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I attended an interesting International Medical English seminar in Norwich last Saturday which was hosted by Paul East of The Pyramid Group. Lots of different perspectives on teaching medical English in various arenas - workplace, online, universities and test prep. It was in the area of test prep that I spoke ( 'Medical English tests: How much medical? How much English?) as well as Lesley Hay of Cambridge English Language Assessment ('Promoting effective clinician-patient spoken communication through English language teaching and assessment: the case of Occupational English Test').
An interesting point came out of Lesley's talk which was the challenge of getting non-verbal communication skills across in an audio-only test. The OET role plays are performed face-to-face with an interlocutor playing the part of a patient or caregiver. Audio recordings are made of the role plays. The recordings are then sent to a central marking place where they are assessed. So, the interlocutor is not the assessor. But, the interlocutor is the witness of any non-verbal language used by the candidate. This is an important factor as your interlocutor will still respond to your body language even if it is not recorded visually.
Does this really matter? Well, yes it does. We know that we rely on non-verbal communication for most of the message of what the speaker delivers. We have all watched good and bad examples of the delivery of the same dialogue. That is, the words are the same but the surrounding non-verbal communication is different. The words 'I'm not angry with you' can have a range of meanings from 'Yes, I am really angry with you' to 'No, I'm not angry with you (because I understand the circumstances)'.
The optimum OET test would have a video made of candidates' performance so that all forms of communication could be assessed (as in the 'real world'). Unfortunately, this is not possible because of the resulting increase in cost and the need for more technology and operators of the technology. At present, the audio recording is what candidates have to deal with.
How then to convey non-verbal communication in an 'audio test'? Is it possible?
I believe it is. Think for a minute about people who are visually impaired. They also use non-verbal communication and, more importantly, are able to pick up on non-verbal communication. They listen to the tone and pitch of a person's voice - as in the previous example of 'I'm not angry with you.' They are aware of the direction of a voice. Imagine that I am talking to you but suddenly look around to check the clock on the wall behind me. If I am talking as I am talking, my voice will sound different as I turn around.
Non-verbal communication such as nodding your head or shaking your head will not be recorded on the audio so you'll need to use some verbal communication as well. Nod your head and say things like 'Mm', 'I see' or 'No,I don't think so'. Don't ignore the non-verbal communication, just add to it. You'll use this a lot when you are using empathetic responses. What you are trying to convey is 'I understand that this is difficult'.
Finally, smiling is a powerful tool to use when you are building a rapport with your interlocutor. Everyone responds to a smile and can 'hear' it in your voice. Try saying 'I don't think so' without smiling and then while smiling. What happens? When you smile, the tone of your voice changes and sounds more positive.
co-author of 'Cambridge English for Nursing' Pre-Intermediate and Intermediate+
- Medical English: Spelling