Interdisciplinary collaboration for clinical skills acquisition in the transition to ward-based learning
DOI:
https://doi.org/10.1558/japl.v8i1.89Keywords:
clinical skills, communication skills, medical education, student support, transition, internationalization of the curriculumAbstract
Internationalization of higher education affects strategies accommodating different learning styles and the provision of communication and learning support to students. This paper describes clinical communication skills training initiatives developed by linguists in collaboration with clinicians for undergraduate medical students on their first clinical placement. This approach deconstructs the language, underlying behavioural factors, argumentation and interactional features of professional tasks, serving several pedagogical purposes: learning needs analysis; deconstruction of tutor modelling; and concrete strategies to improve learner performance. Communication frameworks and their application are described with two illustrative cases. Three years of evaluation data determined impacts on students and tutors. Students report increased confidence in communication, capacity to practise clinical skills independently and supported integration of medical knowledge into clinical practice. Co-delivery enriched teaching methodology for tutors. Collaboration between linguists and clinicians provides a useful model for clinical and communication skills teaching in a wide range of undergraduate and graduate clinical and health discipline training contexts.
References
Bhatia, V. K. (1993) Analysing Genre: Language Use in Professional Settings. New York: Longman.
Candlin, C. and Candlin S. (2003) Healthcare communication: A problematic site for applied linguistics research. Annual Review of Applied Linguistics (23): 134–154.
Confederation of Postgraduate Medical Education Councils (CPMEC) (2006) Australian Curriculum Framework for Junior Doctors (2006)Accessed January 2012 at: http://curriculum.cpmec.org.au/
Daelmans, H. E. M., Hoogenboom, R. J. I., Donker, A. J. M., Scherpbier, C. D. A. and van der Vleuten, C. (2004) Effectiveness of clinical rotations as a learning environment for achieving competence. Medical Teacher 26 (4): 305–312. http://dx.doi.org/10.1080/01421590410001683195
DeVito, J. (2009) The Interpersonal Communication Book. New York: Pearson.
Dolmans, D. H. J. M., Wolfhagen, I. H. A. P., Heineman, E. and Scherpbier, A. J. J. A. (2008) Factors adversely affecting student learning in the clinical learning environment: A student perspective. Education for Health. Accessed January 2012 at: http://www.educationforhealth.net/
Eggins, S. (1994, 2004) Introduction to Systemic Functional Grammar. 1st and 2nd editions. New York: Continuum.
Eggins, S. and Slade, D. (1997) Analysing Casual Conversation. London: Equinox.
Graham, J. G. and Beardsley, R. S. (1986) English for special purposes: Content, language, and communication in a pharmacy course model. TESOL Quarterly 20(2): 227–45. http://dx.doi.org/10.2307/3586542
Hall, P. and Weaver, L. (2001) Interdisciplinary education and teamwork: A long and winding road. Medical Education 35 (9): 867–845. http://dx.doi.org/10.1046/j.1365-2923.2001.00919.x
Halliday, M. A. K. and Matthiessen, C. M. I. M. (2004) An Introduction to Functional Grammar. 3rd Edition. London: Arnold.
Harman, G. (2004) New directions in internationalizing higher education: Australia’s development as an exporter of higher education services. Higher Education Policy17: 101–120. http://dx.doi.org/10.1057/palgrave.hep.8300044
Heritage, J. and Maynard, D. (2006) (eds) Communication in Medical Care: Interaction between Primary Care Physicians. Cambridge: Cambridge University Press.
Hoekje, B. J. (2007) Medical discourse and ESP courses for international medical graduates (IMGs). English for Specific Purposes 26(3): 327–343. http://dx.doi.org/10.1016/j.esp.2006.09.002
Iedema, R. (1994) The Language of Administration: A Detailed Description of the Literacy Demands of Administration and Bureaucracy. Sydney: NSW Department of Education, Disadvantaged Schools Program Metropolitan East.
Iedema, R, Degeling, P., White, L. and Braithwaite, J. (2004) Analysing discourse practices in organizations. Qualitative Research Journal 4(1): 9–25.
