Based on fieldnotes and video recordings of consultations performed mainly by two pharmacy interns with random patients at two independently owned community pharmacies in the US, Nguyen tries to explore how novices in pharmacy develop interactional competence in patient consultation primarily on their own rather than alongside experts. Focusing on four interactional aspects—sequencing of actions, topic management, formulation of referents and processes in turn design, and participation frameworks—the two parts of the book present two levels of analysis: episodic analysis of each patient consultation in its own right (Part 1) and longitudinal comparison of the interns' behaviors across consultations (Part 2). Part 1 is comprised of five chapters. Ch. 2 briefly reviews the historical background of patient counselling in the US and the impact of pharmacist-patient communication on the outcome of healthcare. Ch. 3 describes how actions are sequentially organized in the patient consultations. Ch. 4, “Topics and topic management,” analyses what gets talked about, how these content areas are managed in the sequential organization of actions in patient consultations, and how role construction may be transparent in the management of topics. Ch. 5 is on the formulation of objects and processes, with a focus on lexical choice in turn design. The last chapter in Part 1 describes the complex and dynamic participation frameworks in the patient consultations. Through elaborate description and multi-dimensional conversational analysis, Part 1 exhibits the interactional architecture of the patient consultation as a discursive practice, thus providing a basis for the longitudinal analysis in Part 2.

Part 2 reports on how the two interns changed over time along the four dimensions described in Part 1. Analysis in Ch. 7 shows how the two interns developed in the achievement of the patient consultation's sequential organization in three aspects: action structuring, ordering, and transitioning. Ch. 8 describes how each intern altered patient consultations in their management of some topics. Ch. 9 discusses how the interns changed in their formulation and reformulation of objects and processes toward more recipient-designed strategies as part of their interactional competence development. Ch. 10 shows that the interns adjusted in their discursive performance of being an expert with respect to self-positioning. Both the interns were able to present expert information contextually and became more adept at sharing the patients' perspectives towards medicines, illness symptoms, and medical texts. Ch. 11 discusses possible explanations for the changes described in prior chapters and possible implications of the findings for some fundamental concepts in conversation analysis, and it puts forward some possible directions for health communication training and future research.

As mentioned by Cecilia Ford in the foreword, the book represents a milestone in the interdisciplinary application of conversation analysis (x). As a longitudinal study using conversation analysis, this book extends the conversation analysis framework to the longitudinal observation of changes in individuals' interactional competence. Offering in-depth research on how novices learn to communicate as experts in a professional practice, this study fills an important gap in research on the development of communication skills in professional settings and it sheds light on another less investigated area in situated learning theory and sociocultural theory, namely, the role of the novice's self-guided interaction. Developing interactional competence is a useful resource for those involved in health communication training.