Assessment of communicative competence in adult patients with minimum response in intensive care units: A scoping review.

BACKGROUND: Few formal instruments exist to assess the communicative competence of patients hospitalized in intensive care units (ICUs). This can limit interventions by health professionals. AIMS: To map the categories and instruments for assessing the communicative competence of adult patients with minimal response in ICUs. METHODS & PROCEDURES: A scoping review was carried out following the Joanna Briggs Institute protocol between February and March 2022 and using the MEDLINE (PubMed), Scopus, Scielo, Business Source Complete (via EBSCOhost), Academic Search Complete (via EBSCOhost) and Web of Science databases, in Portuguese, English and Spanish. MAIN CONTRIBUTION: Eight studies met the inclusion criteria. The different communication and pain assessment protocols covered awareness, cognition, sensory capacity, motor capacity, language, speech and literacy. CONCLUSIONS & IMPLICATIONS: The present review offers a starting point for the construction of a formal assessment instrument to enable clinicians to implement an augmentative or alternative communication system (AACS) for the voluntary, independent and active participation of patients. WHAT THIS PAPER ADDS: What is already known on the subject Patients in ICUs are subject to various forms of treatment and continuous and intensive monitoring, compromising their capacity to communicate and actively participate (e.g., sharing symptoms and making decisions). Although there is some awareness of their disadvantage in such a regard, few protocols of assessment of communicative competence have been adapted to patients with a minimum response. What this paper adds to the existing knowledge The present review highlights different protocols for the assessment of communication and pain. They include the following categories: awareness, sensory capacity, auditory and visual acuity, positioning and motor capacity, language, speech, and literacy. The review offers a starting point for the construction of a formal assessment instrument encompassing the aforementioned categories, along with duly validated guidelines for its application. What are the potential or actual clinical implications of this work? Our formal assessment instrument takes into account the need to adapt to different patient profiles. It is hoped that it will provide speech therapists and other health professionals with the information required to implement an AACS in which patients participate actively.

"Communicative competence assessment of the person with aphasia caregiver: Standardization of the ACCA-CHECKLIST".

Aphasia constitutes a very complex clinical entity that requires a "competent" caregiver to interact with the person with aphasia (PWA). The literature lacks a valid and reliable set of standardized tools which can offer objective and quantifiable data of a caregiver's communicative competence. The aim of the study was to develop, standardize and validate an evaluation tool suited to measur the caregivers' competence in communicating with family members affected by aphasic disorders. Forty-two patients with aphasia and their respective caregivers were enrolled in the study. Caregivers' communicative competence was assessed through a new evaluation tool called ACCA-cl. Aphasia severity and functional communication abilities of the PWA were also investigated. Our data showed encouraging results regarding the reliability and the validity of the ACCA-cl scale in detecting the caregiver's communicative competence, especially as far as verbal content was considered. This scale can also be used to assess the improvement achieved by the caregiver after a communication training. The analysis provides encouraging findings for verbal content scales of the ACCA-cl and its possible use in clinical settings as a quantitative tool for detecting changes induced by the educational method of the caregiver. The tool is currently available in Italian.

Examining the Significance of Intercultural Communicative Competence Development in Trainees during Pre-service Training.

