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Table 4 Verbatim statements for the theme “Cultural and language issues”

From: Supporting culturally and linguistically diverse students during clinical placement: strategies from both sides of the table

Sub-theme

CALD Student challenges

Supervisor challenges

Supportive strategies

Using English as a primary communication tool

…[when] the patient got different pronunciation. You know… it’s difficult for me to understand them sometime. So… if I can’t understand the patient… I can’t keep going [with] my assessment or… treatment. We don’t lack the knowledge, but… our language is a barrier. (Student group 2)

Because if they were better at that (writing) and better at being able to express themselves in writing I think they might find they do a bit better overall [on placement]. (Supervisor group 1)

Practical placement communication tips:

Giving them a few key sentences that they can use and that they know are respectful and not too abrasive …(Supervisor group 1)

The other thing is I’ll get a student to repeat what I have just told them, “Can you tell me”… So that I check the understanding. Because often they’ll smile and they’ll nod and they’ll say “Yes, yes”, “Do you understand that?” “Yes, yes”. “Can you explain to me what I’ve just explained to you if you had to go and explain that to a patient?” And that’s when they come unstuck because they often then haven’t really understood it. (Supervisor group 2)

They are, possibly because of the language…possibly, they are a little less willing to…and it may be a cultural thing too—they may be less willing to ask questions, and less likely to admit that they don’t know something. (Supervisor group 1)

Building language skills for everyday communication:

..in the third year…I…will go and find… a voluntary organization to work there… so that I start interacting… because the earlier you start… talking to them [patients] then… it becomes natural… after a while. (Student group 3)

there could be some sort of structuring in the uni system to have, and maybe interesting for them too on a cultural level, maybe Australian culture evening or something once a month where they get together and talk about the footy or, you know, Australian, Australian slang, and make it sort of almost entertaining but useful. Useful stuff for them and try to engage Aussie kids to come as well so in the breaks they could have a bit of…bit of chatting, rapport building type conversation skills. (Supervisor group 1)

Insight needed into the Australian healthcare system and society generally

[It]… is good to know the basic structure [of the Australian health care system] but also… where you refer patients to after their discharge… they call it the ‘continuum of care’…(Student group 2)

Students who came from societies where it was a very patriarchal type of, you know, “I’m the expert and I tell you what to do and you do it”, and it just doesn’t work like that here. And they didn’t understand why we didn’t use that model, they just didn’t get it and even though we would tell them “You need to negotiate” and you need to motivate your patient and so on, they didn’t understand. I’m the person telling them what to do and they do it. It’s just such a different model. (Supervisor group 3)

Healthcare system awareness and how it interacts with public and healthcare professions:

… it would have been helpful to have something about the Australian health care system… but we didn’t get that until… well into… the second semester of… final year… would have been helpful to at least know that… way earlier. (Student group 2)

… watching Australian [hospital] drama… like, ‘All Saints’. (Student group 3) [referring to providing an opportunity to understand slang in context of health care and people’s lives]

Social nature of interpersonal relationships required on placement

 

And I suppose that probably really comes up in you know even that initial establishing a rapport with a patient and that initial ‘how you going, what have you been watching on TV’…you know we might talk about what’s on … or footy or whatever, but obviously that would be much more difficult and is much more difficult for those CALD students and you know, that is something we assess the students on is being able to put the patient at ease…(Supervisor group 1)

Peer mentoring:

I think it would be good to have…, a mentoring system… [using] students above… especially if they are… international student… mentors… or… a small group… it doesn’t necessarily have to be one to one. You get can some… local students who are willing to mentor… then there can be some cross cultural learning as well. (Student group 2)

  

They’ve had a very poor reception by staff and sometimes the facilitator there, like outright discrimination, doors being slammed in their face and told they’re not welcome if you’re not Aussie, which I just find is totally disgusting, disgraceful beyond comprehension. So they’re quite pleased some of them I think when they come to us and they realise that we’re not like that. (Supervisor group 2)

 

Pressures of self-care in a culturally foreign setting

 

I was just going to say there’s also that extra element with a lot of CALD students in the lack of support they have at home as well, they’ve been away from their families for four years […] (Supervisor group 3)

 

[…] and they might have to catch a bus, a tram and two trains to get to placement in the morning. That is really stressful for them, and I think sometimes, yeah, like where they’ve been placed isn’t fantastic for them either. So I think that’s a big constraint as well, we’ve got students who are running late in the morning and they’re all flustered and it takes them half the morning to calm down and get into the frame of mind to get into placement. Yeah, I’ve found that to be a problem. (Supervisor group 3)