Conference Agenda

This presentation focuses on Bakhtin’s theory as a conceptual foundation for multidisciplinary collaboration in healthcare and social welfare practices, while also examining its relevance to Dialogical Self Theory. Bakhtin’s dialogism provides a powerful way to conceptualize such encounters as dialogical processes with developmental potential.

Bakhtin (1981, 1984) is particularly relevant for healthcare and social welfare practices because it frames collaboration among professionals with different backgrounds as dialogical activity. Dialogue, in this sense, is not merely an exchange of information but a dynamic process through which meaning emerges through tension, difference, and responsiveness to others’ perspectives. This presentation highlights Bakhtin’s dialogical ideas as a theoretical basis for understanding and sustaining multidisciplinary collaboration in complex professional contexts.

The presentation further connects Bakhtin’s dialogism with the concept of the “dialogical self” as developed by Hermans and Kempen (1993), with particular attention to the notion of I-positions—representations of internalized others within self-consciousness. Dialogical Self Theory emphasizes positioning as the ongoing movement among multiple I-positions rather than fixation on a single standpoint. Bakhtin conceptualized this capacity to wave among heterogeneous perspectives as “ambivalence”, identifying it as a key condition for dialogue to unfold as collaborative activity among differently positioned others (Tajima, 2025).

Through a close examination of Bakhtin’s texts, this presentation elaborates ambivalence as a core characteristic of dialogical self-formation in professional practice. It proposes a theoretical model of self-formation that explains how professionals can sustain rich and productive dialogue across differences in expertise, roles, and institutional contexts. By foregrounding ambivalence as a generative rather than problematic feature of professional interaction, the presentation contributes to a dialogical understanding of selfhood that supports and sustains multidisciplinary collaboration in healthcare and social welfare.

Field placement supervision plays a crucial role in social work students’ development of professional identity, including the professional self. However, unclear expectations from educational institutions may leave supervisors uncertain about how to contribute to students’ learning processes (Eriksen, 2024). Previous research indicates that supervisors of social work professionals-to-be tend either to view control as their main task (Nordstrand & Skjefstad, 2019) or to prioritise supervisees’ psychological safety over other aspects of supervision (Eriksen & Søndenå, 2023). This may be problematic, as professionals-to-be need to develop competences relevant for future professional practice. It highlights the need for professionals able to engage openly with others’ perspectives, manage ambiguity, and sustain dialogue.

This study examines how field placement supervision may contribute to the development of such capacities by fostering a dialogical professional self. Inspired by Hermans’ Dialogic Self Theory, the professional self is understood as a dynamic, multi-voiced configuration shaped through dialogue rather than as a stable individual trait. Empirically, the study analyses 15 observations of supervision sessions conducted during field placements. The material is examined using a dialogical approach (Sullivan, 2012), inspired by Bakhtin et al. (1981), with a focus on identifying “key moments” in the data—parts of supervisory conversations that evoke a strong need for response (Madill & Sullivan, 2010).

By analysing how supervisors and students negotiate meaning and professional positioning in these “key moments,” the study explores how supervision can function as a site for developing dialogical capacities essential to social work practice. The main contribution lies in providing access to a rare data material and in demonstrating how a dialogical analytical framework can generate new insights into the development of a dialogical professional self in professional education.

Sano examines the dialogical self in online reflective sessions in which healthcare professionals employ dialogic frameworks to explore how discomfort emerges in interprofessional practice. Participants’ descriptions and analyses of interprofessional conflict suggest that others’ voices are not merely internalized but reconstructed as part of the self in personal ways (Hermans, 2002). Notably, even after the sessions conclude, participants report continued engagement with this part of the self, indicating ongoing internal dialogue beyond the formal dialogic space.

To conceptualize this process, Sano draws on Mederu, a Japanese concept referring to a loving and attentive orientation toward others or materials, involving deliberate observation and care (Sano et al., 2025). In a subsequent interview study, Sano explored how participants engage with and care for vulnerable aspects of the self through Mederu.

Participants described the delicate balance between categories and fluidity, hierarchy and equality in healthcare professional education, noting that societal contradictions mirror their internal dialogical struggles. Through educational practices designed with student diversity or equity in mind, participants came to understand themselves as “different” and “vulnerable.”　However, in online sessions, they reported avoiding quick fixes and instead emphasize the need to operate amid and with paradoxes.

Some participants explicitly connected this stance to Kintsugi, a fifteenth-century Japanese practice in which broken objects are repaired by emphasizing cracks with gold rather than concealing them (Santini, 2019). Kintsugi symbolizes a process of care, acceptance, and transformation, whereby breakage becomes integral to an object’s history and value. Similarly, in the online sessions, vulnerability was not treated as a deficiency to be corrected but as part of participants’ lived histories. Through care and acknowledgment, vulnerability became a generative force, giving rise to new dialogical positions and contributing to the ongoing construction of the professional self.

Following Speaker 2 (Sano)’s exploration of vulnerability and inner dialogue in interprofessional practice, this presentation turns attention to external assessment and asks how professional selves are dialogically shaped when they are seen, measured, and interpreted by artificial intelligence (AI). Within healthcare education, particularly in medical interviews, eye contact is regarded as a key indicator of empathy and relational competence, yet its assessment remains context-dependent, culturally sensitive, and difficult to standardize.

Grounded in the dialogical thinking of Mikhail Bakhtin, this study conceptualizes eye contact not as a single observable behavior but as a dialogical process in which professionals negotiate attention, emotion, and meaning in interaction with others. Moments of gaze aversion or silence—often judged negatively in assessment—may instead reflect inner dialogue, emotional regulation, or reflective pauses under evaluative pressure. In this sense, eye contact oscillates between routine, automated performance and dialogically meaningful engagement.

Empirically, this presentation draws on an ongoing study analyzing approximately 200 video-recorded OSCE (Objective Structured Clinical Examination) medical interviews in Japan. Using a transparent, human-AI collaborative framework, multimodal features such as gaze direction, duration, speech–gaze synchrony, and non-contact balance are extracted with the ConverSearch system and interpreted alongside expert human judgments. Rather than positioning AI as a replacement for assessors, it is framed as a measurement partner whose logic remains visible and open to dialogue with educators.

Connecting back to Sano’s focus on the inner reconstruction of the professional self, this presentation proposes understanding AI as an external other that enters the dialogical self. In line with Dialogical Self Theory as articulated by Hubert Hermans, AI-assisted assessments can be seen as one voice among many, prompting reflection rather than closure. This study illustrates how dialogue between self, others, and technology could support more reflective and humane professional practice in healthcare and social welfare.