Speaking the patient's language: in efforts to more effectively serve the increasingly Hispanic clientele, University of Texas requires Spanish courses for health care students, but critics question responsibility of language barrier - Special report: Hispanic focus

Black Issues in Higher Education, Sept 26, 2002 by Lydia Lum

As this country becomes increasingly Hispanic, a growing number of universities now offer--and sometimes require--Spanish courses geared to health care students. At public and private universities, medical and nursing students are clamoring for classes that better equip them to communicate with patients who speak little or no English. This is occurring even in areas that historically have been primarily White. Educators are responding with classes melding conversational Spanish with medical terms.

"We're acutely aware of the multicultural world we now live in, and we want to be sensitive to that diverse world," says Dr. Geraldine Bednash, executive director of the American Association of Colleges and Nursing. "We cannot provide the best medical care without communicating in other languages, especially Spanish."

In a well-publicized move, the University of Texas at Austin became one of the latest to require its nursing students to enroll in a Spanish course especially designed for health care workers. The move affects this fall semester's freshman class of 136 students, but they won't enroll in that Spanish class until fall 2004 to coincide with upper-division clinical courses taught in English, says Dr. Joy Penticuff, UT professor of nursing and former assistant dean for undergraduate nursing programs. Meanwhile, seven upperclassmen chose to enroll in the new three-hour credit course this semester as an elective, she says.

By the end of the course, students should be able to prescribe medication in Spanish and guide patients through basic procedures like drawing blood. They also should be able to translate aloud body parts and basic body functions, Penticuff says. Less emphasis is placed on grammar and the many verb tenses taught in traditional Spanish courses. "We don't have any delusions that our students will be proficient in discussing every medical procedure in Spanish," she says. "On the other hand, you cannot give health care today without knowing that you, as a provider, have to reach out and do what's necessary. It's not the time to say, `I'm not going to speak to you in Spanish.'"

UT officials are making this such a high priority that they plan on requiting even bilingual nursing students to enroll. "We might eventually change the policy, but we also know that bilingual speakers don't necessarily know specialized medical terms," says Penticuff, a 27-year UT veteran.

MIRRORING THE WORKING WORLD

Nationally, workplaces of all kinds are recognizing the need for employees to speak, read and write basic Spanish. Whether it's in retail, government or corporate life, many working professionals are learning Spanish so they can more effectively serve the increasingly Hispanic clientele. Since 1990, the Hispanic population has swelled by at least 60 percent nationally. Consequently, enrollment in short, intensive Spanish courses has skyrocketed. From 1986 to 1998, enrollment in Spanish courses doubled at community colleges, reports say, where working professionals got doses of "occupational" Spanish. Those courses blended basic conversational skills with specialized vocabulary for a variety of industries, such as hotel and hospitality, law enforcement, construction and health care.

Among academia, many universities for years have required undergraduates to enroll in four semesters or a foreign language as a condition to graduate. Quite often, Spanish is a popular choice. But mirroring the working world, more professional schools are integrating occupational Spanish into the curriculum.

At the University of Miami's law school, educators now teach several comparative law courses in Spanish each year that students can take as electives. Naturally, the instructors can revert briefly to English if confusion occurs, but "the idea is immersion," says law dean Dennis O. Lynch. Teaching in Spanish better conveys aspects of indigenous topics such as Argentinian commercial law, Lynch says. In turn, such courses better prepare graduates for transactional work involving Latin and South America, he says.

And, some legal concepts don't really translate to English anyway, but instead reflect the history and culture of Spanish-speaking countries so it's more practical to learn them in Spanish. For instance, there's no American counterpart to the "judge of instruction" of many Spanish-speaking countries, says Lynch, a nationally known Latin American law expert. A judge of instruction is a cross between an American judge and prosecutor.

"Not only can students capture substantive knowledge by learning in Spanish, but it lets them validate their ability to work while using that language," Lynch says.

That's what health care educators hope for. At Wake Forest University, medical school educators required graduating seniors this past spring to take a five-week intensive Spanish course right after they secured their residency matches. The three levels of the course accommodated first-time Spanish students as well as fluent speakers. After five weeks, all of them could, at the very least, ask in Spanish, "Where does it hurt?" and "Can you speak English?," says Dr. Venita Morell, associate professor of family and community medicine. Wake Forest officials plan the same requirement for next year's graduates. The Spanish requirement was added because students, accompanying doctors on their rounds at the nearby teaching hospital, became frustrated at not being able to work with patients with limited English. Even though North Carolina does not have nearly as high a Hispanic population as states such as California and Texas, it also has seen a sharp increase in Spanish-speaking migrant farm workers in recent years.