This paper describes the COSTA scheme for coding structures and actions in conversation. Informed by Conversation Analysis, the scheme introduces an innovative method for marking multi-layer structural organization of conversation and a structure-informed taxonomy of actions. In addition, we create a corpus of naturally occurring medical conversations, containing 318 video-recorded and manually transcribed pediatric consultations. Based on the annotated corpus, we investigate 1) treatment decision-making process in medical conversations, and 2) effects of physician-caregiver communication behaviors on antibiotic over-prescribing. Although the COSTA annotation scheme is developed based on data from the task-specific domain of pediatric consultations, it can be easily extended to apply to more general domains and other languages.
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