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Patient-Provider Communication and Health Disparities: An Experiment Exploring Language Proficiency and Communication

Kathrin Rothermich^1,2, Rose P Baker-Iyore³, Dai'Sha Dowson⁴

¹Department of Communication Sciences and Disorders, East Carolina University, Greenville, NC, 27834, USA. rothermichk17@ecu.edu.

Journal of Racial and Ethnic Health Disparities

|November 5, 2025

Summary

This summary is machine-generated.

Healthcare providers adapt their communication, slowing speech and simplifying language, when interacting with patients with lower English proficiency. These adjustments aim to improve understanding and reduce health disparities.

Keywords:

Communication barriers Cultural competency Healthcare disparities Language Simulation training

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Area of Science:

Medical Communication
Health Disparities Research
Linguistics in Healthcare

Background:

Effective healthcare communication is vital for equitable delivery.
Language discordance and patients using a second language (L2) can worsen health disparities.
Communication accommodation strategies are not typically taught in medical training.

Purpose of the Study:

To investigate how native English (L1) speaking physician assistant students modify their communication when interacting with Latine L2 avatar patients of varying English proficiency.
To understand the role of patient English proficiency in guiding provider language choices.

Main Methods:

Experimental study using mixed-reality simulation (Mursion) with 41 physician assistant students.
Analysis of acoustic (speech rate, pitch modulation) and lexical (word frequency, contextual diversity) adjustments.
Interviews conducted with L2 avatar patients simulating varying English proficiency levels.

Main Results:

Physician assistant students significantly reduced speech rate when interacting with lower-proficiency L2 avatars.
Students narrowed pitch range and used higher-frequency vocabulary with less proficient L2 avatars.
Demonstrated evidence of communication accommodation by L1 speakers towards L2 speakers.

Conclusions:

Communication accommodation occurs and influences patient-provider interactions.
These accommodations may widen or narrow healthcare disparities.
Further research needed to identify specific accommodations that improve patient comprehension and relationships.