ePoster
E-learning about using interpreters in medical interview: improvement of students' knowledge and self-efficacy

Authors

  1. Jeanine Suurmond
  2. Umar Ikram
  3. Marie-Louise Essink-Bot

Theme

eLearning

INSTITUTION

AMC - University of Amsterdam

Background

 

Language barriers in health care contribute to poorer health outcomes among patients who do not speak the same language as their health care provider. Several studies have found that when health care providers use professional interpreters, clinical care for patients with limited English language proficiency is significantly improved (e.g. Karliner et al. 2007). Despite clear clinical benefits, health care providers often do not use professional interpreters (Diamond et al. 2008), for example because they find it easier to 'get by' without (professional) interpreters, or because they tend to overestimate their own competencies in this regard (Hudelson et al. 2012).

Studies have shown that care providers who have received any training about the impact of language barriers and/or the use of interpreters are more likely to call on appropriate interpreters when needed (e.g. Lee et al. 2006; Kalet et al. 2010).

In order to train our medical students , an e-learning-module was developed, which aimed to increase students' knowledge and self-perceived self-efficacy in working with professional interpreters.

121 fourth-year medical students took this e-learning just before the start of their clinical rotations. In this e-learning, they answered questions relating to three patient-physician-interpreter video vignettes, and compared their answers with best practices. In the video vignettes main pitfalls were introduced, for example, when using a family member or a bilingual staff member as an interpreter.

Summary of Work

Before and after the e-learning students completed a questionnaire. This pretest and posttest consisted of 10 multiple choice questions and 2 self-efficacy questions.

  

Summary of Results

Our results indicate that the median score of knowledge increased after the e-learning (median 9.00, IQR 2.00 vs. before the e-learning: median 6.00, IQR 4.00; p<0.001).  A similar pattern was observed for self-efficacy. Before the e-learning the median score was 4.00 (IQR 2.00) whereas after the median score was 7.00 (IQR 2.00), with a statistically significant difference (p<0.001).

Conclusion

Our e-learning resulted in improved knowledge and self-efficacy in arranging and using professional interpretation services among fourth-year medical students.  Such interactive educational formats may lower the barriers for current and future healthcare providers to use professional interpreters in clinical practice, improving quality of services for a multi-ethnic patient population.

Take-home Messages

 

 

  

 

  •  An e-learning module is an efficient educational intervention to improve students' knowledge and self-efficacy with regard to the use of interpreters;
  • The e-learning, however, does not replace face to face teaching sessions;
  • Role-playing sessions in which students have the opportunity to practice working with an interpreter are equally important.

 

  

 

 

References

    Diamond LC, Schenker Y, Curry L, Bradley EH, Fernandez A. Getting By: Underuse of interpreters by resident physicians. J Gen Intern Med. 2008;24(2):256-262.

Hudelson  P, Pernegere T, Kolly V, Perron NJ. Self-assessed competency at working with a medical interpreter is not associated with knowledge of good practice. PLos One 2012;7(6)e38973.

Kalet AL, Mukherjee D, Felix K, Steinberg SE, Nachbar M, Lee A, Changrani J, Gany F. Can a web-based curriculum improve students' knowledge of, and attitudes about, the interpreted medical interview? J Gen Intern Med. 2005; Oct 20(10):929-34.

 

Hudelson P, Perneger T, Kolly V, Perron NJ. Self-assessed competency at working with a medical interpreter is not associated with knowledge of good practice. PLoS One. 2012;7(6):e38973.

Karliner LS, Jacobs EA, Chen AH, Mutha S. Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health Serv Res. 2007;42(2):727-754.

 

Lee KC, Winickoff JP, Kim MK, Campbell EG, Betancourt JR, Park ER, Maina AW, Weissman JS. Resident physicians' use of professional and nonprofessional interpreters: a national study. JAMA 2006: 296: 1050-3.

 

   

 

Background

 

Summary of Work

 

Example of self-efficacy question:


How prepared do you feel to care for patients who do not speak Dutch?

 

 

 

 

Very unprepared 0 0 0 0 0 Very prepared

 

Example of multiple choice question:


When under time pressure a care provider should ask the interpreter:

A. To give a summary of the patient's words

B. To answer for the patient

C. Not to join the conversation between care provider and patient

D. Just translate the patient's turns

E. To give a word for word translation

(Option E is correct)

Summary of Results

 Table 1 - Scores on pretest and posttest 'knowledge items' 

Ranks

 

N

Mean Rank

Sum of Ranks

Total knowledge POST - Total knowledge PRE

Negative Ranks

12a

27,88

334,50

Positive Ranks

90b

54,65

4918,50

Ties

19c

 

 

Total

121

 

 

a. Total knowledge POST < Total knowledge PRE

b. Total knowledge POST > Total knowledge PRE

c. Total knowledge POST = Total knowledge PRE

 

 

Table 2 - Significance of test results 'knowledge' 

 

Test Statisticsb

 

Total knowledge POST - Total knowledge PRE

Z

-7,680a

Asymp. Sig. (2-tailed)

,000

a. Based on negative ranks.

b. Wilcoxon Signed Ranks Test

 

 Table 3 Scores on pretest and posttest 'self-efficacy items'

 

Ranks

 

N

Mean Rank

Sum of Ranks

Total self-efficacy POST - Total self-efficacy PRE

Negative Ranks

6a

13,08

78,50

Positive Ranks

95b

53,39

5072,50

Ties

20c

 

 

Total

121

 

 

a. Total self-efficacy POST < Total self-efficacy PRE

b. Total self-efficacy POST > Total self-efficacy PRE

c. Total self-effcacy POST = Total self-effcacy PRE

 

Table 4 significance of test results 'self-efficacy'

 

Test Statisticsb

 

Total self-efficacy POST - Total self-efficacy PRE

Z

-8,545a

Asymp. Sig. (2-tailed)

,000

a. Based on negative ranks.

b. Wilcoxon Signed Ranks Test

 

 

 

 

Conclusion

The longterm impact of this type of teaching should also be evaluated, in order to provide information about how much impact this teaching has, eg do students feel confident using an interpreter during their clinical rotations?

Take-home Messages
References
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