■文化能力和谦逊是多元化社会中医学教育的核心要素。语言与文化密不可分,正如语言所告知的那样,索引,框架,并编码了文化和世界观。西班牙语是美国医学院教授的最常见的非英语语言,然而,医学西班牙语课程倾向于人为地将语言与文化分开。目前尚不清楚医学西班牙语课程在多大程度上提高了学生的社会文化知识或患者护理技能。
■基于当前的主流教学法,医学西班牙语课程可能无法充分整合与西班牙裔/拉丁裔健康相关的社会文化问题。我们假设完成医学西班牙语课程的学生在教育干预后不会表现出社会文化技能的显着提高。
■一个跨专业团队开发了一份社会文化问卷,15个医学院邀请他们的学生在完成医学西班牙语课程之前和之后完成问卷。参与的学校,12个实施了标准化的医学西班牙语课程,3个作为控制地点。调查数据进行了以下方面的分析:(1)感知的社会文化能力(对共同文化信仰的认可,承认文化规范的非语言线索,手势,和社会行为,在医疗保健背景下解决社会文化问题的能力,和健康差异的知识);(2)社会文化知识的应用;(3)人口统计学因素和自我评估的语言能力(差,公平,很好,非常好,或优秀)在医疗保健机构间语言圆桌会议量表(ILR-H)上。
■总的来说,610名学生在2020年1月至2022年1月期间参加了社会文化问卷调查。课程结束后,参与者报告说,他们对与西班牙语患者沟通的文化方面以及将社会文化知识应用于患者护理的能力有了更多的了解(均p<0.001).当按人口因素分析时,确定为西班牙裔/拉丁裔或西班牙语传统使用者的学生倾向于在课程结束后报告增加的社会文化知识/技能。当通过西班牙语水平检查时,初步趋势表明,处于ILR-H贫困和优秀水平的学生都没有表现出社会文化知识或应用社会文化技能的能力。参加标准化课程的学生可能会提高心理健康对话中的社会文化技能(p<0.001),而对照组的学生则没有(p=0.05)。
■医学西班牙语教育者可能会从有关交流的社会文化方面的教学的额外指导中受益。我们的发现支持ILR-H公平水平的学生,很好,非常好,特别适合在当前的医学西班牙语课程中获得社会文化技能。未来的研究应该探索潜在的指标,以评估与患者实际互动中的文化谦逊/能力。
UNASSIGNED: Cultural competence and humility are core elements of medical education in a diverse society. Language is inseparable from culture, as language informs, indexes, frames, and encodes both culture and worldview. Spanish is the most common non-English language taught in U.S. medical schools, yet medical Spanish courses tend to artificially separate language from culture. It is unknown to what extent medical Spanish courses advance students\' sociocultural knowledge or patient care skills.
UNASSIGNED: Based on current predominant pedagogy, medical Spanish classes may not adequately integrate sociocultural issues relevant to Hispanic/Latinx health. We hypothesized that students who completed a medical Spanish course would not demonstrate significant gains in sociocultural skills following the educational intervention.
UNASSIGNED: An interprofessional team developed a sociocultural questionnaire, and 15 medical schools invited their students to complete the questionnaire before and after completing a medical Spanish course. Of participating schools, 12 implemented a standardized medical Spanish course and three served as control sites. Survey data were analyzed regarding: (1) perceived sociocultural competence (recognition of common cultural beliefs, recognition of culturally normative non-verbal cues, gestures, and social behaviors, ability to address sociocultural issues in healthcare context, and knowledge of health disparities); (2) application of sociocultural knowledge; and (3) demographic factors and self-rated language proficiency (Poor, Fair, Good, Very Good, or Excellent) on the Interagency Language Roundtable scale for healthcare (ILR-H).
UNASSIGNED: Overall, 610 students participated in sociocultural questionnaire between January 2020 and January 2022. After the course, participants reported an increased understanding of cultural aspects of communication with Spanish-speaking patients and the ability to apply sociocultural knowledge to patient care (all p < 0.001). When analyzed by demographic factors, students who identified as Hispanic/Latinx or as heritage speakers of Spanish tended to report increased sociocultural knowledge/skills following the course. When examined by Spanish proficiency, preliminary trends showed that students at both ILR-H Poor and Excellent levels did not demonstrate gains in sociocultural knowledge or ability to apply sociocultural skills. Students at sites with a standardized course were likely to improve sociocultural skills in mental health conversations (p < 0.001) while students at control sites were not (p = 0.05).
UNASSIGNED: Medical Spanish educators may benefit from additional guidance on teaching sociocultural aspects of communication. Our findings support that students at ILR-H levels of Fair, Good, and Very Good are particularly well-suited for gaining sociocultural skills in current medical Spanish courses. Future studies should explore potential metrics to evaluate cultural humility/competence within actual interactions with patients.