1. COTs and Communication Trainers’ Workshop 31 st March 2010

2. Suggestions Update and trainer/ AT item –Spring Symposium –Educational Supervision –Expansion of training capacity Mark two COTs individually Benchmarking of scores Discussion – where are you ‘Hawks’ and ‘Doves’ The trainee who needs extra help – discussion of communication skills

3. COT VIDEOs

4. Benchmarking scores PC1 4N 5C PC2 8N 3C PC3 9N 2C PC4 2I 9N 0C PC5 2N 9C PC6 2I 2N 7C PC7 11 1N 8C 1E PC8 10N 1C PC9 3I 7N 1C PC10 3N 7C 1E PC11 11N PC12 2I, 3N, 8C PC13 1I 6N 4C Global 8N 3C

5. Benchmarking scores PC1 I N8 C3 E PC2 I N10 C1 E PC3 I N6 C5 E PC4 I N11 C E PC5 I N11 C E PC6 I N11 C E PC7 I N11 C E PC8 I N6 C5 E PC9 I N2 C8 E1 PC10 I1 N10 C E PC11 I N7 C4 E PC12 I2 N10 C E PC13 I N10 C3 E Global I N11 C E

6. Discussion

7. Help for trainees with communication difficulty Identify the nature of the problem Make an accurate educational diagnosis –Is there an element of lack of clinical knowledge or skills? –Is there lack of confidence in applying treatments and recommendations independently? –Is there a primary communication problem?

8. What is communication?

9. Communicative Competence in the consultation requires - Sufficient level of language Recognition of cultural values underpinning good medical practice Familiarity with consultation models Awareness of communicative outcomes required Ability to apply language skills appropriately Ability to use and interpret para-and extra- linguistic signals

11. Language Skills Fluency and cohesion (length, pausing, topic development) Accuracy (frequency, gravity of errors) Range (lexical/grammatical flexibility) Pronunciation (sounds, intonation, word and sentence stress) Listening (comprehension, responding) Reading and writing skills

12. Language Skills Fluency and cohesion (length, pausing, topic development) Accuracy (frequency, gravity of errors) Range (lexical/grammatical flexibility) Pronunciation (sounds, intonation, word and sentence stress) Listening (comprehension, responding) Reading and writing skills

13. Para/Extralinguistic Skills Pitch, volume, speed of speech Noises (encouragers, tutting, sighing) Interactional norms (turn-taking, use of silence, structure) Eye contact, facial expression, gesture Personal space, touch, smell

14. Cultural dimensions Direct – indirect Heirarchical – egalitarian Individualist – collectivist Task/fact focused – relationship focused High involvement (affective) – High consideration (low emotional display) Formal – informal Linear active – multi active

15. Issues in assessing communication across cultures Decoder filters message through own language, cultural and professional expectations Communication assessed against both explicit and implicit norms Non-specialist may not recognise source of ‘noise’ Cause of problems often generalised (’language barrier’, behavioural/attitude issues, poor communication skills)

16. Our challenges in education Recognise cause of ‘interference’ Respect its origin Reconcile differences

17. Communicative Competence in the consultation requires - Sufficient level of language Recognition of cultural values underpinning good medical practice Familiarity with consultation models Awareness of communicative outcomes required Ability to apply language skills appropriately Ability to use and interpret para-and extra- linguistic signals

18. THE END