The article begins with this worrying example:
“It was just one word in one email, but it triggered huge financial losses for a multinational company. The message, written in English, was sent by a native speaker to a colleague for whom English was a second language. Unsure of the word, the recipient found two contradictory meanings in his dictionary. He acted on the wrong one. (See link to full article below.)
The gist of the BBC article is that non-native speakers generally use more limited vocabulary and simpler expressions, without flowery language or slang. Because of that, they understand one another at face value. “But… often you have a boardroom full of people from different countries communicating in English and all understanding each other and then suddenly the American or Brit walks into the room and nobody can understand them.”
In fairness, any person will speak more purposefully and carefully in a second language they have learned than they will in their mother tongue. It is not just Americans and Brits who speak their native language too fast for others to follow, and use jokes, slang, and references specific to their own culture.
Speaking English With Non-Native Speakers in Healthcare
The BBC article is useful in as far as it raises awareness of intentional communication. The kind of language barriers that led to a financial disaster for an international company can just as easily create a dire siutation for a medical patient. Given the number of medical cases that prove this, it’s worth remembering some of these key points about effective communication.
Acronyms, Mumbling, and Talking Too Fast
One Zurich-based businessman who was interviewed for the article spoke to the problem of acronyms favored by Americans and Brits. “The first time I worked in an international context somebody said ‘Eta 16:53’ and I thought ‘What the hell is ETA?” He also said that unusual words, speed of talking, and mumbling made things worse— especially if the phone or video connection is poor quality. People start disengaging and doing something else when there isn’t any chance of understanding. In healthcare, acronyms and medical terminology have to be explained. Overall, a heightened awareness of routine habits of speech is extremely important.
The High-Context Head Nod
The BBC article also addressed the common use of head nodding to signal approval by some non-native speakers of English, and how this can be misinterpreted as agreement or understanding by Americans and Brits. People will nod approvingly while not getting the message at all, according to one senior international marketing executive at IBM. Most doctors and nurses will recognize this communication behavior which is so common in healthcare settings. Patients from some cultures will focus on pleasing the doctor who is seen as an authority figure and will be reluctant to admit confusion or ask questions. Similarly, patients whose English is limited will often refuse interpreter services because they don’t want to feel ashamed of their language proficiency.
Complexity of Patient-Provider Communication
The potential for misunderstood social cues and other factors that complicate communication in any setting are especially complex in cross-cultural healthcare situations. In addition to language and culture differences – with culture being understood very broadly –
a patient’s understanding is further conditioned by socioeconomic, educational, and other life circumstances a doctor may only be able to guess at. Family dynamics can be especially important but very difficult to discern.
The bottom line is that providers who learn to use intentional communication skills will demonstrate that their native speaker status isn’t being taken for granted. Being cognizant of “healthcare speak” is also important.
Last but not least, only a medical professional can really assess the level of complexity a medical conversation will entail, and
offering an interpreter may not be as important as simply stating that an interpreter will be needed to assure the success of the conversation.
“BBC Article Claims Native English Speakers Are The Worst Communicators In The World” by Marcia Carteret M. ED. Copyright © 2018. All rights reserved.
