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 soci...

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Main Authors: Hawthorne, Kamila, Roberts, Celia, Atkins, Sarah
Format: Article
Published: Royal College of General Practioners 2017
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Online Access:https://eprints.nottingham.ac.uk/49889/
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author Hawthorne, Kamila
Roberts, Celia
Atkins, Sarah
author_facet Hawthorne, Kamila
Roberts, Celia
Atkins, Sarah
author_sort Hawthorne, Kamila
building Nottingham Research Data Repository
collection Online Access
description 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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spelling nottingham-498892020-05-04T18:34:39Z https://eprints.nottingham.ac.uk/49889/ Sociolinguistic factors affecting performance in the Clinical Skills Assessment of the MRCGP: a mixed methods approach Hawthorne, Kamila Roberts, Celia Atkins, Sarah 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. Royal College of General Practioners 2017-02-15 Article PeerReviewed Hawthorne, Kamila, Roberts, Celia and Atkins, Sarah (2017) Sociolinguistic factors affecting performance in the Clinical Skills Assessment of the MRCGP: a mixed methods approach. BJGP Open, 1 (1). pp. 1-9. ISSN 2398-3795 simulated consultations; communication skills; assessment; sociolinguistics; general practice http://bjgpopen.org/content/1/1/BJGP-2017-0713 doi:10.3399/ bjgpopen17X100713 doi:10.3399/ bjgpopen17X100713
spellingShingle simulated consultations; communication skills; assessment; sociolinguistics; general practice
Hawthorne, Kamila
Roberts, Celia
Atkins, Sarah
Sociolinguistic factors affecting performance in the Clinical Skills Assessment of the MRCGP: a mixed methods approach
title Sociolinguistic factors affecting performance in the Clinical Skills Assessment of the MRCGP: a mixed methods approach
title_full Sociolinguistic factors affecting performance in the Clinical Skills Assessment of the MRCGP: a mixed methods approach
title_fullStr Sociolinguistic factors affecting performance in the Clinical Skills Assessment of the MRCGP: a mixed methods approach
title_full_unstemmed Sociolinguistic factors affecting performance in the Clinical Skills Assessment of the MRCGP: a mixed methods approach
title_short Sociolinguistic factors affecting performance in the Clinical Skills Assessment of the MRCGP: a mixed methods approach
title_sort sociolinguistic factors affecting performance in the clinical skills assessment of the mrcgp: a mixed methods approach
topic simulated consultations; communication skills; assessment; sociolinguistics; general practice
url https://eprints.nottingham.ac.uk/49889/
https://eprints.nottingham.ac.uk/49889/
https://eprints.nottingham.ac.uk/49889/