Impact of language barrier on quality of patient care, resident stress, and teaching

Abstract

Background: 1990 U.S. Census data reveal that nearly 14 million people in the United States have poor to no English language skills, limiting their access to health care. Purpose: This study evaluated the effect of language barriers on quality of patient care, a resident's ability to learn and teach, and also the effect on length of workday and daily stress. Methods: Data were collected from a 25‐item standardized questionnaire. We used a 5‐point Likert scale ranging from 1 (very significant) to 5 (no influence). Data were cross‐tabulated with biographical attributes of residents and were tested for significance. Results: Language barriers had significant negative impact on quality of patient care, lengthened resident workday (average 52 min), and increased daily stress. With bedside teaching encounters, residents reported compensating by shifting the focus to issues not requiring patient participation. Language barriers had significant negative influence on the resident's ability to role model (i.e., demonstrate for more junior residents) and on the acquisition and practice of good patient‐physician interaction skills. Conclusions: Language barriers significantly impact the daily activity of surgical residents, and we believe that they similarly impact residents in all specialties. All teaching hospitals should have adequate and available medical translators as a tool to bridge the language barrier. Translators should receive specialized training in medical terminology and cultural awareness.