This document discusses assessing the communicative competence of health professionals through language tests. It focuses on incorporating assessment of clinical communication skills into the Occupational English Test (OET). Clinical communication involves relationship building, understanding patients' perspectives, information gathering and giving, and providing structure. Research found many patient-doctor misunderstandings in multilingual healthcare settings due to limitations in communication. The OET will now assess clinical communication alongside linguistic criteria to improve test validity and prepare professionals for diverse healthcare environments.
This document discusses assessing the communicative competence of health professionals through language tests. It focuses on incorporating assessment of clinical communication skills into the Occupational English Test (OET). Clinical communication involves relationship building, understanding patients' perspectives, information gathering and giving, and providing structure. Research found many patient-doctor misunderstandings in multilingual healthcare settings due to limitations in communication. The OET will now assess clinical communication alongside linguistic criteria to improve test validity and prepare professionals for diverse healthcare environments.
This document discusses assessing the communicative competence of health professionals through language tests. It focuses on incorporating assessment of clinical communication skills into the Occupational English Test (OET). Clinical communication involves relationship building, understanding patients' perspectives, information gathering and giving, and providing structure. Research found many patient-doctor misunderstandings in multilingual healthcare settings due to limitations in communication. The OET will now assess clinical communication alongside linguistic criteria to improve test validity and prepare professionals for diverse healthcare environments.
This document discusses assessing the communicative competence of health professionals through language tests. It focuses on incorporating assessment of clinical communication skills into the Occupational English Test (OET). Clinical communication involves relationship building, understanding patients' perspectives, information gathering and giving, and providing structure. Research found many patient-doctor misunderstandings in multilingual healthcare settings due to limitations in communication. The OET will now assess clinical communication alongside linguistic criteria to improve test validity and prepare professionals for diverse healthcare environments.
Dr Brigita Séguis Overview 1. The Occupational English Test (OET) 2. What is meant by “communicative competence”? 3. The challenges of working in a multilingual healthcare setting 4. What is clinical communication? 5. Incorporation of clinical communication into the OET About OET • designed specifically to test the English language competence of healthcare professionals • four components: listening, reading, writing, speaking • productive components are profession-specific • 12 professions: medicine, dentistry, dietetics, nursing, occupational therapy, optometry, pharmacy, physiotherapy, podiatry, radiography, speech pathology, veterinary science Speaking Separate role cards for candidate and Assessor listens to • 20 minutes total interlocutor recording online • 2 role plays • recorded via DVR • ‘lay’ interlocutor
Candidate takes role
of health professional
MARKING • 1-2 weeks post-test • 2 different assessors Interlocutor • via rating scale takes the role of the patient Assessment criteria
• Overall Communicative Effectiveness
• Intelligibility • Fluency • Appropriateness of Language • Resources of Grammar and Expression Communication vs language testing
• communication involves not only speaking but also
active listening and encouraging • highly interactive • non-verbal • making space for the patient • patient-centred Communicative competence
Language Interactional Ability Competence
Clinical Communication Communicative competence
Language Interactional Ability Competence
Clinical Communication Interactional competence On a macro level: - co-constructing interaction in a purposeful and meaningful way - taking into account socio-cultural and pragmatic dimensions of the speech situation. On a micro level: - aspects of topic management, turn management, interactive listening, breakdown repair and non-verbal behaviours. The issue of authenticity
• interactional authenticity: how candidates engage
with the test task. Do they draw on context-relevant language skills? • situational authenticity: the degree of correspondence between the test and the non-test domain Roberts and Moss (2003): “Doing the Lambeth talk: real life GP/patient encounters in the multi-lingual city”
• 232 video recordings in 19 inner London general
practices • to identify how patients consult with general practitioners (GPs) and develop training strategies • 30 languages other than English reported as patients’ first or dominant language • 20% of all consultations with non-native speakers contained misunderstandings caused by breakdowns in communication Multilingualism in London • 12.4% of NHS staff report a non-British nationality • A total of 202 nationalities • Doctors: India, Pakistan, Egypt, Nigeria and Greece • Nurses: Philippines, India, Ireland, Spain and Portugal The setting
• Super-diversity: “diversity within diversity”,
characterised by mobility, complexity and unpredictability (Vertovec 2007) • “more people from more places migrated into more and different places and for more and different reasons and motives than before; and the outcomes was an escalation of ethnic, social, cultural and economic diversity in societies almost everywhere” (Vertovec 2010) Impact on public policies and practices
“Clearly no ‘knowledge based’ training can prepare
[health] professionals for all the issues that ever increasing diversity creates. Learning generic skills to respond flexibly to all encounters is more appropriate. In other words, responding to each patient as an individual, with individual needs, and to variations in patients’ culture in its broadest sense”. Kai (2003: 33) Communicative competence
Language Interactional Ability Competence
Clinical Communication Clinical communication skills Clinical communication and OET
1. Research project by Language Testing Research
Centre (LTRC) at the University of Melbourne 2. Checklist reviewed by Dr Jonathan Silverman 3. Standards setting and examiner trial
• Clinical communication to be assessed alongside
linguistically-oriented criteria from September 2018 Clinical communication skills
1. Relationship-building 2. Understanding the Patient’s Perspective 3. Providing Structure 4. Information-gathering 5. Information-giving Standard setting
• 13 judges were played 14 audio-recorded test
performances • high consensus for Speaking – out of a maximum score of 30: - 8 judges selected a score of 18 - 3 judges selected a score of 17 - 2 judges selected a score of 19 • high level of confidence in judgment Assessor trial feedback
“Assessing clinical communication skills is the
missing link under the current assessment criteria situation.” “It will be a fairer test if these aspects of communication are included.” “[…] I believe that these criteria have the potential to improve the test validity.” Why include clinical communication? improve test authenticity immediate washback positive impact on stakeholders and society more generally framework for managing consultations in a multilingual, multi-ethnic and multi-cultural environment THANK YOU! [email protected]
