A Novel Simulation to Assess Residents' Utilization of a Medical Interpreter

• Type of Material: Article
• Authors: Michael J. Zdradzinski, Lewis Katz School of Medicine; Anika Backster, Emory University; Sheryl Heron, Emory University; Melissa White, Emory University; Deborah Laubscher, Emory University; Jeffrey N. Siegelman, Emory University
• Language: English
• Date: 2019-11-22
• Publisher: Association of American Medical Colleges
• Publication Version: Final Published Version
• Copyright Statement: © 2019 Zdradzinski et al.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.15766/mep_2374-8265.10853
• Title of Journal or Parent Work: MedEdPORTAL
• Volume: 15
• Start Page: 10853
• End Page: 10853
• Grant/Funding Information: None to report.
• Keywords: Medical Interpreter; Language Barrier; Health Care Disparities, Diversity, Inclusion, Health Equity; Simulation; Spanish; Resident Assessment
• Research Categories: Health Sciences, Health Care Management; Health Sciences, Medicine and Surgery

Abstract

Introduction: Physicians must be facile in working with a medical interpreter (MI) given the large population of patients with limited English proficiency. Methods: To facilitate residents' assessment of their ability to interact with non-English-speaking patients, we developed a simulation case involving one such patient. The case involved a 31-year-old Spanish-speaking postpartum female who presented with eclamptic seizures. The learner needed to request an MI to assist with obtaining the patient's medical history once her concerned family member (also Spanish speaking) arrived. The major critical actions included appropriate use of MI services, recognition of the risk for eclamptic seizures, proper evaluation and treatment, and appropriate disposition to an obstetrician. The case required a high-fidelity mannequin and simulation operator, nurse simulated participant, Spanish-speaking actor (to play the husband or family member), certified Spanish MI, and faculty evaluator. Results: We implemented this case with 60 emergency medicine residents, ranging from PGY 1 to 3. The learner was assessed by both the faculty observer and MI. Checklists for assessment and debriefing materials were provided. Two of 60 residents did not request an MI. When compared to a prior version of this case that did not include the language barrier, median scores dropped from 12 to 10 out of 24, suggesting that the language barrier created a more challenging case. Discussion: The use of MIs is an integral part of health care practice in the United States, and we present a simulation case that can assess learners' use of MIs.