The truth about language barriers: one residency program's experience.
OBJECTIVE
To describe perceptions of how a lack of house staff Spanish proficiency adversely affects communication with Spanish-speaking families with limited English proficiency (LEP).


METHODS
An anonymous, structured questionnaire was administered to the house staff an of urban, university-affiliated children's hospital that serves a population in which 10%-20% have LEP.


RESULTS
Ninety-four percent (59 of 63) completed the questionnaire. Sixty-eight percent (40 of 59) reported that they spoke little or no Spanish (although 36 of 40 expressed a desire to learn Spanish). Fifty-three percent (21 of 40) of these nonproficient residents reported that they used their inadequate language skills in the care of patients "often" or "every day." Many of these residents believed that LEP families under their care "never" or only "sometimes" understood their child's diagnosis (21 of 40), medications (11 of 40), discharge instructions (17 of 40), or follow-up plan (16 of 40). Eighty percent (32 of 40) admitted to avoiding communication with such families. Although all (40 of 40) agreed that hospital interpreters were effective, 30 of 40 nonproficient residents reported use of hospital interpreters "never" or only "sometimes." Fifty-three percent (21 of 40) of these nonproficient residents reported calling on their proficient colleagues "often" or "every day" for assistance. Thirty-two percent (19 of 59) of residents described themselves as "fluent" or "proficient" in Spanish. Fifty-eight percent (11 of 19) reported that they were asked to interpret for fellow residents "often" or "every day." Proficient residents estimated that they spent a mean of 2.3 hours per week interpreting for other residents.


CONCLUSIONS
Despite a perception that they are providing suboptimal communication, nonproficient residents rarely use professional interpreters. Instead, they tend to rely on their own inadequate language skills, impose on their proficient colleagues, or avoid communication with Spanish-speaking families with LEP.
Pediatric Residency Program, The Children's Hospital, Denver, Colorado, USA. burboleary@frii.com
Sonja C
SC
Burbano O'Leary
Steven
S
Federico
Louis C
LC
Hampers
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003120:Colorado; D003144:Communication Barriers; D016001:Confidence Intervals; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006776:Hospitals, Pediatric / Q000458:organization & administration / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007396:Internship and Residency / Q000458:organization & administration / Q000706:statistics & numerical data*; D007802:Language; D008297:Male; D019303:Multilingualism; D011320:Primary Health Care / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014175:Translating; D014481:United States; D000078329:Workforce