MULTICULTURAL

CONTACT:
Dr. Saavedra

PULLMAN/MOSCOW
RESOURCE LIST

FWelcome to the Spanish for Health Professionals

Welcome to SHP

Francisco Saavedra, M.D.
Course Chair, SHP-FAMED 556
Multicultural Programs Coordinator, WSU/UI-WWAMI
Clinical Assistant Professor, UW School of Medicine

Linguistically-capable, knowledgeable, and culturally-sensitive physician-patient communication is linked to improved patient satisfaction, adherence to recommendations, and better health outcomes. As the U.S. becomes more ethnically diverse, physicians will increasingly see patents with a broad range of perceptions regarding health. The concept of Spanish for Health Professionals (SHP) has recently emerged as an important goal in U.S. medical schools in response to such findings and changing demographics. Patients may present their symptoms quite differently from what we've learned in our textbooks. They may have different expectations or thresholds for seeking care, and their beliefs will influence whether or not they will follow our recommendations. Two recent reports by the Institute of Medicine , highlight the importance of patient-centered care based on linguistic and cultural competence as a means of improving communication, and thereby improving quality, eliminating disparities, and even achieving equity in health care. Bilingual physicians -the gold standard in communication- who converse directly with Latino patients in Spanish must demonstrate a command of the language that includes knowledge and facility with the terms and concepts relevant to each type of encounter. When linguistic and sociocultural differences between patient and physician are not explored and communicated, patient dissatisfaction, nonadherence, and poorer health outcomes are likely.

We are clearly aware that patients really value and look forward to an individual relationship with a well-trained, experienced, and open-minded physician who is accessible, knows them as a person, and deeply understands the bio-social and cultural context of their lives. They envision a professional who is truly willing to work objectively for their best interest, and even in the face of the most dangerous illness, prevail against all odds. SHP is an effort to provide a genuine response to how we need to adapt to an ever-changing world.

What is Spanish for Health Professionals?

COURSE ANNOUNCEMENT (PDF)

Why Learn Spanish?
If you speak Spanish, you can communicate with nearly 500 million people in the world! This means you will have a greater number of possibilities in the labor market. Should you only want to visit Spain or Latin America, a basic level of Spanish will help you go far!

• At the end of the 19th century, 60 million people were Spanish speakers. Today, nearly 500 million people across the world speak Spanish!
  
  
• The Latino population in the United States has grown by 60 per cent in just one decade. As of July 2003, the Hispanic population stood at 39.9 million.
  
  
• Spanish is the mother tongue of approximately 500 million people in 21 countries (Mexico: 100 million, Spain: 40 million, Argentina: 35 million, Colombia: 35 million, Venezuela: 25 million, Peru: 20 million...).
  
  
• Spanish is the second most used language in international communication and the third as an international language of politics, economics and culture.
  
  
• The creation of MERCOSUR and many other free trade agreements between South American countries and North America (ALADI, the Andean Community, CACM, NAFTA, G3) which already exist in order to improve the economies of these countries, making them more efficient and competitive.
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Course Description & Objectives:

I.Faculty:

Francisco Saavedra, M.D., Course Chair, and Natalie Cifuentes, M.A., TA.
Collaborators: Alexander Carvajal-González, M.D., MSc. Associate Researcher, WSU-VCAPP Department; and Michael Heim, graduate student.

II. Course Description:

SHP (or FAMED 556) is an elective, one-credit, intensive Spanish language course, devoted to the study of medical Spanish and the cultural issues related to successful interactions with the Spanish-speaking patient in the clinical encounter, regardless of one's current level of Spanish comprehension.

III. Objectives:

• Vocabulary and Basics of Grammar:
  Medical, common and colloquial, sentence construction/ questions, and verb tenses.
  
• The Clinical History in Spanish:
  Spoken Spanish -the clinical encounter- asking questions, providing commands and instructions, and farewell; oral case presentations and written clinical history/ notes (Identifying Data-ID; Chief Complaint-CC; History of Present Illness-HPI; Standard Medical Database: Past Medical History-PMH, Family History-FH, Social History-SH & Review of Systems-ROS; and Heath Maintenance and Functional Status).
  
• Evaluating Patients in Spanish:
  Comprehensive physical examination, laboratory workup and diagnostic evaluation.
  
• Explaining Diagnoses in Spanish:
  Diagnoses and their explanations and rationale.
  
