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0040 Assessing Our Assessments: A Sociolinguistic Investigation Into Communicative Issues In Simulated Consultations
  1. Sarah Atkins
  1. University of Nottingham, Nottingham, UK


Background A key component for many medical simulations is assessing communication, or ‘non-technical’ skills. The ability to see a candidate deploy their medical knowledge, for a specific task in a spoken scenario, is one of the great advantages of simulation as an integrated assessment. But the way these skills are assessed can be controversial, particularly when uneven pass rates occur for overseas candidates. This paper will look at some assessed simulations, in which interpersonal skills form a central part of the marking criteria, and investigate the ways relationships with the role-played patient are performed through talk, by candidates from different backgrounds.

Methodology Videos are transcribed from a purposive sample of 50 candidates sitting a simulated exam, encompassing a range of performances from UK graduates and international medical graduates. Discourse analysis, as a means of analysing ‘real-world’ linguistic data in its social context, is a useful means of approaching the data. In this paper, we initially perform a quantitative, ‘corpus linguistic’ survey, to establish the patterns of talk in the exam. Micro-interactional analysis, which allows the researcher to look closely at how the interaction progresses, turn-by-turn, is then used to investigate how a relationship is established with the role-played patient, successfully or not, through talk.

Results/outcomes The quantitative overview of the transcribed consultations finds that certain, recipe-like ‘stock phrases’ are used by all candidates in the exam. However, a closer look through micro-interactional analysis reveals that some are more successful at performing these phrases than others. Areas of relative difficulty for candidates, particularly in terms of performing patient-centredness, are discussed further in the paper.

Potential impact The way that ‘stock phrases’ are used in simulated consultations raises questions for the design and function of medical simulations in assessing communication, as well as the training candidates receive for such exams.

  • Category: Course or curriculum evaluation/innovation/integration

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