The aim of this study is to discuss the need for improved intercultural communicative competence (ICC) training for pre-service Chinese as a Second Language (CSL) teachers who travel abroad to teach. Previous studies have shown that pre-service CSL teachers often struggle with intercultural communication, and this study investigates the reasons behind their difficulties and suggests ways to address them. The researchers used the Intercultural Sensitivity Scale (ISS) and the Intercultural Effectiveness Scale (IES) to measure the ICC of 217 pre-service CSL teachers. The study found that while pre-service CSL teachers have strong intercultural communicative emotional ability, their behavioral ability in intercultural communication is weak. In particular, they lacked skills in interactive control, interactive relaxation, identity management, information skills, and behavioral flexibility. The study proposes several strategies to improve ICC training for pre-service CSL teachers. One potential approach is the use of Computer Assisted Language Learning to provide teacher-trainee students with opportunities to practice intercultural communication skills in simulated contexts, receive personalized feedback, and engage with authentic materials and cultural information relevant to their host country. CALL could also facilitate communication between pre-service CSL teachers and former CSL teachers, providing a platform for information exchange and additional psychological support. The study also suggests that pre-service training should distinguish between foreign language learning and intercultural communication skills training. Specifically, it recommends that foreign language proficiency should be improved, while training should focus on educational culture and work culture in the host country, rather than providing a general introduction to the national conditions of the country. Finally, the study proposes that pre-service training should establish contact between pre-service CSL teachers and former CSL teachers as early as possible so that trainees can learn specific relevant information in advance, which can help them get ready, avoid intercultural communication mistakes, and obtain additional psychological support. By incorporating CALL and addressing the areas of weakness identified in the study, pre-service CSL teachers can be better prepared to navigate the challenges of intercultural communication and provide effective and culturally sensitive instruction abroad.

Developing a screening instrument for underlying core domains of communicative competence in children with communication support needs.

A socio-neurocognitive approach to augmentative and alternative communication (AAC) shows several underlying domains of communicative competence: Attention, perception, cognition, memory, orientation, socio-emotional development, motor skills, and language. To determine developmental markers of these underlying core domains of communicative competence in children with communication support needs, we developed a new screening instrument. The present article consists of three consecutive studies. In study 1, we constructed the first version of the screening instrument based on a sample of both children without disabilities and children with Down syndrome. In study 2, we confirmed the reliability (i.e., internal consistency) of the screening instrument in a new group of young children with typical development and established concurrent validity with the Early Language Scale. In study 3, we established concurrent validity with the Communication Matrix in a clinical sample of children with communication support needs. The screening instrument can be used in clinical practice as part of AAC assessment to provide comprehensive insights into strengths and weaknesses in the underlying core domains of communicative competence of children with communication support needs.

INDIVIDUAL FACTORS OF MEDICAL PHD STUDENTS' ENGLISH COMMUNICATIVE COMPETENCE.

OBJECTIVE: The aim: The paper is aimed to find correlations between English language communicative academic and medical competence components (theoretical, practical, and individual by certain methods), to improve design of the course "Academic English for PhDs in Medicine", its methods and strategy. PATIENTS AND METHODS: Materials and methods: The study sample includes postgraduate groups studying for PhD in Healthcare, aged 21-59 years, in Bukovinian State Medical University (39 respondents), Zaporizhzhia State Medical University (32 respondents), Kharkiv Medical Academy of Postgraduate Education (33 respondents), and Bogomolets National Medical University (318 respondents). The study was held in 2019-2023. We assessed theoretical and practical components using our tests, individual component - psychological methods. The values of three components were transformed into general English communicative academic and medical competence level. The data were treated with SPSS Statistica 18.0, using Spearman correlation significance. RESULTS: Results: We found positive correlation between English communicative competence and communicative tolerance, general communicative skills level, and high or medium communicative control level. Also, positive correlation characterizes interaction as a conflict-resolving strategy and communicative competence. Highly manifested intolerance in communication, predominance of negative mindsets, intolerance to stress negatively affect the level of English communicative academic and professional competence of PhD students. CONCLUSION: Conclusions: Analysis of the English speaking competence, and its components, showed positive correlation between interaction as a conflict-resolving strategy and English communicative competence of respondents. Regarding the results, the curriculum of the "Academic English for Medical PhDs" should be modified, including interactive methods, case studies, problem solving, and other methods for individual component training.

Intercultural communicative competence in higher education through telecollaboration: typology and development.