Leask, B. (2005) Internationalisation of the Curriculum and Intercultural Engagement: A Variety of Perspectives and Possibilities. Refereed paper presented at the Australian International Education Conference (AIEC), Gold Coast Convention and Exhibition Centre, October 11-14, 2005, Queensland, Australia. Accessed January 2012 at: http://www.aiec.idp.com/pdf/Leask,%20Betty.pdf
Lingard, L. (2007) The rhetorical ‘turn’ in medical education: What have we learned and where are we going? Advances in Health Science Education Theory and Practice 12: 121–133. http://dx.doi.org/10.1007/s10459-006-9046-y
Mariano, C. (1999) The case for interdisciplinary collaboration. Nursing Outlook 37: 285–288.
Martin, J. R. (1996). Register and Genre: Modeling Social Context in Functional Linguistics—Narrative Genres. Discourse Analysis: Proceedings of the International Conference on Discourse Analysis. University of Lisbon, Portugal: Colibri/Portugese Linguistics Association.
Mathieson, F., Barnfield, T. and Young, G. (2009). What gets in the way of clinical contact? Student perceptions of barriers to patient contact. Journal of the New Zealand Medical Association 122, No.1292.
McCarthy, M. (1998) Spoken Language and Applied Linguistics. Cambridge: Cambridge University Press.
McGregor, J., Lee, M., Slade, D. and Dunston, R. (2011) Effective Clinical Handover Communication: Improving Patient Safety, Experiences and Outcomes. Sydney: Sydney University of Technology.
Mishler, E. G. (1984) The Discourse of Medicine: Dialectics of Medical Interviews. Norwood, NJ: Ablex.
Moss, F. and McManus, I. C. (1992) The anxieties of new clinical students. Medical Education 26(1): 17–20. http://dx.doi.org/10.1111/j.1365-2923.1992.tb00116.x
Penciner, R. (2002) Clinical teaching in a busy emergency department: Strategies for success. Canadian Journal of Emergency Medicine 4 (4): 286–288. Accessed January 2012 at: http://www.cjem-online.ca/v4/n4/p286
Pilotto, L. S., Ducan, G. F. and Anderson-Wurf, J. (2007) Issues for clinicians training international medical graduates: a systematic review. Medical Journal of Australia 187 (4): 225–228.
Prince, K. J. A. H., Boshuizen, H. P. A., van der Vleuten, C. P. M., Scherpbier, A. J. J. A. (2005) Students’ opinions about their preparation for clinical practice. Med Education 39(7): 704–712. http://dx.doi.org/10.1111/j.1365-2929.2005.02207.x
Radcliffe, C. and Lester, H. (2003) Perceived stress during undergraduate medical training: A qualitative study. Medical Education 37(1): 32–38. http://dx.doi.org/10.1046/j.1365-2923.2003.01405.x
Riggenbach, H. (2006) Discourse Analysis in the Language Classroom. Volume 1: The Spoken Language. Ann Arbor: University of Michigan Press.
Roberts, C., Sarangi, S., Southgate, L., Wakeford, R. and Wass, V. (2000) Oral examinations: Equal opportunities, ethnicity, and fairness in the MRCGP. BMJ 320: 370–374. http://dx.doi.org/10.1136/bmj.320.7231.370
Sarikaya, O., Civaner, M. and Kalaca, S. (2006) The anxieties of medical students related to Clinical Training. International Journal of Clinical Practice 60 (11): 1414–1418. Accessed January 2012 at: http://onlinelibrary.wiley.com/doi/10.1111/j.1742-1241.2006.00869.x/abstract
Small, R. M., Soriano R. P., Chietero, M., Quintana, J., Parkas, V. and Koestler, J. (2008) Easing the transition: Medical students’ perceptions for critical skills required for the clerkships. Education for Health. Accessed January 2012 at: http://www.educationforhealth.net/
Swales, J. (1990) Genre Analysis: English in Academic and Research Settings. Cambridge: Cambridge University Press.
Swales, J. and Feak, C. (2000) English in Today’s Research World: A Writing Guide.Ann Arbor: University of Michigan Press.
Swales, J. and Feak, C. (2004) Academic Writing for Graduate Students: Essential Skills and Tasks. 2nd Edition. Ann Arbor: University of Michigan Press.