• Managing Treatment Decisions in Spanish:
  Implementing, explaining treatment regimens and options and the use of the familiar "prescription" notes for patients.
  
• Cultural Sensitivity:
  Provides essential tools to improve students' cultural and linguistic competence and communicate in a specialized and culturally-sensitive manner with Spanish-speaking patients. Awareness of the differences in the perceptions of physicians, medicine and treatment; this also includes learning how to be assertive, while demonstrating the appropriate skills and cultural sensitivity, approaching Spanish-speaking patients. These skills could then be applied when dealing with Latino patients in the U.S. and abroad.
  
• Set a foundation for further learning of Spanish.
  Develop of a sense of awareness and continuity in improving the medical Spanish for professional use.
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Why Spanish for Health Professionals? Important Points to Consider:

IV. Background and Rationale:

A. After English, Spanish is the most important spoken language in the U.S.

B. Hispanics are the fastest growing minority in the U.S. As of July 2003, the Hispanic population stood at 39.9 million.

C. The clinical encounter with non-English-speaking Hispanics or those with limited English skills is a frequent situation in clinical settings throughout the U.S.

D. There are important cultural considerations regarding Hispanics: they feel much more comfortable if a health care provider can communicate with them in Spanish, even with basic Spanish. This in itself could be the key element to opening an effective professional relationship.

E. Relying on untrained/impromptu translators for the collection of clinical data can create problems/liabilities during diagnosis, management and follow up.

F. The Federal Government will support the legalization of transitional workers in the U.S. from Mexico, which will increase the open exposure of this population to mainstream medical care.

G. To know another language, especially Spanish, gives one a strong cultural base to support professional activities and credibility in society.

H. Bilingual (Spanish) physicians have a strong advantage in the marketplace, are able to get better international clinical experience, and be more accessible in global medicine initiatives and programs.
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V. Class format:

a. Culture discussion (when article is assigned)
b. Vocabulary/Grammar review from previous class and Quiz
c. Grammar explanation (based on assigned reading)
d. Vocabulary and dialogue pre-view
e. Case scenario dialogue practice

VI. Methodology-Hands On:

a. Skill-based: students are divided into small groups based on their initial language level, and are given different tasks and evaluations.
b. Interactive: two-way, constant communication emphasizing pronunciation and essential vocabulary and key grammatical construction.
c. Practical: use of basic high-frequency expressions in the clinical encounters as you would use it in a professional setting.
d. Fun!-¡Divertido!

VII. Syllabus: Duration, Schedule and Place:

a. Total Duration: 16 hours, eight sessions, which includes a middle practice and the final exam both with standardized Spanish-speaking patients.
b. Where: WSU Morrill 124 and UI EP 214
c. Schedule: Below
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VIII. Materials:

1. Saavedra, Francisco, MD., Diana Villanueva, M.D. (2006), Komlos, Barbara Z. (2006). WWAMI Spanish for Health Professionals course reader.
   
2. Handouts: available in advance.
   
3. Blackboard.
   
4. Transparencies.
   
5. PowerPoint Presentations.
   
6. Bibliography-book reviews and recommended references.
   
7. Electronic resources: SHP on the web-materials accessible on-line, and other resources such as Spanish dictionaries and electronic books.

IX. Assessment:

a. Pre-Instruction Survey: this self-assessment will be used to from groups in class and tailor course to students' needs.

b. Quizzes: these daily assessments will not be graded, rather serve as measures of each student's progress.

c. Clinical Skills Assessment (CSA) in Spanish: this final exercise with standardized Spanish speaking patients will assess students' ability to understand basic clinical Spanish and ask relevant questions related to the clinical history and identifying a patient's chief complaint. Students will be scored by the instructor for comprehension and by the patients for basic communication skills and cultural sensitivity.
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Class Documents:

Evaluations:

1. CLASS ASSESSMENT: self-assessment at the first meeting. For specific information and instructions CLASS ASSESSMENT (PDF)
   
   
2. QUIZ: at the beginning of each class—review of vocabulary and basic anatomical terms. EXAMPLE QUIZ. (PDF)
   
   
3. CSA EVALUATION: Clinical Skills Assessment (CSA) in Spanish with standardized Spanish-speaking patients. For specific information and instructions:

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Faculty:

FRANCISCO SAAVEDRA M.D., Course Chair; and NATALIE S. CIFUENTES M.A., Teaching Assistant

BOOKS TO REVIEW(PDF)