Strategies and Tactics in the «Clinical Case Review» as an Spoken Medical Discourse Genre

The paper explores the genre «Clinical Case Review» as a type of oral professional polylogue among physicians. The aim of the study is to identify the communicative strategies and tactics facilitating the discussion of complex clinical cases and to describe their linguistic representation. The relevance of the study lies in the need to reveal how genre conventions in this type of professional communication are both shaped by the professional context and participate in fulfilling social functions. The material comprises 20 palliative and 20 cardiological clinical case reviews available in open access on the Internet. The methodological framework of the study is based on functional-communicative and structural approaches within the framework of discourse analysis. Three main genre strategies are identified: cognitive-communicative, institutional ritualization of communication, and humanization of clinical experience. It is shown that tactics are realized through sequences of discursive moves, which combine both the means of professional academic language and the document format borrowed from written medical discourse, as well as features of spontaneous oral communication. The combination of the documentary form of presenting biomedical information and colloquial markers suggests local hybridization of the genre under study. Due to the multi-aspect nature of communicative goals, several tactics may be simultaneously employed within a single turn which is determined by the specificity of the genre conventions, which are conditioned by the social context. A comparison of the palliative care and cardiology cases revealed interdisciplinary variability in the choice of mitigation, professional solidarity, and emotional and ethical appraisal tactics. The results obtained can be used to systematize knowledge about the genres of oral medical discourse and in teaching medical communication.