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Reaching Patients Loud and Clear: A medical Spanish certification
Katherine M. O'Rourke, MD
Gregory Gruener, MD , Donna Quinones , Erin Stratta, MD , Jason Howell, MD , Scott Graziano, MD
Objective: Many US medical schools provide medical Spanish instruction to help students improve patient outcomes by providing language concordant care to the growing number of Spanish-speaking patients. For example, for the past four years Loyola University Chicago Stritch School of Medicine has provided a peer-led medical Spanish program that consists of: four levels of medical Spanish courses that meet on a weekly basis; exercises with Spanish-speaking standardized patients; and medical interpreter shadowing and volunteer opportunities. The goal of the Spanish Bilingual Medical Student Certification (Certification) is to provide students with feedback on their medical Spanish skills which guides their ongoing skill development and ensures they use their skills in clinical settings in a safe manner.
Methods: The Certification consists of three component exams: two standardized phone exams developed by Kaiser Permanente and ALTA Language Services, Inc. and an objective structured clinical exam (OSCE) developed by Loyola University Chicago faculty. The phone exams evaluate Spanish medical interpreting and customer service skills as well as ability to take a history and explain diagnoses and treatments in a culturally competent manner. The OSCE most closely mimics true clinical situations as it evaluates students’ abilities to conduct an unprompted history and physical in Spanish, develop a diagnostic and treatment plan, and document the encounter in English. All students receive formative feedback regarding their exam performance. Students who pass all three exams and earn the Certification are given an “Hablo Español” ID tag so staff and patients can easily recognize their skills and receive priority placement at primarily Spanish-speaking clerkship sites.
Results: To date, 24 students have participated in the Certification. Seventeen earned the Certification on their first attempt. The seven students who did not earn the Certification recognized the limits of their skills and the need to work with a professional interpreter while caring for Spanish-speaking patients. Two of these students responded to the exam feedback, improved their skills, and subsequently passed the exams and earned the Certification. Certified students have gone on to improve the quality and safety of patient care both in the Chicago area, across the nation, and in multiple Spanish-speaking countries.
Conclusions: The Spanish Bilingual Medical Student Certification is a program which improves patient care while teaching students communication skills [Liaison Committee on Medical Education Educational Directive 19 (ED-19)], preparing students to respond to medical consequences of societal problems (ED-20), and ensuring students demonstrate cultural competency (ED-21). The success of this program has inspired Loyola to offer the Certification to physicians as well as students. The Certification serves as a model that can be adopted on a national level.
CREOG & APGO Annual Meeting, 2013, Resident, Clerkship Director, Residency Director, Patient Care, Professionalism, Systems-Based Practice & Improvement, Interpersonal & Communication Skills, Practice-Based Learning & Improvement, GME, CME, Quality & Safety, Global Health, Public Health, Advocacy,