Open Access“Oh! She Doesn't Speak English!” Assessing Resident Competence in Managing Linguistic and Cultural Barriers
Author(s) -
Zabar Sondra,
Hanley Kathleen,
Kachur Elizabeth,
Stevens David,
Schwartz Mark D.,
Pearlman Ellen,
Adams Jennifer,
Felix Karla,
Lipkin Mack,
Kalet Adina
Publication year - 2006
Publication title -
journal of general internal medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.746
H-Index - 180
eISSN - 1525-1497
pISSN - 0884-8734
DOI - 10.1111/j.1525-1497.2006.00439.x
Subject(s) - medicine , cronbach's alpha , interpreter , competence (human resources) , cultural competence , medical education , family medicine , social psychology , psychology , psychometrics , clinical psychology , pedagogy , computer science , programming language
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.