Oral communication skills of international medical graduates: Assessing empathy in discourse
Keywords:empathy, discourse analysis, reassurance, division of work, International Medical Graduate (IMG), OSCE
AbstractWe examine a dataset consisting of 11 International Medical Graduates (IMGs) performing an Objective Structured Clinical Examination (OSCE). Our aim is to address questions about the linguistic realization of empathy in the clinical discourse of IMGs and the extent to which OSCE examiners are sensitive to relevant features of the discourse. We analyse three aspects of the dataset as manifestations of empathy: sequential organization to provide reassurance; responsiveness to the simulated patient’s lexical choices for emotionally charged words; and the organization of turn taking in the interaction. Our analysis suggests that in each of these areas it is possible to identify discourse strategies which realize empathy. These strategies are used by IMGs who are good communicators and not used by poor communicators. Our evidence suggests that of the features we examine, the most salient for the examiner is a greater than normal occurrence of transition pauses. We argue that it is only in the area of the organization of conversation that the problems displayed by some IMGs are due to differences in cultural background, and it is therefore significant that the feature we identify as salient comes from this area.
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