Spanish language immersion and reinforcement during residency: a model for rapid acquisition of competency

Residencies serving non-English-speaking populations face the challenge of language training in addition to usual resident education issues. The clinic for the Lawrence Family Medicine residency is based in a 45,000-person Community Health Center serving a majority Spanish-language preference population. Although translators are available, they increase visit time for patients.

Three successive intern classes and one faculty member (n = 24) participated in a preresidency, 10-day immersion program at a nearby language institute; thrice-monthly classroom instruction for a year; and personal instruction during continuity clinics by a teacher/translator during the R1 year.

An independent examiner tested participants (average age = 29.5; 15 female) using a competency examination based on American Council of Teachers of Foreign Languages scoring. Prior Spanish preparation averaged 2 years in high school and 1 year of college, but was variable. Results were compared with Tukey's Honestly Significant Differences test of repeated measures. All individuals improved following immersion, 4.8 to 6.3, (p <.01), and 6 months of reinforcement, 6.3 to 7.4 (p <.05). The first cohort (n = 7), including those entering with little Spanish ability, scored at a level permitting use of five verb tenses after 2 years (cost = $5,035.00/resident).

This study demonstrates significant improvement in Spanish competency after 10-day immersion, and continued improvement following 6 months of reinforcement.