‘Shift’ ‘n ‘control’: The computer as a third interactant in Spanish-language medical consultations


  • Ryan Goble University of Wisconsin, Madison
  • Caroline Vickers California State University




computer, discourse analysis, language, medical, narrative, Spanish


The purpose of this paper is to examine the role of the computer in medical consultations in which EnglishSpanish-bilingual medical providers interact with Spanish-monolingual patients. Following previous studies that have revealed that the presence of the computer in consultations detracts from direct provider–patient communication, we pay specific attention to how the use of the computer in Spanishlanguage medical consultations can complement or adversely affect the co-construction of the patient’s health narrative. The data for the present study consist of 36 Spanish-language medical consultations in Southern California. Applying a conversation analytical approach to the health narratives in the corpus, we argue that the computer is essentially a third interactant to which medical providers orient through lowered volume, minimal responses, bureaucratic side talk, and, most importantly, codeswitching to English – all of which strip the patients of control over the co-construction of their health narrative with their medical provider. Because the patient does not have access to the computational task and the language, we posit that this exacerbates the already existing adverse effects that the computer has on provider–patient interaction.

Author Biographies

Ryan Goble, University of Wisconsin, Madison

Ryan Goble received his MA in the Applied Linguistics/Teaching English as a Second Language track of the English Composition program at California State University, San bernardino, where he was recognized as the College of Arts and Letters Outstanding Graduate Student for 2013–2014. He was also a recipient of the American Association for Applied Linguistics (AAAL) Graduate Student Award in 2014. He is presently a PhD student in the Second Language Acquisition program at the University of Wisconsin, Madison. His research interests include sociolinguistics, discourse analysis, and medical dis course

Caroline Vickers, California State University

Caroline H. Vickers is Professor of Linguistics in the English Department and the co-director for the Promotion of Health Disparities Research and Training at California State University, San Bernardino, USA. Her research interests include community identity, discourse analysis, health disparities, language and identity, linguistic landscapes, and medical discourse.


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How to Cite

Goble, R., & Vickers, C. (2016). ‘Shift’ ‘n ‘control’: The computer as a third interactant in Spanish-language medical consultations. Communication and Medicine, 12(2-3), 171–185. https://doi.org/10.1558/cam.30177