Pursuing a question: Reinitiating IRE sequences as a method ofinstruction

Alan Zemel a,*, Timothy Koschmann b

aUniversity at Albany SUNY, Department of Communication SS351, 1400 Washington Ave., Albany, NY 12222, United Statesb Southern Illinois University School of Medicine, Department of Medical Education, 913 N. Rutledge Street, Springfield, IL 62702, United States

1. Introduction

‘‘[W]ithout systematic provision for a world known and held in common by some collectivity of persons, one has not amisunderstood world, but no conjoint reality at all’’ (Schegloff, 1992: 1296).

Schegloff et al. (1977:[2_TD$DIFF] 381) state that ‘‘the organization of repair is the self-righting mechanism for the organization oflanguage use in social interaction.’’ In a later work, Schegloff (1992:[3_TD$DIFF] 1296) explores the relationship between repair andintersubjectivity, suggesting that repair is ‘‘the procedural basis for locating and dealingwith breakdowns in intersubjectivity’’and ‘‘iswoven into theverywarpandweftofordinary conversationand,by implication,possiblyof anyorganizedconduct.’’ Thefoundational relationship between repair, especially third-position repair, and intersubjectivity establishes clear links amonginteraction, socially shared forms of understanding and cognition, and the achievement andmaintenance of a conjoint reality(Schegloff, 1991). In our paper, we are concerned with how one form of repair, viz. correction, is used and its relations tounderstanding as the achievement of intersubjectivity or ‘‘cognitive order’’ (Schegloff, 1992:[4_TD$DIFF] 1296) in a particular episode ofinstruction accomplished at an Americanmedical school. Of specific interest is theway that a tutor uses self-correction as ‘‘theprocedural basis for locating and dealing with breakdowns in intersubjectivity’’ (ibid).

According toMehan (1979), instructional interactions are overwhelmingly organized in terms of a three-part sequence ofinteraction between a teacher and a student, referred to as the Initiation-Response-Evaluation (IRE) sequence. In an IRE

Journal of Pragmatics 43 (2011) 475–488

A R T I C L E I N F O

Article history:

Received 16 February 2009

Received in revised form 12 February 2010

Accepted 26 August 2010

Keywords:

Initiation-Repair-Evaluation

Repair

Correction

Instruction

Understanding

Conversation analysis

A B S T R A C T

When an instructor initiates an Initiation-Response-Evaluation (IRE) instructional

sequence, problems may become evident in the recipients’ response to those questions

that suggest the source of the trouble may be with how recipients understand the

instructor’s question rather than the adequacy of the response. One strategy for attending

to this problem is for the instructor to pursue a correct response by withholding explicit

evaluation in the third slot of the IRE sequence and instead producing a revised version of

the sequence-initiating question. Question revision or correction on the part of the

instructor affords recipients the opportunity to produce revised responses as evidence that

they also properly ‘understand’ what made the revised query relevant in the first place. In

our analysis, we show that this strategy of pursuing a correct response by offering

successive corrections/revisions of an IRE-initiating query treats understanding as the

‘‘convergence between the ‘[1_TD$DIFF]doers’ of an action or bit of conduct and its recipients, as

coproducers of an increment of interactional and social reality’’ (Schegloff, 1992: 1299).

� 2010 Elsevier B.V. All rights reserved.

* Corresponding author. Tel.: +1 518 442 4882; fax: +1 518 442 3884.

E-mail addresses: azemel@albany.edu (A. Zemel), tkoschmann@siumed.edu (T. Koschmann).

Contents lists available at ScienceDirect

Journal of Pragmatics

journa l homepage: www.e lsev ier .com/ locate /pragma

0378-2166/$ – see front matter � 2010 Elsevier B.V. All rights reserved.

doi:10.1016/j.pragma.2010.08.022

sequence, the instructor initiates (I) interaction in the first position; a student responds (R) to the instructor’s question in thesecond position; and the instructor offers some form of assessment or evaluation (E) in the third position. The primary focusof most research on IRE sequences has been on the interactional work participants do to assess, repair and/or correct astudent’s response when its adequacy is treated as problematic (cf. Cazden, 1988; Macbeth, 2003, 2004; McHoul, 1978,1990; Mehan, 1979, 1982; Waring, 2002b, 2008, 2009; Weeks, 1985).

Evidence suggests that there may be at least two sources of asymmetry between teacher initiation and student reply(Mehan, 1979) when students produce responses to instructor queries that the instructor sees as inadequate. On the onehand, a student’s responsemight be seen as inadequate by virtue of a deficiency in the student’s knowledge or understandingof the matter being queried. For example, a student may ‘‘understand’’ the instructor’s question but may not ‘‘know’’ thecorrect answer. We call this circumstance an IRE with a second-position trouble (SPT) source. On the other hand, thestudent’s responsemight be seen as inadequate because of a problemwith or deficiency in the instructor’s query itself.Whenthe instructor sees his or her own initiating query as the source of the trouble, redesign of the question and re-initiation of theIRE sequence in the third position becomes the relevant interactional trajectory. We call this circumstance an IRE sequencewith a first-position trouble (FPT) source.Whilemostwork examines SPT sources, very little work has been donewith regardto FPT sources. IRE sequences with first-position trouble sources have interactional trajectories that suggest logics ofclassroom participation and instruction different from IRE sequences with second-position trouble sources (cf. Ende et al.,1995; Pomerantz et al., 1995; Zemel et al., forthcoming). Most importantly for our interests, these trajectories representdifferent ways of constituting and resolving problems of understanding in instructional interaction.

In the IRE sequence, it is the teacher that determines if a trouble source has occurred in the first or second position of theIRE based on the student’s second-position response. If the teacher recognizes a trouble source, the kind of trouble source heor she recognizes is consequential for what the teacher will produce in the third position of the IRE, which could include adelayed turn-initiation, explicit evaluation or correction of the student response, or even a re-initiation of the IRE sequence.When a teacher offers an explicit assessment or evaluation, a repair-initiation or a correction in the third turn slot, thisimplies that the trouble source is the student’s reply in the second position of the IRE. In this case, the teacher’s action isfounded on the presumption that there is intersubjective symmetry between the teacher and student with regard to theteacher’s first-position IRE initiation. This allows the student and the teacher to treat the teacher initiation as ‘‘understood’’by the student. The asymmetry between the first-position IRE initiation and the second-position IRE reply is thusaccountably attributable to some problem with the student’s response only. Alternatively, the teacher can produce a thirdposition action, based on the student’s response, that implies the teacher’s initiating first position action is somehowinadequate and the source of interactional trouble. When a teacher reinitiates the IRE with a variant of the original IREinitiating action, the teacher is displaying through the representation of an alternative version of the initiating action that thetrouble source is located in the first position of the IRE with the original initiating action, making relevant its correction bythe teacher as a re-initiation of the IRE.1 Thus, the nature, recognition and location of the trouble source are consequential atthe very least for determining what will be treated as the correctable matter (the IRE initiation or response) and anyconstraints on the production of the correction.

