Cultural respect encompassing simulation training: being heard about health through broadband

Background. Cultural Respect Encompassing Simulation Training (CREST) is a learning program that uses simulation to provide health professional students and practitioners with strategies to communicate sensitively with culturally and linguistically diverse (CALD) patients. It consists of training modules with a cultural competency evaluation framework and CALD simulated patients to interact with trainees in immersive simulation scenarios. The aim of this study was to test the feasibility of expanding the delivery of CREST to rural Australia using live video streaming; and to investigate the fidelity of cultural sensitivity – defined within the process of cultural competency which includes awareness, knowledge, skills, encounters and desire – of the streamed simulations. Design and Methods. In this mixed-methods evaluative study, health professional trainees were recruited at three rural academic campuses and one rural hospital to pilot CREST sessions via live video streaming and simulation from the city campus in 2014. Cultural competency, teaching and learning evaluations were conducted. Results. Forty-five participants rated 26 reliable items before and after each session and reported statistically significant improvement in 4 of 5 cultural competency domains, particularly in cultural skills (P<0.05). Qualitative data indicated an overall acknowledgement amongst participants of the importance of communication training and the quality of the simulation training provided remotely by CREST. Conclusions. Cultural sensitivity education using live video-streaming and simulation can contribute to health professionals’ learning and is effective in improving cultural competency. CREST has the potential to be embedded within health professional curricula across Australian universities to address issues of health inequalities arising from a lack of cultural sensitivity training

"This means that...": a linguistic perspective of writing and learning in a discipline

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Negotiating meanings and scaffolding learning: writing support for non-english speaking background postgraduate students

C1 - Refereed Journal Articl

A comparative discourse study of simulated clinical roleplays in two assessment contexts: Validating a specific-purpose language test

The aim of this paper is to investigate from a discourse analytic perspective task authenticity in the speaking component of the Occupational English Test (OET), an English language screening test for clinicians designed to reflect the language demands of health professional–patient communication. The study compares the OET speaking sub-test roleplay performances of 12 doctors who were successful OET candidates with practice Objective Structured Clinical Examination (OSCE) roleplay performances of 12 international medical graduates (IMGs) preparing for the Australian Medical Council clinical examination. The premise for the comparison is that the OSCE roleplays can represent communication practices that are valued within the medical profession; therefore a finding of similarity in the discourse structure across the OET and the OSCE roleplays could be taken as supporting the validity of the OET as a tool for eliciting relevant communication skills in the medical profession. The study draws on genre theory as developed in Systemic Functional Linguistics (SFL) in order to compare the roleplay discourse structure and the linguistic realizations of the two tasks. In particular, it examines the role relationships of the participants (i.e. the tenor of the discourse), and the ways in which content is represented (i.e. the field of the discourse) by roleplay participants. The findings reveal some key similarities but also important differences. Although both tests inevitably fall short in terms of authentic representation of real world interactions, the findings suggest that the OET task, for a range of reasons including time allowances, training of test interlocutors, and the limits of contextual information provided to candidates, constrains candidate topic exploration and treatment negotiation, compared to the OSCE format. The paper concludes with proposals for mitigating these limitations in the interests of enhancing the OET’s capacity to elicit more professionally relevant language and communication skills

Clinical Education: embracing diversity

Anna Chur-Hansenhttp://shop.elsevier.com.au/ISBN/9780729539005/Clinical-Education-in-the-Health-Profession

Self-regulated learning lens on trainee perceptions of the mini-CEX: a qualitative study

OBJECTIVES: The formative aspect of the mini-clinical evaluation exercise (mini-CEX) in postgraduate medical workplace-based assessment is intended to afford opportunities for active learning. Yet, there is little understanding of the perceived relationship between the mini-CEX and how trainees self-regulate their learning. Our objective was to explore trainees' perceptions of their mini-CEX experiences from a learning perspective, using Zimmerman's self-regulated learning theoretical framework as an interpretive lens. DESIGN: Qualitative, using semi-structured interviews conducted in 2017. The interviews were analysed thematically. SETTING: Geriatric medicine training. PARTICIPANTS: Purposive sampling was employed to recruit geriatric medicine trainees in Melbourne, Australia. Twelve advanced trainees participated in the interviews. RESULTS: Four themes were found with a cyclical inter-relationship between three of these themes: namely, goal setting, task translation and perceived outcome. These themes reflect the phases of the self-regulated learning framework. Each phase was influenced by the fourth theme, supervisor co-regulation. Goal setting had motivational properties that had significant impact on the later phases of the cycle. A 'tick box' goal aligned with an opportunistic approach and poorer perceived educational outcomes. Participants reported that external feedback following assessment was critical for their self-evaluation, affective responses and perceived outcomes. CONCLUSIONS: Trainees perceived the performance of a mini-CEX as a complex, inter-related cyclical process, influenced at all stages by the supervisor. Based on our trainee perspectives of the mini-CEX, we conclude that supervisor engagement is essential to support trainees to individually regulate their learning in the clinical environment