Won Best Education prize at RCGP conference 2011

1. A combined linguistic and medical approach to
improve written and verbal communication skills U n i v e r s i t y Te a c h i n g Tr u s t
for International Medical Graduates (IMGs)
Duncan Cross and Ann Smalldridge
Reache NorthWest, Salford Royal NHS Foundation Trust, Stott Lane, Salford, M6 8HD, UK
Summary
Background “I think one of the
Language teachers and
problems is they don’t
REACHE (Refugee and Asylum clinicians ran a course for IMGs
fully understand what the
Seekers Centre for Healthcare to improve written and verbal
language suggests to them,
Professionals Education) communication skills in a clinical
as well as being able to
context to a level appropriate for a
Northwest has provided translate it. It is one thing
Foundation Year 1 doctor. It included
education, training and to speak the language and history taking, summarising and
support for internationally the other one is to actually presentation skills. All training was
understand what people placed in a medical context
trained Refugee and Asylum say to you.” using simulated patients
seeking Health Professionals
Clinical Supervisors comment and ‘mock’ records
(RHPs) since 2002. We have regarding IMG on placement
found the challenges include
straightforward language
barriers but also more complex
issues relating to picking up non The combination
verbal cues and concerns about Examples of Issues
of language and clinical tutors
meant that analysis of
different cultural protocols. Rising tones at ends of communication difficulties could be
sentences suggested constant made from different perspectives and
questioning detailed, specific feedback could be
Not seeking clarification of terms e.g. given to each student. Sometimes small
“funny turn” or even pronunciation / adjustments to syntax pronunciation
accent of a word they did not understand and context improved the
effectiveness of
Cultural issues - addressing nursing
communication
Teaching staff, waking a consultant
Linguist Medic and at 4am
Learning Communication difficulty
can take many forms -
language, clinical and cultural.
Many of the learning needs are hidden.
Using a combined linguistic and clinical
approach can provide solutions to
clinical communication problems
that individual approaches
may miss
Two videos of medical Students were taught A three stage verbal-to Pre-taught skills were
encounters on a ward the SBAR method -written summarisation consolidated and
were shown. For each (Haig KM, Sutton S, exercise was undertaken applied practically in a
encounter the students Whittington J) for to ensure clinical hospital skills lab using
wrote clinical notes. handover and as a information could be simulated patients.
These were then peer practical exercise recorded verbatim
marked against pre- verbal handover using and also summarised Feedback was given by
linguistic and clinical
Take-home
prepared “correct”
summaries with
summaries prepared
in the previous session
accurately in
bullet points. assessors message
feedback by tutors were done in pairs with Feedback was given
focussing on linguistic
Teaching should be
tutor feedback
skills (e.g. pace, practical with multiple
pronunciation, spelling)
as well as accurate, opportunities to
legible recording practice skills in a
variety of settings
Reache NorthWest, Salford Royal Foundation NHS Trust, Stott Lane, Salford, M6 8HD, UK
Corresponding author: Dr Ann Smalldridge - ann.smalldridge@nhs.net
http://informahealthcare.com/doi/pdf/10.3109/0142159X.2011.577469 © Design Services, Salford Royal NHS Foundation Trust. G11081002. All Rights Reserved 2011