Assessment of Medical Spanish Language Proficiency in BSN Students: A Pilot Study

Nurse-patient communication in the United States has become more complex as the population has increasingly become more ethnically and linguistically diverse (Ali & Johnson, 2017; Ali & Watson, 2018). According to the Pew Research Center, “In 2022, Hispanics (Latinos) made up nearly one-in-five people in the U.S. (19%), up from 16% in 2010 and just 5% in 1970” (Krogstad et al., 2023). Language discordance between healthcare providers and patients has been shown to result in increased medical errors, thus perpetuating health disparities (Berdahl & Kirby, 2019; Cano-Ibáñez et al., 2021; Diamond et al., 2019a).

Study Objectives and Design

The purpose of this study was to measure medical Spanish language proficiency before and after a medical Spanish language course in Bachelor of Science in Nursing students. The research was structured as a quantitative pre-and-post test pilot study. The study setting was an urban School of Nursing located in the northeastern US, featuring participants with a sample size of N = 10.

Regarding the methodology, self-assessed medical Spanish language proficiency was compared before and after a non-credit-bearing medical Spanish course using the Interagency Language Roundtable (ILR) scale. Additionally, objective faculty-rated proficiency assessments were administered using faculty developed, rubric-guided clinical scenarios at mid and endpoints of the course that coincided with the levels of the ILR scale.

Research Hypotheses

We hypothesized that:

• Participants’ self-assessed final ILR scores would align with objective faculty-rated final ILR scores.
• Medical Spanish language proficiency scores would improve when comparing objective mid- and end-point evaluations.
• Participants would demonstrate improved self-assessment of medical Spanish language proficiency using the ILR scale after completing the course.

Results and Statistical Analysis

The Wilcoxon signed-rank test compared participants’ self-assessed final ILR scores with objective faculty-rated final ILR scores, participants’ mid- and end-point evaluation scores, and participants’ baseline and final self-assessed ILR scores after completing the course. Results indicated that participants’ self-assessed final ILR scores were aligned with objective faculty-rated final ILR scores (Z = –.577, p = .564) after completing the course. However, participants’ mid- and end-point evaluation scores (p = .498) were not significantly different.

Significant differences were noted between participants’ self-assessed ILR baseline and final scores (Z = –2.887, p = .004). This suggests that a medical Spanish course offered in Bachelor of Science in Nursing programs may improve nurses’ self-assessment of medical Spanish language proficiency.

Comparison of Proficiency Metrics

The following data summarizes the statistical comparisons performed during the study:

Ultimately, these findings indicate that such courses may improve nurse-patient communication when encountering Spanish-speaking patients with limited English proficiency (LEP) in clinical settings.