Page 278 - Handbooks of Applied Linguistics Communication Competence Language and Communication Problems Practical Solutions

256 Celia Roberts

9. Oral assessment and its potential for indirect discrimination

The first of these studies concerns the oral examination for membership of the
Royal College of General Practitioners and the possibility of discriminatory
outcomes for certain groups of ethnic minority candidates (Roberts and Sarangi
1999). Video recordings of the examinations were analysed using interactional
sociolinguistic methods. The study concluded that the “hybrid discourses” of
the exam were particularly problematic for non-traditional candidates es-
pecially those trained overseas. The exam consisted of three different modes of
question: institutional, professional and personal. However the exam criteria
were institutionally driven. For those candidates not used to the institutional
discourses of gate keeping oral assessments, however proficient they were as
doctors, the examination remained an unfair hurdle.
A similar concern with equal opportunities for certain groups of ethnic mi-
norities, led to research in a large London medical school on the final year
undergraduate clinical examination which consists of role-played consultations
with actor-patients (Roberts et al. 2003). Candidates who were rated highly
were compared with those that failed and three components of their perform-
ance were identified as shedding light on the contrast in their marks: communi-
cative style in which highly situated talk was contrasted with a schema driven
agenda; thematic staging in which candidates either staged their arguments to
persuade or closed off negotiating too early; and ideological assumptions about
“slippery areas” to do with beliefs and values. Ethnic minority candidates from
overseas who had performed well in medical knowledge tests tended to be
marked lower in these three areas.

10. Conclusion

Discourse analysis and interactional sociolinguistics have started to look at the
differences and misunderstandings which can occur in intercultural encounters
in healthcare. Lack of shared assumptions about role-relations, differences in
communicative style and a lack of resources on both sides to create conditions
for negotiating understanding are fed by and feed into negative ethnic and lin-
guistic ideologies. Inequalities in healthcare can result both for patients and for
professionals working in healthcare settings. Studies of intercultural communi-
cation in such settings have made a contribution to the field of applied lin-
guistics and shed new light on medical practices. Oral examinations are now
looked at through the discourse analyst’s lens. Judgements about candidates are
no longer simply read off from their talk; and the interactional construction of
the candidate by the examiner is now acknowledged (Roberts, Sarangi, South-
gate, Wakeford and Wass 2000). Similarly, issues of language and ethnicity in