Introduction: Language discordance increases hospital length of stay and morbidity. We developed a medical Spanish program aimed at improving equitable, language-concordant care. We hypothesized that the course would improve Spanish-speaking patient satisfaction, increase clinician empathy, and enhance language proficiency.
Methods: A 20-week Medical Spanish curriculum was implemented for pediatric, neonatal, and cardiac ICU physicians, nurses, and social workers. Patient satisfaction was assessed using the CAHPS Child Hospital survey and analyzed with an unpaired t-test. Clinician empathy was measured using a validated self-assessment questionnaire, analyzed with the Wilcoxon Signed-Rank Test. Respondents rated statements such as “I respected the patient as a person” on a 5-point Likert scale. Clinicians completed pre- and post-course proficiency testing.
Results: Preliminary data from 39 pre-course CAHPS surveys (30 English-speaking, 9 Spanish-speaking) showed Spanish-speaking caregivers perceived nurses as less likely to listen carefully, explain clearly, or encourage questions compared to English-speaking caregivers on a 5-point Likert scale (3.5 vs. 4, p=0.05). However, they rated their overall hospital experience higher than English-speaking caregivers on a 10-point scale (9.89 vs. 8.68, p=0.0114). Post-course surveys (n=34) showed no improvement in satisfaction. Language proficiency ranged from novice-low to intermediate-low pre-course and remained unchanged post-course. Clinician empathy data (n=93) showed significantly lower empathy toward Spanish-speaking patients in 15/16 statements pre-intervention. Post-intervention, empathy toward Spanish-speaking patients improved significantly in 8/16 statements (p = 0.002 - 0.027).
Conclusions: The medical Spanish curriculum in the pediatric and neonatal ICU was associated with significant improvement in empathy toward Spanish-speaking patients. While patient satisfaction did not improve, this may reflect inadequate clinician proficiency and challenges related to clinician attendance. Additionally, patients who completed the survey may not have interacted with clinicians who participated in the course. Despite these limitations, the results underscore the importance of language-concordant interventions and the need for further evaluation and refinement.
