title: Patient safety and communication: a new assessment for doctors trained in countries where language differs from that of the host country: results of a pilot using a domain-based assessment.
abstract: OBJECTIVE
  Global migration of healthcare workers places responsibility on employers to comply with legal employment rights whilst ensuring patient safety remains the central goal. We describe the pilot of a communication assessment designed for doctors who trained and communicated with patients and colleagues in a different language from that of the host country. It is unique in assessing clinical communication without assessing knowledge.
  
  
  METHODS
  A 14-station OSCE was developed using a domain-based marking scheme, covering professional communication and English language skills (speaking, listening, reading and writing) in routine, acute and emotionally challenging contexts, with patients, carers and healthcare teams. Candidates (n=43), non-UK trained volunteers applying to the UK Foundation Programme, were provided with relevant station information prior to the exam.
  
  
  RESULTS
  The criteria for passing the test included achieving the pass score and passing 10 or more of the 14 stations. Of the 43 candidates, nine failed on the station criteria. Two failed the pass score and also the station criteria. The Cronbach's alpha coefficient was 0.866.
  
  
  CONCLUSIONS
  This pilot tested 'proof of concept' of a new domain-based communication assessment for non-UK trained doctors.
  
  
  CONCLUSIONS
  The test would enable employers and regulators to verify communication competence and safety in clinical contexts, independent of clinical knowledge, for doctors who trained in a language different from that of the host country.
authors.affiliation: Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London E1 2AD, UK.
authors.forename: Annie M
authors.initials: AM
authors.lastname: Cushing
authors.affiliation: Medical Education Institute, Dundee Medical School, University of Dundee, Dundee DD1 9SY, Scotland, UK.
authors.forename: Jean S
authors.initials: JS
authors.lastname: Ker
authors.affiliation: Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff CF14 4YS, Wales, UK.
authors.forename: Paul
authors.initials: P
authors.lastname: Kinnersley
authors.affiliation: Centre for Public Health, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, BT9 7AB Northern Ireland, UK.
authors.forename: Pascal
authors.initials: P
authors.lastname: McKeown
authors.affiliation: Cambridge University School of Clinical Medicine, Cambridge CB2 0SP UK.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Silverman
authors.affiliation: Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London E1 2AD, UK.
authors.forename: John
authors.initials: J
authors.lastname: Patterson
authors.affiliation: Barts and The London School of Medicine and Dentistry, Queen Mary, University of London, London E1 2AD, UK. Electronic address: o.westwood@qmul.ac.uk.
authors.forename: Olwyn M R
authors.initials: OM
authors.lastname: Westwood
mesh_terms: D002983:Clinical Competence; D003142:Communication; D004521:Educational Measurement / Q000379:methods*; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D010820:Physicians; D010865:Pilot Projects; D015203:Reproducibility of Results; D006113:United Kingdom; D014956:Writing
keywords: Assessment; Clinical communication; Global healthcare workforce