When the trouble source is the student’s reply in the second position of the IRE, either the student or the teacher performsrepair-initiation and either the teacher or the student may, depending on the contingencies of the situation, produce theactual repair or correction. Whether the student self-corrects or the teacher corrects the student, symmetry with theteacher’s initiating IRE action is achieved with the production of the correct reply and the student stands corrected.2 Whenthe trouble source is located in the first position of the IRE, it is up to the teacher to perform the repair, thereby recalibratingand reinitiating the IRE sequence itself. In this manner, the teacher can avoid (a) the issue of whether the student’s initialreply is correct or incorrect and (b) any implication of disagreement with the student by leaving the student’s initial replyunevaluated and creating an opportunity for the student to produce another reply.

2. The data

In the following analysis, we examine how a tutor engages in an extended interaction with an ensemble3 of students toelicit from them a proper description of the way a particular antibiotic works. Our data consist of video recordings of aproblem-based learning (PBL) tutorial, conducted in an American medical school. PBL is an organization of instructionalactivity that incorporates elements of learner-directed, case-based, and collaborative instruction (Koschmann et al., 1996:716). Nominally, PBL is organized to allow learners to discover and recognize (a)what they do not knowbut (b) need to knowto properly address issues relevant to the case materials on which they are working. Tutors routinely participate in PBLsessions since it is acknowledged that recognizing a deficit in what one knows or understands can be difficult if not locallyimpossible to achieve without some kind of guidance from someone whose competence or expertise exceeds that of thestudents (Barrows, 1994; Koschmann et al., 1996). In our data a highly qualified medical doctor serves as the tutor. The task

1 For example, this would be the circumstance in which a teacher asks a different version of an initial question to the same student rather than the

circumstance in which a teacher recycles an initiating question by asking the same question of a different recipient.2 Other-repair and other-correction are systematically related to disagreement (Schegloff et al., 1977).3 According to Lerner (1993). ‘‘All associations are constituted by the relevance of, or opportunity for ‘conjoined participation’. Ensembles (i.e. ensemble-

type associations) are constituted by a distinguishable form of conjoined participation—the coordinated participation of a team’’ (214-215).

A. Zemel, T. Koschmann / Journal of Pragmatics 43 (2011) 475–488476

of the tutor is to engage with the students in ways that allow them to recognize that something about their own actionsrequires correction without explicitly engaging in such correction work (Barrows, 1994).4 In the segment we examine, thetutor queries the students about the action of an antibiotic referred to as Doxicillin. We examine the work that the studentsand the tutor do to extend and redesign tutor questions in ways that make it possible for the students to collaborativelyproduce what ultimately becomes a ‘correct’ description of ‘‘the action of Doxicillin.’’ By examining how the tutor and thestudents attend to the tutor’s questions in the tutorial, it is possible to identify those constitutive practices by which anagreed-upon and properly constituted understanding, in the form of a description of ‘‘the action of Doxicillin,’’ is achieved.

3. Analysis

3.1. Initiating the IRE Sequence: Round 1

Transcript Segment 1

1 Tutor: Movin’ right along before we fo:llow he:r 2 -> (.) do you all know the action of Doxicillin?3 -> How it uh how it affects the organism?4 Jackie: <°Dox⎡i-cil-lin.°>5 -> Tutor: ⎣What it's mode of action is?6 Melissa: Doxicillin.7 Joel: S-sim⎡ilar to Erythro↑mycin (.) ↓ isn't it?8 |((Joel looking toward Jackie))9 Jackie: ⎣Doxycycline?

10 (Laura): °Doxicillin.°11 Brenda: Itsa ⎡Tetracy↓cline ( ) 30S sub↓unit (.)12 Laura: ⎣It's a Tetracyclin⎡e13 Joel: ⎣Is ↑it? O:h 14 ↓Okay ((Joel looking at Brenda))15 Brenda: inhibitor,

In lines 1, 2, 3 and 5, the tutor suspends further consideration of the patient and the case materials and calls for anunderstanding check. The understanding check is called for in lines 2, 3 and 5 where the tutor asks a question of theassembled students: ‘‘do you all know the action of Doxicillin? How it uh how it affects the organism? What its mode ofaction is?’’ The first part of this portion of the tutor’s utterance, ‘‘Do you all know the action of Doxicillin?’’ isgrammatically organized as a yes/no question is followed by clausal extensions, ‘‘How it uh how it affects the organism?What its mode of action is?’’5 Though the tutor’s interrogative (lines 2, 3 and 5), is produced as a yes/no inquiry (cf.Koshik, 2005b; Raymond, 2003), it is asking for more than a ‘yes’ or a ‘no’ from the students. It is produced and heard as acall for an ‘understanding check’ by which the tutor requests that the assembled students produce a description of theaction of Doxicillin (Fig. 1).

The students treat the tutor’s utterance as an unambiguous and unproblematic request for a description of the action ofDoxicillin. Structurally, the tutor’s question prefers some form of an affirmative response; interactionally, its elaborate andexpanded design authored by the tutor in an instructional setting anticipates and projects that students produce at least aminimal account or description of what they know rather than a simple ‘yes’ or ‘no’. The students’ conjointly producedresponse (in lines 10 through 15) is such a description, thereby constituting the tutor’s query as a request for a description ofwhat they as a class know about Doxicillin. This treatment of the question also implies that the students are treating the tutoras someone who already knows how Doxicillin acts and is in a position to assess the adequacy of whatever description theymight produce, thus making relevant the production of such a description as a response.6

Additionally, the tutor’s question is not addressed to any student in particular but is addressed to the students as anassociation or ‘‘collectivity’’ (Lerner, 1993). For Lerner, ‘‘All associations are constituted by the relevance of, or opportunityfor ‘conjoined participation’’’ (214-215). Addressing a collectivity is consequentially different in interactional terms fromaddressing a single actor because it calls for an organization of participation different from ordinary conversation [6_TD$DIFF] (cf. Lerner,1993: 219). Thus, the way the tutor’s question is addressed serves as evidence that the tutor is orienting to the ongoinginteraction as an instructional sequence different from ordinary conversation. Specifically, he is calling on the students as anensemble to produce an adequate and appropriate description of the action of the drug.

4 See Ende et al. (1995) for a discussion of similar work done by preceptors when correcting residents in ambulatory care settings.5 Grammatically and indexically, these two clausal extensions elaborate and expand the sense of the queried referent ‘‘the action of Doxicillin’’ and thus

are not self-corrections in the strict sense.6 In instructional circumstance, questions produced by an instructor as part of thework of instruction, especially questions whose answers are presumed

to be already known to the instructor, are routinely treated as initiating Initiation-Response-Evaluation (IRE) sequences (cf. Cazden, 1988; Lemke, 1990;

Mehan, 1979; Sinclair and Coulthard, 1975; Wells, 1999).

A. Zemel, T. Koschmann / Journal of Pragmatics 43 (2011) 475–488 477

Though the tutor’s question may seem to be a relatively straightforward request for a description, the students face theproblemof how toproperly producewhat is for them the called-for object of interest, a description of ‘‘the action of Doxicillin,’’given the resources provided by the tutor’s query. The tutor’s initiating question, while providing certain resources forconstituting a student reply, doesnot indicate (a)what a correct orproperdescriptionmightbeor (b)whoamong the recipientsshould respond. As a result, the tutor projects the nature of recipient participation bymaking them responsible for identifying,organizing and producing what they as a collectivity (Lerner, 1993) would take to be an adequate description of Doxicillin’saction.

