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Exploring the influence of cultural orientations on assessment of communication behaviours during patient-practitioner interactions

机译：探索文化取向对医患互动过程中交流行为评估的影响

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Background Research has shown that patients’ and practitioners’ cultural orientations affect communication behaviors and interpretations in cross-cultural patient-practitioner interactions. Little is known about the effect of cultural orientations on assessment of communication behaviors in cross-cultural educational settings. The purpose of this study is to explore cultural orientation as a potential source of assessor idiosyncrasy or between-assessor variability in assessment of communication skills. More specifically, we explored if and how (expert) assessors’ valuing of communication behaviours aligned with their cultural orientations (power-distance, masculinity-femininity, uncertainty avoidance, and individualism-collectivism). Methods Twenty-five pharmacist-assessors watched 3 videotaped scenarios (patient-pharmacist interactions) and ranked each on a 5-point global rating scale. Videotaped scenarios demonstrated combinations of well-portrayed and borderline examples of instrumental and affective communication behaviours. We used stimulated recall and verbal protocol analysis to investigate assessors’ interpretations and evaluations of communication behaviours. Uttered assessments of communication behaviours were coded as instrumental (task-oriented) or affective (socioemotional) and either positive or negative. Cultural orientations were measured using the Individual Cultural Values Scale. Correlations between cultural orientations and global scores, and frequencies of positive, negative, and total utterances of instrumental and affective behaviours were determined. Results Correlations were found to be scenario specific. In videos with poor or good performance, no differences were found across cultural orientations. When borderline performance was demonstrated, high power-distance and masculinity were significantly associated with higher global ratings ( r =?.445, and .537 respectively, p Conclusions Our findings thus confirm cultural orientation as a source of assessor idiosyncrasy and meaningful variations in interpretation of communication behaviours. Interestingly, expert assessors generally agreed on scenarios of good or poor performances but borderline performance was influenced by cultural orientation. Contrary to current practices of assessor and assessment instrument standardization, findings support the use of multiple assessors for patient-practitioner interactions and development of qualitative assessment tools to capture these varying, yet valid, interpretations of performance.
机译：背景研究表明，患者和从业者的文化取向会影响跨文化的患者-从业者互动中的交流行为和解释。关于文化取向对跨文化教育环境中交流行为评估的影响知之甚少。这项研究的目的是探索文化取向，作为评估交流能力的评估者特质或评估者之间变异的潜在来源。更具体地说，我们探讨了（专家）评估者对交流行为的评估是否以及如何与他们的文化取向（权力距离，男性气质-女性气质，避免不确定性和个人主义-集体主义）保持一致。方法25名药剂师评估员观看了3个录像场景（患者与药剂师的互动），并在5分全球评分量表上对其进行了排名。录像场景演示了工具性和情感性交流行为的良好描绘和边缘例子的结合。我们使用刺激的回忆和口头协议分析来调查评估者对沟通行为的解释和评估。对沟通行为的全面评估被编码为工具性（面向任务）或情感性（社会情感），且肯定或否定。使用个人文化价值观量表来衡量文化取向。确定了文化取向和整体得分之间的相关性，以及工具性和情感性行为的正面，负面和总话语频率。结果发现相关性是特定于场景的。在效果不佳的视频中，各个文化取向都没有差异。当证明具有临界性能时，高功率距离和阳刚之气与较高的总体评价显着相关（r分别为？445和.537，p结论）因此，我们的发现证实了文化取向是评估者特质的来源和解释中有意义的变化有趣的是，专家评估人员普遍同意表现良好或较差的情况，但临界性能受文化取向的影响;与评估者和评估工具标准化的现行做法相反，研究结果支持使用多个评估者进行医患互动。定性评估工具的开发，以捕获对性能的这些变化但有效的解释。

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