de la Croix, Anne (2010)
Ph.D. thesis, University of Birmingham.
Simulated patients (SPs), are widely used in communication skills teaching and testing worldwide. However, little research has been undertaken regarding the linguistic structure of the simulated consultation between students and SPs. Mixed method analysis (Conversation Analysis, Discourse Analysis and statistical analysis)of 100 transcribed assessed conversations between SPs and students were analysed for linguistic markers of conversational control, namely: talking more, interrupting more, asking questions, controlling the topic development, opening and closing the conversation. Results showed that the SP rather than the student seems to have conversational control over the conversation, except in the opening of the consultation. Qualitative analysis shows that this dominance is functional, as students have little knowledge and experience. The SP directs the conversation in order to give the student opportunities to show their skills. The SP and student seem not only to follow the rules of the ‘language game of medicine’ but also the rules of the ‘language game of education’, which suggests that the language of simulated consultations should be seen as a different genre, rather than a mirror of reality. These findings raise questions about role-play in medical education, devising scenarios, communication skills assessments, and the training of SPs.
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