'Doing Questioning' in the Emergency Department (ED).

Eliciting information from patients is fundamental to medical professionals' capacity to deliver good healthcare outcomes in Emergency Departments (EDs). There are different kinds of utterances that "do questioning", and health professionals can variously attend to the medical agenda and the interpersonal aspects of their interactions with those attending the ED in the way that they construct these utterances. We investigate a corpus of ED interactions to determine the prevalence and range of utterances produced by doctors and directed at patients that "do questioning." We developed a questioning utterance typology, informed by previous research on the formulation of such utterances and extended according to observations of our data. We subsequently manually coded 4,355 questioning utterances and report the variety of forms that such utterances can take, considering how these are distributed across doctors at different levels of seniority. We found that doctors at different seniority levels favored similar questioning utterance types and the most frequently used appeared to restrict the contributions of patients. We conclude that our extended typology of questioning utterances has value for understanding the ways in which doctors may encourage patients to provide more extensive responses.

How we developed Doctors Speak Up: an evidence-based language and communication skills open access resource for International Medical Graduates.

BACKGROUND: Some International Medical Graduates (IMGs) need to develop language and communication skills for patient-centred care but have limited opportunities to do so. AIM: To develop an evidence-based, language and communication skills web resource for IMG doctors and supervisors, focussing on culturally challenging patient interviews. METHODS: Forty-eight IMGs participated in four practice OSCEs. We video-recorded the interactions and applied discourse analytic methods to investigate salient language and communication features. RESULTS: The findings from the OSCE workshops showed that many participants demonstrated aspects of patient-centred interviewing but were hindered by limited interactional competence to elicit information and negotiate behaviours as well as a limited repertoire of English grammar, vocabulary, and phonological phrasing for effective interaction. These findings guided the choice of content and pedagogy for the development of the web-based resource Doctors Speak Up. CONCLUSION: Evaluation and uptake of the Doctors Speak Up website confirm the demand for a resource combining targeted communication skills and language instruction. Over 19 500 users visited the website between March 2012 and November 2013.

What counts as effective communication in nursing? Evidence from nurse educators' and clinicians' feedback on nurse interactions with simulated patients.

AIM: To examine the feedback given by nurse educators and clinicians on the quality of communication skills of nurses in interactions with simulated patients. BACKGROUND: The quality of communication in interactions between nurses and patients has a major influence on patient outcomes. To support the development of effective nursing communication in clinical practice, a good understanding of what constitutes effective communication is helpful. DESIGN: An exploratory design was used involving individual interviews, focus groups and written notes from participants and field notes from researchers to investigate perspectives on nurse-patient communication. METHODS: Focus groups and individual interviews were held between August 2010-September 2011 with a purposive sample of 15 nurse educators and clinicians who observed videos of interactions between nurses and simulated patients. These participants were asked to give oral feedback on the quality and content of these interactions. Verbatim transcriptions were undertaken of all data collected. All written notes and field notes were also transcribed. Thematic analysis of the data was undertaken. FINDINGS: Four major themes related to nurse-patient communication were derived from the educators' and clinicians' feedback: approach to patients and patient care, manner towards patients, techniques used for interacting with patients and generic aspects of communication. CONCLUSION: This study has added to previous research by contributing grounded evidence from a group of nurse educators and clinicians on the aspects of communication that are relevant for effective nurse-patient interactions in clinical practice.