Assessing Medical Student Readiness to Navigate Language Barriers in Telehealth: A Cross-Sectional Survey Study (Preprint)

2021 ◽  
Author(s):  
Leena Yin ◽  
Fiona Ng ◽  
Mateo Rutherford-Rojas ◽  
Mia William ◽  
Susannah Cornes ◽  
...  
Keyword(s):  
Medical Students ◽  
Limited English Proficiency ◽  
Diabetes Management ◽  
Barriers To Care ◽  
Language Barriers ◽  
Survey Study ◽  
Lifestyle Modifications ◽  
Cross Sectional Survey ◽  
English Speaking ◽  
The U.S

BACKGROUND The COVID-19 pandemic has massively increased telehealth usage in the U.S. Patients with limited English proficiency (LEP) face barriers to healthcare, which may be mitigated when providers work with professional interpreters. However, telemedicine may exacerbate disparities if clinicians are not trained to work with interpreters in that setting. Although medical students are now involved in telehealth on an unprecedented scale, no educational innovations have been published that focus on digital care across language barriers. OBJECTIVE To investigate advanced medical students’ confidence in caring for patients with LEP during telehealth encounters. METHODS We administered a written survey to medical students on clinical clerkships in one U.S.-based institution between August to September 2020. We assessed students’ overall confidence in working with interpreters; confidence in performing eight clinical tasks in in-person versus telehealth encounters; and frequency of performing five different clinical tasks with patients with LEP compared to English-speaking patients during in-person versus telehealth encounters. Wilcoxon signed rank tests and chi-squared tests were used to compare confidence and task performance frequency respectively for patients with LEP vs. English-speaking patients during telehealth encounters. Students were also asked to identify barriers to care for patients with LEP. The free response was qualitatively analyzed using open coding to categorize barriers (key themes). RESULTS Of 300 medical students surveyed, 121 responded. 72 students answered >50% of questions and were included in the analyses. Compared to caring for patients with LEP during in-person encounters, respondents were less confident in working with interpreters (p<0.001), developing trust (p<0.001), identifying agenda (p=0.005), eliciting preferences for diabetes management (p=0.012), and empowering patient in lifestyle modifications (p=0.044) during telehealth encounters. During both in-person and telehealth encounters, nearly half of students (40-78%) reported engaging less frequently in every clinical task with patients with LEP and this was as low as 22% (13/59) for some tasks. Students identified these key barriers to care for patients with LEP: time pressure, interpretation quality and access, technical difficulties, cultural differences, and difficulty with rapport building. CONCLUSIONS Advanced medical students were significantly less confident caring for patients with LEP via telehealth than in person. Broader implementation of training around navigating language barriers is necessary for telehealth care, which has rapidly expanded in the U.S. Our study identified potential key areas for curricular focus, including creating patient-centered agendas and management plans within the constraints of virtual settings. These developments must take place simultaneously with systems-level improvements in interpreter infrastructure in order to ensure high quality care for linguistically diverse patients. CLINICALTRIAL N/A

scholarly journals Knowledge and attitudes of U.S. medical students regarding the care of Asian American patients: a cross-sectional survey study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Sharon Pang ◽  
Hursuong Vongsachang ◽  
Thomas K. Le ◽  
George Q. Zhang ◽  
Taibo Li ◽  
...  
Keyword(s):  
Medical Students ◽  
Medical School ◽  
Asian American ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Explicit Bias ◽  
Caucasian Patients ◽  
The U.S ◽  
Growing Population

Abstract Background Asian Americans (AsAm) are a rapidly growing population in the U.S. With this growing population, U.S. healthcare providers must be equipped to provide culturally competent care for AsAm patients. This project surveyed U.S. medical students on their knowledge of and attitudes towards AsAm to assess predictors of readiness to care for AsAm patients. Method This cross-sectional study surveyed medical students who had completed at least one clinical rotation. The survey was distributed online to nine medical schools throughout the U.S. The survey measured self-rated knowledge of, comfort with, cultural competency (CC) towards, and explicit biases towards AsAm patients. The first three domains were analyzed in a multivariate regression model including sociodemographic characteristics and past clinical, curricular, and social experiences with AsAm. Explicit bias questions were reported descriptively. Results There were 688 respondents. Asian race, AsAm-prevalent hometown, AsAm-related extracurricular activities, Asian language knowledge, and having taken a population health course predicted increased AsAm knowledge. Social interactions with AsAm increased comfort with AsAm patients. Increasing year in medical school, more frequent exposure to AsAm patients on rotations, and prior travel to an Asian country were predictors of increased CC toward AsAm. Importantly, having completed a CC course was a significant predictor in all domains. In terms of explicit bias, students felt that AsAm patients were more compliant than Caucasian patients. Students also believed that Caucasian patients were generally more likely to receive self-perceived “preferred” versus “acceptable” care, but that in their own clinical experiences neither group received preferred care. Conclusion Experience with and exposure to AsAm prior to and during medical school and CC courses may increase medical student knowledge, comfort, and CC with AsAm patients. Standardized and longitudinal CC training, increased simulations with AsAm patients, diverse student recruitment, and support for students to engage in AsAm-related activities and interact with AsAm may improve CC of future physicians towards AsAm patients and possibly other minority populations.

