Partnering With Interpreter Services: Standardized Patient Cases to Improve Communication With Limited English Proficiency Patients

Abstract

Introduction: As the number of patients with limited English proficiency grows, there is increasing awareness in the medical community about disparities in health outcomes for this population. The proper use of professional medical interpreters improves communication between physicians and patients with limited English proficiency. Typically, however, little curricular time in medical training is devoted to this competency.

Methods: We developed a two-station objective structured clinical examination (OSCE) in which learners worked with interpreters to conduct medical interviews with Spanish-speaking standardized patients (SPs). Cases were designed for use with residents from any medical specialty and to have personal and emotional richness in keeping with the real-life circumstances of many patients. Twelve residents from six medical specialties completed a session evaluation and were assessed by faculty, SPs, and interpreters using existing validated instruments and case-specific checklists.

Results: All residents reported that the cases mimicked real patient encounters. The checklists were well received and easy to use. While scores varied between residents, deficiencies were identified in basic communication skills for interacting with a non-English-speaking SP through an interpreter, including maintaining proper eye contact and open body posture with patients and introducing and clearly articulating the role of the interpreter.

Discussion: A two-station OSCE utilizing professional medical interpreters and Spanish-speaking SPs was well received by all participants. Residents' scores helped identify common skill gaps in their work with interpreters. Based on the success of the pilot deployment, we plan to target educational interventions at these common deficiencies and offer the OSCE to more trainees.

Keywords: Cultural Competence; Health Equity; Interpreter Communication; Interpreter Use; Limited English Proficiency; OSCE; Spanish; Standardized Patient.