Grall Kristi H, Panchal Ashish R, Chuffe Eliud, Stoneking Lisa R
Department of Emergency Medicine, Regions Hospital, Health Partners Institute, St Paul, MN, USA.
Department of Emergency Medicine, Wexner Medical Center, Ohio State University, Columbus, OH, USA.
Adv Med Educ Pract. 2016 Feb 18;7:81-6. doi: 10.2147/AMEP.S96928. eCollection 2016.
Language and cultural barriers are detriments to quality health care. In acute medical settings, these barriers are more pronounced, which can lead to poor patient outcomes.
We implemented a longitudinal Spanish-language immersion curriculum for emergency medicine (EM) resident physicians. This curriculum includes language and cultural instruction, and is integrated into the weekly EM didactic conference, longitudinal over the entire 3-year residency program. Language proficiency was assessed at baseline and annually on the Interagency Language Roundtable (ILR) scale, via an oral exam conducted by the same trained examiner each time. The objective of the curriculum was improvement of resident language skills to ILR level 1+ by year 3. Significance was evaluated through repeated-measures analysis of variance.
The curriculum was launched in July 2010 and followed through June 2012 (n=16). After 1 year, 38% had improved over one ILR level, with 50% achieving ILR 1+ or above. After year 2, 100% had improved over one level, with 90% achieving the objective level of ILR 1+. Mean ILR improved significantly from baseline, year 1, and year 2 (F=55, df =1; P<0.001).
Implementation of a longitudinal, integrated Spanish-immersion curriculum is feasible and improves language skills in EM residents. The curriculum improved EM-resident language proficiency above the goal in just 2 years. Further studies will focus on the effect of language acquisition on patient care in acute settings.
语言和文化障碍不利于提供高质量的医疗保健。在急性医疗环境中,这些障碍更为突出,可能导致患者预后不良。
我们为急诊医学住院医师实施了一项纵向西班牙语沉浸式课程。该课程包括语言和文化教学,并融入到每周的急诊医学教学会议中,在整个3年的住院医师培训项目中持续进行。在基线时以及每年通过由同一名经过培训的考官进行的口试,按照跨部门语言圆桌会议(ILR)量表评估语言能力。该课程的目标是到第3年时将住院医师的语言技能提高到ILR 1+水平。通过重复测量方差分析评估显著性。
该课程于2010年7月启动,持续到2012年6月(n = 16)。1年后,38%的人在ILR水平上提高了一个等级,50%的人达到了ILR 1+或更高水平。2年后,100%的人提高了一个等级,90%的人达到了ILR 1+的目标水平。平均ILR从基线、第1年和第2年有显著提高(F = 55,自由度 = 1;P < 0.001)。
实施纵向、综合的西班牙语沉浸式课程是可行的,并且可以提高急诊医学住院医师的语言技能。该课程仅用2年时间就使急诊医学住院医师的语言水平提高到超出目标水平。进一步的研究将聚焦于语言习得对急性医疗环境中患者护理的影响。