Discussion Leader: Charles P. Vega, MD, Residency Director
[The National Conferences on Primary Health Care Access highlight local initiatives throughout the United States that are designed to improve the health status of populations within our nation. One of the California’s largest Latino barrios, in Orange County, has been served for the past 35 years by the University of California Irvine’s family medicine residency program. Current initiatives will be discussed at the Twenty-first National Conference.]
Healthcare disparities faced by the Latino population in the United States have been shown to be related to access, language barriers, and poor communication. At the University of California, Irvine Family Medicine Residency Program, we have had success in addressing barriers to health care.
However, Spanish fluency and cultural knowledge among our trainees and graduates continues to fall short of the needs of our surrounding community.
While nearly two-thirds of their patients use Spanish as their preferred language, only 20% to 30% of our residents feel fluent in Spanish. At the same time, half of the residents do not feel competent in cultural issues important to Latinos.
In response, we have developed a longitudinal resident curriculum in Spanish language and Latino culture that incorporates didactic sessions, “language lab” experiences in the residents’ clinic, cultural immersion experiences in the local community, home visits, and community outreach.
Multiple outcome measurements have been or will be employed to judge the success of our efforts. We have performed baseline assessments with 2 validated surveys which assess general patient satisfaction with their physician as well as examine specific cross-cultural skills pertinent to Latino patients.
The baseline surveys provided some surprising results. In addition, the UCI Family Medicine Class of 2012 received a completely redesigned objective structured clinical examination, in which each standardized patient case emphasized Spanish language and issues of culture and disparities in patient care.
The most critical outcome to our project is the number of residency graduates who go on to provide high-quality, culturally-sensitive care for poor and disenfranchised Latino communities.
Overall, the Health Education and Language for the Latino Community (HEAL-LC) project has the potential to be replicated throughout the country to better prepare physicians-in-training for a multicultural environment and improve health care disparities for Latino and other populations in need.