title: Feasibility of Spanish-language acquisition for acute medical care providers: novel curriculum for emergency medicine residencies.
abstract: BACKGROUND
  Language and cultural barriers are detriments to quality health care. In acute medical settings, these barriers are more pronounced, which can lead to poor patient outcomes.
  
  
  METHODS
  We implemented a longitudinal Spanish-language immersion curriculum for emergency medicine (EM) resident physicians. This curriculum includes language and cultural instruction, and is integrated into the weekly EM didactic conference, longitudinal over the entire 3-year residency program. Language proficiency was assessed at baseline and annually on the Interagency Language Roundtable (ILR) scale, via an oral exam conducted by the same trained examiner each time. The objective of the curriculum was improvement of resident language skills to ILR level 1+ by year 3. Significance was evaluated through repeated-measures analysis of variance.
  
  
  RESULTS
  The curriculum was launched in July 2010 and followed through June 2012 (n=16). After 1 year, 38% had improved over one ILR level, with 50% achieving ILR 1+ or above. After year 2, 100% had improved over one level, with 90% achieving the objective level of ILR 1+. Mean ILR improved significantly from baseline, year 1, and year 2 (F=55, df =1; P<0.001).
  
  
  CONCLUSIONS
  Implementation of a longitudinal, integrated Spanish-immersion curriculum is feasible and improves language skills in EM residents. The curriculum improved EM-resident language proficiency above the goal in just 2 years. Further studies will focus on the effect of language acquisition on patient care in acute settings.
authors.affiliation: Department of Emergency Medicine, Regions Hospital, Health Partners Institute, St Paul, MN, USA.
authors.forename: Kristi H
authors.initials: KH
authors.lastname: Grall
authors.affiliation: Department of Emergency Medicine, Wexner Medical Center, Ohio State University, Columbus, OH, USA.
authors.forename: Ashish R
authors.initials: AR
authors.lastname: Panchal
authors.affiliation: Department of Spanish and Portuguese, University of Arizona, Tucson, AZ, USA.
authors.forename: Eliud
authors.initials: E
authors.lastname: Chuffe
authors.affiliation: Department of Emergency Medicine, University of Arizona, Tucson, AZ, USA.
authors.forename: Lisa R
authors.initials: LR
authors.lastname: Stoneking
keywords: Spanish; emergency medicine; graduate medical education; immersion curriculum; language