This chapter explores the role of repetition for expressing cognitive empathy during simulated primary care medical consultation between Japanese and non-Japanese student doctors and simulated patients (SPs) from different lingua-cultural backgrounds in English as a Lingua Franca (ELF), using conversation analysis. “Empathy” in medicine has been discussed in a number of extensive literatures, but empathy practice in doctor-patient communication in ELF has rarely been investigated. This chapter adopts the definition of empathy in patient care by Hojat (Empathy in Patient Care: Antecedents, Development, Measurement, and Outcomes. Springer, New York, 2007) and empathy categories by Duan and Hill (J Couns Psychol 43:261-274, 1996) and examines how the student doctors express cognitive empathy, that is, the student doctors’ understanding of the SP’s state by using repetition, which has been argued as the effective strategies for co-constructing mutual understanding and accommodation in ELF communication. The analysis section compares two cases of medical interview in ELF and provides an emic perspective on how cognitive empathy is delivered and received.
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