This study aims to analyse intercultural communicative competence, understood as the individual's ability to effectively and appropriately develop communication and behaviour, when interacting in an intercultural context. In this study, the Behavioural, Affective and Cognitive Dimensions, and their sub-dimensions, are considered by using videoconferencing as a tool for telecollaboration in Higher Education. These sub-dimensions are observed according to their positive and negative orientation (facilitating or inhibiting). The objectives of the current study are to analyse the dimensions and sub-dimensions distribution, to assess the incidence of the typology of generic and specific topics, and to assess the over time communication evolution. Content analysis of communications between university peers was carried out and we undertook a percentage frequency index. The results show behavioural communications to be in the majority, followed by affective and, finally, cognitive communications. Communications with a negative aspect are almost absent from this study. MANOVA was performed to investigate differences between typologies of topics (generic/specific) in dimensions. This research founds statistically significant differences in Affective Dimension. ANOVAs were conducted to observe if there are differences in the development over time of Behavioural, Affective and Cognitive Dimensions of intercultural online communications. There was a significant effect over time in Affective and Behavioural Dimension. The present study finds expressions that show a positive attitude towards communication, as well as interest in and an effort to maintain it. We can conclude that, in Affective Dimension, where generic topics enhance communication, while educational topics inhibit it. However, a sustained evolution over time has not been found, rather a significant incidence depending on topic themes.

Negotiating scientific knowledge in the development of an eHealth MOOC.

Interdisciplinary team communication in eHealth development is challenging because all disciplines have unique, intrinsic discursive practices, theories and artefacts. Due to these factors, members of interdisciplinary teams can experience problems in communication and collaboration. Through a centered focus, members can benefit individually, inspire one another, and ultimately reach a timely delivery of their common pedagogical goal(s). Using the lens of dialogism, this paper aims to identify the conceptual considerations that arose during the development of a Massive Open Online Course (MOOC) for higher education in eHealth. Methods included auto-ethnography and interdisciplinary dialogue supported by literacy artefacts, including visual material. Results yielded a visual tool for meta-assessment of team communication, and an organizing principle for topics in the MOOC. A major implication is that especially for eHealth, scientific communicative competence of experts-while establishing a common understanding-can lead to a unique and meaningful delivery of high pedagogical quality.

Attitudes Toward and Perceived Communicative Competence of Individuals with Aphasia Using Speech-Generating Devices.

The purpose of this study was to investigate the effects of interface display and respondent group on listener attitudes toward and perceived communicative competence of persons with aphasia. The Attitudes Toward Nonspeaking Persons scale and the Communicative Competence Scale was used to measure listener attitudes and communicative competence, respectively. A 2 × 3 mixed factorial design was used. Interface display videos served as the within-subjects variable (i.e., grid and scene displays), and the respondent group served as the between-subjects variable. A total of 113 respondents (i.e., undergraduate lower-division students, undergraduate upper-division students, and family caregivers of individuals with aphasia) watched an individual with aphasia using a grid display in one video and a scene display in another video. The respondents completed the two scales. Significant main effects (p < .05) were found for interface display and respondent group. The use of scene displays had a more favorable impact on competence ratings than the use of grid displays. Family caregiver ratings were significantly (p < .05) more favorable than ratings from other groups. The Communicative Competence Scale was found to be a reliable measure of perceived communicative competence. Scene displays have the potential to enhance the perceived communicative competence of this population.

HOLISTIC APPROACH IN COMMUNICATION SKILLS TEACHING OF MEDICAL STUDENTS.

OBJECTIVE: The aim: To analyze the relevance of communicative competence in medical practice and to choose the best pedagogical methods by improve communication skills in future doctors through the use of a holistic approach in teaching. PATIENTS AND METHODS: Materials and methods: Sociological, informational and analytical research methods were used in the research. CONCLUSION: Conclusions: The holistic direction in education promotes partnership between a student and a teacher, the achievement of mutual understanding and trust, better commitment and motivation to learn. The use of feedback forms helps to recognize and understand the needs and feelings of each student, work effectively with diversity, motivates the teacher to continuous self-development and self-improvement. Modern teaching methods such as working in small groups, Storytellling and role-play according to students are more valid in mastering the communicative competence of the future doctor.

