title: Relationship between self-assessed and tested non-English-language proficiency among primary care providers.
abstract: BACKGROUND
  Individuals with limited English proficiency experience poor patient-clinician communication. Most studies of language concordance have not measured clinician non-English-language proficiency.
  
  
  OBJECTIVE
  To evaluate the accuracy of the self-assessment of non-English-language proficiency by clinicians compared with an oral proficiency interview.
  
  
  METHODS
  Primary care providers (PCPs) in California and Massachusetts.
  
  
  METHODS
  PCPs first completed a self-assessment of non-English-language proficiency using a version of the Interagency Language Roundtable (ILR) Scale, followed by the Clinician Cultural and Linguistic Assessment (CCLA), a validated oral proficiency interview. We used nonparametric approaches to analyze CCLA scores at each ILR scale level and the correlation between CCLA and ILR scale scores.
  
  
  RESULTS
  Sixteen PCPs in California and 51 in Massachusetts participated (n=67). Participants spoke Spanish (79%), followed by Cantonese, Mandarin, French, Portuguese, and Vietnamese. The respondents self-assessed as having "excellent" proficiency 9% of the time, "very good" proficiency 24% of the time, "good" proficiency 46% of the time, "fair" proficiency 18% of the time, and "poor" proficiency 3% of the time. The average CCLA score was 76/100. There was a positive correlation between self-reported ILR scale and CCLA score (σ=0.49, P<0.001). The variance in CCLA scores was wider in the middle categories than in the low or high ILR categories (P=0.003).
  
  
  CONCLUSIONS
  Self-assessment of non-English-language proficiency using the ILR correlates to tested language proficiency, particularly on the low and high ends of the scale. Participants who self-assess in the middle of the scale may require additional testing. Further research needs to be conducted to identify the characteristics of PCP whose self-assessments are inaccurate and, thus, require proficiency testing.
authors.affiliation: Departments of *Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service †Medicine, Memorial Sloan-Kettering Cancer Center ‡Department of Public Health, Weill Cornell Medical College, New York, NY §Palo Alto Medical Foundation Research Institute, Palo Alto, CA ∥Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA ¶Department of Medicine & Health Innovation Program, University of Wisconsin, Madison, WI.
authors.forename: Lisa
authors.initials: L
authors.lastname: Diamond
authors.forename: Sukyung
authors.initials: S
authors.lastname: Chung
authors.forename: Warren
authors.initials: W
authors.lastname: Ferguson
authors.forename: Javier
authors.initials: J
authors.lastname: Gonzalez
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Jacobs
authors.forename: Francesca
authors.initials: F
authors.lastname: Gany
mesh_terms: D002140:California; D003144:Communication Barriers; D005260:Female; D006282:Health Personnel / Q000523:psychology / Q000706:statistics & numerical data*; D006801:Humans; D007802:Language; D008297:Male; D008404:Massachusetts; D019303:Multilingualism; D010820:Physicians / Q000706:statistics & numerical data; D011320:Primary Health Care / Q000706:statistics & numerical data*; D011369:Professional-Patient Relations; D057566:Self Report