A genre-based approach in ESP classes to teaching clinical communication focusing on breaking bad news to patients

Vol.17,No.1(2024)
Discourse and Interaction 1 2024

Abstract

Healthcare professionals have the responsibility to regularly convey difficult information such as unfavourable diagnoses, as well as adverse treatment outcomes. While this task can be uncomfortable, successfully carrying it out plays a crucial role in determining patient outcomes (Sweeney et al. 2011: 230). This necessity has led to the creation of evidence-based protocols such as SPIKES developed by Baile et al. (2000). The goal of the paper is to explore the suitability of the genre-based approach for the study and teaching of medical English, focusing on the integration of the selected clinical communication tool into the ESP classroom. As this study stems from the ESP practitioner’s experience and its outcomes will directly influence her future ESP classroom teaching, action research has been conducted. The feasibility of using an authentic clinical tool in an ESP lesson was assessed through a two-step methodology: i) devising an ESP task based on the SPIKES protocol, emphasizing linguistic elements, and ii) obtaining student feedback focusing on the perceived usefulness of the tool. Overall, the collected data indicate that students acknowledged the significance of effective clinical communication for successful therapeutic practice. However, given the fact that medical English is inconveniently scheduled in a pre-clinical phase of their curriculum, they also exhibited a certain level of hesitancy, unsurprisingly, when it came to readiness in handling serious communication scenarios.


Keywords:
medical English; medical oral genre; delivering bad news; clinical communication; action research; ESP lesson; student survey; mediation
Author biography

Veronika Dvořáčková

Masaryk University Language Centre, Faculty of Medicine, Czech Republic

Veronika Dvořáčková is Assistant Professor affiliated with Masaryk University Language Centre, specifically within the Faculty of Medicine Unit. Her research primarily focuses on exploring diverse facets of clinical communication within the context of English for Specific Purposes (ESP).

Address: Veronika Dvořáčková, Masaryk University Language Centre, Faculty of Medicine, Kamenice 5, 625 00 Brno, Czech Republic. [e-mail: veronika.dvorackova@med.muni.cz]

References

Ainsworth-Vaughn, N. (2001) ‘The discourse of medical encounters.’ In: Schiffrin, D., Tannen, D. and Hamilton, H. E. (eds) The Handbook of Discourse Analysis. Oxford: Blackwell Publishers. 453-469. https://doi.org/10.1002/9780470753460.ch24

Baile, W. F., Buckman, R., Lenzi, R., Glober, G., Beale, E. A. and Kudelka, A. P. (2000) ‘SPIKES – A six-step protocol for delivering bad news: Application to the patient with cancer.’ The Oncologist 5(4), 302-311. https://doi.org/10.1634/theoncologist.5-4-302

Bhatia, V. K. (1991) ‘A genre-based approach to ESP materials.’ World Englishes 10(2),153-166. https://doi.org/10.1111/j.1467-971x.1991.tb00148.x

Council of Europe (2020) Common European Framework of Reference for Languages: Learning, teaching, assessment. Companion volume with new descriptors. Language Policy Unit, Strasbourg. Online document. Retrieved on 9 September
2023 from https://www.coe.int/en/web/common-european-framework-referencelanguages/newsroom/-/asset_publisher/rg3sWjrNNmPK/content/upcoming-vonlineconference-organised-by-the-council-of-europe-the-cefr-companion-volume-a-keyresource-for-inclusive-plurilingual-education-ideoconfe

Cushing, A., Abbott, S., Lothian, D., Hall, A. and Westwood, O. M. (2011) ‘Peer feedback as an aid to learning – What do we want? Feedback. When do we want it? Now!’ Medical Teacher 33(2), e105-e112. https://doi.org/10.3109/0142159x.2011.542522

Fleischman, Z. (2001) ‘The discourse of medical encounters.’ In: Schiffrin, D., Tannen, D. and Hamilton, H. E. (eds) The Handbook of Discourse Analysis. Oxford: Blackwell Publishers. 470-502. https://doi.org/10.1002/9780470753460.ch25

Have, Paul ten. (1989) ‘The consultation as a genre.’ In: Torode, B. (ed.) Text and Talk as Social Practice. Dordrecht: Foris. 115-135. https://doi.org/10.1515/9783111684369-008

Hutchinson, T. and Waters, A. (1987) English for Specific Purposes. Cambridge: Cambridge University Press.

Mahendiran, M., Yeung, H., Rossi, S., Khosravani, H. and Perri, G. (2023) ‘Evaluating the effectiveness of the SPIKES model to break bad news – A systematic review.’ American Journal of Hospice and Palliative Medicine 40(11), 1231-1260. https://doi.org/10.1177/10499091221146296

McCullagh, M. and Wright, R. (2007) Good Practice. Communication Skills in English for the Medical Practitioner. Cambridge: Cambridge University Press.