A Tale of Two Inquiries (or, Doing Being Competent in a Clinical Skills Exam).

Phenomenon: In high-stakes evaluations of communicative competency, data-gathering skills are commonly assessed through the use of standardized patient encounters. This article seeks to document inquiry practices in 2 such encounters in a setting designed to emulate a consequential, clinical skills examination. Approach: Drawing on the methods and findings of Conversation Analysis, we examine selected fragments seeking to understand how, in the ways in which they are organized, they produce quite different outcomes. Findings: In the first encounter, the topic of the patient's history of depression arises naturally in the course of the interview. It happens to be a checklist item for the case and the examinee receives credit for having elicited it. In the second encounter, though the examinee was the more clinically experienced, the topic does not come up and the examinee fails to receive credit. Insights: When we examine how the two inquiry sequences develop on a turn-by-turn basis, it becomes clear that the differences between inquiry practices that carefully constrain patient responses and those that leave space for patient elaboration are subtle but evident. Both types of practice, however, are presumably a part of competent clinical performance. We argue that looking carefully at how specific interactional practices operate within clinical interviews can enable us to become more articulate as to what might count as communicative competence in the clinic.

Principles for evaluating knowledge co-production in natural resource management: Incorporating decision-maker values.

A key reason for undertaking transdisciplinary processes such as knowledge co-production in natural resource management is to access and apply different knowledge systems to complex issues. However, the value of co-production is predominantly framed by academics. They have focused on research design and outcomes in the form of 'science informing policy'. In this paper we build a more inclusive and holistic framing of knowledge co-production incorporating values of non-academic participants, and values related to the participatory process. Specifically, we examine how knowledge is communicated and deliberated upon and the requirements for this to be done effectively. We draw upon empirical data from interviews with natural resource managers who participated in two case studies of knowledge co-production in Australia and South Africa. Their perspectives are captured in eight evaluation principles that build upon existing evaluation frameworks for public participation. Critically, decision-makers valued science-based outputs not just as salient knowledge sources, but to give legitimacy to their decisions. This need for legitimacy necessitates transparency, fairness and inclusivity in knowledge selection, participation and dialogue within knowledge co-production processes. The practice-based knowledge of decision-makers was important for contextualizing and applying science to specific decision contexts. Another key finding is that communicative competence is central to the process of knowledge co-production because it enables participants to critically explore and understand the knowledge claims of others.

A Meta-analysis of L2 Willingness to Communicate and Its Three High-Evidence Correlates.

Willingness to communicate (WTC) has been considered an important part of the language learning and communication process, playing a pivotal role in the development of language learners' communicative competence. Many studies have been conducted on the relationship between WTC and related variables in learning English as a foreign language. However, there is a lack of a comprehensive meta-analysis concerning the effect sizes of these studies. Thus, the present meta-analysis investigated the overall average correlation between L2 WTC and three key variables influencing foreign/second language learners' WTC, specifically perceived communicative competence, language anxiety, and motivation. The results of the meta-analysis indicated that all three variables were moderately correlated with L2 WTC, with perceived communicative competence having the largest effect. Finally, tests of the heterogeneity of the effect sizes indicated the possibility of the presence of the moderators which might play an influential role in the relationship of WTC with anxiety, perceived communicative competence, and motivation.

[New Technologies in the Diagnostics and Treatment of Brain Deseases: from Neurosciences to the Multidisciplinary Clinical Practice and Maintaining of Mental Health].

Over the past years, the prevalence of brain diseases and, consequently, their social significance and economic burden for society has been steadily increasing throughout the world. Brain diseases are a heterogeneous group of diseases that unite a number of disorders that are within the competence of both neurology and psychiatry, often concurrent or comorbid with each other. Z. P. Soloviev Research and Clinical Center for Neuropsychiatry is a leading medical organization in Moscow, which performs a full treatment cycle, studies the data and has postgraduate training programs in this field of medicine. It is conducting a number of relevant research programs; some in collaboration with international clinics. This study deals with the following programs: fundamental aspects of depression and stress-reactivity, suicidal and self-damaging behavior, usage of biofeedback and gravity therapy in rehabilitation and training programs for medical workers in successful communication.

