Even with Yolŋu who are fluent in conversational English serious miscommunication
can occur - and go unnoticed - as the following examples again illustrate.
In this education session in which the (very experienced) nurse is informing a long term renal patient (relatively fluent in English) about her blood test results a shared understanding is not achieved about key concepts related to either the test results or management (medication and diet).
The nurse's goal was to inform Galikali about her blood test results and she therefore did most of the talking.
There was little opportunity for Galikali to actively participate in the interaction and few attempts to check her understanding so Galikali's misunderstanding of key biomedical concepts remained unrecognised.
Galikali's fluency in English 'masked' the extent of misunderstanding - both she and the nurse assumed they were communicating effectively. However..
Through the process of video analysis and interviews with Galikali, we found that she did not share the nurse's understanding of any of the key terms related to test results, she was unable to name most of her medications, and she had a very different understanding of their actions.
In this video example, the nurse begins her feedback about Galikali's test results by talking about haemoglobin: click here to watch the video.
During a later interview Galikali talked about her understanding of haemoglobin:
you Balanda know all about this... red cells are dangerous, they hit...the white cells - they are the protecting ones - they prevent trouble; the red cells they won't be able to go and kill the white ones, maybe or what do they do? Do they eat the blood - the red cells?
Click here for more examples of serious miscommunication related to medication between staff and clients who are relatively fluent speakers of English.
Click here for an illustration of why using family members as interpreters - even though they may speak 'good English' - is not good practice.