scholarly journals Influence of language skills on the choice of terms used to describe lung sounds in a language other than English: a cross-sectional survey of staff physicians, residents and medical students

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e044240
Author(s):  
Abraham Bohadana ◽  
Hava Azulai ◽  
Amir Jarjoui ◽  
George Kalak ◽  
Ariel Rokach ◽  
...  
Keyword(s):  
Medical Students ◽  
Dual Language ◽  
Language Skills ◽  
Cross Sectional Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
C Language ◽  
Audio Recordings ◽  
Chest Auscultation ◽  
English Speaking

IntroductionThe value of chest auscultation would be enhanced by the use of a standardised terminology. To that end, the recommended English terminology must be transferred to a language other than English (LOTE) without distortion.ObjectiveTo examine the transfer to Hebrew—taken as a model of LOTE—of the recommended terminology in English.Design/settingCross-sectional study; university-based hospital.Participants143 caregivers, including 31 staff physicians, 65 residents and 47 medical students.MethodsObservers provided uninstructed descriptions in Hebrew and English of audio recordings of five common sounds, namely, normal breath sound (NBS), wheezes, crackles, stridor and pleural friction rub (PFR).Outcomes(a) Rates of correct/incorrect classification; (b) correspondence between Hebrew and recommended English terms; c) language and auscultation skills, assessed by crossing the responses in the two languages with each other and with the classification of the audio recordings validated by computer analysis.ResultsRange (%) of correct rating was as follows: NBS=11.3–20, wheezes=79.7–87.2, crackles=58.6–69.8, stridor=67.4–96.3 and PFR=2.7–28.6. Of 60 Hebrew terms, 11 were correct, and 5 matched the recommended English terms. Many Hebrew terms were adaptations or transliterations of inadequate English terms. Of 687 evaluations, good dual-language and single-language skills were found in 586 (85.3%) and 41 (6%), respectively. However, in 325 (47.3%) evaluations, good language skills were associated with poor auscultation skills.ConclusionPoor auscultation skills surpassed poor language skills as a factor hampering the transfer to Hebrew (LOTE) of the recommended English terminology. Improved education in auscultation emerged as the main factor to promote the use of standardised lung sound terminology. Using our data, a strategy was devised to encourage the use of standardised terminology in non-native English-speaking countries.

scholarly journals Impact of the COVID-19 Pandemic on the Psychological Distress of Medical Students in Japan: Cross-sectional Survey Study (Preprint)

2020 ◽  
Author(s):  
Yoshito Nishimura ◽  
Kanako Ochi ◽  
Kazuki Tokumasu ◽  
Mikako Obika ◽  
Hideharu Hagiya ◽  
...  
Keyword(s):  
Mental Health ◽  
Medical Students ◽  
Online Education ◽  
Cross Sectional Study ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
State Of Emergency ◽  
Web Based ◽  
Subjective Mental Health

BACKGROUND The COVID-19 pandemic has negatively affected medical education. However, little data are available about medical students’ distress during the pandemic. OBJECTIVE This study aimed to provide details on how medical students have been affected by the pandemic. METHODS A cross-sectional study was conducted. A total of 717 medical students participated in the web-based survey. The survey included questions about how the participants’ mental status had changed from before to after the Japanese nationwide state of emergency (SOE). RESULTS Out of 717 medical students, 473 (66.0%) participated in the study. In total, 29.8% (141/473) of the students reported concerns about the shift toward online education, mostly because they thought online education would be ineffective compared with in-person learning. The participants’ subjective mental health status significantly worsened after the SOE was lifted (<i>P</i>&lt;.001). Those who had concerns about a shift toward online education had higher odds of having generalized anxiety and being depressed (odds ratio [OR] 1.97, 95% CI 1.19-3.28) as did those who said they would request food aid (OR 1.99, 95% CI 1.16-3.44) and mental health care resources (OR 3.56, 95% CI 2.07-6.15). CONCLUSIONS Given our findings, the sudden shift to online education might have overwhelmed medical students. Thus, we recommend that educators inform learners that online learning is not inferior to in-person learning, which could attenuate potential depression and anxiety.

