Evaluating the spoken English proficiency of international medical graduates: detecting threats to the validity of standardised patient ratings.
ABSTRACT To investigate potential threats to the validity of the spoken English proficiency ratings provided by standardised patients (SPs) in high-stakes clinical skills examinations.
Spoken English ratings from 43 327 patient encounters were studied. These involved over 5000 candidates, 40% of whom were female and 33% of whom self-reported English to be their native language. Over 100 SPs were involved in the study, 51% of whom were female and 90% of whom were native English speakers. Possible performance differences in English ratings were studied as a function of candidate and SP gender, and as a function of candidate and SP native language (English versus all other languages).
No significant candidate by SP gender effect was detected. There were no meaningful differences in mean English ratings as a function of SP or candidate gender. Likewise, English ratings did not vary as a function of either candidate or SP native language. While candidate mean English ratings were not associated with the native language of the SP, native English-speaking candidates did achieve significantly higher ratings.
The lack of significant interaction between candidate and SP gender, and candidate and SP native language, suggests that the SPs provided unbiased English ratings. These results, combined with the expected higher English ratings given to candidates with English-speaking backgrounds, provides additional evidence to support the validity and fairness of spoken English proficiency ratings provided by standardised patients.
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ABSTRACT: This chapter reviews the literature on language, culture, and communication issues in IMG education and practice. An English for specific purposes (ESP)/applied linguistics research agenda on these topics is proposed in order to situate IMG issues within a cross-cultural perspective on medical discourse, education, and communication. It is proposed that the flow of international medical graduates (IMGs) into U.S. graduate medical education has characteristics similar to that of international graduate teaching assistants (ITAs) coming into U.S. universities from the 1970s, and that much can be learned from the perspectives and frameworks developed by ESP and applied linguistics in that case.11/2011; 5:3-19. DOI:10.1108/S2041-272X(2011)0000005007
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ABSTRACT: International medical graduates seeking to practice in the United States must pass the United States Medical Licensing Examination® (USMLE®) Step 2 Clinical Skills (CS), a seven-hour performance test which incorporates an assessment of an examinee's spoken English proficiency evaluated by trained lay raters who are simulating patients in a mock medical environment. This chapter focuses on issues associated with that assessment, including scale development, rater training, standard setting, and ongoing reliability and validity data. Aggregate IMG performance statistics are provided. While overall reliability for the spoken English proficiency measure in the Step 2 CS is high, future studies are needed to better understand nonnative English-speaking IMGs' performance in the medical workplace.11/2011; 5:75-90. DOI:10.1108/S2041-272X(2011)0000005010