A discourse analysis study of 'good' and 'poor' communication in an OSCE: a proposed new framework for teaching students

Abstract

Detailed discourse analysis sheds light on patterns of communicative style and provides an analytic language for students to raise awareness of their own communication. This challenges standard approaches to teaching communication and shows the value of using summative assessments in formative ways.

The Relationship between Checklist Scores on a Communication OSCE and Analogue Patients’ Perceptions of Communication

“…Our exploratory analysis of analogue patients' ratings as a function of performance on individual checklist items supports this view. Others have argued that specific communication behaviors can have a very different impact depending on the context in which they occur (Roberts et al, 2003). In an earlier study, Hodges and colleagues (Hodges et al, 1996), found that OSCE checklists which focused on specific communication behaviors defined by the clinical encounter were more effective than global communication ratings.…”

English Proficiency Tests and Communication Skills Training for Overseas-Qualified Health Professionals in Australia and New Zealand

“…Patients often signal their concerns implicitly in medical interviews, and these "empathic opportunities" need to be noticed and responded to (Levinson, Gorawar-Bhat, & Lamb, 2000;Suchman, Markakis, Beckman, & Frankel, 1997). A study by Roberts, Wass, Jones, Sarangi, and Gillett (2003) of advanced medical students' performance on an objective structured clinical examination revealed the subtle verbal and nonverbal differences between an empathetic interviewing style and a less successful retractive style characterized by interrogative questioning, inappropriate responses, an absence of rapport, an agenda-driven structure, and a lack of sensitivity to the patient's level of understanding.…”

How Professionally Relevant Can Language Tests Be?: The Author Responds

“…(Silverman, 2007, p. 87) Pill's claim that evidence of ongoing diffculties of overseas qualified health professionals in the Australian context is "largely anecdotal" suggests that there may be no real cause for concern. Although it is true that relatively few studies have been conducted on actual performances in medical interviews by overseas trained health professionals in Australasian contexts (see, however, Cordella &Musgrave, 2009, andScheeres, Slade, Manidis, McGregor, &Matthiessen, 2008), the findings of the many studies carried out in other English-speaking countries (e.g., Roberts, Wass, Jones, Sarangi, & Gillett, 2003;van Zanten, Boulet, & McKinley, 2003) are surely relevant, as these nations are recipients of overseas qualified health professionals from the same source countries (Mullan, 2005) and use similar proficiency testing procedures. Moreover, there is compelling evidence from other sources that overseas qualified health professionals from non-English-speaking backgrounds in New Zealand and Australia face significant communicative challenges both before and after the English proficiency requirement is achieved.…”