Oral Communication Patterns Of Foreign Medical Graduates: Educational Implications Of Some Case Studies (physician-patient Interaction, Esl).

Abstract

The main objective of this exporatory research was to determine the oral English patterns of foreign medical graduates (FMGs) and their effect on the FMG's communication with American patients. While a number of articles attributed the FMGs' oral communication difficulties with patients to social and linguistic differences between them, actual investigations of those proclaimed difficulties have not been conducted. The methods used in this investigation combined survey and empirical (observational) techniques to elicit data about FMGs and American medical graduates (AMGs) to make some comparisons of their communication differences. Twenty-one psychiatric interviews conducted by thirteen FMGs and eight AMGs with seven American patients (six real and one simulated) were examined to compare oral English patterns. Additional data were gathered from videotaped interviews conducted by the researcher. The FMGs' oral English patterns were characterized by discourse forms common to foreign language users, such as incoherence of themes, serial questions, short sentences, cliches, and so forth in comparison with those of native speakers. However, the FMGs were able to communicate with their patients. While they lacked social, cultural, and familiar frames of reference to interpret their patients' oral English, there was no empirical evidence that the FMGs' oral English or their interpretation of their patients' English caused a major communication problem during their interviews. Conceptual, cultural, and social skills, rather than knowledge of English grammar, were the apparent communication problems for the foreign medical graduates. Differences between the FMGs and AMGs in the communication process with American patients were statistically non-significant. Although different backgrounds influenced each group's overall communication process, their oral communication difficulties appear to be deeper than simply using inappropriate English. Due to many limitations of this study--small samples and a large number of variables--this research must be regarded as exploratory. It is an initial step toward improving physicians' skills in effective oral communication. Programs that can help the FMGs in their processes of adaptation and assimilation could ease their anxiety and difficulty in communicating with native English-speaking American patients, including those from different social classes. (Abstract shortened with permission of author.)