In building a response, the students first conferred among themselves to sort out a bit of confusion over the tutor’s use ofthe term Doxicillin in his initiating utterance at line 2. At lines 4 and again at line 6, students repeat, the tutor’s term,‘‘Doxicillin.’’ At line 7, Joel asks ‘‘Se-similar to Erythro"mycin (.) #isn’t it?’’ This candidate position, formulated as an assertionwith an interrogative tag, employs the notion of family resemblance (Jayyusi, 1984: 62) with respect to a category of drugs.Interestingly, Joel’s query is addressed to ‘no-one-in-particular’, thereby treating the students as a collectivity. This isfollowed by a query by Jackie using an alternate formulation of the term at line 8, ‘‘Doxycycline?’’ and another repetition ofthe tutor’s term by Laura, ‘‘8Doxicillin8’’ at line 9. This brief exchange demonstrates what Lerner (1993) has called a‘‘conference sequence’’ or what Jefferson and Schenkein (1978) call a ‘‘conference pass’’ that ‘‘is produced in response to aninquiry that makes relevant shared, but independent opportunities to participate’’ (Lerner, 1993: 234-235). As it turns out,the tutor had misnamed the drug in question and the conference sequence (lines 4 through 14) displays the students’sensitivity to the fact that the tutor had used what appears to be an incorrect term.7In producing the conference sequence(lines 4 through 14), the students also articulate an initial description of the ‘‘action of Doxicillin.’’ As the data show, thestudents (a) conferred among themselves to try to resolve a problem of reference and then (b) produced an initial descriptionof thematter raised by the tutor by attempting to address this the referential trouble. In thisway, the students acknowledgedand oriented to the tutor’a initiating query and each other as a collectivity and produced a description as the work of thatcollectivity (Lerner, 1993).

The constitutive procedures by which the students organize their participation in the production of their response, i.e.,conferring to produce a description in terms of a family resemblance of drugs, allows their description to be treated as arecognizable object: the collectively endorsed description of ‘‘the action of Doxicillin.’’ By describing ‘‘the action ofDoxicillin’’ in terms of a set of family resemblances of drugs (‘‘Itsa Tetracy#cline 30S sub#unit inhibitor’’), the students arerelying on the fact that individual drugs can be classified asmembers of drug families based on variousways that drugswork.In other words, all drugs in a drug family work in the same basic way. Thus, the claim the Doxicillin is a Tetracyline is treatedas a provisionally appropriate and proper description of the ‘‘action of Doxicillin.’’

[(Fig._1)TD$FIG]

Fig. 1. The PBL Tutorial.

7 Themethod recipients used to construct their response to the tutor’s query involved producing a description of the action of Doxicillin that located it in a

family of drugs that share similar properties. A reader with a working knowledge of clinical pharmacology might be somewhat puzzled by the participants’

use of the label ‘Doxicillin.’ As a medical school faculty member informed us, ‘‘Doxycycline is used for the treatment of C. trachomatis infections. As far as I

know there is no drug known as doxycillin although there are drugs with similar sounding names oxacillin, cloxicillin and dicloxicillin. Doxycycline is

related to the bacteriostatic tetracycline class which inhibits bacterial protein synthesis while oxacillin, cloxicillin and dicloxicillin are bacteriocidal beta

lactams related to penicillin and inhibit bacterial cell wall (peptidoglycan) synthesis.’’ (P. Borgia, personal communication). Indeed, Jackie calls the name

into question in line 7. Despite their use of what might appear to be an improper label, the group’s subsequent discussion of ‘Doxicillin’ is largely consistent

with this description.What is beingworked out in this discussion is just how a practicing physician, when prescribing an antibiotic, needs to understand its

mode of action. The label, and whatever actual pharmaceutical product it might portend, are just placeholders, therefore, within a broader discussion that

seeks to address this aspect of professional competency.

A. Zemel, T. Koschmann / Journal of Pragmatics 43 (2011) 475–488478

At this point, it should be remarked that whether or not the response represents what all the students ‘‘actually’’ know or‘‘really’’ understand in the sense of some internal cognitive resources are not the concerns of this analysis. Macbeth (2004:704) describes classrooms as ‘‘local cultures of knowledge production,’’ and furthermore argues that ‘‘producing ‘‘correctanswers,’’ and thus ‘‘correction,’’ is . . . a prevailing task and orientation in the practical life of classrooms, for students andteachers alike.’’ This locally relevant concernwith the production of an assessably ‘correct’ description of Doxicillin allows allparticipants, students and tutor alike, to treat the called-for student description of ‘‘the action of Doxicillin’’ as theirassessable and defeasible understanding of the matter.

3.2. Reinitiating the IRE Sequence: Round 2

While under certain organizations of interaction, the production of a descriptionwould be sufficient for actors tomove on toother things, part of the constitutiveprocedures thatmake this an instructional interaction for the participants iswhat the tutor,upon receipt of this description, elects to do in the third and next turn. What the tutor might choose to do in the third turndepends on

� Whether or not the tutor recognizes a trouble source in the initiation-response (question-answer) sequence,� If a trouble source is recognized, whether the trouble is with:� The initiating action of the tutor, or� The reply action of the student, and

� Whether or not the trouble warrants a correction or a correction-initiation.

The interaction between the tutor and the students will be identifiable to the students and to the tutor as an instructionalinteraction if, in the next turn, the tutor:

� Explicitly evaluates the students’ response as correct or incorrect.� Produces a correction or acts in ways that prompt the students to produce a correction.� Recycles an alternative version of the initiating query as a way of demonstrating ‘‘another route to a correct answer’’8

(Drew, 1981: 260)

If this were an unremarkable and routine IRE sequence, a projected relevant next activity for the tutor to perform wouldbe to evaluate in someway the student’s proffered description. Aswe see in Transcript Segment 2, the tutor does not producesuch an evaluation, does not engage in correction-initiation work, does not offer any correction. Instead, the tutor offers upanother question: ‘‘So what’s it #do (0.8) to the poor little chlamydia?’’ (lines 16 and 18).

Transcript Segment 2

-> Tutor: So what's it ↓do (0.8)

-> ⎡to the poor little chlamydia Melissa: ⎣It interrupts the (.) protein synthesis.Laura: Right. There's 30S's along the sub-

unit of the ribosome, and it's th- the bacteria have different (.) like sizesub units to the ribosome, so that's ↓why it's selected.

Melissa: Except, ⎡ the mitochon- ex↑cept-> Tutor: ⎣She could sure fool me. Is that -> is that ↑right?

Patrick: Hm ↑mmMelissa: It's ↑true=

-> Tutor: =O↑kayMelissa: ((Pointing finger)) but the mito↑chondria

are ↓similar to the (0.8) are sim- ourmitochondria are similar to the bacterial⎡mitochondria so if

Laura: ⎣Only because once they were↓bacteria.

Melissa: Right so if you have high concentrations you can get or in (.) hhh young ((hand gesture)) children or (.) fetal you can ⎡have um (.) a toxi?city

Joel: ⎣(mm right)

1617181920212223242526272829303132333435363738394041

8 Drew (1981) argues that producing an alternative query as a correction demonstrating another route to a possibly correct response displays ‘‘the

speaker’s prior knowledge of the answer’’ and thus serves to identify the speaker’s work as instructional (1981: 260).

