The interplay of text, meaning and practice: methodological considerations on discourse analysis in medical education.

CONTEXT: The study of discourses (i.e. verbal interactions or written accounts) is increasingly used in social sciences to gain insight into issues connected to discourse, such as meanings, behaviours and actions. This paper situates discourse analysis in medical education, based on a framework developed in organisational discourse analysis and widely deployed in other social science disciplines.

OBJECTIVES: This paper aims to examine the constructs of 'discourse' and 'discourse analysis', and how various understandings of discourse and discourse analysis may play out in empirical and analytical settings, with a particular focus on the field of medical education.

METHODS: The study is based on a literature analysis of discourse analysis approaches published in Medical Education.

RESULTS: Findings suggest that empirical studies through discourse analysis can be heuristically understood in terms of the links between text, practices and meaning.

CONCLUSIONS: Discourse analysis provides a more strongly supported argument when it is possible to defend claims on three levels: practice, using observational data; meaning, using ethnographic data, and text, using conversational and textual data.