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New Lancaster County medical Spanish certificate program tackles language-related medical barriers

  • Gabriela Martínez/WITF
Students at Elizabethtown College walk to classes in this file photo.

 Richard Hertzler / LNP | LancasterOnline

Students at Elizabethtown College walk to classes in this file photo.

As central Pennsylvania’s Spanish-speaking community grows, the need for more Spanish interpreting services in medical settings increases as well.

Starting this fall, Elizabethtown College in Lancaster County will offer a graduate certificate Spanish program for medical Spanish. 

The 5-course, 15-credit online graduate program is open to anyone who has a medical background and wants to practice medical interpreting. Classes include Medical Spanish, Cultural Sensitivity, Interpretation/Translation Skills and Latinx Health Issues in the U.S. Students must speak fluent Spanish or take a Spanish placement exam or complete a 300-level Spanish course.

“This certificate is designed to give anyone who completes it the ability to effectively do all of the components of interpretation, to have the vocabulary to be able to transfer the information faithfully, and to have that sense of the culture,” said Sarah Dutton, Medical Spanish Program director at Elizabethtown College.

The course is also aimed at providers who are working with Spanish-speaking patients and want to improve their abilities to communicate directly with them without the need of an interpreter. 

The cost is $525 per credit, and there are some scholarship opportunities, including a 15% tuition discount for alumni or employees of community organizations partnered with Elizabethtown College’s School of Graduate and Professional Studies. 

After completing the course, the students will be prepared to sit for medical certification tests, such as the ALTA Clinician Cultural and Linguistic Assessment Test or the Qualified Bilingual Staff Test.

The program’s curriculum goals were based on prior research that showed gaps in language services for Latino patients. Based on interviews with multiple health providers, Elizabethtown College researchers found that the amount and the type of service changed  dramatically from system to system, and that showed that there is no standardized approach to providing and funding medical language services, said Kevin Shorner-Johnson, Elizabethtown’s Dean of the School of Arts and Humanities.

There are national studies that show that Hispanic people with limited English proficiency receive less medical care. A study published in Health Affairs found that between 2014 and 2018 Hispanic patients with limited English skills spent $1,463 less annually per capita than Hispanic patients who spoke English. These patients with limited English skills also  made fewer outpatient and emergency department visits, had fewer inpatient days, and received fewer prescription medications than Hispanic patients who spoke English. Researchers found that the gap has widened in recent years.

Federal law requires health providers to offer language assistance for patients who need it. At a minimum, health providers should have access to a translation phone line to assist patients.

Large hospital systems such as  UPMC have various resources including in-person interpreters in multiple languages, Ipad-based language interpretation, and translation services over the phone. There is also Bridging the Gap, an interpreter training program for employees who are native speakers of a language that is not English. 

According to Elisabeth Perez, Manager for Community Health Initiatives and Language Services for UPMC Central PA, 3.7% of central Pennsylvania patients served by UPMC hospitals require language services. About  60% of them request Spanish. Between January 2019 and December 2020,  the demand for language services at UPMC’s Dauphin County hospitals increased by 42%, according to the provider’s 2022 community health needs assessment report. The top spoken languages are Spanish, Nepali, Vietnamese, Arabic, and American Sign Language. 

Hamilton Health Center in Harrisburg also offers similar services. It has three  on-site Spanish interpreters, as well as Ipad-based interpreting through a company called Cyracom. Between January and November 2022, 69.1% of Hamilton’s Cyracom calls were in Spanish.   

While many health providers offer interpreting services, there is still work to be done, especially with scheduling and referrals, Limann said. When patients are on-site at a medical medical clinic, there may be interpreting services there to help the patient. 

“However, when we place referrals, for example, to specialists, many of my patients have concerns when they get calls, because calls are in English, and so there isn’t an interpreter used consistently with the scheduling,” Limann said.  Because of this, patients might not get specialized care that they need.

Elizabethtown College’s medical Spanish certificate program aims to address some of those gaps. In one of its courses on health issues that disproportionately affect Latino communities, there will be a focus on women’s health issues and how traditional gender roles affect women’s opportunities to develop language skills, transportation barriers and access to insurance. 

“A lot of times things that I’ve heard people say is that they’re frustrated that people come in with such advanced disease,” Dutton said. “There’s a component there, that’s both cultural in terms of seeking care in your community, then also the systemic barriers, timeframes, and transportation and time off from jobs that typically don’t provide time off.” 

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