Introduction: Cultivating effective cross-cultural communication skills requires an understanding of culture that includes both the physician's and the patient's perspectives. Building on a foundation of cultural awareness, knowledge, and skills that students have acquired during preclinical curriculum, this exercise provides an opportunity for students to continue to refine their clinical skills as they practice medical interpretation at the bedside. Methods: This clinical experience in medical interpretation is designed for implementation during the required third-year OB/GYN clerkship. After a brief didactic review on the use of medical interpreters, students are assigned to care for a laboring woman with limited English proficiency through the course of her labor. Following the clinical encounter, a written reflection is assigned to assist students with reflecting on their skills in providing care to limited English proficiency patients. Faculty-led small-group discussions utilize these reflections as a means to discuss the students’ clinical encounters. Finally, evaluation of student mastery of interpretation skills is made by an objective structured clinical exam (OSCE) during the final week of the clerkship. A diverse patient population that speak a variety of languages is necessary for clinical assignment. Standardized patients who speak languages other than English are needed for OSCE implementation. Results: OSCE scores confirmed students’ ability to demonstrate the clinical skills of empathy and non-verbal communication. Students demonstrated an average score of 73% for medical interpretation principles. On a 6-point scale, with 6 being best, an overall self-efficacy score of 4.0 was reported. Scores at the end of the year were slightly increased (4.2) when compared to the first rotation (3.9). Discussion: Orientation to the student activity of the entire medical team (residents, attendings, nurses) positively impacts the success of the project. Integrating cultural competence into the clinical clerkships allows students to apply cultural competence knowledge gained in the first 2 years of medical education, as well as develop clinical skills in caring for patients with a variety of cultural backgrounds.
- Acknowledge the importance of understanding, accepting, and appreciating one's cultural diversity and understand how cultural beliefs, perspectives, and practices may enable or hinder one's ability to have equitable access to healthcare services.
- Provide healthcare to a diverse, multicultural patient population and recognize the impact of social and cultural practices upon the physician and patient relationship as well as management of disease.
- Articulate the complex realities of using both professional and ad-hoc interpreters.
- Discuss the impact of a being a limited English proficiency patient on the birth process in particular.
- Describe disparities in healthcare experienced by labor women who have limited English proficiency.
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Poster presented at: American Professors of Gynecology and Obstetrics Annual Meeting; 2008; Orlando, FL.
Poster presented at: University of Southern California Innovations in Medical Education; 2008; Los Angeles, CA.
Presented at: Western Group on Educational Affairs Western Region Innovations in Medical Education; 2008; Assilomar, CA.
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