Clinical Spanish Use and Language Proficiency Testing Among Pediatric Residents

Details

• Personal Author:
  Cowden JD ; Ebel BE ; Fernandez J ; Hamdy RF ; Killough EF ; Lion KC ; Michel E ; Rafton SA ; Thompson DA
• Description:
  Purpose: To describe patterns of clinical Spanish use by pediatric residents, and to compare self-assessment of language proficiency against an objective language test. Method: In 2010, the authors e-mailed a survey to all 247 pediatric residents at three institutions, inviting those with any level of Spanish language ability to participate. Participants completed a survey reporting Spanish proficiency, interpreter use, and comfort using Spanish in a range of clinical scenarios. Clinical scenarios were grouped and analyzed by degree of complexity. Self-reported Spanish proficiency was compared with tested proficiency, as measured by a 20-minute telephone assessment of general language ability. Scores were categorized as "not proficient," "proficient," and "highly proficient." Results: Of the 247 residents, 78 (32%) participated, self-reporting a range of Spanish skills; 23% of those reported spoken proficiency ("proficient" or "fluent"). Participants at all levels of proficiency reported using Spanish without interpretation, including 63% of those who were not proficient. The majority (56%) of nonproficient residents reported comfort using Spanish in straightforward clinical scenarios, and 10% reported comfort in clinical scenarios with legal implications. Self-reported proficiency had a positive predictive value of 67% for testing at a proficient level and 22% for testing at a highly proficient level. Conclusions: Regardless of level of Spanish proficiency, pediatric residents provide clinical care to patients in Spanish. Self-reported Spanish proficiency does not reliably predict tested ability, especially when using stringent criteria to define proficiency. Provider language "credentialing" is an important step in implementing a policy to improve care for limited English proficiency patients. [Description provided by NIOSH]
• Subjects:
  Communication Health Personnel Health Promotion Occupational Health Safety
• Keywords:
  Communication Research Health Care Workers Health Communications Language Barrier Physicians
• ISSN:
  1040-2446
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  Colorado ; Maryland ; Missouri ; OSHA Region 10 ; OSHA Region 3 ; OSHA Region 7 ; OSHA Region 8 ; Washington
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  88
• Issue:
  10
• NIOSHTIC Number:
  nn:20056844
• Citation:
  Acad Med 2013 Oct; 88(10):1478-1484
• Contact Point Address:
  Dr. Lion, University of Washington Center for Child Health, Behavior and Development, Seattle Children's Research Institute, M/S CW8-6 PO Box 5371, Seattle, WA 98145-5005
• Email:
  casey.lion@seattlechildrens.org
• Federal Fiscal Year:
  2014
• Performing Organization:
  University of Washington
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Academic Medicine: Journal of the Association of American Medical Colleges
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:e0d6681af997359c051e7e1eefbcc53f7972c6e27e382f88146063473c35e1a28c74b13a94be9520cead6f8ec64dc539aa3cfab75f4f02b678cdbb88efc80dbb
• Download URL:
  https://stacks.cdc.gov/view/cdc/214343/cdc_214343_DS1.pdf
• File Type:
  [PDF - 279.08 KB ]