oa African Journal of Health Professions Education - Discourse of final-year medical students during clinical case presentations
Introduction: The need for medical students to adopt a discourse appropriate to the field is repeatedly emphasised by teaching staff during lectures and ward rounds. The acquisition of such discourse is often not assessed, resulting in inconsistency between the levels used among students of similar academic backgrounds.
Objective: The aim of this study was to determine the extent to which appropriate discourse was adopted by 9 medical students early in their final year during clinical case presentations, and to compare this usage with the students' final results.
Methods: Transcriptions of recorded case presentations by 9 students were assessed by 2 experts and a peer evaluator, using a rubric which drew on prior research in medical discourse, and included the prominent themes of terminology and thematic staging. These were then compared with their academic results.
Results: Our findings show that most students are able to use the appropriate terminology when they reach their final year of study. However, our data also support the hypothesis that students with similar academic backgrounds may display considerable variation in their level of discourse. Although it appears as if the students were all beginning to shift towards a more mature form of medical discourse, the degree to which this occurs is sporadic. The apparent absence of a relationship between discursive competencies and academic achievement may suggest that the ability of assessment to encourage the adoption of disciplinary discourse is perhaps not being optimally applied, although further research is required.
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