The discourse of final year medical students during clinical case presentations

Botha, Hugo ; Van Schalkwyk, Gerrit Ian ; Bezuidenhout, Juanita ; Van Schalkwyk, Susan C. (2011)

CITATION: Botha, H., et al. 2011. The discourse of final year medical students during clinical case presentations. African Journal of Health Professions Education, 3(1):3-6.

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Context and setting: The need for medical students to adopt a discourse appropriate to the field is repeatedly emphasized by teaching staff during lectures and ward rounds. The acquisition of such discourse is often not assessed, resulting in inconsistency between the levels used amongst students of similar academic backgrounds. Why the idea was necessary: Exploring this phenomenon has great potential to influence future teaching and assessment practice, and remains a comparatively uncharted area within medical education. What was done: Transcriptions of recorded case presentations by nine students were assessed by two experts and a peer evaluator, using a rubric which drew on prior research in medical discourse, and included the prominent themes of terminology and thematic staging. These were then compared with their academic results. Results and impact: Our findings show that most students are able to use the appropriate terminology by the time they reach their final year of study. However, our data also supports the hypothesis that students with similar academic backgrounds may display considerable variation in their level of discourse. Although it appears as if the students were all beginning to shift towards a more mature form of medical discourse, the degree to which this occurs is sporadic. The apparent absence of a relationship between discursive competencies and academic achievement may suggests that the ability of assessment to encourage the adoption of disciplinary discourse is perhaps not being optimally applied, although further research is required.

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