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Beyond Knowledge, Toward Linguistic Competency: An Experiential Curriculum

  • Innovations in Education
  • Published:
Journal of General Internal Medicine Aims and scope Submit manuscript

Abstract

Introduction/Aims

Training is essential for future health care providers to effectively communicate with limited English proficient (LEP) patients during interpreted encounters. Our aim is to describe an innovative skill-based medical school linguistic competency curriculum and its impact on knowledge and skills.

Setting

At Stanford University School of Medicine, we incorporated a linguistic competency curriculum into a 2-year Practice of Medicine preclinical doctoring course and pediatrics clerkship over three cohorts.

Program Description

First year students participated in extensive interpreter-related training including: a knowledge-based online module, interactive role-play exercises, and didactic skill-building sessions. Students in the pediatrics clerkship participated in interpreted training exercises with facilitated feedback.

Program Evaluation

Knowledge and skills were evaluated in the first and fourth years. First year students’ knowledge scores increased (pre-test = 0.62, post-test = 0.89, P < 0.001), and they demonstrated good skill attainment during an end-year performance assessment. One cohort of students participated in the entire curriculum and maintained performance into the fourth year.

Discussion

Our curriculum increased knowledge and led to skill attainment, each of which showed good durability for a cohort of students evaluated 3 years later. With a growing LEP population, these skills are essential to foster in future health care providers to effectively communicate with LEP patients and reduce health disparities.

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References

  1. U.S. Census Bureau. Language Use and English-Speaking Ability: 2000. Census 2000 Brief. Available at: (http://www.census.gov/prod/2003pubs/c2kbr-29.pdf) Accessed January 21, 2010.

  2. Title VI of the Civil Rights Act of 1964. 42 U.S.C. 2000d ed; 1964.

  3. Institute of Medicine. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. Washington: National Academies Press; 2001.

    Google Scholar 

  4. Wilson E, Chen AH, Grumbach K, Wang F, Fernandez A. Effects of limited English proficiency and physician language on health care comprehension. J Gen Intern Med. 2005;20(9):800–6.

    Article  PubMed  Google Scholar 

  5. Ngo-Metzger Q, Sorkin DH, Phillips RS, et al. Providing high-quality care for limited English proficient patients: the importance of language concordance and interpreter use. J Gen Intern Med. 2007;22(Suppl 2):324–30.

    Article  PubMed  Google Scholar 

  6. Morales LS, Cunningham WE, Brown JA, Liu H, Hays RD. Are Latinos less satisfied with communication by health care providers? J Gen Intern Med. 1999;14(7):409–17.

    Article  CAS  PubMed  Google Scholar 

  7. Hornberger J, Itakura H, Wilson SR. Bridging language and cultural barriers between physicians and patients. Public Health Rep. 1997;112(5):410–7.

    CAS  PubMed  Google Scholar 

  8. Baker DW, Hayes R, Fortier JP. Interpreter use and satisfaction with interpersonal aspects of care for Spanish-speaking patients. Med Care. 1998;36(10):1461–70.

    Article  CAS  PubMed  Google Scholar 

  9. Karliner LS, Perez-Stable EJ, Gildengorin G. language divide. The importance of training in the use of interpreters for outpatient practice. J Gen Intern Med. 2004;19(2):175–83.

    Article  PubMed  Google Scholar 

  10. Liason Committee on Medical Education. LCME Accreditation Standards. Available at: (http://www.lcme.org/functionslist.htm) Accessed January 21, 2010.

  11. Lie D, Boker J, Crandall SJ, et al. Revising the Tool for Assessing Cultural Competence Training (TACCT) for curriculum evaluation: Findings derived from seven US schools and expert consensus. Med Educ Online. 2008;13(11).

  12. Bischoff A, Perneger TV, Bovier PA, Loutan L, Stalder H. Improving communication between physicians and patients who speak a foreign language. Br J Gen Pract. 2003;53(492):541–6.

    PubMed  Google Scholar 

  13. Gurman TA, Moran A. Predictors of appropriate use of interpreters: identifying professional development training needs for labor and delivery clinical staff serving Spanish-speaking patients. J Health Care Poor Underserved. 2008;19(4):1303–20.

    Article  PubMed  Google Scholar 

  14. Dysart-Gale D. Clinicians and medical interpreters: negotiating culturally appropriate care for patients with limited English ability. Fam Community Health. 2007;30(3):237–46.

    PubMed  Google Scholar 

  15. Kalet AL, Mukherjee D, Felix K, et al. Can a web-based curriculum improve students' knowledge of, and attitudes about, the interpreted medical interview? J Gen Intern Med. 2005;20(10):929–34.

    Article  PubMed  Google Scholar 

  16. Lie D, Bereknyei S, Kalet A, Braddock C 3rd. Learning outcomes of a web module for teaching interpreter interaction skills to pre-clerkship students. Fam Med. 2009;41(4):234–5.

    PubMed  Google Scholar 

  17. Makoul G. Essential elements of communication in medical encounters: the Kalamazoo consensus statement. Acad Med. 2001;76(4):390–3.

    Article  CAS  PubMed  Google Scholar 

  18. Lie D, Bereknyei S, Braddock C 3rd, Encinas J, Ahearn S, Boker J. Assessing medical students' skills in working with interpreters during patient encounters: a validation study of the interpreter scale. Acad Med. 2009;84(5):8.

    Article  Google Scholar 

  19. Lie D, Boker J, Bereknyei S, Ahearn S, Fesko C, Lenahan P. Validating measures of third year medical students' use of interpreters by standardized patients and faculty observers. J Gen Intern Med. 2007;22(Suppl 2):336–40.

    Article  PubMed  Google Scholar 

  20. Grant J, Arnall J, Bereknyei S, et al. Preparing medical students to work with interpreters: successful team training techniques to enhance the effectiveness of standardized patients. Presented at: Western Group on Educational Affairs (WGEA) Regional Conference. Pacific Grove, CA. April 28, 2008.

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Acknowledgments

All authors gratefully acknowledge the assistance of Dr. Pree Basaviah, Ms. Madika Bryant, and Ms. Julianne Arnall in the implementation process of this curriculum. The authors also acknowledge funding from the National Institutes of Health (NIH), National Heart, Lung and Blood Institute, award no. K07 HL079330 “Integrated Immersive Approaches to Cultural Competence” (2005-2010) and the Association of American Medical Colleges grant initiative "Enhancing Cultural Competence in Medical Schools" (2005-2008) supported by the California Endowment.

Conflict of Interest

The authors have no conflicts of interest to disclose.

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Authors and Affiliations

  1. Medical Education, Stanford University School of Medicine, 251 Campus Drive, MSOB x333, Stanford, CA, 94305, USA

    Sylvia Bereknyei MS, Andrew Nevins MD, Erika Schillinger MD, Ronald D. Garcia PhD, A. Elizabeth Stuart MD, MSEd & Clarence H. Braddock III MD, MPH

Authors
  1. Sylvia Bereknyei MS
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  2. Andrew Nevins MD
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  3. Erika Schillinger MD
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  4. Ronald D. Garcia PhD
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  5. A. Elizabeth Stuart MD, MSEd
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  6. Clarence H. Braddock III MD, MPH
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Corresponding author

Correspondence to Clarence H. Braddock III MD, MPH.

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Bereknyei, S., Nevins, A., Schillinger, E. et al. Beyond Knowledge, Toward Linguistic Competency: An Experiential Curriculum. J GEN INTERN MED 25 (Suppl 2), 155–159 (2010). https://doi.org/10.1007/s11606-010-1271-7

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  • DOI: https://doi.org/10.1007/s11606-010-1271-7

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