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RESOURCES                .                                                                                                                                                                                REVIEWS & RESOURCES


        Empathy, not sympathy                                                                                                  experienced the anxiety of taking their own   Legitimise the emotion                      Tell me what’s upsetting you the most.
                                                                                                                               child to hospital might say, “I can understand
                                                                                                                               your anxiety. I recently had to take my child to
                                                                                                                               A&E with a broken arm. Please let me reassure   Explore the emotion                           Let’s see how we can work through this together.
                                                                                                                               you that you did the right thing bringing   Empathise                                            Most people find this challenging. It’s understandable.
        Ros Wright helps trainers preparing candidates for OET Speaking                                                        Benjamin in to see us today.”  Even if your   Offer support                                      I can appreciate this is a difficult time for you.
                                                                                                                               candidate is not a parent, this is still a
                                                                                                                               technique they could use on test day. In the
             often start OET Speaking sessions with a   Empathy - what it is and                                               case of indirect empathy, the above example,   contact generally indicates the healthcare   pausing is a simple but invaluable technique
           quote from the 20  century Canadian   what it’s not                                                                 “I can appreciate how angry this must make you   professional is giving the patient their full   that helps denote empathy, affording patients
                        th
           physician William Osler: “The good   For Goleman (2011), empathy is, ‘the                                           feel,” shows the patient you are with them,   attention, and therefore according them the   ‘space’ to collect their thoughts and
        Iphysician treats the disease; the great   capacity to understand the other’s                             JOHN HAIN / PIXABAY  even if you haven’t experienced the exact   respect they deserve; a first step in   assimilate potentially difficult information.
        physician treats the patient who has the   predicament and to feel with them but also                                  same situation personally.          demonstrating empathy.
        disease.”                           to spontaneously want to take action to help                                                                             Further to this, positive facial expressions   Conclusion
          Never is this quotation more pertinent   them’. While sympathy is an appropriate and                                 Empathy - an ongoing process        help convey warmth and compassion, while   The question of whether valuable time is
        than when stressing the need for a patient-  acceptable acknowledgement of suffering, it                               Demonstrating empathy requires more than   an open posture avoids creating a physical   wasted in engaging in empathy has long been
        centred approach in healthcare. At the heart   doesn’t go quite far enough.                                            just a single statement of expression. It is an   barrier with the patient. She cites doctors on   cause for debate. Indeed, this may well be the
        of a patient centred approach – one that   Candidates are usually unaware of the                                       ongoing process of recognising cues and   ward rounds who sit rather than stand. They   concern of some candidates, especially given
        considers the patient as a whole rather than a   difference between sympathy and empathy                               interpreting meaning, exploring the patient’s   are often considered more caring than their   the time constraints of the OET role play
        set of symptoms – is empathy; a skill not easy   and how they are expressed in English. When                           emotion, as well as legitimising feelings and   colleagues, even if they use exactly the same   (approximately 5 minutes). In response,
        to achieve, but one that is key to success in   someone dies, we often hear people say, “I’m                           concerns and providing support.     words.                              however, Anfossi and Numico (2004) point
        OET Speaking. The subject of empathy is   sorry for your loss.” or “I was really sorry to                                Legitimising the patient’s concerns, e.g.   Finally, Dr Reiss encourages healthcare   out that expressing empathy should not take
        vast, but I hope to provide some insight for   hear about your father”. Candidates reproduce                           “Most people find this challenging. It’s   professionals to ‘hear the whole person,’ not   time out from clinical work, rather it should
        those new to OET as well as a few pointers to   these, not realising that, unless substantiated,                       understandable,” validates and normalises   simply the words they use. Is there a crack in   be, ‘embodied in the physician's overall
        help develop this all-important skill with your   they tend to denote sympathy rather than                             their emotion. Exploring the emotion with an   the voice denoting sadness or a look away to   attitude…’ I recently came across the
        candidates.                         empathy.                                                                           open question, “Tell me what’s upsetting you   suggest embarrassment? Both require further   embodiment of empathy in the form of Mark,
                                              In a healthcare context, sympathy is a                                           the most,” helps the candidate better   exploration and, of course, empathy.    a consultant appearing in 24 hours in A&E,
        Introducing OET Speaking            problem. It can create distance and pity, and                                      understand the patient’s perspective. And in   Although in OET Speaking, role-plays are   (Channel 4), seen here (below left),
        The Occupational English Test (OET)   even go so far as to impair the professional’s                                   offering support, the practitioner reinforces   audio recorded, the development of non-  communicating with 95-year-old Sylvia.
