Medical communication in L1 and L2 contexts: Comparative modification analysis

Abstract

Good communicative skills are key to medical professionals; they may even be life saving. Because of a lack of research on migrant doctors (rather than migrant patients) and on pragmatic aspects of doctors' communication with patients (rather than on strictly linguistic aspects), the present study investigated the pragmatic competence of doctors using an L2 in their clinical setting. By means of discourse completion tasks, L1 and L2 doctors in Belgium and Sweden were studied in terms of how they modify their interactions with patients. Discrepancies were found between the different groups of doctors. The Belgian L1 doctors used more internal modification than their L2 colleagues (syntactic and lexical modification of their main message). The Belgian L2 doctors' underrepresentation of syntactic and lexical modification is counterbalanced by a native-like pattern for external modification, whereby these doctors seem to pay particular attention to consolidation. The Swedish L1 doctors used more external modification (adding an utterance after their main message) than their L2 colleagues, but the Swedish L2 doctors used more internal, syntactic modification which can be understood as an expression of an overcompensation strategy to ensure adequate mitigation and consolidation. Pragmatically, one type of Swedish L2 underrepresentation, i.e., external modification, is counterbalanced by another type of modification, i.e., internal modification.