Thornbury, S. and Slade, D. (2006) Conversation: From Description to Pedagogy. Cambridge: Cambridge University Press. http://dx.doi.org/10.1017/CBO9780511733123
Van der Hem-Stokroos, H. H., Daelmans, H. E., van der Vleuten, C. P., Haarman, H. J. and Scherpbier, A. J. (2003) A qualitative study of constructive clinical learning experiences. Medical Teacher 25: 120–126. http://dx.doi.org/10.1080/0142159031000092481
Woolf, K. Cave, J., Greenhalgh, T. and Dacre, J. (2008) Ethnic stereotypes and the underachievement of UK medical students from ethnic minorities: qualitative study. British Medical Journal 337: a1220. http://dx.doi.org/10.1136/bmj.a1220
Candlin, C. and Candlin S. (2003) Healthcare communication: A problematic site for applied linguistics research. Annual Review of Applied Linguistics (23): 134–154.
Confederation of Postgraduate Medical Education Councils (CPMEC) (2006) Australian Curriculum Framework for Junior Doctors (2006)Accessed January 2012 at: http://curriculum.cpmec.org.au/
Daelmans, H. E. M., Hoogenboom, R. J. I., Donker, A. J. M., Scherpbier, C. D. A. and van der Vleuten, C. (2004) Effectiveness of clinical rotations as a learning environment for achieving competence. Medical Teacher 26 (4): 305–312. http://dx.doi.org/10.1080/01421590410001683195
DeVito, J. (2009) The Interpersonal Communication Book. New York: Pearson.
Dolmans, D. H. J. M., Wolfhagen, I. H. A. P., Heineman, E. and Scherpbier, A. J. J. A. (2008) Factors adversely affecting student learning in the clinical learning environment: A student perspective. Education for Health. Accessed January 2012 at: http://www.educationforhealth.net/
Eggins, S. (1994, 2004) Introduction to Systemic Functional Grammar. 1st and 2nd editions. New York: Continuum.
Eggins, S. and Slade, D. (1997) Analysing Casual Conversation. London: Equinox.
Graham, J. G. and Beardsley, R. S. (1986) English for special purposes: Content, language, and communication in a pharmacy course model. TESOL Quarterly 20(2): 227–45. http://dx.doi.org/10.2307/3586542
Hall, P. and Weaver, L. (2001) Interdisciplinary education and teamwork: A long and winding road. Medical Education 35 (9): 867–845. http://dx.doi.org/10.1046/j.1365-2923.2001.00919.x
Halliday, M. A. K. and Matthiessen, C. M. I. M. (2004) An Introduction to Functional Grammar. 3rd Edition. London: Arnold.
Harman, G. (2004) New directions in internationalizing higher education: Australia’s development as an exporter of higher education services. Higher Education Policy17: 101–120. http://dx.doi.org/10.1057/palgrave.hep.8300044
Heritage, J. and Maynard, D. (2006) (eds) Communication in Medical Care: Interaction between Primary Care Physicians. Cambridge: Cambridge University Press.
Hoekje, B. J. (2007) Medical discourse and ESP courses for international medical graduates (IMGs). English for Specific Purposes 26(3): 327–343. http://dx.doi.org/10.1016/j.esp.2006.09.002
Iedema, R. (1994) The Language of Administration: A Detailed Description of the Literacy Demands of Administration and Bureaucracy. Sydney: NSW Department of Education, Disadvantaged Schools Program Metropolitan East.
Iedema, R, Degeling, P., White, L. and Braithwaite, J. (2004) Analysing discourse practices in organizations. Qualitative Research Journal 4(1): 9–25.
Leask, B. (2005) Internationalisation of the Curriculum and Intercultural Engagement: A Variety of Perspectives and Possibilities. Refereed paper presented at the Australian International Education Conference (AIEC), Gold Coast Convention and Exhibition Centre, October 11-14, 2005, Queensland, Australia. Accessed January 2012 at: http://www.aiec.idp.com/pdf/Leask,%20Betty.pdf
Lingard, L. (2007) The rhetorical ‘turn’ in medical education: What have we learned and where are we going? Advances in Health Science Education Theory and Practice 12: 121–133. http://dx.doi.org/10.1007/s10459-006-9046-y
Mariano, C. (1999) The case for interdisciplinary collaboration. Nursing Outlook 37: 285–288.
Martin, J. R. (1996). Register and Genre: Modeling Social Context in Functional Linguistics—Narrative Genres. Discourse Analysis: Proceedings of the International Conference on Discourse Analysis. University of Lisbon, Portugal: Colibri/Portugese Linguistics Association.
