Perspectives of junior doctor intercultural clinical communication: Lessons for medical education

Abstract

Introduction: Increasingly, junior doctors are culturally diverse due to globalisation of the tertiary education system and health workforce shortages. These graduates deliver healthcare where a proportion of the population may not have the English language skills to communicate effectively. The aim of this study was to examine perspectives of junior doctor–patient communication in a culturally diverse setting.  Methods: We adopted a qualitative design with focus group discussions with junior doctors and semi-structured interviews with senior hospital staff at one regional hospital in Australia. We asked participants to discuss challenges and enabling strategies. There were five focus groups with 20 junior doctors and interviews with 10 senior doctors and 4 senior professional staff. Data were analysed thematically.  Results: The two major themes to emerge in the discussion with the junior doctors were their own and the patient’s language as a barrier, and cultural influences on healthcare communication. The subthemes for language as a barrier were fluency, impact and mediated communication. The subthemes for cultural influences were uncertainty and cultural comfort. The results of the semi-structured interviews with senior clinical and hospital staff identified similar themes, yet the focus was on the junior doctors’ language ability, their ability to understand and engage with the needs of “country” people and their ability to explain complexity.  Discussion: The findings suggest that intercultural communication is multi-faceted and intrinsically challenging, confirming the need for intercultural communication in medical curricula, particularly teaching that makes reference to culturally and linguistically diverse patients as well as cultural diversity in the medical workforce.