A boy and his AAC team: building instructional competence across team members.

Families and education professionals face unique challenges when working together to support augmentative and alternative communication (AAC) for a child who does not use speech and has only prelinguistic forms of communication. For this study, a family-school team was provided with a specially designed support package comprising training and one-on-one coaching in evidence-based instructional strategies. As part of a larger mixed methods investigation, a single-case experimental design was conducted to explore the effectiveness of the support package on facilitating team members' competence in AAC instruction and communication. In the case reported here, the support package improved instructional competence across all team members, which led to small, positive changes in the child's communication using AAC. However, it was not sufficient for overcoming contextual barriers and supporting adults' ongoing instructional adjustment to the level necessary to promote the child's independent communication via AAC. Implications of these findings for both practice and research are discussed.

[Communicative competence and physician - patient relationship in aboriginal health care].

Modern society consists of people from all walks of life. This melting pot of cultures might be considered both enriching and problematic. In order to communicate successfully, society members should acquire some social skills specific to a given community or, in other words, develop their communicative competence. The aim of this paper is to examine the way extralinguistic knowledge can influence physician - patient relationship in Aboriginal Australian communities. The paper is concerned with not only reviewing fundamental principles of ethnography and communicative competence but also identifying the main cultural differences that may affect the quality of healthcare services.

Variations in an African Grey parrot's speech patterns following ignored and denied requests.

Communicative competence is one measure of an individual's ability to navigate conversations with social partners. The current study explored the possibility of basic communicative competence in a non-mammal speaker, a speech-using African Grey parrot. Spontaneous conversations between one Grey named Cosmo and her caregiver were recorded, from which three corpora (i.e., bodies of text) of Cosmo's vocalizations were developed: (1) Baseline: Vocalizations containing no requests, (2) Ignored Requests: Vocalizations immediately following Cosmo's caregiver ignoring Cosmo's requests, and (3) Denied Requests: Vocalizations immediately following Cosmo's caregiver denying Cosmo's requests. The distributions of social (e.g., "I love you," kiss sounds) and nonsocial (e.g., answering machine beeps, "That's squirrel") vocalizations, as well as speech and nonword vocalizations, were statistically different across the three corpora. Additionally, qualitative analysis of the datasets indicated Cosmo was persistent in repeating vocalizations when denied and ignored, and interrupted her caregiver more often when requests were denied compared to ignored. Neither repetition nor interruption occurred during the Baseline conversations. The data indicate that despite the outcome being the same (i.e., request was unmet), Cosmo treated an ignored request differently than a denied request, modifying her vocalizations in accord with the specific context. Such modification is evidence of basic communicative competence.

Revisiting Communicative Competence in Augmentative and Alternative Communication.

OBJECTIVE: This tutorial paper is to explore the novel nature of communicative competence in augmentative and alternative communication (AAC) practice by comparing it to communicative competence in naturally verbal dyadic communication. PATIENTS AND METHODS: This paper first reviews the four domains of communicative competence in AAC practice. Second, it examines competence in dyadic communications between naturally verbal people without disabilities, deriving new insights and using these to analyze the evolution of communicative competence in AAC practice. RESULTS: Communicative competence in AAC practice should be reconceptualized from a new perspective as dyadic, learned, co-constructed, and of relative value, ascertained through performance. CONCLUSION: In the past decades, the study of communicative competence in AAC practice has primarily focused on individual persons who use AAC. However, the conceptualization of communicative competence should shift away from an individualized construct toward a dyadic construct. This leads to a discussion of potential implications and future research directions. This paper might offer AAC researchers and practitioners an opportunity to deepen their understanding of communicative competence and promote more positive outcomes for people who use AAC.

