eprintid: 1499948
rev_number: 23
eprint_status: archive
userid: 608
dir: disk0/01/49/99/48
datestamp: 2016-06-19 01:09:41
lastmod: 2021-09-25 22:54:39
status_changed: 2016-08-10 11:07:58
type: article
metadata_visibility: show
creators_name: Verma, A
creators_name: Griffin, A
creators_name: Dacre, J
creators_name: Elder, A
title: Exploring cultural and linguistic influences on clinical communication skills: a qualitative study of International Medical Graduates
ispublished: pub
divisions: UCL
divisions: B02
divisions: C10
divisions: D20
keywords: Communication skills, Cultural dimensions, Differential attainment, Hofstede, IMG, MRCP(UK) PACES
note: Copyright © The Author(s) 2016. This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
abstract: BACKGROUND: International Medical Graduates (IMGs) are known to perform less well in many postgraduate medical examinations when compared to their UK trained counterparts. This "differential attainment" is observed in both knowledge-based and clinical skills assessments. This study explored the influence of culture and language on IMGs clinical communication skills, in particular, their ability to seek, detect and acknowledge patients' concerns in a high stakes postgraduate clinical skills examination. Hofstede's cultural dimensions framework was used to look at the impact of culture on examination performance. METHODS: This was a qualitative, interpretative study using thematic content analysis of video-recorded doctor-simulated patient consultations of candidates sitting the MRCP(UK) PACES examination, at a single examination centre in November 2012. The research utilised Hofstede's cultural dimension theory, a framework for comparing cultural factors amongst different nations, to help understand the reasons for failure. RESULTS: Five key themes accounted for the majority of communication failures in station 2, "history taking" and station 4, "communication skills and ethics" of the MRCP(UK) PACES examination. Two themes, the ability to detect clues and the ability to address concerns, related directly to the overall construct managing patients' concerns. Three other themes were found to impact the whole consultation. These were building relationships, providing structure and explanation and planning. CONCLUSION: Hofstede's cultural dimensions may help to contextualise some of these observations. In some cultures doctor and patient roles are relatively inflexible: the doctor may convey less information to the patient (higher power distance societies) and give less attention to building rapport (high uncertainty avoidance societies.) This may explain why cues and concerns presented by patients were overlooked in this setting. Understanding cultural differences through Hofstede's cultural dimensions theory can inform the preparation of candidates for high stakes bedside clinical skills examinations and for professional practice.
date: 2016-06-10
date_type: published
official_url: http://dx.doi.org/10.1186/s12909-016-0680-7
oa_status: green
full_text_type: pub
pmcid: PMC4902940
language: eng
primo: open
primo_central: open_green
article_type_text: Journal Article
verified: verified_manual
elements_id: 1135956
doi: 10.1186/s12909-016-0680-7
pii: 10.1186/s12909-016-0680-7
lyricists_name: Dacre, Jane
lyricists_name: Griffin, Ann
lyricists_id: JEDAC05
lyricists_id: AGRIF93
full_text_status: public
publication: BMC Medical Education
volume: 16
article_number: 162
event_location: England
issn: 1472-6920
citation:        Verma, A;    Griffin, A;    Dacre, J;    Elder, A;      (2016)    Exploring cultural and linguistic influences on clinical communication skills: a qualitative study of International Medical Graduates.                   BMC Medical Education , 16     , Article 162.  10.1186/s12909-016-0680-7 <https://doi.org/10.1186/s12909-016-0680-7>.       Green open access   
 
document_url: https://discovery.ucl.ac.uk/id/eprint/1499948/1/Griffin_Exploring%20cultural%20and%20linguistic%20influences%20on%20clinical%20communication%20skills%253A%20a%20qualitative%20study%20of%20International%20Medical%20Graduates.pdf