Morales Raymond, Rodriguez Lauren, Singh Angad, Stratta Erin, Mendoza Lydia, Valerio Melissa A, Vela Monica
Department of Pediatrics, Kaiser Permamente, Oakland, CA, USA.
Department of Emergency Medicine, Emergency Medicine at Henry Ford Hospital, Detroit, MI, USA.
J Gen Intern Med. 2015 Oct;30(10):1434-9. doi: 10.1007/s11606-015-3309-3. Epub 2015 Apr 11.
Patients with limited English proficiency (LEP) may be at risk for medical errors and worse health outcomes. Language concordance between patient and provider has been shown to improve health outcomes for Spanish-speaking patients. Nearly 40 % of Hispanics, a growing population in the United States, are categorized as having limited English proficiency. Many medical schools have incorporated a medical Spanish curriculum to prepare students for clinical encounters with LEP patients.
To describe the current state of medical Spanish curricula at United States medical schools.
The Latino Medical Student Association distributed an e-mail survey comprising 39 items to deans from each U.S. medical school from July 2012 through July 2014. This study was IRB-exempt.
Eighty-three percent (110/132) of the U.S. medical schools completed the survey. Sixty-six percent (73/110) of these schools reported offering a medical Spanish curriculum. In addition, of schools with no curriculum, 32 % (12/37) planned to incorporate the curriculum within the next two years. Most existing curricula were elective, not eligible for course credit, and taught by faculty or students. Teaching modalities included didactic instruction, role play, and immersion activities. Schools with the curriculum reported that the diverse patient populations in their respective service areas and/or student interest drove course development. Barriers to implementing the curriculum included lack of time in students' schedules, overly heterogeneous student language skill levels, and a lack of financial resources. Few schools reported the use of validated instruments to measure language proficiency after completion of the curriculum.
Growing LEP patient populations and medical student interest have driven the implementation of medical Spanish curricula at U.S. medical schools, and more schools have plans to incorporate this curriculum in the near future. Studies are needed to reveal best practices for developing and evaluating the curriculum.
英语水平有限(LEP)的患者可能面临医疗差错风险及更差的健康结局。患者与医疗服务提供者之间的语言一致性已被证明可改善说西班牙语患者的健康结局。在美国不断增长的西班牙裔人口中,近40%被归类为英语水平有限。许多医学院校已纳入医学西班牙语课程,以使学生为与LEP患者的临床接触做好准备。
描述美国医学院校医学西班牙语课程的现状。
拉丁裔医学生协会在2012年7月至2014年7月期间向美国各医学院校的院长发送了一份包含39个项目的电子邮件调查问卷。本研究无需经过机构审查委员会审批。
83%(110/132)的美国医学院校完成了调查。其中66%(73/110)的学校报告开设了医学西班牙语课程。此外,在没有该课程的学校中,32%(12/37)计划在未来两年内纳入该课程。大多数现有课程为选修课,无课程学分,由教师或学生授课。教学方式包括理论教学、角色扮演和沉浸式活动。开设该课程的学校报告称,各自服务区域内多样化的患者群体和/或学生兴趣推动了课程的开发。实施该课程的障碍包括学生日程中时间不足、学生语言技能水平差异过大以及缺乏财政资源。很少有学校报告在课程结束后使用经过验证的工具来测量语言能力。
不断增加的LEP患者群体和医学生的兴趣推动了美国医学院校医学西班牙语课程的实施,并且更多学校计划在不久的将来纳入该课程。需要开展研究以揭示课程开发和评估的最佳实践。