“D’yuh like porridge”: social talk as a relational, interactional, and clinical component of surgical consultations

Background: Small talk and social talk are often recommended to doctors as rapport building strategies for consultations. These types of talk occur across different activities in clinical consultations. Aim: To explore how small talk and social talk are used in surgical consultations. Methods: Using conversation analysis, we examined the sequential positioning and action ascription of small talk and social talk in a sample of video-recorded surgeon-patient consultations from New Zealand and Australia. Results: Small talk and social talk sequences almost always do more than build rapport in surgical interactions. Rather, they contribute in complex ways to all three institutional agendas of a consultation – clinical, interactional, and relational. Discussion: This study broadens previous topic-based analyses and binary or linear conceptualisations. We show that small talk and social talk provide a rich resource for enabling different actions within consultations as well as managing relationships (e.g. managing transitions between activities, facilitating sensitive discussions or examinations, and supporting treatment planning). Conclusion: This study has provided a basis for further research to more fully understand the complexities of small talk and social talk in clinical consultations, as well as considerations of how such evidence might best be applied within training and assessment for clinicians.