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. 2025 Jun 24;9(3):e70056.
doi: 10.1002/aet2.70056. eCollection 2025 Jun.

Bridging the language gap: Simulation-based education improves communication, confidence, and knowledge for emergency medicine residents working with interpreters

William Mundo  1 , Jacqueline Ward-Gaines  2 , Molly Thiessen  1 , Benjamin Li  1 , Maria Pamboukis  3 , Emily Hopkins  1 , Jean Hoffman  2 , Maria Moreira  1 , Jason Haukoos  1 , Steven Lowenstein  2
Affiliations

Bridging the language gap: Simulation-based education improves communication, confidence, and knowledge for emergency medicine residents working with interpreters

William Mundo et al. AEM Educ Train. .

Abstract

Introduction: Language barriers present unique challenges to health care delivery in emergency medicine (EM). There is a gap in understanding the impact of education and training on EM residents' ability to work effectively with interpreters. We developed and piloted a simulation to improve residents' knowledge and confidence in working with medical interpreters (MIs).

Methods: We conducted a pre-post quasi-experiment involving Denver Health EM residents. Participants engaged in a 120-min simulation exercise, including five 20-min scenarios involving Spanish-, American Sign Language-, Russian-, and Vietnamese-speaking standardized patients. Learning objectives focused on acquiring essential skills needed to communicate effectively with patients while working with MIs. We compared pre- and postsimulation knowledge and self-rated confidence.

Results: Of 68 eligible EM residents, 17 (25%) participated in the elective simulation, including mostly female (71%) and non-Hispanic White (77%) individuals; most were members of the PGY-1 and PGY-2 classes (82% and 12%, respectively). English-only proficiency was reported in 82% of residents. After the simulation, participants reported increased confidence in working with MIs, accessing MIs promptly, identifying the optimal mode of interpretation, and addressing common barriers to MI use. There was improvement in identifying when family and another ad hoc interpreter may be used and understanding the differences between interpretation and translation.

Conclusions: Among EM residents, simulation-based training enhanced understanding of, and confidence with, working effectively with MIs. These results demonstrate the utility of using simulation-based learning to impart important communication skills for working with various language groups in medical training.

Keywords: diversity and inclusion; health care disparities; health equity; language barrier; medical interpreter; simulation.

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Conflict of interest statement

The authors declare no conflicts of interest.

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