'Communicative competence' in the field of augmentative and alternative communication: a review and critique.

BACKGROUND: Understandings of 'communicative competency' (CC) have an important influence on the ways that researchers and practitioners in augmentative and alternative communication (AAC) work toward achieving positive outcomes with AAC users. Yet, very little literature has critically examined conceptualizations of CC in AAC. Following an overview of the emergence of the concept of CC and of the field of AAC, we review seven conceptualizations of CC identified in the literature. AIMS: To consider the contributions and potential shortcomings of conceptualizations of CC in AAC. METHODS & PROCEDURES: We use a critical theoretical approach to review, critique and synthesize conceptualizations of CC in AAC, with a particular focus on uncovering 'taken for granted' assumptions. By historically situating the reviewed literature, we examine the shifting boundaries and tensions among theoretical conceptualizations of CC in AAC and their potential impacts on practice. MAIN CONTRIBUTIONS: We suggest ways that revisiting past scholarly work, alongside emergent, innovative conceptualizations of CC might shift ways of thinking about CC in AAC which tend to focus on the individual who communicates differently, toward (re)location of CC as a shared, socially incorporated and performed communication construct. CONCLUSION & IMPLICATIONS: We propose that emerging critical perspectives drawn from AAC and other interdisciplinary literatures offer innovative ways of theorizing communication difference, which might inform evolving conceptualizations of CC in AAC.

Formation of communicative competence of massage therapists with visual impairments: A research study.

Background: Communicative competence for massage therapists with visual impairments is an important aspect in ensuring their successful integration into the profession and society. However, visually impaired massage therapists face numerous barriers to effective communication during their education, hiring process, and professional employment. Aim: To study why communicative competence is important for students with visual impairments; to research features of communication of persons with visual impairments; to identify barriers and effective strategies for formation of communicative competence in the educational process. Design: A qualitative descriptive study with focus groups and semi-structured interviews. Settings: Higher education institution in Lviv (Ukraine) offering a nursing programme for students with visual impairments. Participants: Three groups of respondents, namely visually impaired alumni of Lviv Medical Academy, Ukraine (n = 6), alumni's employers and co-workers (n = 4), and experts in the education of visually impaired persons (n = 11), participated in the research. Methods: Two focus groups and in-depth semi-structured interviews were used to collect data. Interviews were transcribed verbatim and thematic coding was used to analyze transcripts. Results: Five themes arose: significance of communication for nurse massage therapists with visual impairments; features of communication of persons with visual impairments; barriers to communication of persons with visual impairments; tools and approaches to improve communicative competence of massage therapists with visual impairments; ineffective methods in teaching communication to visually impaired students. Conclusions: Communication barriers faced by visually impaired nursing students include isolation in specialized institutions, parental hypervigilance, and the challenge of establishing eye contact, which impedes reading nonverbal cues. To enhance communicative competence, it is essential to implement interactive teaching methods, involve students in various activities, ensure educational accessibility, and adopt an individualized and empathetic approach. Both inclusive and special education have advantages and disadvantages. It is recommended to advocate for a "reasonable accommodation" model to ensure high-quality education for visually impaired massage therapists.

L2 communication apprehension and communicative competence of pre-service English teachers.

Communication in a foreign language is essential, and it requires an individual's competence in speaking skills. It needs to be improved to enhance an effective means of communication. The current study investigates the relationship between L2 communication apprehension and communicative competence of pre-service EFL teachers studying at a state university in Türkiye. The quantitative research approach focuses on understanding pre-service teachers' perceptions regarding communication apprehension and communicative competence. The study included 200 pre-service EFL teachers, with 146 female and 54 male participants. The age range of the participants was between 18 and 34. The results indicate that pre-service EFL teachers have varying levels of communication apprehension and are notably more apprehensive in certain situations. Additionally, the study found that perceived communication competence significantly influences communication apprehension. Some pedagogical strategies are discussed and suggested according to the findings of the study.