Team Decision-Making through English as a Medium of Professional Medical Communication in Doctor-Doctor Meetings in a Saudi Hospital: A multimethod discourse approach

Abstract

This study addresses the gap in understanding decision-making (DM) as a distinct interactional genre in multilingual, multicultural healthcare teams, such as those in Saudi Arabia. While past research focused on DM in doctor-patient interactions, little is known about doctor-doctor communication, especially where English is the medium of professional medical communication (PMC). Effective DM is crucial, as miscommunication can affect patient outcomes. This study explores the language and discursive resources doctors use in team DM, offering insights for professionals and pedagogical implications for improving English medical education in Saudi Arabia, where research critiques graduates’ English without identifying practical workplace needs. A multimethod discourse approach was adopted, combining Genre Analysis (GA), Conversation Analysis (CA), and Interactional Sociolinguistics (IS). Data are weekly doctor to doctor meetings where critical decisions are made. GA revealed two DM types: unambiguous (straightforward, less frequent) and complex (more frequent, extended). Both shared core Moves: Presenting the patient, Pre-decision, Decision, and Closing. Complex DM included Decision execution details and Re-discussing patient status. Both required collective agreement. Complex DM involved elaborated turn-taking and uncertainty, expressed through hedges, hesitation, silences, and pauses prompting rationale. Findings show DM is transactional but relies on relational work. Unambiguous decisions were short and mainly in English. Complex ones used code-switching (CS) and humour. Arabic in CS and humour helped retrieve patient details, defend image, maintain solidarity, and express stress or anger under pressure. This study makes two contributions. First, it presents an authentic view of DM as shaped by hierarchy and epistemic status, which structure asymmetrical interaction and guide members within role boundaries. Second, it addresses the gap in English medical textbooks in Saudi Arabia. Data showed a mismatch between textbook and real-life interaction, limiting student preparation for workplace demands.