Simulated assessments of General Practitioners' consultations in a multicultural society: a linguistic analysis

多元文化社会中全科医生咨询的模拟评估：语言分析

• 批准号: ES/K00865X/1
• 负责人: Sarah Atkins
• 金额: $ 14.88万
• 依托单位: University of Nottingham
• 依托单位国家: 英国
• 项目类别: Research Grant
• 财政年份: 2013
• 资助国家: 英国
• 起止时间: 2013 至 无数据
• 项目状态: 已结题
• 来源: https://gtr.ukri.org/projects?ref=ES%2FK00865X%2F1
• 关键词: Simulated; assessments; General; Practitioners; consultations

The multicultural society we live in necessitates a similarly diverse healthcare provision. Nowhere is this more the case than in the frontline of the NHS healthcare system, General Practice, our first port of call for nearly all health enquiries as a population. But achieving this diversity is difficult. Medical graduates and in particular GP trainees for whom English is a second language are faced with a system of medical education and exams in which they are continually aware of the lower pass rates for non-white and non-British candidates. But this is not an issue that has gone unrecognised. The Royal College of General Practitioners who administer the membership and licensing exam to work as GP in the UK would like to look at the disparity in pass rates between candidates in greater detail, addressing how the exam and the training leading up to it might be improved. The most important focus of attention is on their 'Clinical Skills Assessment', an appraisal of GP candidates' abilities to conduct consultations through observing them in simulated, pre-designed cases with actors. In order to look at this, they are working closely with researchers in the academic field of linguistics to look at issues of social communication that might affect performance in the exam, and the study proposed here would enable the expertise of academics at the University of Nottingham to be centrally involved in this.The purpose of the study is to look at linguistic and communicative aspects of the exam, including the integration of nonverbal elements of communication such as body language, that contribute to candidates' successful or poorer performance.It is clear that failure to do well in the exam is not simply a case of second language fluency, but much subtler aspects of communication that may or may not convey a patient centred and empathetic manner. These elements have been identified by examiners to be significant in their assessments of potential GPs but are often overlooked or misunderstood in the actual training of GP registrars. Given current controversies over biases in the pass rates for particular candidates in this exam, a better understanding of these communicative, interpersonal requirements is of great importance. A more detailed understanding of how to achieve the sometimes under recognised and complex requirements in the exam will enable better training for GPs and also a more insightful discussion of the exam's setup more generally.The academic field of Applied Linguistics, in which this study falls, particularly the directions that have been pioneered at the University of Nottingham for looking at videos and gestural communication using up to the minute developments in technology, means that this is an evidence based analytical discipline that is ideally placed to address these issues. A dataset of videoed consultations from some 200 candidates for the exam will be carefully analysed using specialised software tools that enable a carefully substantiated understanding of the exam that can then be used further in informative material for GP candidates, trainers and examiners.The outputs from the research will therefore fall into many areas. There will be direct impacts for the Royal College of General Practitioners, who wish to provide greater training resources and information on the Clinical Skills Assessment so as to better prepare candidates for their role as GPs. The academic developments in analysing these types of complex video datasets will be of great importance to the field of Applied Linguistics, where these methods are still in their early stages. The work will also have an impact on those who study healthcare communication more broadly and wish to learn more about under researched aspects of communication, such as gesture and body-language in patient-centred consultation styles, as well as addressing issues surrounding simulations in medical education with greater evidence.

我们所生活的多元文化社会需要类似的多样化医疗服务。没有什么地方比NHS医疗保健系统的前线更是如此，全科医学是我们作为一个人口几乎所有健康查询的第一个停靠港。但实现这种多样性是困难的。医学毕业生，特别是以英语为第二语言的全科医生实习生，面临着一种医学教育和考试制度，在这种制度中，他们不断意识到非白人和非英国考生的通过率较低。但这并不是一个没有被认识到的问题。负责管理英国全科医生会员资格和执照考试的皇家全科医生学院希望更详细地了解候选人之间通过率的差异，并解决如何改进考试和培训。最重要的注意力集中在他们的“临床技能评估”上，这是通过观察他们在模拟的、预先设计的情况下与演员进行协商来评估GP候选人的能力。为了研究这一点，他们正在与语言学学术领域的研究人员密切合作，研究可能影响考试成绩的社会交际问题，这里提出的研究将使诺丁汉大学的学者们能够集中参与这一研究。研究的目的是研究考试的语言和交际方面，包括非语言交流元素的整合，如肢体语言，这有助于考生的成功或较差的表现。很明显，在考试中没有做好不仅仅是第二语言流利的情况，但更微妙的方面的沟通，可能会或可能不会传达一个病人为中心和同情的方式。这些要素已被鉴定的考官是重要的，在他们的评估潜在的全科医生，但往往被忽视或误解，在实际培训的全科医生注册。考虑到目前对考试中特定考生的通过率存在偏见的争议，更好地理解这些沟通，人际关系的要求是非常重要的。更详细地了解如何实现考试中有时未被认可和复杂的要求，将有助于更好地培训全科医生，并更全面地对考试的设置进行更深入的讨论。本研究福尔斯所属的应用语言学学术领域，特别是诺丁汉大学开创的观看视频和手势交流的方向，技术的发展，意味着这是一个基于证据的分析学科，是解决这些问题的理想选择。将使用专业软件工具仔细分析约200名考生的视频咨询数据集，这些软件工具可以对考试进行仔细的证实，然后可以进一步用于GP考生，培训师和考官的信息材料。因此，研究的结果将涉及许多领域。这将对皇家全科医生学院产生直接影响，他们希望提供更多的培训资源和临床技能评估信息，以便更好地为候选人担任全科医生做好准备。分析这些类型的复杂视频数据集的学术发展将对应用语言学领域非常重要，这些方法仍处于早期阶段。这项工作也将对那些更广泛地研究医疗保健沟通的人产生影响，并希望更多地了解沟通的研究方面，例如以患者为中心的咨询风格中的手势和肢体语言，以及以更多的证据解决围绕医学教育模拟的问题。

项目成果

"Everyone happy with what their role is?": A pragmalinguistic evaluation of leadership practices in emergency medicine training

“每个人都对自己的角色感到满意吗？”：对急诊医学培训中领导实践的实用语言评估

• DOI: 10.1016/j.pragma.2020.02.014
• 发表时间: 2020
• 期刊: Journal of Pragmatics
• 影响因子: 1.6
• 作者: Chalupnik M

Analysing voice quality and pitch in interactions of emergency care simulation.

分析紧急护理模拟交互中的语音质量和音调。

• DOI: 10.1136/bmjstel-2017-000212
• 发表时间: 2018
• 期刊: BMJ simulation & technology enhanced learning
• 影响因子: 1.1
• 作者: Coffey F

Pragmatics: Leadership and team communication in emergency medicine training

语用学：急诊医学培训中的领导力和团队沟通

• 发表时间: 2021
• 作者: Atkins S

Politeness in Professional Contexts

专业环境中的礼貌

• 发表时间: 2020
• 作者: Chalupnik M

Simulated consultations: a sociolinguistic perspective.

• DOI: 10.1186/s12909-016-0535-2
• 发表时间: 2016-01-15
• 期刊: BMC medical education
• 影响因子: 3.6
• 作者: Atkins S;Roberts C;Hawthorne K;Greenhalgh T
• 通讯作者: Greenhalgh T