Mathieson, F., Barnfield, T. and Young, G. (2009). What gets in the way of clinical contact? Student perceptions of barriers to patient contact. Journal of the New Zealand Medical Association 122, No.1292.
McCarthy, M. (1998) Spoken Language and Applied Linguistics. Cambridge: Cambridge University Press.
McGregor, J., Lee, M., Slade, D. and Dunston, R. (2011) Effective Clinical Handover Communication: Improving Patient Safety, Experiences and Outcomes. Sydney: Sydney University of Technology.
Mishler, E. G. (1984) The Discourse of Medicine: Dialectics of Medical Interviews. Norwood, NJ: Ablex.
Moss, F. and McManus, I. C. (1992) The anxieties of new clinical students. Medical Education 26(1): 17–20. http://dx.doi.org/10.1111/j.1365-2923.1992.tb00116.x
Penciner, R. (2002) Clinical teaching in a busy emergency department: Strategies for success. Canadian Journal of Emergency Medicine 4 (4): 286–288. Accessed January 2012 at: http://www.cjem-online.ca/v4/n4/p286
Pilotto, L. S., Ducan, G. F. and Anderson-Wurf, J. (2007) Issues for clinicians training international medical graduates: a systematic review. Medical Journal of Australia 187 (4): 225–228.
Prince, K. J. A. H., Boshuizen, H. P. A., van der Vleuten, C. P. M., Scherpbier, A. J. J. A. (2005) Students’ opinions about their preparation for clinical practice. Med Education 39(7): 704–712. http://dx.doi.org/10.1111/j.1365-2929.2005.02207.x
Radcliffe, C. and Lester, H. (2003) Perceived stress during undergraduate medical training: A qualitative study. Medical Education 37(1): 32–38. http://dx.doi.org/10.1046/j.1365-2923.2003.01405.x
Riggenbach, H. (2006) Discourse Analysis in the Language Classroom. Volume 1: The Spoken Language. Ann Arbor: University of Michigan Press.
Roberts, C., Sarangi, S., Southgate, L., Wakeford, R. and Wass, V. (2000) Oral examinations: Equal opportunities, ethnicity, and fairness in the MRCGP. BMJ 320: 370–374. http://dx.doi.org/10.1136/bmj.320.7231.370
Sarikaya, O., Civaner, M. and Kalaca, S. (2006) The anxieties of medical students related to Clinical Training. International Journal of Clinical Practice 60 (11): 1414–1418. Accessed January 2012 at: http://onlinelibrary.wiley.com/doi/10.1111/j.1742-1241.2006.00869.x/abstract
Small, R. M., Soriano R. P., Chietero, M., Quintana, J., Parkas, V. and Koestler, J. (2008) Easing the transition: Medical students’ perceptions for critical skills required for the clerkships. Education for Health. Accessed January 2012 at: http://www.educationforhealth.net/
Swales, J. (1990) Genre Analysis: English in Academic and Research Settings. Cambridge: Cambridge University Press.
Swales, J. and Feak, C. (2000) English in Today’s Research World: A Writing Guide.Ann Arbor: University of Michigan Press.
Swales, J. and Feak, C. (2004) Academic Writing for Graduate Students: Essential Skills and Tasks. 2nd Edition. Ann Arbor: University of Michigan Press.
Thornbury, S. and Slade, D. (2006) Conversation: From Description to Pedagogy. Cambridge: Cambridge University Press. http://dx.doi.org/10.1017/CBO9780511733123
Van der Hem-Stokroos, H. H., Daelmans, H. E., van der Vleuten, C. P., Haarman, H. J. and Scherpbier, A. J. (2003) A qualitative study of constructive clinical learning experiences. Medical Teacher 25: 120–126. http://dx.doi.org/10.1080/0142159031000092481
Woolf, K. Cave, J., Greenhalgh, T. and Dacre, J. (2008) Ethnic stereotypes and the underachievement of UK medical students from ethnic minorities: qualitative study. British Medical Journal 337: a1220. http://dx.doi.org/10.1136/bmj.a1220
Published
2013-07-19
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Articles
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Equinox Publishing Ltd.
How to Cite
Paul, A., & Gilbert, K. (2013). Interdisciplinary collaboration for clinical skills acquisition in the transition to ward-based learning. Journal of Applied Linguistics and Professional Practice, 8(1), 89-119. https://doi.org/10.1558/japl.v8i1.89
