The authors do not have any conflicts of interest to declare.
“Oh! She Doesn't Speak English!” Assessing Resident Competence in Managing Linguistic and Cultural Barriers
Article first published online: 2 MAY 2006
Journal of General Internal Medicine
Volume 21, Issue 5, pages 510–513, May 2006
How to Cite
Zabar, S., Hanley, K., Kachur, E., Stevens, D., Schwartz, M. D., Pearlman, E., Adams, J., Felix, K., Lipkin, M. and Kalet, A. (2006), “Oh! She Doesn't Speak English!” Assessing Resident Competence in Managing Linguistic and Cultural Barriers. Journal of General Internal Medicine, 21: 510–513. doi: 10.1111/j.1525-1497.2006.00439.x
Presented in part at the Annual Meeting of the Society of General Internal Medicine, May 10, 2004. Funded by HRSA, Bureau of Health Professionals.
- Issue published online: 2 MAY 2006
- Article first published online: 2 MAY 2006
- medical education;
- residency evaluation;
- cross-language skills
BACKGROUND: Residents must master complex skills to care for culturally and linguistically diverse patients.
METHODS: As part of an annual 10-station, standardized patient (SP) examination, medical residents interacted with a 50-year-old reserved, Bengali-speaking woman (SP) with a positive fecal occult blood accompanied by her bilingual brother (standardized interpreter (SI)). While the resident addressed the need for a colonoscopy, the SI did not translate word for word unless directed to, questioned medical terms, and was reluctant to tell the SP frightening information. The SP/SI, faculty observers, and the resident assessed the performance.
RESULTS: Seventy-six residents participated. Mean faculty ratings (9-point scale) were as follows: overall 6.0, communication 6.0, knowledge 6.3. Mean SP/SI ratings (3.1, range 1.9 to 3.9) correlated with faculty ratings (overall r=.719, communication r=.639, knowledge r=.457, all P<.01). Internal reliability as measured by Cronbach's α coefficients for the 20 item instrument was 0.91. Poor performance on this station was associated with poor performance on other stations. Eighty-nine percent of residents stated that the educational value was moderate to high.
CONCLUSION: We reliably assessed residents communication skills conducting a common clincal task across a significant language barrier. This medical education innovation provides the first steps to measuring interpreter facilitated skills in residency training.