title: Evaluation of medical student self-rated preparedness to care for limited English proficiency patients.
abstract: BACKGROUND
  Patients with limited English proficiency (LEP) represent a growing proportion of the US population and are at risk of receiving suboptimal care due to difficulty communicating with healthcare providers who do not speak their language. Medical school curricula are required to prepare students to care for all patients, including those with LEP, but little is known about how well they achieve this goal. We used data from a survey of medical students' cross-cultural preparedness, skills, and training to specifically explore their self-rated preparedness to care for LEP patients.
  
  
  METHODS
  We electronically surveyed students at one northeastern US medical school. We used bivariate analyses to identify factors associated with student self-rated preparedness to care for LEP patients including gender, training year, first language, race/ethnicity, percent LEP and minority patients seen, and skill with interpreters. We used multivariate logistic regression to examine the independent effect of each factor on LEP preparedness. In a secondary analysis, we explored the association between year in medical school and self-perceived skill level in working with an interpreter.
  
  
  RESULTS
  Of 651 students, 416 completed questionnaires (63.9% response rate). Twenty percent of medical students reported being very well or well-prepared to care for LEP patients. Of these, 40% were in their fourth year of training. Skill level working with interpreters, prevalence of LEP patients seen, and training year were correlated (p < 0.001) with LEP preparedness. Using multivariate logistic regression, only student race/ethnicity and self-rated skill with interpreters remained statistically significant. Students in third and fourth years were more likely to feel skilled with interpreters (p < 0.001).
  
  
  CONCLUSIONS
  Increasingly, medical students will need to be prepared to care for LEP patients. Our study supports two strategies to improve student preparedness: training students to work effectively with interpreters and increasing student diversity to better reflect the changing US demographics.
authors.affiliation: Harvard Medical School, 25 Shattuck Street, Boston, MA, USA.
authors.forename: Fatima
authors.initials: F
authors.lastname: Rodriguez
authors.forename: Amy
authors.initials: A
authors.lastname: Cohen
authors.forename: Joseph R
authors.initials: JR
authors.lastname: Betancourt
authors.forename: Alexander R
authors.initials: AR
authors.lastname: Green
mesh_terms: D002983:Clinical Competence; D003142:Communication; D004504:Education, Medical, Undergraduate; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D019303:Multilingualism; D010817:Physician-Patient Relations; D020377:Self Efficacy; D013337:Students, Medical / Q000523:psychology*; D014175:Translating; D014481:United States