In this study, we applied corpus linguistic methodology to explore graduate entry medical students’ shared understanding in medical PBL tutorial conversations.
The interactional response words indicating shared understanding showed certain noteworthy features. The low prevalence of non-lexical ‘oh/ah’ response words, overall and in each PBL session, suggests that the students engaged in active interactive conversations, as one would expect in a PBL situation, and invested more in collaborative efforts, with less emphasis on non-vocal reactions. Shared understanding is attained through a collaborative process that requires effort from discourse participants [22, 23]. The affirmation interactional response words contained a mixture of ‘yeah’ and ‘yes’ words. The prevalence of ‘yeah’ interactional response words could suggest that the students pronounced the lexical form ‘yes’ informally, which supports the likelihood of a more relaxed collegial discourse within participants’ interactive responses that generally characterises a tutor-led classroom.
In general, data analysis results suggest that interactional response words were most frequent in PBL 1, and least prevalent in PBL 2. This finding suggests that most interactional-response-word-prefaced conversation may have occurred in PBL 1, perhaps meaning that the students were engaged in trying to understand what was required and the perspectives involved concerning the new case problem. The participants in this study were mature learners with rich educational, work, and life experiences that they could bring to bear collectively. Any ensuing conflicts, which perhaps needed resolving to attain a shared understanding, may have resulted in the overuse of interactional response words to preface their discourse. Moreover, the low prevalence of interactional response words in PBL 2 seems reasonable; the students might have resolved conflicts due to contrasting understandings in PBL 1, and PBL 2 could have been devoted to long stretches of discourse as they presented the results of their self-directed learning. The prevalence of interactional response words in PBL 3 followed the PBL 1 pattern. This finding suggests that the students marked their discourse with interactional response words as they negotiated the pros and cons of management plans and expressed individual views about the case scenario, their input, and how the PBL cycle had been conducted.
Shared meaning in interactive talk progresses and accumulates incrementally through processes of refinement and monitoring [10, 24]. The various affirmation interactional response functions in this study suggest that the students appear to have engaged in interactional responses in which they agreed explicitly with peers’ contributions, checked and monitored mutual understanding, as well as confirmed, reasserted, repaired, and expanded peers’ ideas and information to achieve shared meaning. The prevalence of negation interactional response functions, overall and across the PBL sessions, suggests that the students engaged in discussions involving contending views in relation to their knowledge and ideas, and provided sophisticated evidence for their disagreements in the form of corrections, additions, and cause-effect relationships. Reactive interactional response words were used to orientate students to peers’ contributions and recall previous knowledge and ideas. Orientation to information and information recall are considered to be associated with the creation of shared knowledge [25].
Further analysis of interactional response words provided various levels of evidence to show how the students shared an understanding in their tutorial conversation. Affirmation interactional response words were used for a mixture of unexpanded and simple and complex content expansion talk. Although interactional response functions without content expansion, such as acknowledgement and talk sequence (in instalments and continuatively) may constitute lower-order evidence of shared meaning, they are essential in that they indicate the attention and mutual support that students give to each other during talk-in-interaction [26]. These functions were more prevalent in PBL 1, where the focus was on hypothesis generation with limited criticism, than in other PBL sessions. Interactional response functions with content expansion could be simple or complex. Simple content expansion provided more developed evidence of shared meaning through confirming, restatement, paraphrasing, and comment on ideas and perspectives. More sophisticated and complex forms of content expansion were also evident in the students’ conversation, as the students extended the contribution of a prior speaker through the addition of further information, contrasting of ideas, the development of specificity through refining previous contributions, and cause-effect enhancement [10]. This process of shared understanding aligned with integration-oriented consensus building as described by Weinberger and Fischer [27].
Conflict is a potent stimulus for knowledge development and attainment of shared understanding, in that it can generate explanation, justification, and reflection [26]. While students engaged in simple negation responses in all tutorial groups in this study, they were also involved in content expansion conflict-oriented talk. There was disagreement about ideas and correction of perspectives with the potential for conceptual change and shared meaning. This finding suggests the presence of conflict-oriented consensus building talk [27] in the tutorial groups, primarily in PBL 2. Overall, disagreement functions were more prevalent in PBL 2, and this finding concurs with the focus of the session, where students were expected to challenge each other’s ideas and critically scrutinise the credibility and sources of the knowledge emanating from self-study.
The presence of reactive interactional response information orientation and recall functions is also noteworthy. Heritage [28] and Goffman [29] have observed that information orientation and recall evoked by peers’ contributions lead to understanding convergence through aligning a listener’s understanding with that of the speaker. Schiffrin [25] also observed that orientation to information and information recall are associated with shared knowledge.
The interactional processes in this study were mainly knowledge-based. Physical action and task coordination were more prevalent in PBL 1 than in either PBL 2 or PBL 3. This finding was expected, because the students planned tasks and engaged in writing on the blackboard in PBL 1. It is also not surprising that interactional response words were used to mark reflection talk in PBL 3, since this type of discourse activity was confined to this session.