetics, obstetrics, paediatrics, neurology, speech therapy, dietetics, pharmacy, dentistry, general practice, psychotherapy, psychiatry, diabetes care, nursing, surgical care, cancer care, dementia care, and geriatrics. Some of these areas have received more attention in conversation analytic research, such as psychotherapy, while others have not been researched much at all, like dietetics.
As is typical for conversation analytic research, analyses presented were at varying stages of completeness, from very early in a project to completed and published work. Because of this, I won’t be describing specific findings to ensure I don’t misrepresent works in progress in particular, where the findings may develop with further analysis. Instead, I will describe the thematically similar topics studied across all kinds of different healthcare interactions. Some of these were within specific panels while others occurred across different presentations. There are many sessions that I did not get to attend that were about healthcare and these are not described here (except a couple of notable mentions). Check out the abstracts to see more.
Day One
The first panel I attended was on Providing unsolicited medical advice. Chaired by Robert Prettner, we heard from researchers researching offers for vaccines, cancer screening, and smoking cessation support. Across these presentations, researchers discussed how perceptions of morality of health behaviours played out interactionally. The analyses examined how people formulate their resistance to, and how they account for their hesitancy to participate in, such health promotion programs. They also looked at how clinicians can design their turns to create conditions for uptake.
At the same was a panel that I did not get to attend, which was on Diversity in healthcare contexts: Doing medicine in Asian societies, chaired by Ni-Eng Lim and K.K. Luke. This is a welcome focus that diversifies from the mainstay of such research in CA, which predominately comes from Western societies, particularly those that are primarily English-speaking. I am pleased to see more publications coming from such research - make sure you take a look.
Day Two
The second day offered an entire day of healthcare research, with a panel chaired by Tanya Stivers on The mutual consequentiality of physician-patient communication practices. These presentations varied more than those of the previous day, allowing for a comparative view of topics across different clinical contexts, with topics including how patients structure narratives, how participants manage differing epistemic authority, how clinicians modulate their medical authority, how decision making is managed, and how health literacy occurs in practice. Through these presentations there was exploration into the relationship between question/turn design and response formulation, identifying different constraining features of first position turns on responses. I noticed an increased interest in patient perspectives, with analytic consideration of patient worry and reassurance as well as patient opinions.
Day Three
The third day of the conference included presentations outside of healthcare-specific panels. Across these, presenters pursued analyses designed to address safety and quality concerns, where medical errors were at least in part due to communication difficulties. This work demonstrated how even small changes, that might be otherwise challenging for people to identify as being significant, can impact how a conversation unfolds, and thus the safety and quality of patient care.
Day three also included my own and my PhD student’s presentations, which were sadly at the same time in different sessions. Irene Simpson presented in the mixed methods session on her PhD research, building on the work from her Masters research into consultation length in general practice. I presented a small section in the panel on affect in interaction, exploring when people get frustrated at automated conversation agents in a healthcare setting. This was a small exploratory tangent to a larger process review project with a group at the University of Sydney.
Day Four
As we came to the end of the conference, there were still a few healthcare presentations to go, with my favourite of the whole conference on decision making about moving to palliative care and how it is achieved as an incremental activity, by Aija Logren and Jenny Paananen. While I won’t go into detail as they have not yet published, this was my favourite as it demonstrated a rigorous approach to using conversation analysis to examine how such decisions are achieved through interaction over time.
Toward the end of the day were presentations specifically about conversations on weight and dietary habits, which is also an analytic interest of mine. The presenters explored the incremental work that is required to develop a shared understanding of how patients engage in healthy behaviours in their everyday lives, and again, how morality plays a part in these conversations.
Final thoughts
I noticed an increased engagement with clinician expertise, including some presenters who themselves are both clinicians and conversation analysts. These projects clearly demonstrated the value of including clinical expertise in research into clinical encounters. Some projects demonstrated this through absence, with work that would have benefitted from the additional lens of a clinician researcher. Not all interactional research into specific institutional domains requires such insider expertise, however when either making analytic decisions that might be dependent on clinical reasoning or that might be designed for future guidance for clinical practice, including clinicians as researchers is particularly important.
Where to from here? My long-term goal has always been on application of research on healthcare interactions into policy and practice and this view definitely influences where I think the field of conversation analysis as it is used in healthcare should go. There should definitely be research that is focused on understanding how such interactions work in the wild, however I’d like to see more research that is designed to support improvement of communication in practice. This should include research into how that improvement is implemented as well as on the effectiveness of other attempts at improving communication that are not based on CA research. With more and more archival data available, it would also be interesting for more longitudinal research to explore how conversations in healthcare have changed over time as well as comparative research across healthcare systems, cultures, and languages.
Given the difficulties in research funding occurring internationally, my primary hope is that research into how communication occurs in real healthcare interactions is supported to continue and grow in whichever format possible.
Sarah
p.s. There is now a Conversation Analysis Special Interest Group for the International Association for Communication in Healthcare for those interested!