An open randomized controlled trial of the effects of linguistic simplification and mediation on the comprehension of "easy read" text by people with intellectual disabilities.

BACKGROUND: This trial aimed to measure the effects of extrinsic and intrinsic factors on users' comprehension of health information provided in adapted written "easy read" material. METHOD: Sixty adults with intellectual disabilities undertook The Easy Read Task, randomly allocated with stratification by reading ability to one of four conditions (with and without simplified language/with and without mediation). RESULTS: Neither linguistic complexity of the text nor mediation independently or combined made a significant difference to the understanding of information. Post hoc testing revealed that the group who received simplified language with mediation performed significantly better than the group that had complex text with mediation. None of the other differences between the remaining groups were significant. CONCLUSIONS: Constructing meaning needs to extend beyond a consideration of form as found in "easy read" documents to recognize the role of individual capacity for language processing.

Patient-centred communication in British, Italian and Spanish 'Ask-the-Expert' healthcare websites.

Existing studies on the online asynchronous consultation mode afforded by 'Ask-the-Expert' health websites (e.g. Thomson et al. 2012) are concerned with the possible loss in the quality of interaction between patients and clinicians in this type of consultation. The potential loss is worrying, given the central role of patient-centred communication (PCC), particularly empathy, in medical consultation practice and patients' increasing use of and reliance on online consultations. This study addresses the following three related questions: (1) To what extent is PCC represented in 'Ask-the-Expert' healthcare websites? (2) Are there noticeable differences in PCC between sites operating in different linguistic and cultural settings (the UK, Spain and Italy)? (3) What are the implications of the above? Seventy exchanges from the leading independent health websites NetDoctor (UK), Netdoctor (Spain) and Medicitalia (Italy) were analysed, adapting a framework developed for the linguistic analysis of clinical empathy (combining discourse analytical and pragmatic categories ­ Pounds 2011) and drawing on existing definitions of PCC and classifications of advice-giving structures. The analysis shows that PCC is used on these sites to varying degrees, conforming to the site's affordances. The significance of the findings and potential further applications of the analytical framework are discussed in the final part.

Developing a new empathy-specific admissions test for applicants to medical schools: A discourse-pragmatic approach.

The ability to empathise with patients is an important professional skill for doctors. Medical students practise this skill as part of their medical education, and are tested on their use of empathy within their final examination. Evidence shows that appropriate training makes a difference but that natural aptitude also plays a role. Most medical schools, therefore, probe applicants' basic understanding of empathy at admissions interviews. The purpose of the project presented in this paper was to apply existing understanding of how empathy may be communicated in a clinical context (building on a literature review by Pounds [2011]) to develop a new empathy-specific medical admissions interview station, probing applicants' empathic communicative performance (not just theoretical knowledge) and fitting the widely used Multiple Mini Interview (MMI) format. The paper outlines how this tool was developed, trialled and implemented by: (1) conceptualising empathic communication in discourse-pragmatic terms - that is, as a set of specific but context-dependant empathic speech acts; and (2) formulating and trialling a written and two oral versions of a situational test, capable of probing the applicants' ability to communicate empathically in everyday conversation and suitable for use at Norwich Medical School and other similar educational institutions.