When asides become central: small talk and big talk in interpreted health interactions

Abstract

Objective: In health interactions which require an interpreter, there are occasions when there are uninterpreted asides between participants. These are often construed to be features which hinder the interpreting process. However they have potential to yield critical information in certain health care contexts.

Methods: This paper examines 17 instances of asides in interpreted interactions which took place in 3 intercultural health care contexts in South Africa. The asides were transcribed, translated and analysed based on conversation analysis principles.

Results: The topics of the asides as well as who initiates them appear highly dependent on contextual features. There is evidence for the emergence of 'small talk' which serves the purpose of framing comfort levels, aligning the interpreter and patient or offering guidance for example, and the emergence of 'big talk' or engagement on topics which for cultural and historical reasons and power imbalances between the health practitioner and patient may be too difficult to raise directly. Such information also yields critical diagnostic and therapeutic information.

Conclusion: Our findings suggest evidence for the presence of multiple patterns and roles that the interpreter may assume in such interactions.

Practice implications: Implications for team training and practice are provided.