A. Zemel, T. Koschmann / Journal of Pragmatics 43 (2011) 475–488 479

The analytical question of interest here is whether or not the tutor’s query at lines 16 and 18 is an information-seekingquestion, or is designed to be seen as a ‘correction’ of his initial query in lines 2, 3 and 5. When the adequacy of the initialquestion is an issue, then both the tutor’s question and the students’ reply become potential correctables in a subsequentturn. Thus, a new or altered question may be called for by the tutor’s understanding of the students’ response, and theproduction of a tutor-initiated student correction or expansion of the prior description may be called for as well. The waythat the question in lines 16 and 18 is produced suggests that was produced as a tutor self-correction of his initial questionfor the following reasons:

� First, the second question is a version of the first question.� It is syntactically different.� It is not a yes/no question like the first query.� It is a so-prefaced query that, like the first version, calls for a description of how Doxicillin affects chlamydia, apreviously unspecified kind of organism.

� Second, it is indexically linked to the initial query through the use of the pronoun ‘‘it’’ without a respecification of thepronominal referent.� The pronoun ‘‘it’’ serves as an indexical tie to the initial appearance of the term ‘‘Doxicillin’’ in the first question.� Elements of the first query remain relevant for the intelligibility of the subsequent question.

� Third, the second question differs from the first in that it not only indexes a new referent, viz. chlamydia, the referent alsoprovides an explicit resource for students to use as an alternative way of understanding the query in order to produce analternate description of the action of Doxicillin as an adequate response.

The tutor’s second query is prefaced with the conjunction ‘so’. While so-prefaced questions are occasionally used to dounderstanding checks (cf. Beun, 2000; Jurafsky et al., 1997; Jurafsky andMartin, 2000; Waring, 2002a), they are also used todo what Waring (2002a) called extensive corrections, which ‘‘involves stretching out a prior explication or assertion . . . toensure the full development of such explication or assertion’’ (Waring, 2002a: 464). However, ‘‘unlike reformulation, whichis oriented to with some sort of delay or weakened acceptance, extending is produced and oriented to as an affiliative movethat maintains the continuity of the prior speaker’s perspective’’ (Waring, 2002a: 466). From this view, the tutor ‘attaches’the students description to his second query in lines 16 and 18 with the conjunction so. In doing so, the tutor treats thestudents’ initial description as a coordinate clausal structure, attached to his second query, to suggest that the priordescriptionwas only part of an as-yet-to-be-completed description, a description thatmust take up the question of the effectof Doxicillin on chlamydia.

By introducing the new term, chlamydia, and onlymaking pronominal reference toDoxicillin (‘‘Sowhat’s itdo. . .’’), the tutorindicates that the description he is looking for has to specifically address howDoxicillin acts on chlamydia. Also, correcting byextending his first question with a second question that incorporates the students’ initial description implies that the tutor’sinitial query did not adequately provide students with adequate resources for producing an initial description, or was in someothermannerproblematic. Thenewversionof the tutor’squestion ‘‘Sowhat’s it #do (0.8) to thepoor little chlamydia?’’ (lines16through 18) explicitly calls for recipients to produce another description. By asking about ‘‘the poor little chlamydia,’’ the tutorprovides the students with a clue as to what an adequate response might need to address.

This extensive correction of the initial query is not without its problems. On the one hand, the tutor’s query design leavesit to the students once again to work out what an adequate response might be. Furthermore, the pause at the end of the firstpart of the tutor’s utterance, ‘‘So what’s it #do’’ introduces interactional issues by projecting a turn transition space thatmakes it relevant for students to offer responses at that point. What in fact occurs is a continuation of the query at line 18 inoverlap with Melissa’s utterance in line 19 as a response to the first part of the tutor’s query. Melissa’s response is taken upand expanded by Laura at lines 20 through 24. While Laura and Melissa recognize the tutor’s utterance at line 16 as a querycalling for a response, there seems to be some difficulty in properly marking the completion of the tutor’s query. Both as ananalytical and a practical matter, this raises the question of whether Melissa and Laura are responding to the first part of thetutor’s question (line 16 only) or to the tutor’s full question (lines 16–18). Both students use the prior student response as aresource and expand on one element of that response, that Doxicillin disrupts a bacterium’smechanismof protein synthesis9

(lines 19 through 24). Presumably this applies to chlamydia as well as other bacteria. However, though the tutor makesexplicit reference to chlamydia in the production of his query, there is no such reference made in any of the students’responses. Because they do not explicitly address thematter of the chlamydia raised in the second part of the tutor’s query, itremains indeterminate whether or not the answer they do offer addresses the concerns of the tutor’s question.

Another interesting feature of student response to the corrected question is that it expands on elements introduced in theprior response. This suggests that, in the absence of any explicit action that calls into question the propriety or correctness ofcurrently deployed constitutive practices for producing a response, actors will continue to work with those constitutive

9 The antibiotic works by selectively binding to the bacterium’s 30S ribosomal subunit to disrupt the bacterium’s protein synthesis. Protein synthesis in

human cells also uses similar mechanisms. However the ribosome involved inmammalian cell protein synthesis is quite different than the ribosome found

in the bacterium. Doxycycline only binds to the 30S bacterial ribosome unit; it does not bind to the human ribosome unit (N. Young, personal

communication).

A. Zemel, T. Koschmann / Journal of Pragmatics 43 (2011) 475–488480

practices when they are called upon to expand on prior answers. In other words, if a follow-up question is asked in responseto a previously offered answer, respondents will assume the initial answer:

� Is not incorrect,� May need repair, correction, expansion, elaboration, etc., and/or,� May be used along with the constitutive practices of its production as a way of producing subsequent responses.

At line 25, Melissa begins to offer an exception to Laura’s prior version of an answer to the tutor’s question (lines 20through 24). At lines 26 and 27, the tutor assesses Laura’s response ‘‘She could sure fool me,’’ and then asks a yes/no questionas part of the same utterance, ‘‘Is that is that "right?’’ In the video, the tutor’s gaze is at first directed at Laura as she speaks.Then he directs his gaze at Patrick as he asks, ‘‘Is that is that "right?’’ The tutor used his gaze to address the question to Patrickwho had not yet weighed in on the topic. By asking a yes/no question that called on Patrick to assess Laura’s description, thetutor adjusted his participation in the scene such that the query can be seen as eliciting what, in members’ terms, could beeliciting an endorsement from other students. Doing so is away that the tutor can transform an intervention thatmight havebeen seen as a way of bringing the IRE to a close into a ‘‘side bar’’ to Melissa’s ongoing work of qualifying Laura’sdescription.10 Furthermore, by addressing a query to Patrick inwhatmight be heard as the third position of the IRE sequencewhere an evaluation would be expected, the tutor is inviting others to participate in the production of responses and isindicating that the response phase may not be over yet.11

Patrick first attests to the veracity of Laura’s remarks at line 28. This displays that Patrick recognizes the tutor’s utteranceas a question calling for an answer fromhim. Patrick’s answer is followed immediately at line 29 byMelissa’s endorsement ofwhat Laura has said At this point the tutor accepts the student’s affirmations, allowing Melissa to continue her ongoingelaboration of Laura’s explanation (see lines 31 through 34, and 36). Melissa expands Laura’s initial candidate explanation byproposing that there are potential problemswith the use of this antibiotic, i.e. that high concentrations of the antibiotic couldbe toxic to young children and fetuses.12 Again, we are confronted with the analytical and members’ concern with regard tothe situated adequacy of the workMelissa and Laura are doing. The tutor’s proffered assessment ‘‘She could sure fool me’’ atline 26 calls into question in a specific and local way the work that Melissa and Laura have been doing up to that point toproduce a more elaborate version of their responses to his queries. At line 30, the tutor accepts Patrick’s endorsement at line28 andMelissa’s declaration, ‘‘It’s "true’’ at line 29. The tutor thus continues to treat the adequacy of their answers as amatterof interactional relevance to the students themselves. It is at this point that the tutor reinitiates the IRE by asking a kind ofquestion as a correction of his Round 2 question that is very different from the kinds of questions he has asked up to thatpoint.

