Lyon Alison, Tan Lawrence, Abbott Penny, Hu Wendy, Reath Jenny
Western Sydney University School of Medicine, Campbelltown, New South Wales, Australia.
Clin Teach. 2019 Oct;16(5):468-473. doi: 10.1111/tct.12951. Epub 2018 Oct 16.
Learning about general practice in a context of linguistic diversity is an understudied area. There may be additional learning needs or unrecognised opportunities in this environment. This study explores the experiences of general practitioners (GPs) and medical students on placement where consultations are conducted in a language other than English (LOTE).
We conducted 19 semi-structured interviews with medical students and GP supervisors who consult in LOTE. We explored experiences of learning, and teaching strategies implemented by GP supervisors. Thematic analysis was undertaken.
Participants reported that LOTE consultations provided unique learning opportunities, including use of interpreters and development of cross-cultural communication skills. Facilitators to learning included the GP engaging the student in the consultation by interpreting, and patients being open to student participation. Some students described language as a barrier to learning, where they had difficulty in following the consultation. Time required for interpreting limited interaction and learning in GP consultations. We identified ways to navigate the language barrier; including the GP acting as interpreter, and students learning key phrases in the consultation language to build rapport.
Learning in the linguistically diverse General Practice environment can be optimised through an active and collaborative approach between the GP, student, and patients. Our findings highlight specific barriers and facilitators to learning. Our participants identified a variety of techniques, including skills in interpreter use and cross-cultural communication skills which can transcend language barriers, to create valuable opportunities for medical students to learn in this setting. Medical students increasingly experience clinical placements in general practices within diverse communities.
在语言多样化背景下了解全科医疗是一个研究不足的领域。在这种环境中可能存在额外的学习需求或未被认识到的机会。本研究探讨了全科医生（GP）和医学生在以非英语语言（LOTE）进行会诊的实习中的经历。
我们对使用LOTE进行会诊的医学生和全科医生督导进行了19次半结构化访谈。我们探讨了学习经历以及全科医生督导实施的教学策略。进行了主题分析。
参与者报告称，使用LOTE进行会诊提供了独特的学习机会，包括使用口译员以及跨文化沟通技能的培养。学习的促进因素包括全科医生通过口译让学生参与会诊，以及患者对学生参与持开放态度。一些学生将语言描述为学习的障碍，他们在理解会诊过程中存在困难。口译所需的时间限制了全科医生会诊中的互动和学习。我们确定了克服语言障碍的方法；包括全科医生担任口译员，以及学生学习会诊语言中的关键短语以建立融洽关系。
通过全科医生、学生和患者之间积极协作的方法，可以优化在语言多样化的全科医疗环境中的学习。我们的研究结果突出了学习的具体障碍和促进因素。我们的参与者确定了多种技巧，包括口译使用技能和跨文化沟通技能，这些技能可以跨越语言障碍，为医学生在这种环境中学习创造宝贵机会。医学生越来越多地在不同社区的全科医疗中体验临床实习。
