|
Conversational partnerships vs taking
a history |
Positioning, power, assumptions |
|
Language,
aging, & intergenerational stereotypes |
Race,
gender, and talking styles |
|
Conversational
management (audio/video) |
Listening,
refocusing, question types |
|
Opening
healthcare discussions: skills practice |
Echoing,
expanding, sustaining |
|
Sequencing
personal disclosures about health |
Affirming-confirming
sequences |
|
Closing
conversations: signaling the close |
Leave-taking,
acknowledging talk |
|
Reflection,
reassessment, recommendations |
Training
evaluation, next steps |
Cognitive Mapping can lead to semi-structured
questions
Ask
your conversation partner to take a few minutes to sketch a map portraying the
world they live in as people with diabetes/breast
cancer/another condition, speaking about places, people, and daily events
that are important to them. This is the technique known as cognitive mapping,
and lets medical educators use mapping techniques from cognitive psychology,
sociolinguistics and medical anthropology, that are also widely used for
systems analysis in multiple fields.
The purpose: to discover
and analyze concepts related to people’s spoken accounts. This mapping approach
turns control of self-disclosure over to the conversation partner.
During
and after sketching their map, ask your partner to expand the narrative they
began with the cognitive map. As they talk, if these topics don’t come up, you
can begin to create conversational, informal versions of the following questions
to elicit cultural belief models. Experience in interviewing leads us to expect
that patient life-history ‘chapters’ will include diagnosis, complications, the
risk of death, emergency services use, and hospitalizations, as well as issues
of income, trust in health services and providers, access to care, and
differing understandings.
Semi-structured Interview
Guide/Script: (Adapted from Kleinman, A. 1988.The Illness Narratives)
*
Disease understanding and causation: What do you think about your diabetes/breast cancer? What do you
think caused your diabetes/breast cancer?
What do your family/friends say? What worries them?
*
Disease onset timing: Why do you think it started when it did? What
do your family/friends think? What did they notice?
*
Disease expectations: How bad is
your diabetes/breast cancer? How long
will it last? How do you think it will affect you in the future?
*
Disease process and impact: What do
you think diabetes/breast cancer or
its treatment is doing to you? To your
body?
*
Disease treatment: What kinds of help or treatments are you
getting? How are they (each treatment or
medicine) working for you? What other things do you do to help deal with your diabetes/breast cancer? Where do you get help? (Often, this will
provide an opportunity for the partner to discuss or explore role of
spirituality)
*
Disease complications: In a typical
week, where and how does the diabetes/breast
cancer affect your life? What problems do the treatments cause you? How do
you handle these sorts of things?
*
Disease concerns: What fears or worries do you have about your diabetes/breast cancer?
*
Disease successes: Who or what helps
you most with your diabetes/breast cancer?
What things you do for yourself seem to be helping? What would you teach others
who have diabetes/breast cancer?
Minimally-annotated Selected
Bibliography: cognitive and concept mapping
Originally: rats, pigeons
and hippocampus (Tolman)
Samsonovich
AV, Ascoli GA, DeJong KA. 2006. Human-level psychometrics for cognitive
architectures. In Smith L, Sporns O, Yu C., Gasser M., Breazeal C., Deak G.,
Weng J. (Eds.). Proceedings of the Fifth International Conference on
Development and Learning ICDL 2006, CD-ROM,
6p. ISBN: 0-9786456-0-X. © Department of Psychological and Brain Sciences,
Cluster analysis, group
input for concept maps
Kane,
Mary and Patrick McMahon. 2002. Using concept mapping to improve health care.
decision making. Health Care. www.conceptsystems.com [Cluster
analysis for pattern matching after brain-storming in groups; keyed to work by
Trochim, W.]
Wiginton, Kristin. 1999.
Illness representations: mapping the experience of Lupus. Health Education
& Behavior 26, 443-453. [cluster analysis of single-words, weighted]
Space, time and self-disclosure via mapping
Abell, Peter. 2004.
Narrative explanation: an alternative to variable-centered explanation? Annual Review of Sociology 30,
287-310. [actions and states in
narrative, graphically arrayed]
Antaki,
Charles, Rebecca Barnes and Ivan Leudar. 2005. Self-disclosure as a situated
interactional practice. British Journal of Social Psychology 44,
181-99.
Briggs, Charles. 2005.
