Future physicians create an English-Spanish tool kit while learning to better communicate with Latino patients.

By:    Date: 08-03-2016

Article by Ellen Johnson and Olivia Grider  |  Photos by Lane Stafford and Brandon Bennett

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When University of Alabama medical student Roshmi Bhattacharya saw a problem in her community, she created a course to help solve it.

“Roshmi noticed when she was doing her rotation that some of the nurses were treating Latino patients unfairly or inappropriately,” says Dr. Pamela Payne-Foster, faculty advisor for the class and deputy director of the UA Institute for Rural Health Research. “One part of the course concentrates on cultural competency and Latino health, and the other part is where students learn Spanish so they can interact better with patients.”

Called Effective Cross-Cultural Communication in Clinical Settings, the course is comprised of a lecture portion Dr. Payne-Foster leads and language workshops Bhattacharya conducts.

“I realized a lot of students and faculty members didn’t have a lot of experience dealing with cross-cultural issues,” says Bhattacharya, a third-year medical student at the University of Alabama School of Medicine. “We have a pretty sizeable Spanish-speaking population here in Tuscaloosa, and their needs weren’t being appropriately addressed, so I thought it was a good way to educate myself and my peers.”

Eight of Bhattacharya’s fellow students signed up to take the course in Fall 2015.

Nathan Sherrer, also a third-year medical student, enrolled in the class because he, too, had noticed problems in cross-cultural competency and wanted to better inform himself.
“There’s a lot of different ethnicities that come into the hospital,” Sherrer says. “If you’re not able to identify patients’ cultural norms, then you can’t reach them as efficiently.”

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Students [l-r] Reaves Crabtree, Andrew Watson, Joshua Koplon and Caroline Kennemer practice medical Spanish words and phrases during class. ABOVE: Student Roshmi Bhattacharya uses the medical-Spanish tool kit during an exam.

In addition to learning medical Spanish and improving their cross-cultural skills, the nine students in the Fall 2015 class developed a tool kit to help break down the language barrier between medical professionals and Latino patients. They plan to distribute copies of the tool kit in fall of 2016 to the 45 family-medicine residents in The University of Alabama Family Medicine Residency, which is operated by UA’s College of Community Health Sciences, and to the approximately 60 third- and fourth-year medical students at the College, which also functions as a regional campus of the School of Medicine. Students hope to eventually provide the tool kit to all 180 to 200 School of Medicine students at the Birmingham and Tuscaloosa campuses for use during their third-year rotations and to offer them to faculty as well.  

Students produced the 16-page kit for printing on spiral-bound, tear-proof paper that can easily fit in a medical professional’s coat pocket. Organized by specialty, it includes English-Spanish translations of greetings and common conversational terms as well as discipline-specific key phrases and vocabulary to assist medical staff in taking health histories, performing physical exams and conducting rounds in hospitals.

Caroline Kennemer, a third-year medical student, says she is excited to see the project reach further than the students in the class.

“I think the tool kits are important because not everyone can spend a semester learning medical Spanish,” she says. “They allow us to have a larger impact than just ourselves and the patients we interact with. Anyone with the tool kit can improve their care of Spanish-speaking patients.”

Students in the course also learn about health disparities, how cultural issues affect health and health-care costs and the link between effective communication and quality of care. Weekly, two-hour class meetings include lectures by Dr. Payne-Foster and community speakers, discussions and Spanish-language practice. For the Fall 2015 language workshops, Bhattacharya made handouts with English-Spanish vocabulary and phrases, and students spent the time practicing them with each other. They dedicated approximately two weeks each to basic Spanish, internal medicine and pediatrics, and also learned terms related to various medical specialties.

Sherrer says the class opened his mind to a broader definition of cultural competency. “I think I definitely knew that cultural competency was important, but I didn’t know how much there was to it,” Sherrer says. “You think there are these distinct little differences, but some are huge.”

The medical field is all about serving others, Bhattacharya says, and that can be a complex undertaking. “In order to properly do our jobs, trying to speak the language and understanding cultural differences is a necessity,” she says. “I’ve learned that it’s difficult to single-handedly start up something, but it can be really rewarding. It showed me an idea really can turn into something if you pursue it.”

Effective Cross-Cultural Communication in Clinical Settings will continue to be offered as an elective option for medical students. For more information, contact Roshmi Bhattacharya at roshmi@uab.edu or Dr. Pamela Payne-Foster at 205-348-5148 or ppayne-foster@cchs.ua.edu.