Beyond knowledge, toward linguistic competency: an experiential curriculum

Abstract

Introduction/aims: Training is essential for future health care providers to effectively communicate with limited English proficient (LEP) patients during interpreted encounters. Our aim is to describe an innovative skill-based medical school linguistic competency curriculum and its impact on knowledge and skills.

Setting: At Stanford University School of Medicine, we incorporated a linguistic competency curriculum into a 2-year Practice of Medicine preclinical doctoring course and pediatrics clerkship over three cohorts.

Program description: First year students participated in extensive interpreter-related training including: a knowledge-based online module, interactive role-play exercises, and didactic skill-building sessions. Students in the pediatrics clerkship participated in interpreted training exercises with facilitated feedback.

Program evaluation: Knowledge and skills were evaluated in the first and fourth years. First year students' knowledge scores increased (pre-test = 0.62, post-test = 0.89, P < 0.001), and they demonstrated good skill attainment during an end-year performance assessment. One cohort of students participated in the entire curriculum and maintained performance into the fourth year.

Discussion: Our curriculum increased knowledge and led to skill attainment, each of which showed good durability for a cohort of students evaluated 3 years later. With a growing LEP population, these skills are essential to foster in future health care providers to effectively communicate with LEP patients and reduce health disparities.

Figure 1

Interpreter curriculum and evaluation timeline with student distribution by cohort over a 3-year period. *Students withdrew from the research portion of the knowledge pre-and post-test, but subsequently participated in the curriculum. These students consented to participate in the remaining educational and research activities. All students in each cohort participated in the module as a mandatory assignment. †Although the pediatrics clerkship rotation is required curriculum, it is not necessary to complete by the end of the third year, accounting for the 24 students in the 2005 cohort who completed the exercise prior to the fourth year exam. ‡Of 85 students in the 2005 cohort, 52 students chose to pursue other academic endeavors between their preclinical and clerkship years. These students did not take the 4th year exam; however, they will take the exam in subsequent years. §Students in the later cohorts have not yet participated in the 4th year exam.