A Multimodal Study of Doctors’ Responses in Free Online Medical Consultations

The question-answer adjacency pair constitutes the most frequent sequence organization in online medical consultations (hereafter OMCs). Previous studies on OMC have primarily examined text-based interactions. However, in live-streamed free online medical consultations (hereafter FOMCs), doctors appear on video streaming and display paralinguistic cues, enabling the investigation of the multimodal realization of their response discourse. Drawing on a self-built small-scale multimodal corpus of live-streamed FOMCs, this study adopts the Multimodal Interaction Analysis framework (Norris 2004. Analyzing Multimodal Interaction: A Methodological Framework . Routledge) and Epistemic Gradient Theory (Heritage 2013. “Epistemics in Conversation.” In The Handbook of Conversation Analysis , 370–94. Wiley-Blackwell), and employs ELAN for quantitative annotation of approximately 9 h of video data from eight doctors. The analysis focuses on five modal layers of doctors’ nonverbal responses: gaze, head movements, vocal particles, body postures, and gestures. The findings reveal that the doctors mobilize multimodal resources to accomplish three key interactional tasks: displaying uptake of patient information, managing projections in patients’ questions, and projecting upcoming properties. Notably, doctors frequently employ an information maximization strategy to elaborate beyond the immediate scope of the question, supported by listing gestures or embodied demonstrations using anatomical models or their own body parts. These findings may contribute to improving communicative efficiency in online consultations and provide practical implications for the development of multimodal communication training programs for online medical professionals.