The role of argumentative strategies in the construction of emergent common ground in a patient-centered approach to the medical encounter

In this paper, argumentation practices will be discussed in view of their potential for favoring effective information sharing and the creation of ‘emergent common ground’, i.e. the common ground that is sought, created and co-constructed in the process of communication. Argumentation is usually tightly knit with information sharing: if the parties have not previously shared a sufficient amount of relevant knowledge, it is difficult for them to produce effective argumentation. Based on these premises, in this paper the argumentation stages of medical encounters will be viewed as opportunities to reveal and integrate insufficient common ground between clinicians and patients. By relying on the analysis of a corpus of real life encounters in a chronic care setting, the interaction between information sharing and argumentation will be shown, along with problematic cases of misunderstandings or ineffective argumentation due to lack of common ground. Implications for the clinical practice will be discussed.