The interplay of text, meaning and practice: methodological considerations on discourse analysis in medical education

Dan Karreman, Charlotta Levay

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The study of discourses (i.e., verbal interactions or written accounts) is increasingly used in social sciences to gain insight on issues connected to discourse, such as meanings, behaviours and actions. This paper situates discourse analysis in medical education, based on a framework developed in organizational discourse analysis, and widely deployed in other social science disciplines.

The paper aims to examine the constructs of ‘discourse’ and ‘discourse analysis’, and how various understandings of discourse and discourse analysis may play out in empirical and analytical settings, with a particular focus on the field of medical education. 

The study is based on a literature analysis of discourse analysis approaches published in Medical Education. 

Discourse analytical studies in the field of medical education range from investigations of locally situated discourses to explorations of more overarching, dominant discourses. Most treat discourse as closely linked to and formative of meaning. We suggest that it is helpful to distinguish heuristically between text, practices, and meaning and to carefully consider the links between them.

We suggest that discourse analysis provides a more strongly supported argument when it is possible to defend claims on three levels: Practice, using observational data; Meaning, using ethnographic data; and Text, using conversational and textual data.
Original languageEnglish
Pages (from-to)72–80
Number of pages9
JournalMedical Education
Issue number1
Early online date16 Dec 2016
Publication statusPublished - Jan 2017

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