How the University of Texas Medical Branch responded to changing demographics

Diverse Issues in Higher Education, Dec 27, 2007

PROBLEM

In 2005, the University of Texas Medical Branch in Galveston was struggling to serve the ever-increasing Hispanic population of the state, dealing with growing health disparities between Whites and Hispanics and trying to find a way to satiate the interest of students seeking to learn medical Spanish.

"[There was] a general sense that our Spanish-speaking patients were not receiving adequate health care at least due, in part, to poor communication and cultural misunderstandings. [They were also] less likely to seek care, understand instructions or medications and feel comfortable discussing certain issues with physicians," says Dr Janice K. Smith, director of the Pan American Health Organization/World Health Organization Collaborating Center for Training in International Health at UTMB.

ACTION

Inspired by a successful French immersion program she had read about at the University of Ottawa Faculty of Medicine, Smith helped develop a longitudinal program for medical Spanish and cultural training. The project, Healing in a Bilingual Learning Environment (HABLE, which also means "speak" in Spanish), started in August of 2005.

Conversational and medical Spanish was incorporated into the curriculum of the first-year course, "Principles of Medicine," which teaches students patient interviewing skills and how to perform physical exams. The eight students enrolled in the HABLE version of that course learned medical interviewing simultaneously in English and Spanish, practiced Spanish at outpatient clinics and visited Hispanic patients at home.

"The clinical faculty for this group of students was bilingual, and a Spanish-language facilitator supplemented the language and cultural aspects of the curriculum. Students in the program were also required to develop a community project within the local Hispanic community," Smith adds.

At the end of the first year, the participants took a month-long immersion course in a Spanish-speaking country.

RESULTS

"The students who have participated feel more confident in communicating with Spanish-speaking patients," says Smith, adding that many have asked to do their clinical rotations in locations with largely Hispanic populations.

Participation in HABLE has doubled, from eight students in 2005 to 16 students in 2007. Still, the program has been too successful to keep up with demand. About 20 percent of incoming students, or 45 per year, apply for the program. The lack of enough bilingual clinical faculty keeps the program from reaching its hill potential.

Help Is on the way. Initially, the pilot project was funded through UTMB s President s Cabinet Award, however, the School of Medicine's Dean's office has now recognized the program as an important recruiting tool and has agreed to provide funding to expand the program in 2008. The schools of Allied Health and Nursing are now interested in developing a similar curriculum.

If your college or university has successfully resolved institutional-related problems, share them with Diverse by e-mailing us at editor@diverseeducation.com.

DIVESE DIGITS

The percentage of medical school enrollees
by race/ethnicity in 2007 in the United States

American
Indian/Alaska
Native
0.8%

Asian
20%

Black
6.7%

Hispanic/Latino
6.6%

White
62%

SOURCE: ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2007