Understanding interactions in interpreted triadic medical consultations in primary care

Abstract

Communication is one of the core clinical skills and has been taught at medical schools in many countries for some 30 years. However, the use of ad hoc and professional interpreters in medical consultations has imposed new challenges on the medical professionals’ communication skills and medical education. Traditional communication models have not provided guidance for working with different types of interpreters. Researchers and educators have been striving to develop new communication models to guide education and practice. However, these models are limited in many ways. This research points out that more research is needed to provide a better understanding of interpreted medical consultations, especially of people’s verbal behaviour in talk-in-interaction. Based on this, a more effective communication model can be developed to remedy the limitations the current models have. Therefore, the research has two goals: namely, to develop a better understanding of the interpreted medical consultation and to develop communication skills for work with interpreters. Using conversation analysis (CA) the research investigated 7 naturally recorded GP consultations involving either ad hoc or professional interpreters. Three languages, Slovak, Mirpuri Punjabi and Urdu, were included. GP interviews and focus groups were conducted for member checking and enhancing the validity of the research results. The research has investigated the turn-taking and turn-design of the interpreted medical consultations and established two theoretical frameworks which provide a generic understanding of the participants’ verbal behaviour in the interaction. Based on the frameworks this research has developed 12 communication strategies orienting to behavioural change of the doctor so as to improve the overall communication. The strategies are useful not only for the training of GPs but also other medical professionals and professional interpreters