This interactive workbook is produced in conjunction with a booklet, aimed for key stakeholders involved in Emergency Medical Dispatch (EMD).

View the booklet here: 999 RESPOND Booklet

The material seeks to raise awareness among staff performing the call-taking role, as well as to strengthen the training provided for these staff and to inform relevant policy to support the work of all teams involved in EMD.

This workbook comprises of videos and texts. To view the videos, click the "play" button on each video. Scroll down once the video is completed to read the accompanying text. This is a self-paced workbook. You can pause at any time. We will really appreciate the completion of a feedback form at the end.

a) Introducing a question

This is achieved by claiming the interactional floor typically using a cue that indicates the intention to summarise or extend information provided. These are often small words such as ‘okay’ and ‘so’ that summarise what has been said and make interactional space for creating new information.

b) Verbalising the question

This is achieved through the structure and lexical choices that make up the question. E.g ('is the patient awake?')

c) Opening the interactional floor

To give space for the caller to respond, this is typically achieved through an intonation cue (tone of voice, and rising or falling intonation) and pause.

Question formats

Closed Questions

Closed questions

Closed questions often require the caller to give a yes/no answer. Closed questions could be straightforward for the caller to respond. They increase efficiency in seeking new information and moving forward in the scripted/structured interrogation series, which is essential in a time-critical setting.

For example

In this example, a question is initiated using a cue, “okay” that typically summarises what has been said and moves the conversation forward.

The hesitations followed by long pauses, as indicated by the slowing down in uttering the words, show the struggle of the caller to evaluate the information. The call-taker does respond to the interactional trouble signalled through the break in the flow and repeats the same closed question varying only for the time indication alternating between ‘at the moment’ and ‘now’.

This strategy does not lead to a successful outcome and creates a negative interactional dynamic between the caller and the call taker. In the 999 context, building a synergetic interactional relationship is fundamental for the success of the encounter.

The repetition of the question design, the ‘failure’ of the caller consumes time, breaks down the conversational flow and is only resolved when the call taker reformulates the questions indexing – ‘a response from the patient’ as a marker for whether the patient is conscious or not.

Open Questions

For example:

Summary

Questioning cannot achieve its intended results when:

·The structure or content is unknown or difficult for the caller,

·The interactional timing of questioning is disruptive to the flow,

·The questions may create a negative impact on the relationship between the call-taker and the caller.

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Glossary

Interaction

The act of communicating in and through verbal and body cues

Interactional trouble

Any issue that negatively impacts the flow of conversation e.g., difficulties in understanding the meaning of certain words used in a particular context, difficulties in responding, difficulties in continuing speaking, etc. These ‘bumps’ are common when people communicate, often they are easy to mitigate but they can also have serious consequences to the overall encounter

Interrogation / interrogative series

A series of questions that a call-taker needs to ask a caller according to the scripted system, so as to get information about the emergency.

Interactional floor

The notional space or opportunity for participating in a conversation. E.g., in a 999 call each person takes turns to speak, the call taker ‘holds’ the floor through the questioning process

Intonation

The change of pitch/tone in speech

Lexis / lexical choices

The words we use and the words we choose to use in specialised contexts.

Linguistic practice

The way we communicate in our daily lives and its consequences. E.g., the way a question is asked has immediate implications for the quality and quantity of information that will follow. Linguistic practice is systematic and known to those socialised in a professional setting.

Reformulation (of questions)

Asking for the same information by changing the structure or lexis of a question or replacing the original question with a new question asked from a different angle.

Risk indicators

Verbal and nonverbal cues that could signal urgency and severity of an emergency, e.g., lexical choices, stress, breathing of the speaker.

Questions indexing

The use of specific linguistic cues, such as word order or intonation, to signal that a sentence is a question