MODULE 5: Language and Cultural Barriers (Under Review)

Module Presentation

Learning Objectives

  1. Understand and describe the existing inequities in care for LEP, immigrant and refugee patients.

  2. Understand and describe best practices in caring for Limited English Proficiency (LEP), immigrant and refugee patients.

  3. Understand legal regulations surrounding appropriate language services

  4. Understand legal ramifications for not using professional interpreters

  5. Self-reflect on personal and systemic barriers to utilization of language services and language equity.

Literature Review

Textbooks

Alter HJ et al. Social Emergency Medicine: Principles and Practice. 1st ed.  Springer Cham; 2021. doi: 10.1007/978-3-030-65672-0

Articles

  • Do Words Matter? Stigmatizing Language and the Transmission of Bias in the Medical Record (10.1007/s11606-017-4289-2) - Found that stigmatizing language in medical records leads to a transference of bias from trainee to trainee.

  • Disparities in Preterm Infant Emergency Room Utilization and Rehospitalization by Maternal Immigrant Status (10.1016/j.jpeds.2020.01.052) -- Among immigrant mothers, non-English primary language, >5 years living in the US, and BPD increased the odds of an ER visit. Immigrant mother + Medicaid provided a significant modifying effect on increased rehospitalization and ER use.

  • Evaluating a knowledge translation tool for parents about pediatric acute gastroenteritis: a pilot randomized trial (10.1186/s40814-018-0318-0) -- Outlines a study looking at Knowledge Translation in the form of an informative video in helping parents understand the disease process of acute gastroenteritis. Could not find the results, may be an ongoing or derailed study but interesting topic to look into to improve language barriers. 

  • COVID-19 Education for Health Professionals Caring for Spanish-Speaking Patients (10.15766/mep_2374-8265.11240) -- Created a module to help English-speaking healthcare workers better explain COVID-19 to Spanish-speaking patients.

  • Prehospital emergency care nurses' strategies while caring for patients with limited Swedish-English proficiency (10.1111/jocn.14484) -- "The nurses need to be prepared for how to assess and care for patients when there is a lack of mutual language; otherwise, there is a risk of increased unequal care in the ambulance service."

  • Beliefs, perceptions, and behaviors impacting healthcare utilization of Syrian refugee children (10.1371/journal.pone.0237081) -- "Psychosocial and environmental stressors as well as perceived systemic health barriers, hinder health seeking behaviors in Syrian refugee parents."

  • Factors Impacting Adherence to Diabetes Medication Among Urban, Low Income Mexican-Americans with Diabetes (10.1007/s10903-019-00867-9) -- "suggests that concerns regarding negative impact of diabetes medication and concerns regarding effectiveness are prevalent barriers to adherence."

  • Development of a self-assessment tool for resident doctors’ communication skills in India (10.3352/jeehp.2019.16.17) -- "valid assessment tool of resident doctors’ communication skills, with potential utility for identifying gaps in communication skills and developing communication skills modules."

  1. Poola et al. Self-Reported Barriers to Healthcare and Interpreter Preferences for Patients with Limited-English-Proficiency in an Urban Emergency Department (10.18103/mra.v8i8.2173)

Paired Resources

FOAMED

Supplemental Materials

Sim cases/Case studies