3.3. Reinitiating the IRE Sequence: Round 3

So far, the students in our data continue to produce increasingly detailed responses based on the deployment of theirinitial ‘‘family resemblance’’ description of the antibiotic. Because the tutor consistently withholds explicit evaluation ofstudent responses upon receipt of their description and instead elects to reinitiate the IREwith tutor-corrected questions, thestudents treat the tutor’s queries as evidence that their descriptions are (a) not incorrect, but (b) are somehow deficient inthe level of their detail. They treat the tutor’s corrections as calling for refinement of their prior responses. Thus the studentscan and do maintain and expand upon their use of family resemblances among antibiotics as the constitutive practice bywhich they organize and build their description.

A possible alternative viewmight suggest that the tutor is withholding assessment (cf. Koschmann et al., 2000), because aresponse organized in terms of family resemblances among antibiotics, while not strictly incorrect, is not the kind ofdescription fo[8_TD$DIFF]r which the tutor is looking. Offering a corrected IRE-initiating question as an alternative to a prior IRE-initiating question can also indicate to recipients that the then current response strategy is either incomplete or that it isinappropriate, making relevant a very different kind of response.13 However, rather than treat the repeated queries asopportunities to frame a different kind of description, the students produce increasingly detailed expansions of their initialdescription based on the constitutive practices to which they are apparently committed.

It is at this point that the tutor changes the design of his question to display explicitly that he wants the students toconsider an alternative way of constituting their description of ‘‘the action of Doxicillin.’’ Specifically, the tutor’s next roundof questions are designed with candidate answers embedded within them (Pomerantz, 1988). When candidate answers arebuilt into the question, the questioner is specifying the organization of relevancies displayed in the candidate answers asresources with which a response nominally should be built (Pomerantz and Zemel, 2003). The tutor’s use of candidate

10 The uses of addressing procedures to manage the organization of participation and the sense of utterances are worthy of a separate study.11 We wish to thank an unnamed reviewer for pointing this out.12 Mitochondria are structures in human cells that produce energy units called ATP. In addition, mitochondria are double cell-walled structures that bear

some similarity to bacteria. Mitochondria have their own protein synthesizing mechanism, using ribosomal units that are very similar to 30S bacterial

ribosomes. Doxycycline can also reversibly bind to the ribosome in human mitochondria, however, it does not cause any substantial human toxicity.

Whether this is due to poor binding to humanmitochondrial ribosome or due to lower concentration of the antibiotic in the humanmitochondria is unclear.

In this instance, Melissa’s claim that a high dosage of doxycycline is toxic to the human fetus because of this mechanism is incorrect.13 This view of the tutor’s actions is consistent with what might be called ‘‘learner-directed instruction (Koschmann et al., 1996).

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answers in the design and construction of his question explicitly invokes and projects particular categorical relevancies anddirects the students to the kind of response for which he is looking. This is demonstrated in lines 42 and 43:

Transcript Segment 3

42 -> Tutor: Does it kill ↑off the bacteria or ↓does it 43 -> just >hold them still.<44 Melissa: It kil- it's bactericidal.45 -> Tutor: It's bactericidal. So how long do you 46 -> havta give it.47 (1.5)((sound of flipping pages))48 Jackie: Seven days, isn't it49 Brenda: U::mm((looking at book))50 (1.0)51 Jackie: °Or is it ↓two weeks° ((looking at book))52 Laura: Ten to fourteen ↓days ((reading from book))53 Jackie: Oh.54 Laura: I was just looking right here hhh huh55 Brenda: ⎡I know I just looked it up 56 ⎢((Brenda pointing to book)) 57 -> Tutor: ⎣And it is bactericidal

Lines 42 and 43mark a distinct shift in the constitutive organization of the questions that the tutor addressed to the group.While prior formulations left it to the students to respond in terms of specific categories of relevance to them, this formulationincorporates candidate answers that display to recipients the specific categories that are of relevance to the tutor. As such, thechange in the constitutive organization of the question embodies a different preference organization,14 calling on students toconstruct a description in terms of particular relevancies explicitly incorporated in the design of the question. Thismost recentquery calls on the students to respond in terms of the particular candidate answers provided in the query itself.

The alternative constitutive organization of the tutor’s third question-correction serves to display that prior studentresponses were produced according to a set of constitutive practices that were not consistent with the way this query (lines42 and 43) constitutes the object, ‘‘the action of Doxicillin.’’ In other words, whatever the students had offered previouslymay have been correct but was in some important way not relevant to the tutor’s interests. A different kind of response iscalled for, given the change in the constitutive organization of the tutor’s question. Two alternative candidate answers arebuilt into the question, i.e. ‘‘kill "off the bacteria’’ and ‘‘hold them still.’’ While this does not preclude the possibility thatstudentsmight offer other responses, it (a) serves tomake relevant particular categories for the students in the production ofa response15 and (b) provides a resource of accountability such that any response to the query can be assessed in terms of thecategory relevancies established by the candidate answers. Organized as it is, the query lays out the possibilities for responsein terms of a set of members’ categories that they understand to be and treat as definitive. In other words, any and allantibiotics are designed to either kill off bacteria or hold them still. The problem posed by the tutor’s question is to selectwhich applies to Doxicillin. In making this selection, the students effectively produce a description of ‘‘the action ofDoxicillin’’ in accord with the constitutive organization of the tutor’s question.

Melissa’s response, ‘‘It kil- it’s bactericidal’’ (line 44), is notable for a number of reasons. First of all and without hesitation,Melissa answers in accord with the constitutive organization of the tutor’s question. Additionally, Melissa takes up the tutor’sinitial formulation of the alternatives embedded inhis query, ‘‘It kil-’’, performs a self-repair to finish her response using propermedicinal terminology, ‘‘it’s bactericidal.’’With this repair,Melissaproperly ‘medicalizes’ her response, acknowledging that thetutor’s question is not only an invitation to select an appropriate alternative, but to do so in the proper manner. Selecting anappropriate alternative from the ‘list’ provided by the question itself displays that Melissa not only recognizes the changedconstitutive organization of the tutor’s query but that a different constitutive organization of response is implicated as well.

