Preparing Medical Students for Language-Concordant Healthcare: Efficacy of a Medical Spanish Course

Limited English Proficiency presents significant obstacles to healthcare in English-dominant healthcare systems, with language discordance between patients and physicians contributing to adverse health outcomes. Healthcare quality and outcomes improve when provided by language-concordant clinicians; therefore, Spanish-speaking clinicians are needed to meet the needs of growing Spanish-speaking populations. Although U.S. medical schools offer medical Spanish courses, most are elective and lack standardized assessments. We examined outcomes of a mandatory, credit-bearing medical Spanish course, integrated within a medical education curriculum. The goal of the 2-year course is to prepare medical students for delivery of language-concordant healthcare to Spanish-dominant patients. We assessed Spanish language development among two cohorts of medical students (N = 224) at multiple time points. Utilizing pre-posttest design and paired t-tests, we examined changes in students' Spanish speaking proficiency, and changes in students' perceived confidence in using medical Spanish with patients. We hypothesized Spanish proficiency and confidence in using Spanish with patients would increase upon completion. Results indicated significant increases in Spanish speaking proficiency scores among both cohorts. Analyses accounting for primary language and pre-course Spanish proficiency are provided. Examining changes in proficiency level (beginner, intermediate, advanced) longitudinally, we found significant level increases by course end. Analyses further revealed significant increases in students' self-reported confidence to use Spanish with patients. To contextualize our study, we include description of the integrated medical education curriculum, and medical Spanish programming within this model. Overall, findings support integration of mandatory medical Spanish courses in medical education, with important implications for language-concordant training in healthcare education.