“Oh! She Doesn't Speak English!” Assessing Resident Competence in Managing Linguistic and Cultural Barriers

• Published in: Journal of general internal medicine : JGIM 2006-05, Vol.21 (5), p.510-513
• Main Authors: Zabar, Sondra, Hanley, Kathleen, Kachur, Elizabeth, Stevens, David, Schwartz, Mark D., Pearlman, Ellen, Adams, Jennifer, Felix, Karla, Lipkin, Mack, Kalet, Adina
• Format: Article
• Language: English
• Subjects: Attitude of Health Personnel; Clinical Competence; Colorectal cancer; Communication; Communication Barriers; cross‐language skills; Cultural Diversity; Educational Measurement; Humans; Innovations in Education; Internal medicine; Internship and Residency; medical education; Medical residencies; Patient Simulation; Physician-Patient Relations; Reproducibility of Results; residency evaluation
• ISSN: 0884-8734; 1525-1497
• DOI: 10.1111/j.1525-1497.2006.00439.x

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