After Melissa produces a response to the tutor’s question at lines 42 and 43, the tutor appears to endorse her response atline 45 with ‘‘It’s bactericidal’’ which is also latched to another question, ‘‘So how long do you havta give it.’’ The first part ofthe tutor’s response toMelissa’s second-position IRE reply could be seen as an evaluativemove occupying the third slot of thecurrent IRE sequence. But the tutor’s latched query, ‘‘So how long do you havta give it,’’ serves not to initiate a new IRE per se.Instead, it highlights the relationship between themode of action (bacteriostatic vs. bacteriocidal) and duration of treatment.

The students’ responses (lines 48–55), however, display considerable uncertainty. Jackie initially suggests seven days, butthen admits that it could also be two weeks. Jackie, Laura, and Brenda all consult written references. This represents a shift in

14 In discussing adjacency pair phenomena, Schegloff (2007) observed ‘‘the alternative types of second pair part which a first pair part makes relevant are

not equivalent, or equally valued. They are not ‘symmetrical alternatives’ (Schegloff and Sacks, 1973: 314). Sequences are the vehicle for getting some

activity accomplished, and that response to the first pair part with embodies or favors furthering or the accomplishment of the activity is the favored—or, as

we shall term it, the preferred—second pair part’’ (Schegloff, 2007: 59). In this case, the changed organization of the query produces an alternative

organization of preference and participation.15 Though the tutor presented two alternatives, he left it to the students to provide the appropriate medical terms, thereby leaving it to them to use topic-

appropriate terminology. The alternatives he presented were vernacular glosses for the accepted Latin-based medical terms bactericidal (‘‘kill "off’’) andbacteriostatic (‘‘hold them still.’’), which are appropriate and constitutive of their talk as medical talk.

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their epistemic positionwith regard to thematters under discussion.Where previously theywere confident in their ability as agroup to address the tutor’s question, they now treated it as a matter that needs to be checked, thereby calling their prioranswers into doubt.

The tutor’s ‘‘And it is bactericidal’’ (lines 57), operates as what Koshik (2005b) described as a ‘‘reverse polarity question’’(RPQ). Koshik describes how certain declaratives can be ‘‘treated as questions in that they make relevant a confirmation ofdisconfirmation’’ (Koshik, 2005b: 1). The emphasis placed on the verb ‘‘is,’’ in this case, facilitates hearing the tutor’sstatement as a query. Koshik notes further that RPQs ‘‘are not asked, and are not understood, as ordinary information-seekingquestions but as making some kind of claim, or assertion, an assertion of the opposite polarity to that of the question’’(2005b: 2). The tutor’s and-prefaced assertion operates as a composite declarative (cf. Beun, 1990; 2000). It couples thestudents’ confused collective answer concerning the duration of treatment with their prior answer pertaining to mode ofaction. Problematizing the matter in this way displays the tutor’s position that the students as a collectivity ought to knowthe duration of treatment with certainty, if they know the mode of action since one implies the other.16

The tutor’s skillfuluseof aRPQat thispoint in the interactiondisplays to thestudents that theirunderstandingof themodeofaction of Doxicillin is not consistentwith the understanding of a competent practitioner and constituteswhat Garfinkel (1963,1967)describesasapossiblebreach in thenormativeand constitutiveorderof their interaction.The tutor’s querycalls upon thegroup to repair the breach. At its heart, the tutor’s RPQ inquires into what it means to be a bactericidal antibiotic.

3.4. Resolving the IRE Sequence

Melissa recognizes that the tutor has problematized the status of Doxicillin she has advocated, as is evidenced in heraccountingwork (lines 58, 61 through65). The tutor’s declarative reversepolarity yes/noqueryat line 57calls into question theconstitutive procedures by which the students’ description of the drug as bactericidal had been locally produced. Since thestudents now recognize that they do not know what they should know with regard to the relationship between treatmentdurations and the status of the antibiotic, they find it necessary to more closely and accurately review this relationship.17

Transcript Segment 4

57 -> Tutor: ⎣And it is bactericidal.58 Melissa: I thought that (.) 59 ⎡>I thought that I thought that<60 Laura: ⎣(°Have you ever looked it up? uh huh°)61 Melissa: I thought interrupting the protein, (1.8) 62 °synthesis° was >bacteria- because I ↑thought 63 it made more sense that it< was 64 bacteriostatic an- and it wasn't it was 65 cidal instead.66 Brenda: I think that ⎡all the different um protein67 Laura: ⎣(previously) ((yawning)) H-hhh 68 Brenda: >like the Tetracycline and the 69 Erythromycins< are static70 Melissa: I ↑thought they were ↓cidal, ⎡like71 Brenda: ⎣I always 72 for↓get73 (1.0)74 Melissa: ( ⎡ )=75 Brenda: ⎣My first instinct 76 ⎣((Jackie reaches for and begins to77 consult a manual))78 -> Tutor: Who i::s sure.79 Brenda: i::⎡s80 Melissa: ⎣°Would be static°81 Jackie: ⎡°This book is sure°82 Brenda: ⎣We'll look it up.83 Patrick: I’d love to be be sure but I:: (0.4)

16 A colleague in microbiology informed us, ‘‘The biggest difference between cidal and static agents is that cidal agents, as their name implies kill

microorganisms while static agents only inhibit the growth and multiplication of the agent. For that reason the host immune system is needed to kill the

organism (for static drugs) and thereby clear the infection. Consequently, the length of time necessary to completely kill an organism using a static drug

would be dependent on the immune status of the patient. The weaker the immune status, the longer the treatment would need to be.’’ (P. Borgia, personal

communication, 2/9/2010) [22_TD$DIFF].17 In an online medical reference, we find: ‘‘Doxycycline is generally bacteriostatic against a wide variety of organisms, both gram-positive and gram-

negative’’ (clinicalpharmacology-ip.com, accessed January 4, 2007). The same reference in describing Declomycin, however, reports: ‘‘Tetracyclines can be

bacteriostatic or bactericidal depending on the concentration at the site of action or the organism being treated.’’ The upshot is that terms ‘bacteriostatic’

and ‘bactericidal’ can be used in quite nuanced and complex ways and there is no simple answer to the question, is doxicillin/doxycycline bactericidal?

What this group is effectively doing is exploring what such a question might mean.

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84 ⎡I'm not sure ⎡I (got it)85 Brenda: ⎣We'll look it up. ⎢86 Melissa: ⎣Well I'd be sure-87 ⎡I'm sure that I've h-h-h-re:ad th:at.88 Patrick: ⎣right89 Tutor: Well moving right alo::ng90 Patrick: ⎡(Can I see)91 Laura: ⎣Pregnancy te:st92 (0.7) 93 Tutor: kh⎡mm ⎡>sorry<94 Laura: ⎣Ees ⎣Ee one sixteen. It's a like an( ) 95 (thing) >But (.) I don't know if that's 96 ⎡th'right97 Joel: ⎣Ee↑ one ⎡sixteen?=98 Tutor: ⎣Tee one sixteen.99 Laura: Ee-100 Jackie: ⎡They're bacteriostatic101 Laura: ⎢Ee-102 Tutor: ⎣Ee one sixteen no that's in the-uh 103 examination yeah you ⎡( )104 Jackie: ⎣They're bacteriostatic 105 ˚you guys.˚106 (0.6)107 Brenda: They're s:⎡tati::c?108 Melissa: ⎣They’re static?109 Brenda: Okay.110 (0.4) 111 Brenda: It's (0.4) good to ⎡know112 Joel: ⎣Negative.113 (0.8) 114 Joel: Tee ( ) for pregnancy test ( )115 Brenda: Oh that's ⎡good.116 Patrick: ⎣An- and they'd obviously be more 117 active during (0.9) metabolically active 118 bacteria.119 (0.7)120 Melissa: ⎡°I thought they were ⎡( )121 Patrick: ⎢ ⎣( factor)122 Tutor: ⎣So the::n (.) the:: 123 the concern about (0.7) the patient taking124 the antibiotic for the full length of time125 becomes very real >if we're dealing with126 a bacteriostatic<127 (1.2)128 Brenda: Yes.=129 Tutor: =treatment right?130 (1.3)

