A new learning tool created by a team of Carle Illinois College of Medicine students is helping future clinicians overcome communication barriers when caring for patients who have limited English proficiency. The new clinical simulation is an opportunity to improve care for patients whose access to vital medical information may be hampered by language differences.
CI MED students Brittany Vill and Joanne Chan led the team that developed and piloted the new clinical simulation for first-year medical students. It challenges future physicians to work with a medical interpreter to interview and counsel a Spanish-speaking standardized patient – a surrogate who portrays a real patient during a ‘mock’ clinical encounter. “Our goal was to emphasize the important role interpreter services play in equitable care and to empower students to use this knowledge to inform their care to patients with limited English proficiency in medical school and beyond,” Vill said.
Vill and Chan say they designed the simulation to bridge communication gaps and disparities in medical practice that they witnessed first-hand growing up in communities and families where English wasn’t the primary language. “We found that 38 percent of providers indicated that they rely on asking family members to interpret in the clinic, a practice which can lead to misinterpretation and worse outcomes for patients with Limited English Proficiency (LEP),” Chan said. “I’ve been translating for my parents in medical settings since elementary school. It wasn’t until our first year of medical school that I found out what I thought was ‘normal’ was not actually standard practice.”
Medical interpreters are specially trained to translate complex medical information between health care providers and patients who don’t share a common language. Hospitals started using interpreters to prevent communication errors that can occur when relying on family members or friends to translate for non-English speaking patients.
Even though medical students are taught about medical interpreters and cultural sensitivity, this simulation takes their training a step further with practical application. After viewing a video on interpreter usage tips and common mistakes, students then practiced what they learned to counsel the standardized patient on lifestyle modifications to manage chronic kidney disease. The team found that after completing the simulation, medical students were significantly more confident in their ability to work with a medical interpreter when caring for patients in the clinic.
One of the not-so-hidden teaching nuggets tucked away in the simulation is an emphasis on cultural awareness in medical practice. The team chose a patient simulation dealing with chronic kidney disease – a significant health issue among many populations, including many Latino patients. “It's easy to say ’eat healthier and exercise more,’ and forget how much culture affects how patients approach lifestyle modification,” Chan said. “We intended for this case to challenge students on how to meet patients where they are at in terms of lifestyle counseling.”
Vill’s poster summarizing the results of the simulation pilot won top honors at the Wilbert C. Jordan Research Forum during the Student National Medical Association (SNMA) Annual Medical Education Conference in April. The SNMA is ​committed to supporting current and future underrepresented minority medical students, addressing the needs of underserved communities, and increasing the number of clinically excellent and socially conscious physicians.
Vill and Chan are working to incorporate their simulation activity into CI MED’s introduction to clinical practice (ICP) curriculum for first-year medical students in the coming academic year.
Other team members include CI MED students Ryan Monjazeb and Aashka Shah, CI MED’s Standardized Patient Program Manager Rachel Spaide, and faculty members Dr. Christopher Nelson and Professor Olivia Coiado, who was the team’s principal investigator. Both Vill and Chan hope to specialize in obstetrics/gynecology. Chan also aspires to play an active role in medical education as a clinical professor.