Academic journal article Foreign Language Annals

Developing a Spanish for Health Professions Course: A Preliminary Mixed-Methods Study

Academic journal article Foreign Language Annals

Developing a Spanish for Health Professions Course: A Preliminary Mixed-Methods Study

Article excerpt

I was in Costa Rica for vacation and witnessed a trauma. I was the first on the scene trying to assess the injured individual. It made me realize that no matter where I am, I want to be able to fully treat someone without having to worry about language barriers.

-Study participant

Introduction

The Spanish-speaking population is growing exponentially in the United States: Currently more than one in 10 inhabitants over age 5 speaks Spanish at home, with 42.9% of them speaking English "less than very well" (U.S. Census Bureau, 2014, n.p.). For this already substantial and growing population, language barriers have been identified as one of the factors that affect equitable access to health care and contribute to health care disparities (Diamond, Tuot, & Karliner, 2012). For instance, Martinez (2010b) determined that "[l]anguage barriers affect over an estimated 22 million patients within the U.S. health care delivery system every year [resulting in] misunderstanding of patient concerns, missed diagnoses, costly and unnecessary medical tests, and potentially serious medical error(s)" (p. 59). In addition, Betancourt, Renfrew, Green, Lopez, and Wasserman (2012) noted that "at least 8.6 percent of the U.S. population is at risk for adverse events because of barriers associated with their language ability" (p. 3). Similarly, Flores (2006) pointed out that "language barriers can have deleterious effects. Patients who face such barriers are less likely than others to have a usual source of medical care; they receive preventive services at reduced rates; and they have an increased non-adherence to medication" (p. 230). In addition, he stated that "inadequate communication can have tragic consequences" (p. 230) for patients, ranging from quadriplegia or loss of custody of children (Flores, 2006) to even death (Chen, Youdelman, & Brooks, 2007). Becker (2004) indicated that, for limited-English-proficient (LEP) patients, "the lack of availability of interpreters [...] is the final straw in the battle to get adequate health care" (p. 269): echoing this concern, Baker, Parker, Williams, Coates, and Pitkin (1996) found that interpreter services were not provided in almost half of emergency department cases where a patient with LEP was involved. Eamranond, Davis, Phillips, and Wee (2011) stressed the importance of language-concordant providers and their role in patient care: "many believe that matching LEP patients with providers who speak their language (i.e., language concordance), may improve health outcomes" (p. 2). A critical component of any quality improvement plan in health care settings thus involves ensuring that adequate language services are provided to LEP patients.

Collaborative efforts between departments of foreign languages and literatures and nursing, medical, and dental professional schools in the United States have sought to respond to the need for trained and qualified interpreters, as well as language-concordant providers. To that end, many have offered elective Spanish language courses or programs that focus on developing or enriching students' basic language and cultural skills (Forister & Gonzalez, 2009; Morales et al., 2015; Reuland, Frasier, Slatt, & Aleman, 2008), while some have even required Spanish for health care professional preparation courses (Bloom, Timmermann, & Sands, 2006). These programs often include classes and community service in the home or university community, as well as optional international rotations in Spanish-speaking countries (Reuland, Slatt, Aleman, Fernandez, & DeWalt, 2012).

However, such courses and programs of study for current and future health-care providers must go beyond the teaching of basic Spanish grammar and health-related vocabulary. Rather, programs need to be designed to help students develop their communicative abilities in Spanish so that they can ultimately achieve a proficiency level that is high enough to converse in Spanish with, and provide appropriate treatment to, LEP patients. …

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