Communicability, racial discourse, and disease. Annual Review of Anthropology 34: 269-91. [Crucial discussion of
ideology, race and medical talk]
Hanks, William. 2005.
Pierre Bourdieu and the practices of language. Annual Review of Anthropology
34, 67-83. [Workshop claims
habitus is what individual draws as personal map]
Ryan, Marie-Laure. 2003.
Cognitive maps In David Herman, ed., Narrative theory and the cognitive sciences,
Stanford: CSLI, 213-42. [IT: sketches,
space=time in narrative]
Schaeffer,
Nora and
Exploring experience: drawings identify nodes, aggregate analysis,
ethnographic loop
Davis,
Boyd, M. Smilowitz, and Leah Neely.
Speaking maps and talking worlds. In Language & Variation in the
Franca, S., C. Marchand, C. Craplet et al. 2003. Application of cncept
mapping in obese subjects : a pilot study in normo and underreporters. Diabetes & Metabolism 29: 72-78,Abs. [Sketches differentiate attitudes and beliefs
in normo-and under-reporting obese patients]
Tikkanen,
J. et al 2006. Applying cognitive mapping approach to explore objective
structure of forest owners in a Northern Finnish area. Policy and Economics 9: 139-52. [Quantitative analysis, qualitative
data, hierarchy of concepts: individual controls maps which elicit different data
from researcher-controlled surveys].
Organizing complex
knowledge using concept and cognitive mapping
Clarke,
Adele. 2005. Situational analysis: Grounded theory after the postmodern turn.
Dickerson, J. D. Bedeant, Z.Cox, W. Qi, D. Ashlock, and E.
Wurtele. 2000. Creating metabolic
network models using text mining and expert knowledge. Atlantic Symposium on Computational Biology
and Genome Information Systems & Technology. CBGIST 2000, 26-30. [Theory
and algorithms behind Fuzzy maps; citeseer.ist.psu.edu/487188.html]
Green,
Cable. 2003. Visualizing understandings online: nontraditional pharmacy students’
experiences with concept mapping. Unpublished PhD dissertation,
Hsu, Li-ling and Suh-Ing
Hsieh. 2005. Concept maps as an assessment tool in a nursing course. Journal of Professional
Nursing 21, 141–149 [student-created maps as
flow-chart algorithms]
Kern, Carolyn, Kristine
Bush, Joan McCleish. 2006. Mind-mapped care plans: integrating an innovative
educational tool as an alternative to traditional care. Journal of Nursing Education 45, 112-119 [claims mind maps differ
from concept maps: not for assessment but for teaching]
McCormack,
Brendan and Robert Garbett. 2003. The characteristics, qualities and skills of
practice developers. Journal of Clinical
Nursing 12, 317-25. [Maps used to identify attributes]
Novak, J. D. & A. J.
Cañas. 2006. The Theory Underlying
Concept Maps and How to Construct Them, Technical Report IHMC CmapTools
2006-01,
Machine Cognition.
[Probably best-known discussion since Axelrod 1976, available at:
http://cmap.ihmc.us/Publications/ResearchPapers/TheoryUnderlyingConceptMaps.pdf]
Rodriguez-Repiso, L., R. Setchi, J. Salieron. 2007 Modeling IT projects success with Fuzzy Cognitive Mapping. Expert
Systems with Applications 32: 543-59.
[combines fuzzy logic and neural networks; a FCM map has ‘nodes
indicating the most relevant factors of a decisional environment; and links
between these nodes representing the relationships between those factors’ 545
Cf FCM algorithms used in
Giles, B., C. Findlay, G. Haas et al. 2007. Integrating conventional science
and aboriginal perspectives on diabetes using fuzzy cognitive maps. SS&M 64: 562-76].
Siau,
Keng and Xin Tan. 2005. Technical communication in information systems
development: the use of cognitive mapping. IEEE
Transactions on Professional Communication 48, 269-84. [causal, semantic and concept mapping
(graphic organizers) identify belief systems re problem]
Wang, W., C. Cheung, W. Lee, S. Kwok. 2008. Self-associated concept
mapping for representation, elicititation and inference of knowledge. Knowledge-Based Systems 21, 52-61.
[based
on semantic memory theory: knowledge stored in networks whose representation
can show integration of different concepts; can create inference algorithm
using fuzzy set reasoning]