Medical student and patient language congruence: Impact on clinical learning and communication

Authors

  • J Hamilton Victoria University
  • C Chung Monash University
  • S Yasin Monash University

DOI:

https://doi.org/10.11157/fohpe.v16i1.46

Abstract

Language congruence between practitioner and patient is a key influence on clinical communication. It influences not only the quality of communication in terms of information transferral but also the capacity of practitioners to establish rapport and maintain culturally-appropriate interactions.

This article reports on a qualitative interview study using thematic analysis conducted with final-year medical students of Monash University's Jeffrey Cheah School of Medicine and Health Sciences in Malaysia. It investigated their perceptions of how the different languages used in communicating with patients influenced clinical interactions, as well as the nature of their learning within the clinical environment. Within the clinical learning settings investigated, many of the students and patients were multi-lingual, and both the students and patients varied considerably in their proficiency in the national language, Bahasa Malaysia, as well as in English.

The study found that students perceived that the language used for consultation influenced clinical communication in a variety of ways, including the capacity to establish rapport, the approach to questioning, the amount and type of information elicited from patients and the ability of the students to express ideas and information with sensitivity. In turn, these factors had an impact on clinical learning, influencing, for example, patient expectations and behaviour. In some cases, particularly where there was a lack of alignment between perceived shared ethnicity and language congruence, it even had an impact on medical student “access” to patients. The paper explores some implications of these factors for clinical learning. 

References

Bleakley, A., Bligh, J., & Browne, J. (2011). Medical education for the future. Identity, power and location. Heidelberg, Germany: Springer.

Chwan-Fen, Y., & Gray, B. (2008). Bilingual medical students as interpreters: What are the benefits and risks? New Zealand Medical Journal, 121(1282), 15–28.

Dogra, N., & Karim, K. (2005). Diversity training for psychiatrists. Advances in Psychiatric Treatment, 11, 159–167.

Fadiman, A. (1997). The spirit catches you, and you fall down: A Hmong child, her American doctors, and the collision of two cultures. New York: Farrar, Straus & Giroux.

Galanti, G. (2008). Caring for patients from different cultures (4th ed.). Philadelphia: University of Pennsylvania Press.

Gray, B. (2008). Managing the cross-cultural consultation: The importance of cultural safety. New Zealand Family Physician, 35(2), 124–130.

Manderson, L., & Allotey, P. (2003). Cultural politics and clinical competence in Australian health services. Anthropological Medicine, 10, 71–85.

Miles, M. B., & Huberman, M. (1994). Qualitative data analysis: An expanded sourcebook (2nd ed.). Thousand Oaks, CA: Sage Publications.

Roberts, C., Moss, B., Wass, V., Sarangi, S., & Jones, R. (2005). Misunderstandings: A qualitative study of primary care consultations in multilingual settings, and educational implications. Medical Education, 39, 465–475.

Silverman, D. (2011). Interpreting qualitative data (4th ed.). London: Sage Publications.

Street, R. L., Jr., Gordon, H., & Haidet, P. (2007). Physicians’ communication and perceptions of patients: Is it how they look, how they talk, or is it just the doctor? Social Science and Medicine, 65(3), 586–598.

Sudore, R. L., Landefeld, C. S., Perez-Stable, E. J., Bibbins-Domingo, K., Williams, B. A., & Schillinger, D. (2009). Unravelling the relationship between literacy, language proficiency, and patient–physician communication. Patient Education and Counselling, 75, 398–402.

Teutsch, C. (2003). Patient–doctor communication. Medical Clinics of North America, 87(5), 1115–1145.

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Published

2014-12-10

How to Cite

Hamilton, J., Chung, C., & Yasin, S. (2014). Medical student and patient language congruence: Impact on clinical learning and communication. Focus on Health Professional Education: A Multi-Professional Journal, 16(1), 59–68. https://doi.org/10.11157/fohpe.v16i1.46

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Articles