English Proficiency And Receiving Quality Healthcare
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Being able to speak English clearly with healthcare professionals is critical to the safety of our students and quality of care
English proficiency and receiving quality healthcare is more important today than ever before. When a healthcare professional sees an ill student, let’s say, in hospital, the first step usually is to collect a patient’s history. Clinical history comes through conversations with the patient. In an ideal situation, it would also include the patient’s family, observation of the patient, and perhaps some testing or imaging. Diagnosis and treatment plans are communicated to the patient orally after establishing a procedure. Oral communication is a necessity for patient-family-centered care to limit adverse events in US hospitals.
The collection of accurate and comprehensive patient-specific data are the basis for proper diagnosis and prognosis. This involves verbally communicating between doctors, nurses, and the patient. Healthcare professionals call it effective communication and also includes:
- the patient agreeing to a treatment plan
- “informed” consent
- providing spoken explanations, instructions and educating the patient
- counseling and consoling the patient
English proficiency and receiving quality healthcare is linked directly to effective communication. So what is effective communication? Effective communication is communication that is comprehended by both participants; it is usually bidirectional between participants and enables both participants to clarify the intended message. When effective communication is absent, the provision of healthcare ends — or proceeds only with errors, poor quality, and risks to patient safety.
Effective communication explained
When patients with limited English proficiency are treated by physicians and other health professionals who are proficient only in English, 3 factors converge to create a “triple threat” to effective communication:
- The language barriers themselves are a barrier to effective communication.
- Unfortunately, we associate cultural differences with language differences. These are a barrier to effective communication. One’s culture affects one’s understanding of a word or sentence and even one’s perception of the world. Learning a language is not the same as understanding a culture.
- Many clinicians report thinking the patient understands them if the patient doesn’t ask questions. They belatedly discovered that the patient actually didn’t understand a thing they wrote or spoke about. Doctors call this “health literacy.”
So what’s the answer to keeping students safe when they’re ill?
There is a growing body of evidence-based practices that address these three barriers (above). Therefore, it isn’t enough to test for only listening and writing skills when we bring students into the United States. Incorporating verbal skills into the redesign of the relevant practice of using English proficiency tests to be valid, reliable, and sustainable. Those tests that combine listening and speaking skills keep students safer. The iTEP Conversation test is one test with 100% speaking that is good to try out. There is a verifiable link (see the notation below) regarding language proficiency and adverse events in US hospitals.
References
The Joint Commission. ‘What Did the Doctor Say?:’ Improving Health Literacy to Protect Patient Safety. Oakbrook Terrace, IL: The Joint Commission; 2007.
Divi C, Koss RG, Schmaltz SP, Loeb JM. Language proficiency and adverse events in U.S. hospitals: a pilot study. Int J Qual Health Care. 2007; 19:60–67.
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