<p>Since the anecdotal assumption is that GPs do not effectively diagnose and manage problem drinking amongst their patients, this study investigated the role of GPs in addressing problem drinking in Cape Town as well as the prevalence of problem drinking amongst their patients.</p>

Communication skills are essential to the practice of medicine, and are now included in most medical curricula. Training in communication skills requires an experiential approach to teaching and assessment that focuses on mastery of performance. Simulated patients were introduced to the Communication Skills course for third year medical students at The University of Melbourne in 1995. This thesis describes the evaluation from the first two years of their use, and is set within the body of literature regarding this innovative educational method. The fundamental research question was: Did the introduction of simulated patients represent an improvement and enrichment in the teaching of communication skills to third year medical students? A qualitative evaluation was undertaken by focus groups with students, tutors and simulated patients, and by student questionnaire. (For complete abstract open document)

Good medical care depends on effective communication between patient and health professional. Misunderstandings can occur in any medical setting but can be further compounded by language and cultural factors in those interactions which occur in a cross-cultural context. The medical consultation is an institutional interaction and as such can involve additional, taken-for-granted evaluative and interpretive criteria which are applied by interactants automatically, without conscious reflection. Non-native speakers who may have a good functional control of the language and have few problems at the level of propositional content may experience significant difficulties at the necessary interpretative level. / Questions act to allow the questioner a degree of interactional control and when patients ask questions they not only increase their access to information but also indicate to the doctor that they wish to play a more active role in the consultation. This thesis examines the discourse of doctor-patient interactions and in particular the ways in which questions are framed and presented by patients and, because the patients in this case are children, their parents. Fifty three medical consultations were observed from both public and private pediatric clinics with patients and their parents comprising 33 native and 20 non-native speakers of English. Data for the study comprise 28 of those consultations. The data include post-consultation interviews with patients and their parents, and interviews with the treating doctors. / The analysis indicates that there are considerable differences in the patterns of questioning behaviour of native speakers and non-native speakers, and that the questioning behaviour of patients and parents seems to be influenced by the communication style of the doctor. / These findings indicate that the questioning behaviour of non-native speaking parents in medical consultations has the potential to lead to less access to information, fewer explanations about their child's condition and a less active role overall in the medical consultation. This in turn can lead to different outcomes for those parents such as lower levels of satisfaction and, potentially, lower levels of compliance with medical advice and directives. These findings also indicate that the needs of non-native speakers in such circumstances are more successfully addressed by a doctor-centred approach. / Finally, this study argues that the observed differences in the patterns of questioning behaviour between native speakers and non-native speakers is more than simple lack of linguistic resources but rather is a result of the clash between the often subtle differences in communicative competence of non-native speakers and the specialised inferential frameworks inherent in institutional discourse.

Thesis (Ph.D.)--McMaster University, 2003. / Advisor: Elisabeth Boetzkes Gedge. Includes bibliographical references (leaves 189-198). Also available via World Wide Web.

Thesis (M.S.)--University of Nevada, Reno, 2007. / "May 2007." Includes bibliographical references (leaves 38-41). Online version available on the World Wide Web. Library also has microfilm. Ann Arbor, Mich. : ProQuest Information and Learning Company, [2007]. 1 microfilm reel ; 35 mm.

Diss. Linköping : Univ.

Thesis (Ph.D.)--University of Central Florida, 2008. / Advisers: Edward H. Robinson, III, Glenn Lambie. Includes bibliographical references (p. 134-155).

Thesis (Ph. D.)--University of Washington, 1997. / Vita. Includes bibliographical references (leaves [99]-103).

Thesis (doctoral)--Friedrich-Wilhelm-Universität Bonn.

Thesis (doctoral)--Universitas Negeri Malang, Malang, 2005. / "February 2005." Includes bibliographical references (leaves 245-253).