The teaching of a structured method of communication improved the communication during telephone referral in a simulated clinical setting. This research has implications for how healthcare professionals are taught to communicate with each other.

This paper aims to enhance our understanding of interactions between French/English Foreign Language Assistants (FLAs) and their school men tors (MEs), and, more specifically, of how 'advice' is sought, given and received. More generally, it will articulate a pragmatic approach (employing the notion of 'activity type') that can help achieve this aim. The paper draws on a sub-set of the data produced for the Pragmatics and Intercultural Communication (PIC) project, a project which deployed multiple and different methodologies, including, for example, not only transcriptions of live interactions, but also retrospective reflections on those interactions. We focus on the first non-casual meetings between FLAs and their MEs, a crucial part of which concerns 'advice'. We argue that advice can be viewed as a 'discourse type', and show how it is deployed in the context of the activity types constituted by those meetings. We conduct a detailed qualitative analysis of one audio-recording of a meeting based in England, and then compare it with one based in France, our interpretations being informed by the participants' reflections, especially those of the FLA. We also deploy quantitative analysis and explore whether the patterns identified in our case studies can be generalised. Finally, we reflect on the implications of activity types and discourse types for pragmatics research, particularly politeness theory and cross-cultural pragmatics.

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BackgroundEffective communication between clinicians is essential for safe, efficient healthcare. We undertook a study to determine the longer-term effectiveness of an education session employing a structured method to teach referral-making skills to medical students.MethodsAll final year medical students received a forty-five minute education intervention consisting: discussion of effective telephone referrals; video viewing and critique; explanation, demonstration and practice using ISBAR; provision of a memory aid for use in their clinical work. Audio recordings were taken during a subsequent standardised simulation scenario and blindly assessed using a validated scoring system. Recordings were taken immediately before (control), several hours after (intervention), and at approximately six months after the education. Retention of the acronym and self-reports of transfer to the clinical environment were measured with a questionnaire at eight months.ResultsReferral clarity at six months was significantly improved from pre-intervention, and referral content showed a trend towards improvement. Both measures were lower than the immediate post-education test. The ISBAR acronym was remembered by 59.4% (n = 95/160) and used by the vast majority of the respondents who had made a clinical telephone referral (n = 135/143; 94.4%).ConclusionsA brief education session improved telephone communication in a simulated environment above baseline for over six months, achieved functional retention of the acronym over a seven to eight month period and resulted in self reports of transfer of the learning into practice.

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