A Vega Taylor, Contag Alec G, Urbanowicz Erin, Sanchez Anthony, Martinez Juan Carlos, Garcia Amy, Ortega-Loayza Alex
Oregon Health & Science University, Portland, OR USA.
Scripps Mercy Hospital Chula Vista, Chula Vista, CA USA.
Med Sci Educ. 2021 Feb 16;31(2):495-502. doi: 10.1007/s40670-020-01195-6. eCollection 2021 Apr.
Limited English proficiency patients experience high rates of medical errors and receive lower quality of care. To better prepare the healthcare workforce, Latino Medical Student Association (LMSA) members at Oregon Health & Science University (OHSU) developed an Introductory Medical Spanish course to complement an 18-month pre-clinical curriculum.
This 10-week elective course consisted of 2 h of weekly instruction, two Cafecito cultural sessions, and one clinical standardized assessment (CSA). The authors used Bloom's taxonomy as a theoretical framework to design course components. Pre- and post-course surveys captured comfort scores with performing a history and physical (H&P) and building rapport in Spanish. Change in comfort was analyzed via paired -test in STATA. The authors performed a content analysis of CSA feedback and a thematic analysis of Cafecito reflections.
Fifteen preclinical medical students in cohort 1 and sixteen in cohort 2 completed the 10-week course. Comfort scores significantly ( < 0.05) increased by 2.87 and 1 point(s) for cohorts 1 and 2, respectively. There were differences between cohorts 1 and 2, including self-reported language fluency (93% vs 47% "beginner" level) and value of the cultural sessions (73% vs 50%), respectively. Qualitative content analysis of CSA feedback and thematic analysis of Cafecito reflections revealed students successfully applied learned material to a new case and developed a newfound appreciation for Latinx public health issues.
This course effectively increased students' comfort using medical Spanish which successfully translated into simulated patient environments. It also provided a space to discuss nuances of health and Latinx cultures with peers. Ultimately, this course's feasible, effective structure can serve as a model to complement condensed pre-clinical undergraduate medical education (UME) curricula.
英语水平有限的患者医疗差错发生率高，且获得的医疗服务质量较低。为了让医疗人员做好更充分的准备，俄勒冈健康与科学大学（OHSU）的拉丁裔医学生协会（LMSA）成员开发了一门医学西班牙语入门课程，以补充为期18个月的临床前课程。
这门为期10周的选修课程包括每周2小时的授课、两次Cafecito文化课程和一次临床标准化评估（CSA）。作者以布鲁姆分类法为理论框架来设计课程内容。课程前后的调查收集了学生用西班牙语进行病史采集和体格检查（H&P）以及建立融洽关系时的舒适度评分。舒适度的变化通过STATA中的配对检验进行分析。作者对CSA反馈进行了内容分析，并对Cafecito反思进行了主题分析。
第1组的15名临床前医学生和第2组的16名临床前医学生完成了为期10周的课程。第1组和第2组的舒适度评分分别显著提高（<0.05）了2.87分和1分。第1组和第2组之间存在差异，包括自我报告的语言流利程度（“初学者”水平分别为93%和47%）以及文化课程的价值（分别为73%和50%）。对CSA反馈的定性内容分析和对Cafecito反思的主题分析表明，学生们成功地将所学知识应用于新病例，并对拉丁裔公共卫生问题有了新的认识。
本课程有效地提高了学生使用医学西班牙语的舒适度，并成功地将其应用于模拟患者环境中。它还提供了一个与同龄人讨论健康细微差别和拉丁裔文化的空间。最终，本课程可行、有效的结构可作为补充本科临床前医学教育（UME）精简课程的典范。