Meitar, D. and Karnieli‐Miller, O. (2021) ‘Twelve tips to manage a breaking bad news process: Using S-P-w-ICE-S – A revised version of the SPIKES protocol.’ Medical Teacher 44(10), 1087-1091. https://doi.org/10.1080/0142159x.2021.1928618

Morgans, K. and Schapira, L. (2015) ‘Confronting therapeutic failure: A conversation guide.’ The Oncologist 20(8), 946-951. doi:10.1634/theoncologist.2015-0050

Narayanan, V., Bista, B. and Koshy, C. (2010) ‘‘BREAKS’ protocol for breaking bad news.’ Indian Journal of Palliative Care 16(2), 61-65. https://doi.org/10.4103%2F0973-1075.68401

OpenAI. (2023) ChatGPT. (1 Feb 2023) [Version 3]. https://chat.openai.com/

Pannekoeke, L., Knudsen, S. A. S., Kambe, M., Vae, K. J. U. and Dahl, H. (2023) ‘Ongoing training and peer feedback in simulation-based learning for local faculty development: A participation action research study.’ Nurse Education Today 124, 105768. https://doi.org/10.1016/j.nedt.2023.105768

Raut, A. and Gupta, S. S. (2019) ‘Reflection and peer feedback for augmenting emotional intelligence among undergraduate students: A quasi-experimental study from a rural medical college in central India.’ Education for Health 32(1), 3-10. https://doi.
org/10.4103/efh.efh_31_17

Ruesseler, M., Kalozoumi-Paizi, F., Schill, A., Knobe, M., Byhahn, C., Müller, M., Marzi, I. and Walcher, F. (2014) ‘Impact of peer feedback on the performance of lecturers in emergency medicine: A prospective observational study.’ Scandinavian Journal
of Trauma, Resuscitation and Emergency Medicine 22(1), Article 71. https://doi.org/10.1186/s13049-014-0071-1

Society for Simulation in Healthcare (2020) Healthcare Simulation Dictionary Second Edition (2.1). Online document. Retrieved on 1 August 2023 from https://www.ahrq.gov/sites/default/ files/wysiwyg/ patient-safety/resources/simulation/sim-dictionary-2nd.pdf

Solheim, E., Plathe, H. and Eide, H. (2017) ‘Nursing students’ evaluation of a new feedback and reflection tool for use in high-fidelity simulation – Formative assessment of clinical skills. A descriptive quantitative research design.’ Nurse Education in Practice 27, 114-120. https://doi.org/10.1016/j.nepr.2017.08.021

Stanley, C., Lindsay, S., Parker, K., Kawamura, A. and Zubairi, M. (2018) ‘Value of collaboration with standardized patients and patient facilitators in enhancing reflection during the process of building a simulation.’ Journal of Continuing Education in the
Health Professions 38(3), 184-189. https://doi.org/10.1097/ceh.0000000000000198

Swales, J. M. (1990) Genre Analysis: English in Academic and Research Settings. Cambridge: Cambridge University Press.

Sweeney, K., Shepperd, J. A. and Han, P. K. J. (2011) ‘The goals of communicating bad news in health care: do physicians and patients agree?’ Health Expectations 16(3), 230-238. https://doi.org/10.1111/j.1369-7625.2011.00709.x

Van Blankenstein, F. M., O’Sullivan, J., Saab, N. and Steendijk, P. (2021) ‘The effect of peer modelling and discussing modelled feedback principles on medical students’ feedback skills: A quasi-experimental study.’ BMC Medical Education 21(1), Article 332. https://doi.org/10.1186/s12909-021-02755-z

Von Blanckenburg, P., Hofmann, M., Rief, W., Seifart, U. and Seifart, C. (2020) ‘Assessing patients’ preferences for breaking bad news according to the SPIKES-Protocol: The MABBAN scale.’ Patient Education and Counseling 103(8), 1623-1629. https://doi.
org/10.1016/j.pec.2020.02.036

Wilce, J. M. (2009) ‘Medical discourse.’ Annual Review of Anthropology 38(1), 199-215. https://doi.org/10.1146/annurev-anthro-091908-164450

Sources

‘Gibb’s Reflective Cycle.’ (n.d.) Edinburg: University of Edinburgh. Online document. Retrieved on 4 February 2023 from https://www.ed.ac.uk/reflection/reflectors-toolkit/reflecting-on-experience/gibbs-reflective-cycle

‘I had cancer while I was pregnant.’ (21 January 2012) The Guardian. Accessed on 4 February 2023. Available online at https://www.theguardian.com/lifeandstyle/2012/jan/21/cancer-pregnant-children

Metrics

0

Crossref logo

0


35

Views

19

PDF views