scholarly journals A Qualitative Identification of Gaps in Understanding About Brain Death Among Trainees, Health Care Personnel and Families at an Academic Medical Center

2020 ◽  
Vol 10 (4) ◽  
pp. 266-271
Author(s):  
Patrick M. Chen ◽  
Jamie Nicole LaBuzetta
Keyword(s):  
Health Care ◽  
Medical Students ◽  
Brain Death ◽  
Medical Center ◽  
Academic Medical Center ◽  
Health Care Personnel ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Patient Families

Background and Purpose: Death by whole brain criteria (brain death) is a clinical diagnosis. We sought to identify aspects of brain death that were unclear to both health care personnel and patient families. Methods: Institutional review board approved cross-sectional survey study of attendings, medical trainees (residents and fellows), senior medical students, advanced practice providers (APPs), and critical care nursing (registered nurses [RNs]) at a tertiary referral center over 6 months (March 2018 to September 2018). Surveys were completed on paper or electronically. Participants supplied the top 3 of (1) their own personal questions regarding brain death and (2) questions received from patient families about brain death from a prepared list of questions. Results: Two hundred twenty-nine individuals participated in the survey, with a response rate of 46%. Participation rates in brain death declaration among attendings (92%), RNs (84%), APPs (100%), and trainees of which included fellows (92%) and residents (85%) were high. Most frequently asked questions by trainees and health care personnel were “What are brain death mimics?” and “What is the gold standard testing?”. Questions received from patient families most commonly include “What is brain death?” and “Is brain death reversible?”. All medical students had questions about brain death. Greater than 75% of attendings endorsed having questions regarding brain death. Conclusion: Many health care personnel are involved with brain death declaration, but there are gaps in their understanding about fundamentals regarding brain death. We identify a need for early and targeted brain death education regarding brain death and family communication for various members of the health care profession.

scholarly journals Association Between HEXACO Personality Traits and Medical Specialty Preferences in Mexican Medical Students

2019 ◽  
Author(s):  
Francisco José Barbosa-Camacho ◽  
Roberto Carlos Miranda-Ackerman ◽  
Itzel Vázquez-Reyna ◽  
Vania Brickelia Jimenez-Ley ◽  
Francisco Javier Barrera-López ◽  
...  
Keyword(s):  
Medical Students ◽  
Personality Traits ◽  
Group Versus ◽  
Medical Specialty ◽  
Survey Study ◽  
Clinical Group ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Critical Choice ◽  
Surgical Group

Abstract Background: Medical specialty is a critical choice in a physician’s life because it determines their professional future and medical practice. Some are motivated to choose a specific specialty based on the monetary gain it can provide; others are inspired by seeing the work performed by a physician or a patient’s recovery. It is not uncommon to stereotype doctors’ personalities by their specialty. Methods: This was a cross-sectional survey study in which we administered the 100-item HEXACO-Personality Inventory-R to 292 medical students between September 2018 and March 2019. We evaluated six different domains of personality traits. We also included questions about their medical specialty of choice, their least preferred specialty, and the motivation behind these choices. The participants included 175 women (59.9%) and 117 men (40.1%). Results: When participants were asked about their preferred type of medical specialty, 52.4% indicated a preference for surgical specialties (surgical group) versus 47.6% who preferred clinical specialties (clinical group). We found that the surgical group showed a tendency toward higher scores for the extroversion (p = 0.004) and organization (p = 0.004) scales; while the clinical group presented higher scores in the honesty–humility (p = 0.038), emotionality (p = 0.048), and agreeableness (p = 0.014) scales. We identified critical differences within the overall group of medical students by sex and between medical specialty preference. Conclusions: Some classical stereotypes were confirmed by our results, such as surgical specialists being more prone to being extroverted and organized, while clinical specialists were prone to being more introverted, anxious, and more emotionally attached to their patients.

scholarly journals Change in alcohol consumption and physical activity during the COVID-19 pandemic amongst 76 medical students

PeerJ ◽  
2021 ◽  
Vol 9 ◽  
pp. e12580
Author(s):  
Christina Sandell ◽  
Mikhail Saltychev
Keyword(s):  
Physical Activity ◽  
Medical Students ◽  
Alcohol Consumption ◽  
Leisure Time Physical Activity ◽  
Survey Study ◽  
Rank Test ◽  
Cross Sectional Survey ◽  
Higher Alcohol ◽  
Cross Sectional ◽  
Negative Effect

