Kris Van de Poel

A Critical Approach to the Development of Blended Medical Communication Training Materials

Effective communication between doctors and patients improves patient health outcomes (Hewett et al. 2009; Stewart 1995; Watson et al. 2012), and communication skills courses have become an integrated component of the medical curriculum. However, language-discordant contexts are not fully provided for yet, since “[l]anguage support guides (such as the Calgary-Cambridge guides; Silverman et al. 2005) generally target native speakers rather than language learners, and typically mention the use of a second or foreign language as just one of many issues in cross-cultural communication without providing any solutions or prescriptions to address ensuing communication problems” (Gasiorek and Van de Poel 2012:372). In a South African professional healthcare context, communication challenges are manifold because of the number of languages and cultures involved and because of the diverse views on the nature of a medical encounter. South African public healthcare is further hampered by a lack of doctors (KZN Department of Health 2013). Given the need for tailored communication materials, a new vocational training course in Afrikaans as a second language was introduced for first-year medical students at one South African university applying a blended learning approach (i.e. restricted contact teaching and autonomous online learning). To facilitate the development and implementation process, the European project Medics on the Move (MoM) was adapted and adopted as a communication tool. This paper addresses principles and practices underlying the MoM materials as part of the process of adapting the vocational training concept to the specific South African context, needs and learners. The development process is presented as an integral part of a comprehensive needs analysis (Brown 1995), at the end of which new questions and needs are identified. The results corroborate that MoM-SA is a dynamic and effective teaching/learning tool which functions as a language support system that helps build skills for a multilingual professional environment.

Teachability of collocations: The role of word frequency counts

Abstract This study aims to gain insights into which collocations to teach at which proficiency levels by answering the following questions: (i) Of the Verb+Noun and Adjective+Noun types of collocations, which one is more difficult (and should therefore come at a later stage of learning)? (ii) What is the size of collocations of the types Verb+Noun and Adjective+Noun mastered across proficiency levels? In addition, the study suggests an approach to collocation teaching that should be trialled in an English as a Foreign Language (EFL) teaching context. Two collocation tests (modelled after Laufer and Nation 1999)1 with words selected from Nations (2006)2 word list and Coxheads (2000)3 Academic Word List were administered to two groups of English majors, at different stages of learning, from the University of Antwerp and the University of Burundi. Results showed that Adjective+Noun combinations are more difficult than Verb+Noun combinations. However, in both collocations types, only upper-intermediate and low-advanced students mastered the 2 000-word band. We therefore suggest teaching collocations from the 2 000-word band to beginner/low-intermediate students and only exceed the 2 000-word band from the upper-intermediate learning stage onwards, a suggestion in line with Nations (2006) discussion on how to teach vocabulary.

A needs analysis for communication by pharmacists in a multilingual setting: First steps towards syllabus and materials design

Despite the efforts to manage South Africa’s language and culture diversity, in practice, the linguistic landscape has become increasingly English. This is problematic in contexts such as rural areas where people are not able to communicate in English, and communication on even a fairly proficient level is not a given. Medical contexts, in particular, may create critical situations of practical (life or death) importance, as healthcare professionals are not necessarily trained or equipped to communicate in an efficient and culturally sensitive manner. Moreover, healthcare communication challenges are manifold because of the diverse views on the nature of a medical encounter. This article reports on the first empirical steps taken to bridge the communication gap between patient and medical practitioner (specifically pharmacists). These steps include identifying an appropriate theoretical framework, developing and conducting a needs analysis (among 255 pharmacists who are experts-by-experience), and designing a syllabus and course materials. The findings show that most respondents experience communication in a foreign language to be significantly more problematic than communication in general. Additionally, the qualitative data suggest that support is needed especially for African languages. Language learning materials should cover a wide range of professional topics supplemented with a communication module focusing primarily on history taking and ensuring the correct use of medication. Most importantly, learning materials should be to-the-point and easy to apply, as most practitioners have limited time. These findings might, in turn, inform policy issues regarding responsible and efficient functioning in a multilingual professional environment, where clear and transparent communication can be a matter of life or death.

