Blurb:

Chapter Twelve considers the sociocultural variables related to discourse frameworks and the production of understanding. Discourse frameworks can incorporate components reflecting the cultural and social systems affecting participants. The chapter presents examples of commonplace complexities related to the contemporary social and cultural realities of many clinical and educational settings. It describes the diversity of the research participants and settings in the context of earlier chapters’ discussion of their interpretation activities. Topics discussed include: socioeconomic categories, gender and interpretation activities, and recognizing agency by analyzing processes of understanding. Rather than emphasizing behavioral or status differences that precede interaction as determinants of understandings, analysis of discourse frameworks, process narratives, and grey boxes explains the role of interpretation activities in producing and reproducing professional culture and professional authority. The radiology consultation data show how changes to traditional organizational routines and professional culture can occur and benefit all patients’ understandings of medical information relevant to treatment decisions. Removing negative effects of organizational environments and professional cultures on patients' understandings of their medical conditions and treatment options requires recognizing the components of interpretation activities.