Assessing institutional empathy in medical settings

  • Sarah Atkins University of Nottingham
  • Celia Roberts King's College, London
Keywords: assessment, clinical skills, empathy, prosody, simulation, standardisation, superdiversity

Abstract

The use of role-play in standardised medical assessments raises many problems, particularly around the measurement of interpersonal skills such as 'empathy'. Research on the use of simulations has tended to focus on quantified, psychometric assessments of their reliability and validity. However, communication, which often forms a central part of the assessment in medical simulations, is a difficult matter to address through this post hoc analytic method. A sociolinguistic approach to analysing real recordings of simulated medical assessments allows greater insight into communication and interpersonal skills. We use our research on medical licensing exams to illustrate some of the current questions about the examining of such skills through understanding the fine-grained detail of talk. Drawing on Goffman to critique simulated relationships and on Gumperz to analyse the role of differences in communicative style, and based on microanalysis of video-recorded role-players and candidates, we argue that the focus on interpersonal skills in standardised assessments amplifies the problem of using simulated empathy and requires additional interactional work. This focus on interpersonal skills in such assessments can lead to inequalities, since an unfair weight may be put upon candidates trained overseas. The paper concludes that the debate on 'language' in such exams and their standardisation in superdiverse societies needs to be reset.

 


CC-BY - This work is licensed under https://creativecommons.org/licenses/by/4.0/

Author Biographies

Sarah Atkins, University of Nottingham

Sarah Atkins is Assistant Professor in Applied Linguistics at the University of Nottingham. Her research investigates language and professional communication in a range of workplace settings, with a particular focus on healthcare. She works on an ESRC-funded project at the University of Nottingham (ES/K00865X/1) looking at the use of medical simulations in communication skills training for postgraduate doctors. As a member of the university's Linguistic Profiling for Professionals unit, she also delivers workshops and training for practitioners, based on the findings of her applied linguistic research. Address for correspondence: Centre for Research in Applied Linguistics, School of English, Trent Building, University of Nottingham, NG7 2RD, UK. Email: Sarah.Atkins@nottingham.ac.uk

Celia Roberts, King's College, London

Celia Roberts is Professor Emerita in Sociolinguistics at King's College London. Her interests are in language and cultural processes in workplace and health contexts, their practical relevance to real-world situations of disadvantage and in research methods in ethnography and linguistics. Her publications include: Language and Discrimination (with Davies and Jupp, Routledge, 1992); Achieving Understanding 1996 (with Bremer et al.); Talk, Work and Institutional Order (with Sarangi, De Gruyter, 1999); and Performance Features in Clinical Skills Assessment (with Atkins and Hawthorne, 2014). Address for correspondence: Centre for Language, Discourse and Communication, Franklin-Wilkins Building, Stamford Street, London, SE1 9NH, UK. Email: Celiaroberts11@gmail.com

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Published
2018-12-31
How to Cite
Atkins, S., & Roberts, C. (2018). Assessing institutional empathy in medical settings. Journal of Applied Linguistics and Professional Practice, 13(1-3), 11-33. https://doi.org/10.1558/japl.31861