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This paper details the research design of a multidisciplinary, multi-method, collaborative research project investigating health communication from the experiences of the early childhood education (ECE) sector during the COVID-19 pandemic. With the rapidly evolving pandemic, the ECE sector was instantly tasked with expanding their required health practices to prevent the spread of infection. It was evident that the sector needed a system to communicate health advice in a timely, consistent and effective manner. Founded on a partnership model based on 'knowledge brokering' theory, this project demonstrates the value of a multidisciplinary research team collaborating with stakeholder organisations to investigate how COVID-19 health information traversed through complexities of organisational layers and diverse communities of families and staff. Detailing our data collection and analysis protocols, we conclude by outlining how our innovative research design is generating actionable and impactful recommendations for both the ECE and health sectors.

Canada, like other first-world countries, relies in large part on professional immigrants trained in other cultures and languages to complement its workforce in a wide range of professions, including medicine. International medical graduates (IMGs) who are nonnative English-speaking (NNES) and who have trained in different medical contexts are often unfamiliar with the sociopragmatic norms underlying both general communication and medical practice in their new host countries, and as a result they can have difficulty using the pragmalinguistic resources needed to strike the appropriate interpersonal note in patient-centred approaches to communication. In this article we used data collected through role-plays performed in an Australian setting by practicing, locally trained, native English-speaking (NES) doctors and NNES IMGs to identify the features of patient-centred medical communication that the latter can find challenging. This approach allowed us to use the discourse to highlight those features of approachability that are likely to be relevant to immigrant professionals in both Canada and Australia. It also helped us to illustrate how discourse data can be used to identify culturally appropriate ways of communicating that can, in turn, contribute to an accurate evidence base from which culturally appropriate communication courses for IMGs and other professionals may be developed.

The Intensive Care Unit (ICU) is an information-intense environment where more patient data points are recorded than in other wards. The electronic Record for Intensive Care (eRIC) is an ICU information system that integrates patient data every minute from multiple systems. Once implemented across New South Wales (NSW), eRIC will be one of the largest system-wide ICU clinical information systems in the world. This study explored experiences with the use of eRIC by ICU clinicians at an Australian metropolitan teaching hospital. Semi-structured, in-depth interviews relating to physician electronic test management processes were conducted with 11 ICU clinicians and one clinical information system manager was observed in their use of the system. The introduction of eRIC resulted in an additional patient record, which was perceived to hold implications for workflow and patient safety. Study findings are valuable for informing implementation as the rollout of eRIC continues. [ABSTRACT FROM AUTHOR]

Language and communication skills are among the greatest challenges that non-native-English speaking international medical graduates (IMGs) face in English medical consultations. Especially when patients use unfamiliar everyday expressions or attach different meanings to medical terminology, the communicative burden on doctor-patient communication may be increased. This exploratory study investigates how IMGs attend to everyday language and medical terminology in a professional English for Specific Purposes (ESP) course, and whether or not they are aware that patients and medical professionals may interpret or perceive medical terminology differently. To provide preliminary answers, the IMGs' approach to and use of two specific communication skills was studied: (1) clarifying unclear patient statements and (2) using easily comprehensible language and avoiding or explaining jargon. Two groups of IMGs were observed for a period of approximately three months during a medical professional ESP course in Australia. Data were gathered in form of field notes and artefacts. Findings indicate that participants are only marginally aware of terminological divergences. Concerning the targeted communication skills, the limited English proficiency of many IMGs was often found to result in a mismatch between proposed and executed actions. Implications for teachers of professional ESP training courses are highlighted. (Contains 5 tables.)

To investigate from a linguistic perspective how clinicians deliver diagnosis to patients, and how these statements relate to diagnostic accuracy. To identify temporal and discursive features in diagnostic statements, we analysed 16 video-recorded interactions collected during a practice high-stakes exam for internationally trained clinicians (25% female, n=4) to gain accreditation to practice in Australia. We recorded time spent on history-taking, examination, diagnosis and management. We extracted and deductively analysed types of diagnostic statements informed by literature. Half of the participants arrived at the correct diagnosis, while the other half misdiagnosed the patient. On average, clinicians who made a diagnostic error took 30 s less in history-taking and 30 s more in providing diagnosis than clinicians with correct diagnosis. The majority of diagnostic statements were evidentialised (describing specific observations (n=24) or alluding to diagnostic processes (n=7)), personal knowledge or judgement (n=8), generalisations (n=6) and assertions (n=4). Clinicians who misdiagnosed provided more specific observations (n=14) than those who diagnosed correctly (n=9). Interactions where there is a diagnostic error, had shorter history-taking periods, longer diagnostic statements and featured more evidence. Time spent on history-taking and diagnosis, and use of evidentialised diagnostic statements may be indicators for diagnostic accuracy. [ABSTRACT FROM AUTHOR]

Table 1: Technicality of patient-reported description of diagnosis presented by comparison of patient-reported diagnosis to clinician-documented diagnosis. Keywords: health communication; patient-centered care; patient-provider communication; patient-report EN health communication patient-centered care patient-provider communication patient-report 250 254 5 05/12/22 20220501 NES 220501 Introduction Diagnostic errors are a public health issue of urgent concern. A patient-reported diagnosis can reveal if a patient left a medical encounter knowing the diagnosis explained to them by their clinical team and can ultimately inform on whether the patient agreed with their diagnosis or if a new diagnosis was later realized at a subsequent medical encounter. This patient-centered definition acknowledges the patients' role in the diagnostic process by ensuring that patients must also receive an explanation of the diagnosis. [Extracted from the article]