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PEDIATRICS Vol. 111 No. 5 May 2003, pp. e569-e573

ELECTRONIC ARTICLE

The Truth About Language Barriers: One Residency Program’s Experience

Sonja C. Burbano O’Leary, MD*, Steven Federico, MD* and Louis C. Hampers, MD, MBA{ddagger}

* Pediatric Residency Program
{ddagger} Section of Pediatric Emergency Medicine, The Children’s Hospital, Denver, Colorado

--> 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.

Key Words: language barriers • Spanish • interpreters • house staff

Abbreviations: TCH, The Children’s Hospital • LEP, limited English proficiency • PL, physician level • DHMC, Denver Health Medical Center • OR, odds ratio • CI, confidence interval

Received for publication Aug 20, 2002; Accepted Dec 20, 2002.




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