131 Brenda: C’zz’⎡sn't bacteriostatic just to get things132 Melissa: ⎣You want both 133 Brenda: ⎡under control so that the immune system can134 Laura: ⎣It allows you to fight it off yourself.135 (0.5)136 Joel: You can handle it yourself. 137 Melissa: But even with bacteriocidal:: a-a lot of 138 that is (0.3) bringing down numbers in your 139 immune system.140 (1.0)

In order to produce a response to the tutor’s challenging RPQ at line 57, the students appear to engage in two distinct butrelated and coordinated activities, (a) reassignment of accountability for the initial claim that Doxicillin is bactericidal, and(b) production of a supportable account of Doxicillin as bacteriostatic. Melissa, at lines 58 and 59, and 61 through 65, was thefirst to respond to tutor’s query. Melissa had been a strong advocate for the bactericidal nature of Doxicillin. Her first move isto produce an account to warrant her claim that Doxicillin is bactericidal.

As Melissa reasserts her position, Laura addresses a question and a response to Melissa, in overlap with Melissa’s ownremarks, ‘‘8Have you ever looked it up? uh huh8’’ (line 60). Laura’s utterance calls into question the epistemic basis uponwhich Melissa had made her prior claims. Brenda then offers an alternative description of Doxicillin as bacteriostatic based

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on the family resemblance between Doxicillin and similar classes of drugs such as the Tetracyclines and the Erythromycins(lines 66, 68 and 69).Melissa reasserts her position at line 70, ‘‘I "thought theywere #cidal, like’’ as a counter to the argumentthat Tetracyclines are bacteriostatic. The other students respond to the tutor’s RPQ at line 57 by developing alternativeaccounts of the action of Doxicillin. Brenda then produces an affiliative move at lines 71 and 72, ‘‘I always for#get’’ thatidentifies and serves to mitigate potential face issues Melissa might experience given that alternative accounts were beingput forward.

At lines 74 and 75Melissa and Brenda continue their remarks, further indicating that they are not sure about ‘‘the actionof Doxicillin,’’ i.e. they do not have an appropriate epistemic basis for making or, for that matter, changing their claimsabout Doxicillin. At this point, the tutor asks, ‘‘Who i::s sure.’’ (line 78). Where line 57 offers a question in the form of adeclaration, here we have a declaration in the syntactic form of a question. Rather than seeking the name of themember ofthe group who is most confident in her/his answer, the tutor’s question operates as a blunt negative evaluation of theircollective response to his prior query. To counter such a challenge one must supply the basis or source for one’sunderstanding (Pomerantz, 1984). Prior to the tutor’s challenge, Jackie had already begun to consult an available reference.Her response, tailored to the tutor’s challenge, ‘‘8This book is sure8’’ (line 81) asserts the authority of the text that she holdsin her hand.

While the matter is being researched, the tutor calls on recipients to identify and take up a next matter of relevance totheir work in the tutorial, ‘‘Well moving right alo::ng’’ (line 89). Laura announces a candidate nextmatter, i.e. ‘‘Pregnancy te:st’’ and she, Joel and the tutor begin to identify a page reference in the case materials that will yield the appropriateinformation regarding the pregnancy test for the case on which they are working. This invitation to move on is centrallyimportant at this point because it serves as a provisional, implicit assessment of the students’ description of ‘‘the action ofDoxicillin,’’ one that indicates they have finally got it right, or are about to get it right, without actually saying just so. Just asthe tutor has not topicalized the students’ description of ‘‘the action of Doxicillin’’ when they had it wrong, he did nottopicalize it when they had it right. Instead, with his call for a next topic, he projects that the issue is now a properly settledmatter.

As they work out where in their case materials the relevant materials on the pregnancy test are located,18 Jackie makes afirst attempt to announce the results of her review of the reference document (line 100), ‘‘They’re bacteriostatic’’. Theannouncement does not seem to register with recipients, perhaps because it is in overlap with the ongoing discussion tolocate a page in the reference document. Jackie recycles her announcement at lines 104 and 105, ‘‘They’re bacteriostatic 8youguys8’’. This was followed by a 0.6 second pause. Jackie’s announcement at lines 104 and 105 is designed and delivered in away that definitively confirms the implicit claim, indicated by the tutor’s challenge at line 57, that Doxicillin is bacteriostatic.This elicits from Brenda and Melissa parallel expressions of surprise, also in query form (lines 107 and 108). Brenda’sacceptance of Jackie’s announcement at line 109 is followed by a positive assessment of the information at line 111. WhileJoel and Brendawork toward setting up consideration of the pregnancy test in lines 112 through 116, Patrick begins theworkof expanding on the position articulated by Jackie at line 116 through 119. At lines 122 through 129, the tutor takes thestudent’s acceptance of Jackie’s announcement aswarrant for extending the discussion to the consequences for the patient ofa bacteriostatic treatment[10_TD$DIFF].

Once the students have established that Doxicillin is bacteriostatic, the tutor then explores the consequentiality of thisproperly produced and warranted description of ‘‘the action of Doxicillin,’’ by making it evident that for Doxicillin as abacteriostatic drug to be effective, the patient needed to follow the full course of treatment (lines 122 through 129). Byopening his remarks with ‘‘So the::n (.) . . .,’’ the tutor’s description of a medical ‘‘concern’’ is presented as a reasonedconsequence of the nature of antibiotic treatment, a concern that transcends the particulars of the antibiotic they arediscussing. This is an example of extension, which is treated ‘‘as an affiliativemove that maintains the continuity of the priorspeaker’s perspective’’ (Waring, 2002a: 466). Brenda confirms the consequentiality of the treatment at line 128 after a 1.2second pause. However, after receiving this confirmation, the tutor adds an interrogative tag (line 128) that, like the initialround of questions (lines 1 through 3, 5), indicates that this is nowmore than just a yes/no query calling for confirmation; it isa call for students to produce an expansion or extension of the description of the reason for the consequentiality of thetreatment. It is at this point that Brenda, Melisa, Laura and Joel adequately describe the way a bacteriostatic treatment ingeneral is designed to work (lines 131 through 140).

