aDepartment of Pediatrics, University of Washington, Seattle, ashington 98104-2499, USA.
Pediatrics. 2012 Jul;130(1):e80-7. doi: 10.1542/peds.2011-2794. Epub 2012 Jun 11.
To measure the impact of an objective evaluation of provider Spanish-language skills on self-reported language proficiency and comfort using Spanish in a range of clinical scenarios.
We enrolled pediatric residents with any self-reported Spanish language ability from 3 residency programs. Participants completed a baseline survey, objective language testing, and a posttest survey. We gathered demographics, self-reported Spanish ability, and comfort using Spanish in various clinical scenarios, which were grouped and analyzed by degree of complexity. Between surveys, a language testing service administered a 20-minute, telephone-based assessment of general Spanish proficiency. Scores were reported on a scale from 1 to 12, with scores ≥ 9 designated "proficient." Participants received a numeric score and brief qualitative feedback on their language ability.
Following testing, residents (n = 76) were significantly less likely to report comfort using Spanish in straightforward clinical scenarios, from 64% to 51% (P = .007). That difference was accounted for entirely by residents who tested at a non-proficient level (56% to 39%, P = .006). Testing had no impact on comfort using Spanish in complex or medical-legal scenarios, at any proficiency level. We found no change in self-reported Spanish proficiency in any resident group.
Objective Spanish-language testing decreased nonproficient resident comfort using Spanish in straightforward clinical encounters, but it did not change comfort in complex or legal scenarios. In combination with education and enforceable policies, language testing may play an important role in decreasing nonproficient Spanish use and improving care for patients with limited English proficiency.
衡量对提供者西班牙语技能进行客观评估对自我报告的语言熟练度和在一系列临床场景中使用西班牙语的舒适度的影响。
我们从 3 个住院医师培训计划中招募了具有任何自我报告的西班牙语能力的儿科住院医师。参与者完成了基线调查、客观语言测试和后测调查。我们收集了人口统计学数据、自我报告的西班牙语能力以及在各种临床场景中使用西班牙语的舒适度，这些数据按复杂程度进行分组和分析。在调查之间，语言测试服务通过电话进行了 20 分钟的一般西班牙语熟练度评估。分数在 1 到 12 的范围内报告，分数≥9 被指定为“熟练”。参与者收到他们语言能力的数字分数和简短的定性反馈。
测试后，住院医师（n=76）报告在直接的临床场景中使用西班牙语的舒适度显著降低，从 64%降至 51%（P=0.007）。这一差异完全归因于测试水平不熟练的住院医师（56%降至 39%，P=0.006）。在任何熟练水平下，测试对使用西班牙语进行复杂或医疗法律场景都没有影响。我们没有发现任何居民群体自我报告的西班牙语熟练度发生变化。
客观的西班牙语测试降低了不熟练住院医师在直接的临床接触中使用西班牙语的舒适度，但并没有改变在复杂或法律场景中的舒适度。与教育和可执行的政策相结合，语言测试可能在减少不熟练西班牙语的使用和改善英语水平有限的患者护理方面发挥重要作用。
