How Patients' Inquiry Shapes Meaning in Primary Care Consultations: A Qualitative Study Using Own‐Point‐of‐View Video‐Stimulated Recall
Louis‐Baptiste Jaunay, Anne‐Sophie Ivanoff, Corentin Philippot, Emmanuel Triby, Thierry PelacciaABSTRACT
Rationale
Medical consultations are collaborative encounters in which physicians and patients jointly address health concerns and make decisions. While most research has focused on physicians' clinical reasoning, decision‐making is increasingly viewed as a form of situated cognition, distributed across individuals and their interactions. However, the patient's perspective on how they make sense of their health problems remains underexamined.
Aim and Objectives
The aim of this study was to investigate how patients experience and make sense of their health problems before and during a primary care consultation.
Methods
We conducted video‐stimulated recall interviews with patients after their consultations. Consultations were recorded from the patient's perspective using wearable camera glasses. Each interview comprised two parts: (a) an explicitation interview exploring the patient's experience and reasoning before the consultation, and (b) a video‐based stimulated recall to analyze their experience during the consultation. We performed an abductive thematic analysis using Dewey's theory of inquiry.
Results
Twelve interviews were analyzed. Patients engaged in an inquiry process before the consultation, involving the identification of a problematic situation, hypothesis generation and the exploration of potential actions and interactions. During the consultation, patients interpreted the physician's messages as confirmations, refinements or refutations of their own hypotheses. They attempted to infer the physician's reasoning and its underlying assumptions. Patients' acceptance and integration of medical explanations depended on the coherence between these explanations and the trajectory of their own inquiry.
Conclusion
Patients interpret the physician's messages in light of their own inquiry, which can be described according to John Dewey's pattern of inquiry. The physician's ability to recognize where the patient stands within their inquiry and to make clinical reasoning explicit appears central to knowledge sharing and decision‐making. These findings suggest new orientations for communication training in primary care, emphasizing physicians' capacity to identify and support patients' inquiry processes.