Using communication simulations with multilingual medical students in Hong Kong: Findings of a linguistic and discursive analysis

Communication training for undergraduate medical students poses unique challenges to educators particularly in relation to interaction associated with breaking bad news. Breaking bad news is one of the most common types of interactions that doctors are involved in and it is associated with high levels of clinician stress and anxiety. This article reports on the linguistic and discursive analysis of communication simulations with final year Hong Kong medical students. Hong Kong is a valuable context for the study of medical communication as English is the medium of instruction within Universities but doctors often practice in two varieties of Chinese. Findings highlight the need for the theoretical extension of pedagogical approaches to teaching communication. Over-reliance on protocols and guidelines can reduce the effectiveness of communication between doctors and services users (patients and families). Additionally, protocols and guidelines are usually developed in Western Anglophone contexts and thus do not accommodate linguistic and cultural variety.