“Everyone happy with what their role is?”: A pragmalinguistic evaluation of leadership practices in emergency medicine training

This article reports a study of simulated interactions between emergency medical teams, as they are used in education for specialist trainee doctors. We focus on a key area of communicative competence that trainees are assessed on: the performance of leadership skills. Using videos of simulated trauma cases recorded within a training department of a large teaching hospital in the UK, we analyse how trainee doctors delegate tasks to their teams, matching up their linguistic performance, in particular their use of requests, to how they are assessed in the simulation overall. This allows us to establish the types of linguistic leadership performance that are evaluated positively in this setting and therefore are attributed to success. Through fine-grained, qualitative analysis, we examine the interrelationship between ‘efficiency’, evidenced by the subsequent successful completion of an action by the team, and the use of indirect and mitigated requests, finding that a high number of indirect forms are successfully used to make requests of others in this time-pressured setting. We discuss the theoretical implications of our observations, revisiting claims about linguistic behaviour in urgent contexts, and also consider the practical implications of the study, including professional practice and training

Performance features in clinical skills assessment: Linguistic and cultural factors in the Membership of the Royal College of General Practitioners examination

This book is based on research looking at performance in clinical skills assessment from a linguistic and cultural perspective, with a view to understanding why there are such differential pass rates and giving suggestions on how this issue can be tackled. It is both a research report and a guide to the sociolinguistic methodology used. While the findings are based on a research project in partnership with the Royal College of General Practitioners, they are applicable to many other medical settings where standardised examinations of simulated consultations are used. More widely, this research addresses a central paradox in institutional life – how to balance validity in assessments and be fair to a diverse group of candidates in an increasingly diverse society, while maintaining reliability with standardised and universal marking criteria. It has been widely acknowledged that candidates from overseas fair less well in such examinations. A close look at the interactions which make up these simulated consultations shows that there are complex and subtle differences between passing and failing candidates which cannot be explained simply as ‘language’ and ‘cultural’ differences and put in a box separate from issues of fairness. These structured examinations, unintentionally, contribute to the weight of the assessment on overseas candidates, particularly in how interpersonal effectiveness is judged both explicitly and implicitly. The research has identified a range of successful candidate strategies which form the basis of a set of e–learning materials to be published by the RCGP. It also suggests that aspects of the exam, notably the more subjective features of interpersonal skills, are not best assessed in highly structured exams. This area needs to be better defined, using a new analytic language, to debate how and where it could be most effectively and fairly assessed

Three-dimensional kinematic correlates of ball velocity during maximal instep soccer kicking in males

This is an Accepted Manuscript of an article published by Taylor & Francis Group in European Journal of Sport Science, on 23 April 2014, available online at: https://www.tandfonline.com/doi/abs/10.1080/17461391.2014.908956.Achieving a high ball velocity is important during soccer shooting, as it gives the goalkeeper less time to react, thus improving a player's chance of scoring. This study aimed to identify important technical aspects of kicking linked to the generation of ball velocity using regression analyses. Maximal instep kicks were obtained from 22 academy-level soccer players using a 10-camera motion capture system sampling at 500 Hz. Three-dimensional kinematics of the lower extremity segments were obtained. Regression analysis was used to identify the kinematic parameters associated with the development of ball velocity. A single biomechanical parameter; knee extension velocity of the kicking limb at ball contact Adjusted R(2) = 0.39, p ≤ 0.01 was obtained as a significant predictor of ball-velocity. This study suggests that sagittal plane knee extension velocity is the strongest contributor to ball velocity and potentially overall kicking performance. It is conceivable therefore that players may benefit from exposure to coaching and strength techniques geared towards the improvement of knee extension angular velocity as highlighted in this study.Peer reviewedFinal Accepted Versio

Sociolinguistic factors affecting performance in the Clinical Skills Assessment of the MRCGP: a mixed-methods approach

Background Differential performance in clinical skills assessments is a widespread phenomenon, for which there remain few explanations. Aim To better understand the conversational contexts of simulated consultations and how candidates actually behave in these consultations and to determine sociolinguistic factors for high- and low-performing candidates. Design & setting Taking the Membership of the Royal College of General Practitioners' (MRCGP) clinical skills assessment (CSA) examination as a model, this research applied sociolinguistic analyses to case videos of 198 consecutive candidates presenting for the CSA examination. Method Using a mixed-methods approach, both quantitative and qualitative sociolinguistics methodologies were combined to analyse video consultations, and findings were compared with those from group discussions with MRCGP examiners. Results There is more ‘talk’ in simulated consultations than in real life. On macroanalysis, there was little difference between poor- and well-performing candidates. However, microanalysis found subtle differences in structuring consultations, metacommunication, picking up cues, and misunderstandings with and giving explanations to patients. Formulaic talk, contrary to examiners’ perceptions was more common in successful candidates, but it was personalised and sited appropriately in the consultation. Conclusion This is an interactionally demanding form of clinical assessment, that requires giving support to candidates and a more analytic approach to the development of interpersonal skills. Sociolinguistic features of consulting to help trainers and candidates prepare for the CSA are identified

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