Testing controlled productive knowledge of adverb-verb collocations in junior researchers using English as a foreign language

The present study examines English as a Foreign Language (EFL) junior researchers’ use of adverb-verb collocations of academic vocabulary in both free written and controlled productions. A small corpus was compiled and analysed in order to identify verbs in adverb-verb combinations and examine which ones were collocated correctly or erroneously. A controlled productive test of adverb-verb collocations, with verbs selected from the Academic Word List (Coxhead 2000) and adverbs selected from Lea, Crowther and Dignen’s (2002) Oxford collocations dictionary for students of English was also administered to participants. Results indicate that free productive knowledge of adverb-verb collocations is challenging for EFL users. This finding supports previous studies that focused mainly on verb-noun collocations, and that reached the conclusion that EFL students are not sensitive enough to collocations to use them in their written productions (cf. Nesselhauf 2005). This finding is extended here to adverb-verb collocations. The study also reveals that controlled productive knowledge of adverb-verb collocations is less problematic. Based on these results, teaching strategies aimed at improving the use of adverb-verb collocations among EFL users are proposed.

Productive knowledge of collocations may predict academic literacy

The present study examines the relationship between productive knowledge of collocations and academic literacy among first year students at North-West University. Participants were administered a collocation test, the items of which were selected from Nation’s (2006) word frequency bands, i.e. the 2000-word, 3000-word, 5000-word bands; and the Academic Word List (Coxhead, 2000). The scores from the collocation test were compared to those from the Test of Academic Literacy Levels (version administered in 2012). The results of this study indicate that, overall, knowledge of collocations is significantly correlated with academic literacy, which is also observed at each of the frequency bands from which the items were selected. These results support Nizonkiza’s (2014) findings that a significant correlation between mastery of collocations of words from the Academic Word List and academic literacy exists; which is extended here to words from other frequency bands. They also confirm previous findings that productive knowledge of collocations increases alongside overall proficiency (cf. Gitsaki, 1999; Bonk, 2001; Eyckmans et al., 2004; Boers et al., 2006; Nizonkiza, 2011; among others). This study therefore concludes that growth in productive knowledge of collocations may entail growth in academic literacy; suggesting that productive use of collocations is linked to academic literacy to a considerable extent. In light of these findings, teaching strategies aimed to assist first year students meet academic demands posed by higher education and avenues to explore for further research are discussed. Especially, we suggest adopting a productive oriented approach to teaching collocations, which we believe may prove useful.

The Structure of the Consultation

When patients’ physical, mental and social well-being (i.e. the health triangle) is not in balance, they may see a doctor. To a consultation, patients bring ideas, concerns and expectations (the ICE triad) about health and illness. This triad is situated within a patient’s frame of reference and has both individual and cultural characteristics. In the past 30 years, medicine in the Western world has become increasingly patient-oriented, and the medical world has adopted a model of the consultation where patient’s and doctor’s perspectives are given equal weight. In this chapter, we present the two-perspectives consultation model, which describes the structure and timeline of the consultation. Structuring a consultation means timing and sequencing five major tasks in a logically ordered way following a mental map (cf. the Calgary-Cambridge Guides): initiating the session, information gathering, the physical examination, explaining and planning and closing the session.

Interpersonal and Intercultural Communication in Health Care

This chapter outlines the background of the book and introduces terminology and topics vital for understanding interpersonal and intercultural communication in a health-care context: communication and personal style, communication and patient health outcomes, multiculturalism and cultural competence and communication and mobility. This book is meant to function as a communication performance support tool. The information in it draws on peer-reviewed, international research and focuses on linguistic and cultural challenges faced by mobile medical professionals.

Communication Skills Specific to the Consultation

This chapter discusses communication skills and strategies used at specific points during the consultation, providing specific advice for different stages and parts of the consultation. The first part of the consultation begins with an opening, followed by medical history taking or anamnesis, and concludes with the physical examination. Listening is central to these stages. The second half of the consultation focuses on discussion and generally has two components: (1) explaining the diagnosis and (2) agreeing on the management plan that follows from this diagnosis. Both successful listening and explaining then allow for a proper closing of the session.

General Communication Strategies and Skills

In this chapter, we discuss communication skills that can be used across all stages of the consultation. We first focus on how active listening skills facilitate, direct and structure interaction with others. Then we explain and illustrate what makes verbal and nonverbal communication appropriate. While the focus of our verbal communication is generally the content of our messages, our attitudes about what we say are often communicated through our nonverbal communication. The final topic of the chapter is building rapport: it helps make both communication and consultations more effective, efficient, supportive and satisfying for both medical professionals and patients.

Special Challenges in Medical Communication

During consultations, doctors often have to deal with challenging situations. They can be caused by characteristics of the patients, the content, the communication channel or any combination of these. When patients are challenging, clearly structuring the interaction and acknowledging the patient may help. When dealing with sensitive or taboo topics, particular care and sensitivity are required. Finally, in telephone and other mediated consultations, an explicit and systematic approach to communication can facilitate the conversation. This chapter provides an overview of a range of challenging situations doctors are likely to encounter and provides strategies to address them.