"In every whisper of the wind, there is a story waiting to be heard"
And that is how we embarked on the tale about Azira Sarfaraz, a dedicated PhD candidate who has always been intrigued with matters related to human communication.
Inspired by the firsthand stories of friends grappling with the challenges of housemanship, Azira became interested in exploring communication during the journey of house officer training.
As a result, an interdisciplinary study was conceived involving the fields of linguistics and medicine.
The project 'How do House Officers Learn to Become Doctors? A Study of Interprofessional Discourse during House Officer Training' is led by Dr. Sharifah Ayeshah Binti Syed Mohd Noori, a Senior Lecturer at the English Language Department, Faculty of Languages and Linguistics (FLL) of Universiti Malaya along with Dr. Ang Pei Soo, Senior Lecturer of FLL and Azira Sarfaraz, a PhD candidate and Research Assistant of this project.
This study aims to examine communication between house officers and senior doctors during house officer training. As this research is an interdisciplinary project, clinicians are also an integral part of this study. Associate Professor Dr. Julia Patrick Engkasan, Associate Professor Dr. Azanna Binti Ahmad Kamar and Dr. Muhammad Fawaz-Qisti bin Mohd Takwir from the Faculty of Medicine Universiti Malaya are the co-researchers of this study and are equally significant in navigating this study that is situated across the fields of linguistics and medicine.
What is the reason behind this study of interactions during housemanship training?
Some pressing concerns have been raised within this challenging working environment, for example, that house officers undergo psychological distress and some may experience bullying.
Another concern is, that a higher number of house officers are required to extend their training period due to poor performance.
These issues can ultimately impact the health services received by Malaysians. However, there is no denying the significance of house officer training towards equipping medical graduates with the skills they need to practice medicine and contribute to Malaysia’s health system.
Significantly, it provides a structured and supervised learning environment where young doctors can gain practical experience, hone their clinical skills and apply their theoretical knowledge in real-world patient care situations. Additionally, this training period serves as a critical phase in the ongoing learning journey of medical graduates, setting the foundation for lifelong learning and specialization in various medical fields.
Through their postings in different departments, young doctors explore different specialities and discover their areas of interest and expertise. Remarkably, a significant gap exists in local research in terms of understanding the communication dynamics between house officers and senior doctors. Thus, it becomes essential to unravel and address these complexities to enhance medical training and ultimately improve healthcare delivery.
How are house officers socialised into the medical profession? This is the ultimate question this study aims to answer, hence, by examining interprofessional discourse between house officers and senior doctors at UMMC, a discourse-based model of house officer socialisation will be developed.
Discourse refers to the extended, connected, and meaningful communication that occurs within a specific context or situation. It encompasses not just individual sentences or utterances but also the way language is used to convey information, express ideas, and interact with others over an extended period. Discourse analysis in linguistics involves the systematic examination of spoken or written language to understand how language functions in different social, cultural, and communicative contexts. This study revolves around the interactions between house officers and senior doctors during medical housemanship training in Malaysia.
This study will employ the insightful lens of Discourse Analysis to delve into the intricate dynamics of house officer training, navigating three distinct levels of exploration. At "the big picture" level, it will provide a panoramic view of the training landscape, dissecting the overarching discourse shaping this professional journey.
This will be done by analysing digital journal entries maintained by house officers, offering a unique glimpse into personal experiences and reflections. Moving to "situated practices," it will zoom in on the intricacies of real-time interprofessional interactions during formal teaching sessions, unveiling the microcosms of training realities.
To do this, the researchers will immerse themselves in real-life case presentations and ward walks, gaining first-hand insights into practical training aspects and interprofessional dynamics. Finally, it will delve into "individual meaning-making," delving into the personal experiences and narratives of house officers and senior doctors throughout a clinical posting. They will conduct in-depth interviews with both house officers and senior doctors, capturing diverse perspectives on the training process. This multifaceted approach will harness data from in-situ interactions, personal experiences, and a comprehensive analysis of discourse types over two years of housemanship to unveil patterns and connections within this multifaceted world, ultimately crafting a robust Discourse-Based Model of House Officer Socialization that could provide fresh insights to inform the training of new doctors.
With a keen eye on the broader goal of ensuring the health and well-being of Malaysians, this research aspires to make significant contributions.
By adopting a discourse-based perspective, it seeks to unravel the intricate dynamics of house officer training, shedding light on how house officers and senior doctors interact within the medical training context.
In doing so, it bridges existing knowledge gaps, offering insights into the transformative journey of medical graduates as they evolve into doctors, a critical understanding often left unexplored.
Moreover, this endeavour has the potential to identify and address issues that can provide essential support to both junior and senior doctors, ultimately fostering a culture of continuous improvement in healthcare services. In essence, this research endeavours to establish a direct link between enhanced house officer training and the cultivation of better doctors, consequently leading to improved healthcare services for the benefit of all Malaysians. It is also believed that this research will be helpful for educators and policymakers.
"Every human activity, whether small or large, involves interaction between people at some level and the power lies behind how we talk to each other. For example, healthcare delivery relies on interactions between health professionals and patients and among themselves. In the same way, the training of new doctors is largely conducted over interactions between house officers and senior doctors,"
Picking the words of Dr. Sharifah Ayeshah, the project lead, this study helps illuminate the profound impact of effective communication and interaction in the medical field, where even the smallest actions and words can shape the quality of healthcare and the well-being of patients.
Due to the significant value carried out by this research, it is noteworthy that this project is supported by the Ministry of Higher Education Malaysia via the Fundamental Research Grant Scheme (FRGS).
It was suggested to future researchers to execute impactful studies which will benefit our community. In the wise words of Confucius, "It does not matter how slowly you go as long as you do not stop."
This research, like the steady progress of dedicated individuals, may take time, but its unwavering commitment to understanding the power of communication in healthcare will undoubtedly lead to a brighter and healthier tomorrow for all. It carries the torch of progress and the promise of positive change, reminding us that every small step towards effective interaction contributes to a better future.
Picture taken during interview with Dr Sharifah Ayeshah Binti Syed Mohd Noori, the lead researcher of this study and also a Senior Lecturer at the English Language Department, Faculty of Languages and Linguistics (FLL) of Universiti Malaya and Azira Sarfaraz, a PhD researcher of this study. Both of them enthusiastically provided detailed information about the background and other important aspects of this study.
Ms. Puungkodi Paramasivam
Ms. Puungkodi Paramasivam is a PhD Candidate in Linguistics. Her passion towards writing in her own words, "I translated the nation’s first Tamil longest and coloured hiking travelogue penned by the hiker. That experience encouraged me to indulge in writing which eventually introduced me to this article contribution. Definitely a golden opportunity!"
Dr. Sharifah Ayeshah Binti Syed Mohd Noori is a Senior Lecturer at the English Language Department, Faculty of Languages and Linguistics, Universiti Malaya.
Dr. Kumuthini Chandrasekaram, Research Officer, for BPP, Universiti Malaya.