Daniel S Reuland1, Pamela Y Frasier, Lisa M Slatt, Marco A Alemán. 1. Department of Medicine, Division of General Internal Medicine and Clinical Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. dreuland@med.unc.edu
Abstract
INTRODUCTION: Policymakers have recommended recruiting or training (or both) more US physicians who can provide care in Spanish. Few longitudinal medical Spanish programs have been described and evaluated. OBJECTIVE: This study aims to describe development and evaluation of the preclinical phase of a 4-y program designed to graduate physicians who can provide language-concordant care in Spanish. SETTING: Study was done in one public medical school in southeastern USA. PROGRAM DESCRIPTION: The program targeted intermediate/advanced Spanish speakers. Standardized fluency assessments were used to determine eligibility and evaluate participants' progress. Curriculum included didactic coursework, simulated patients, socio-cultural seminars, clinical skills rotations at sites serving Latinos, service-learning, and international immersion. PROGRAM EVALUATION: For the first two cohorts (n = 45) qualitative evaluation identified program improvement opportunities and found participants believed the program helped them maintain their Spanish skills. Mean interim (2-y) speaking proficiency scores were unchanged from baseline: 9.0 versus 8.7 at baseline on 12-point scale (p = 0.15). Mean interim listening comprehension scores (second cohort only, n = 25) increased from a baseline of 77 to 86% (p = 0.003). Proportions "passing" the listening comprehension test increased from 72 to 92% (p = 0.06). DISCUSSION: We describe development of a longitudinal Spanish program within a medical school. Participation was associated with improved Spanish listening comprehension and no change in speaking proficiency.
INTRODUCTION: Policymakers have recommended recruiting or training (or both) more US physicians who can provide care in Spanish. Few longitudinal medical Spanish programs have been described and evaluated. OBJECTIVE: This study aims to describe development and evaluation of the preclinical phase of a 4-y program designed to graduate physicians who can provide language-concordant care in Spanish. SETTING: Study was done in one public medical school in southeastern USA. PROGRAM DESCRIPTION: The program targeted intermediate/advanced Spanish speakers. Standardized fluency assessments were used to determine eligibility and evaluate participants' progress. Curriculum included didactic coursework, simulated patients, socio-cultural seminars, clinical skills rotations at sites serving Latinos, service-learning, and international immersion. PROGRAM EVALUATION: For the first two cohorts (n = 45) qualitative evaluation identified program improvement opportunities and found participants believed the program helped them maintain their Spanish skills. Mean interim (2-y) speaking proficiency scores were unchanged from baseline: 9.0 versus 8.7 at baseline on 12-point scale (p = 0.15). Mean interim listening comprehension scores (second cohort only, n = 25) increased from a baseline of 77 to 86% (p = 0.003). Proportions "passing" the listening comprehension test increased from 72 to 92% (p = 0.06). DISCUSSION: We describe development of a longitudinal Spanish program within a medical school. Participation was associated with improved Spanish listening comprehension and no change in speaking proficiency.
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