Supervision Resources

It is well known that some IMG registrars have significant language issues that may impact on satisfactory communication, both with patients and peers. This has clear consequences for clinical outcomes, examination performance and confidence.

Most IMGs will have English as their second (or third or fourth!) language, even though they may have been exposed to English as the language of instruction. IMG GPRs may struggle with fluency and structure, and comprehension of colloquial English. IMGs have also specifically identified that understanding Australian slang, idioms and mannerisms can be a challenge.

Specific scenarios that require the use of specific communication skills can also be challenging, for example communicating with children, managing the angry patient, saying no, breaking bad news, motivational interviewing, palliative care, and grief counselling.

Areas in which IMGs may have problems are:

• Picking up patient cues (verbal and non-verbal)

• Demonstrating empathy

• Establishing rapport

• Appropriately responding to difficult situations

• Translating medical jargon into lay language

• Clarity of written communications

• • • Ask your registrar what communication skills training they have done in the past, if any.

    • Employ a broad range of teaching methods to focus on communication skill development e.g. direct observation, role play, random case analysis.

    • Give explicit feedback on communication skill issues, including written English, even though it might be challenging.

    • Demonstrate your ‘spiel’ for explanation and management.

    • Encourage your registrar to use simple communication strategies in the consultation (see diagram 1).

    • Discuss non-verbal cues and their likely meanings in Australian general practice.

    • Discuss and role play situations where specific communication strategies may be required (as above).

    • Encourage reflective practice in your registrar i.e. ‘How well did I communicate in that consultation?

    • Encourage your registrar to watch local TV shows, read newspapers, see Australian films, attend local venues e.g. sports clubs or RSL (if comfortable) etc. to help refine their everyday English language skills.

    • Consider online learning courses e.g. Doctors Speak Up website13 or assistance from professional linguists/language teachers.

    • Provide useful phrases 

Resources

History taking skills

Writing quality referrals

VIDEO: Australian slang

Australian slang dictionary

Slang terms in the consulting room

Website: Doctors Speak Up

VIDEO: Doctors Speak Up website