Objective To investigate whether the COVID-19 pandemic has affected physical activity and alcohol consumption among medical students. Methods Cross-sectional survey study among 76 students in their second year of medical school. The Wilcoxon sign-rank test and Kruskal-Wallis H test were used to assess the difference between groups. Results Of 76 respondents, 68% were women, 66% were single and 34% were co-habiting. The median age was 21 years. Overall alcohol consumption decreased during the pandemic year by 12 g/week. Overall physical activity did not significantly change. The decrease in alcohol consumption was mostly caused by a change seen in a high tertile, change was −96 g/week. Alcohol consumption decreased more in women than in men, p = 0.0001. Conclusions It seems that alcohol consumption among medical students has decreased during the COVID-19 pandemic probably due to reduced social contacts and negative effect of social isolation. This decrease was seen especially among women and among students with higher alcohol consumption before the pandemic. Also, it seems that students had found their ways to remain active during the pandemic since the amount of leisure-time physical activity had not changed significantly.

scholarly journals Interpreting services provided during consultations in the medical sector : identifying shortcomings

2015 ◽  
Author(s):  
◽  
Thabani Robert Khumalo
Keyword(s):  
Limited English Proficiency ◽  
Ad Hoc ◽  
Language Barriers ◽  
Medical Setting ◽  
Medical Practitioners ◽  
Medical Sector ◽  
Medical Institutions ◽  
Medical Interpreting ◽  
English Speaking ◽  
The Difference

The study focuses on the interpreting services provided during consultations in the medical setting. It looks broadly at the communication deficiencies created by the difference in the languages spoken by both medical practitioners and patients during consultations. Several times, the researcher’s personal experience has shown that isiZulu speaking patients are frequently consulted by English speaking doctors whenever they visit medical institutions. Consequently, as a result of this situation, these isiZulu speaking patients with limited English proficiency find it difficult to fully express all their medical conditions to the English speaking doctors and vice versa due to the existing language barriers. These language barriers are most likely to give rise to inferior medical assistance to isiZulu speaking patients. Furthermore, the nurses find themselves being ad hoc interpreters in this regard based on the assumption that they are bilingual. However, their linguistic and interpreting ability are not considered. The study therefore investigates the possible shortcomings and also looks at the implications most likely to occur as a result of reluctance to provide professional medical interpreting services. The data is collected from medical practitioners (doctors and nurses) and patients. From the results obtained, the researcher suggests possible recommendations in order to address the identified shortcomings. Lolu cwaningo lumayelana nokutolika ezikhungweni zezempilo. Lugxile ekubhekeni izinkinga zokuxhumna ngokolimi ngenxa yokwehluka kwezilimi ezikhulunywa abasebenzi bezempilo kanye neziguli uma zize ezikhungweni zezempilo. Umcwaningi usebone izikhawu eziningi ukuthi uma iziguli ezikhuluma ulimi lwesiZulu ziya ezikhungweni zezempilo zivame ukusizwa odokotela abakhuluma isiNgisi. Ngenxa yalesi simo , iziguli ezingasazi kahle isiNgisi ziyehluleka ukuchazela odokotela ngokuphelele izinkinga zazo zezempilo, kanjanlo nodokotela bayehluleka ukuxhumana kahle nazo. Lezi zinkinga zokuxhumana, zingaba nomthelela omubi wokuthi iziguli ezikhuluma isiZulu zingatholi usizo olugculisayo lwezempilo. Ngenxa yalesi simo, abahlengikazi bagcina bezithola sebengotolika ngenxa yokuthi kucatshangelwa ukuthi bayakwazi ukukhuluma izilimi zombili. Akube kusabhekwa ukuthi bazazi kangakanani izilimi lezo kanye nokuthi bayakwazi yini ukutolika. Ucwaningo lubheka izingqinamba ezikhona kanye nezingenzeka ngenxa yokungahlinzekwa ngokutolika okusezingeni elifanele ezikhungweni zezempilo futhi kungahlinzekwa abantu abaqeqeshiwe. Imininingwane yokwenza lolu cwaningo iqoqwe kubasebenzi bezempilo (odokotela kanye nabahlengikazi) kanye neziguli. Umcwaningi ube esenza izincomo ezingasiza ukuqeda izinkinga ezitholakele emuva kokuba esethole imiphumela.

Sign in / Sign up

Export Citation Format

Share Document