        assesses language proficiency in 12 different   ability to care for a patient effectively. A                           the desire to work together as a team. This is   verbal skills should not be ignored. Similar to
        healthcare professions, from doctors and   patient who is pitied feels inferior and                                    further reiterated with use of, ‘we’ e.g. “I can   the customer service employee trained to   REFERENCES
        nurses to podiatrists, speech therapists and   disempowered. Empathy, on the other hand,   OET, like healthcare itself, requires an   appreciate this is a difficult time. Let’s see how   smile on the phone, OET candidates will find    Anfossi, M. and G. Numico (2004)
        vets. OET Speaking consists of two short   tries to see the situation from the patient’s   understanding of the differences   we can work through this together.”    their non-verbal communication skills help   ‘Empathy in the doctor-patient relationship’,
        role-plays, e.g. advising on lifestyle changes,   point of view. By empathising, the   between empathy and sympathy      To develop their usage, asking candidates   reinforce the empathetic process.    Journal of Clinical Oncology
        during which candidates are assessed on both   practitioner is trying to understand their                              to match phrases to the appropriate headings,                           Golman, D., (2011) The Power of Emotional
        their linguistic (including grammatical   mindset and emotions without being   Silverman (2013) suggests demonstrating   generally works well (see table, top right).   Empathy – delivering the right   Intelligence
        expression, lexis and pronunciation) and   judgemental. Empathy is about building a   empathy is a two-stage process: healthcare   This can be followed by an activity   message               Marsden, AJ., (2014) Empathetic Consultation
        their clinical communication skills. Clinical   relationship and connecting with the patient.   professionals need first to understand and   whereby candidates notice the language in   Ensuring any well-chosen expressions convey   Skills in Undergraduate Medical Education: A
        communication skills essentially refer to what                          appreciate their patient’s situation or how    context, preferably in an authentic dialogue   the message intended, focus must be given to   Qualitative Approach PhD thesis, University of
        many in ELT know as ‘soft skills’ and indicate                          they are feeling, and then, most importantly,   between practitioner and patient.    the development of appropriate intonation   East Anglia Norwich Medical School
        a patient-centred approach to care. Five      Candidates are            ‘communicate that understanding back to                                            and tone of voice. In this instance,   Shaw JR, Adams CL, Bonnett BN. What can
        clinical communication skills are assessed,   usually unaware of the    the patient in a supportive way.’              Empathy and non-verbal              candidates will do well to notice native   veterinarians learn from studies of physician-
        amongst those, relationship building with                                 To do this, candidates should be             communication                       speaker usage. YouTube provides a plethora   patient communication about
        empathy as an essential component.       difference between             encouraged to read patient cues (verbal or     Empathy is not simply about employing the   of examples, while listening test samples on   veterinarian-client-patient communication?
                                                                                non-verbal) and name the patient’s emotion,    right expression at the right time. In her   the OET website could also be utilised for the   JAVMA 2004; 224(5): 676-684
        Demonstrating empathy - how                 sympathy and                whether it be anger, frustration or distress,   TEDx Talk, The Power of Empathy, Dr   same purpose.                    Silverman, J., (2013) Skills for Communicating
        easy is it?                               empathy and how               e.g. “I can see this is rather distressing for you.”   Helen Reiss highlights the importance of      Encourage candidates to record their voice   with Patients, 3rd ed., Taylor & Francis
        In the field of veterinary surgery, failure to                          “I can appreciate how angry this must make you   non-verbal communication in empathy. Eye   and replicate the patterns they hear. Finally,   Wright, R., (2020). OET Speaking & Writing
        demonstrate empathy is one of the most   they are expressed             feel.” In doing so, not only does the candidate                                                                        Skills Builder, Express Publishing
        common causes of official complaints from   in English.                 reinforce their expression of empathy; he or
        pet owners (Shaw et al, 2004). Indeed,                                  she also demonstrates to the examiner an                                                                                The official Occupational English Test
        studies of healthcare professionals in general   A useful starting point when preparing   understanding of the situation and its impact                                                         site provides detailed information
        have found that opportunities to demonstrate   candidates is to gauge their understanding of   from the patient’s perspective.                                                                  about OET Speaking, including
        empathy are regularly missed. Even when   the differences between sympathy and   There are different kinds of empathy,                                                                          sample tests and the marking criteria.
        they are acted upon, practitioners tend to   empathy. Ask candidates to analyse common   notably direct and indirect empathy. If                                                              24HRS IN A&E, CHANNEL 4 (MARCH 2020)  https://www.occupationalenglishtest.
        focus on the situation, “How did she die?”,   responses to patient emotion and discuss   empathy is about making a connection, what                                                             org/test-information/speaking/
        rather than the impact on the patient, e.g.   their level of effectiveness. How empathetic   better way than sharing your own experience
        “How is it affecting you?” (Hsu, 2012); the   are these responses (below)?    with the patient? The candidate who has
        latter indicating a level of empathy.
          Not unsurprisingly, allied healthcare                                                                                                                                                                          Ros Wright has
        professionals are considered the best at                                                                                                                                                                         written several titles
        expressing empathy, while women (veterinary                                                                                                                                                                      in medical English.
        surgeons included) are generally more adept                                                               WRIGHT, OET SPEAKING &                                                                                 Her most recent is
        than their male counterparts. When it comes                                                                WRITING SKILLS BUILDER (2020)                                                                         OET Speaking &
        to skills development, Marsden (2014) found                                                                                                                                                                      Writing Skills
        that explicit rather implicit training was                                                                                                                                                                       Builder (Express
        preferred by medical students, with focus on                                                                                                                                                                     Publishing, 2020)
        the benefits of empathy; an approach worth                                                                                                                                                                       which prepares
        considering when preparing OET candidates.                                                                                                                                                      candidates for the Occupational English Test.


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