MedEdPORTAL (Jun 2010)
Interpretation at the OB/GYN Bedside - Cultural Competence in the Third-Year Clerkships
Abstract
Abstract Introduction Cultivating effective cross-cultural communication skills requires an understanding of culture that includes both the physician's and the patient's perspectives. Building on a foundation of cultural awareness, knowledge, and skills that students have acquired during preclinical curriculum, this exercise provides an opportunity for students to continue to refine their clinical skills as they practice medical interpretation at the bedside. Methods This clinical experience in medical interpretation is designed for implementation during the required third-year OB/GYN clerkship. After a brief didactic review on the use of medical interpreters, students are assigned to care for a laboring woman with limited English proficiency through the course of her labor. Following the clinical encounter, a written reflection is assigned to assist students with reflecting on their skills in providing care to limited English proficiency patients. Faculty-led small-group discussions utilize these reflections as a means to discuss the students' clinical encounters. Finally, evaluation of student mastery of interpretation skills is made by an objective structured clinical exam (OSCE) during the final week of the clerkship. A diverse patient population that speak a variety of languages is necessary for clinical assignment. Standardized patients who speak languages other than English are needed for OSCE implementation. Results OSCE scores confirmed students' ability to demonstrate the clinical skills of empathy and non-verbal communication. Students demonstrated an average score of 73% for medical interpretation principles. On a 6-point scale, with 6 being best, an overall self-efficacy score of 4.0 was reported. Scores at the end of the year were slightly increased (4.2) when compared to the first rotation (3.9). Discussion Orientation to the student activity of the entire medical team (residents, attendings, nurses) positively impacts the success of the project. Integrating cultural competence into the clinical clerkships allows students to apply cultural competence knowledge gained in the first 2 years of medical education, as well as develop clinical skills in caring for patients with a variety of cultural backgrounds.
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