Thus it seems that both the students and the tutor are working to achieve more than just the procedural achievementof an acceptable description as a response to questions about the action of Doxicillin. Specifically, the work the tutordoes with the students in exploring the consequentiality of what is taken as their correct response provides a clue thatmore is at stake than just properly identifying the use of Doxicillin as a bacteriostatic antibiotic in the dosages anddurations prescribed. In the final segment, the tutor and the students together expand the description beyond theparticulars of the case on which they are working. From lines 131 through 139, the students themselves discuss theways that antibiotics work in general, not specifically the way that Doxicillin works. In orienting the students to theseconcerns with respect to one antibiotic, the tutor makes available to the students the way that physicians reason aboutantibiotics in general, inviting them to participate in a more membered way. The extended questioning sequence serves

18 The clinical case was simulated using a paper-based representation known as a PBLM (Distlehorst and Barrows, 1982). It is comprised of interview

question responses, exam findings, and laboratory results for the case under discussion. To retrieve any particular item from the PBLM, users must consult

an external guide for the appropriate page number.

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to demonstrate that a practitioner must clearly understand the goal of treatment in order to competently prescribe anantibiotic.

4. Discussion

When the tutor put forward his first question as a request for a description of the action of Doxicillin, he initiated an IREinstructional sequence. The students produced a description in a manner that preferred agreement, suggesting that thedescription they had produced should be seen as proper and adequate. However, the tutor implicitly treated the descriptionas problematic, seeing in their description a problem with the initial version of his own question. The tutor did initiatecorrection of the student’s description in an interestingway, not by identifying some problemwith the description itself, butby revising his own sequence-initiating query in what would have been the third turn slot of the IRE (lines 17 and 18). Thestudents responded to the tutor’s self-correction of the IRE sequence-initiating query by expanding their description,treating the initial description as appropriate but insufficiently detailed. In this way, the students displayed the presumptionthey understood of the tutor’s initial query and that the trouble source was, from their perspective, with the level of detail ofthe description as proffered.

However, not satisfied with the expanded student description, the tutor once again elected to produce a different kind ofquestion in the third turn of the IRE sequence (lines 42 and 43). This is evidence of his recognition that the students had notyet understood the kind of description hewanted them to produce and thus did not properly understand the question he hadpreviously asked. The new, revised question no longer solicited a description in the way that the prior questions had butinstead offered two candidate answers that explicitly presented possibly appropriate descriptions of the action of Doxicillin.Offering the students a list of possible responses fromwhich theywere to select the ‘correct’ response provided awarrant forthe students to abandon their prior description in favor of one of the offered alternatives.

Even though the students were now organizing descriptions in terms that were apparently appropriate, bactericidalversus bacteriostatic, the students took the position that Doxicillin was bactericidal, which as it happenswas incorrect. Onceagain, the tutor produced a sequence-initiating query in the third position of an IRE sequence (line 56), again indicating thatthe students had not properly understood the nature of his question. The students had not taken into consideration thedosages and treatment durations specified in the case materials. The tutor’s query took the form of a declarative, reversepolarity yes/no question. Such questions, as Koshik (2005b) and others have noted, act as opposite polarity assertions thatcall for a response from recipients. Checking the ground for the apparently contradictory assertion of the tutor provided anopportunity for the students to explore the consequences of their selection in terms of the kind of treatment recommended,causing them to recognize that the description they had selected was inconsistent with the treatment recommendationsprovided in the case materials. In this way, the tutor can be seen as having pursued a correct response by offering successiveexpansions and revisions of an IRE initiating query.

Getting students to think in particular ways may not occur if a teacher just presents a version of the reasoning processas a correction to student errors. Getting students to actually think in unfamiliar ways may require guidance andmanipulation of the students’ own reasoning as it is accomplished in situ. Questions provide a mechanism for doing justthis, for calling on students to check their thinking, for providing recipients with ‘‘another route to a correct answer’’(Drew, 1981: 260). This often involves shifting the indexical ground and repairing problems that arise with respect to theparticipants’ intersubjective orientation to thematter at hand. We believe that these data display an artful and elegant setof question-revisions that allow such a repair of intersubjective orientation to occur. At the end of this segment, thestudents have actually done the work of reconciling treatment duration and dosage with the therapeutic action of anantibiotic, thus learning how ‘‘professional’’ physicians ‘‘see’’ the relationship between treatment and action of antibiotics(Goodwin, 1994).

We consider the production of understanding to be something like the sequential achievement of intersubjectivity, or asSchegloff writes, the ‘‘convergence between the ‘‘doers’ of an action or bit of conduct and its recipients, as co-producers of anincrement of interactional and social reality’’ (Schegloff, 1992: 1299). The coproduction of an increment of interactional andsocial reality requires this convergence. In our analysis, we have shown how the tutor organized his ongoing engagementwith the students to encourage this convergence, allowing the students to discover for themselves what was required toachieve a shared intersubjective orientationwith respect to the action of Doxicillin in particular and of antibiotics in general.The tutor achieved this convergence incrementally and interactionally with the students by avoiding explicit evaluation inthe third position of the IRE and instead reinitiating the sequence with new questions.

This ismore than just amatter of conversational repair, though repair is a ubiquitous feature of talk-in-interaction. In fact,conversation analysts routinely treat problems of understanding as occasions for conversational repair (cf. Jefferson, 1974,1987, 2007; Macbeth, 2004; Schegloff, 1992; Schegloff et al., 1977). When problems emerge between doers of an action andits recipients, Schegloff (1992) argues that repair is the self-righting mechanism that assures intersubjectivity andunderstanding as a condition of interaction among interactants. While repair may act as the self-righting mechanism thatassures interactional fit of actions, repair does not address the broader issue of how the competence to achieve fit is acquiredin the first place. Macbeth (2004) addresses this issue, drawing an interesting and nuanced distinction between repair andcorrection which has particular relevance with regard to the achievement of understanding. Macbeth argues that (a) thereare different orders of understanding and (b) these differences are evidenced by the different kinds of self-rightingmechanisms

that are deployed in interaction. Specifically, Macbeth (2004: 723 et passim) holds that repair and correction are distinct but

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co-operating organizations of interaction (cf. Pomerantz, 1978). While repair works to assure the recurrent achievement ofproper ‘‘fit’’ among actions in sequence (including correction),19 correction addresses issues of competence and is thus ofparticular relevance with respect to learning and instruction and the achievement of understanding. According to Macbeth,issues of competence and correction are typically associated with the practical achievement of instruction: ‘‘correction,rather than repair, is routinely produced – but certainly not only produced – on occasions when we can say something likeinstruction is going on, with the full entailments of task, identity, and relation that instruction implies’’ (Macbeth, 2004:726).

While Macbeth (2004) examines conventional classroom interactions in which the correction of an individual student’sactions is routinely performed by a teacher, we have examined a very different set of interactional practices in which thetutor does not explicitly correct student responses but instead corrects his own questions, leaving it to the students toproduce correct responses to each subsequent version of a prior question. Producing a correct response to a revised questionrequires that question recipients, i.e. students, recognize the conceptual, factual and interactional bases for producing therevised question in the first place and what is required to produce a response that ‘fits’ the question. When students actuallydo produce a locally correct response, it is routinely treated as evidence that they also properly ‘understand’ what made therevised query relevant in the first place. This complex, incremental effort to produce questions to which students canproperly respond and the students’ work to produce correct responses is a way of interactionally producing a conjoint andproper understanding of the matter at hand. In terms of the intersubjective orientation of participants, it affirms theincremental achievement of a locally shared social reality.

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