The role of effective communication during the medical interview between native and non-native English speaking dyads.

摘要

The medial interview (H & P) is a primary way in which physician and patient communicate. However, the multicultural communities that reflect America's diversity create a context in which doctor and patient, the participants in the medical interview, may come from different speech communities, and this may impact doctor/patient communication. This study explored "effective communication" within the cross-cultural medical interview, from the perspectives of physicians, patients, and the researcher.;Four medical interviews in a county teaching hospital emergency room between a native and non-native English speaker were video-taped, and participants completed questionnaires regarding their expectations and perceptions of the interview. The combined visual, oral, and written data were analyzed to gain an understanding of what was successfully or not successfully communicated from the video-taped data as well as from the perspectives of the participants.;Results indicated that each doctor and patient in the study thought that effective communication was important in the medical interview, all doctors and patients in the study reported satisfaction with their interactions, and all believed effective communication had occurred. The doctors, who conducted primarily doctor-centered interviews, appeared to base their satisfaction primarily on whether or not they believed they were able to gain an adequate History and Physical. The patients based their perceptions not only their interaction with their doctors, but also on their overall experience at the hospital, culminating in whether they were able to have their personal agendas met.;Interestingly, each dyad contained examples of pragmatic failures, stemming from pragma-linguistic sources, socio-pragmatic sources, nonverbal aspects of communication, or a combination. These failures were sometimes caused by register (medical jargon) and vocabulary differences, by contrasting views of culture-based practices, or by issues of personal space and eye contact.;The ability of some doctors and patients to merge linguistically (register) helped communication and boosted satisfaction. In terms of conversational norms, the interrupting and redirection of the doctors, while in part a reflection of time pressure realities, was sometimes experienced as a lack of empathy. The dyads also contained examples of successful communication, and perceived empathy contributed to the positive perceptions of the patients.