Exploring Factors Influencing Patients' Embarrassment and Feelings of Imposition in Objective Structured Clinical...

Area of Science:

• Medical Education
• Communication Studies
• Psychology

Background:

• Politeness Theory (PT) categorizes social interactions into positive face-threatening acts (FTAs) causing embarrassment and negative FTAs causing imposition.
• Objective Structured Clinical Examinations (OSCEs) present unique communication challenges for trainees in sensitive patient scenarios.

Purpose of the Study:

• To identify factors influencing patient responses in sensitive OSCE situations.
• To evaluate pharmacy trainees' ability to mitigate face-threatening acts (FTAs) using politeness theory (PT).

Main Methods:

• Analysis of 19 OSCE video recordings of 10 pharmacy trainees and mock patients.
• Coding and quantification of speech acts, FTAs, and mitigation strategies.
• Classification of patient responses (preferred vs. dispreferred) using conversation analysis and statistical testing (chi-square).

Main Results:

• A total of 848 FTAs were analyzed.
• Trainees failed to meet patient face needs in 32.4% of positive FTAs and 11.5% of negative FTAs.
• Patients disclosing sensitive lifestyle information elicited dispreferred responses, with trainees less likely to offer reassurance.

Conclusions:

• Educational programs should integrate patient face needs and advanced conversational strategies for sensitive situations.
• Improved training can equip trainees with skills to effectively manage patient rapport and mitigate FTAs.
• Addressing politeness theory (PT) in OSCEs is vital for enhancing clinical communication.