Professionalism, Attitudes, Beliefs and Transformation of the Learning Experience: Cross-Cultural Implications for Developing a Spanish Elective for Non-Spanish-Speaking Physical Therapist Students

Abstract

Background and Purpose. Cultural competency has been recognized as one of essential skills for physical therapists working in clinical practice today. The purpose of this pilot study was to investigate whether learning basic clinical Spanish language and would transform and shape non-Spanish-speaking physical therapist students' professional attitudes, beliefs, and behaviors when working with patients/clients whose preferred language is Spanish. Method/Model Description and Evaluation. Students participating in a Spanish elective at University of Miami completed questionnaires, took pre and post tests, and participated in a focus group regarding their clinical experiences preceding and following Spanish elective. Qualitative and quantitative data was collected and data was triangulated. Outcomes. Quantitative results showed statistical significance between pretest and posttest results (P Discussion and Conclusion. Our findings indicate that transformative learning took place in areas of frames of reference (ie, cultural diversity, cultural awareness), beliefs, self awareness, making and implementing plans related to physical therapy intervention based on this awareness, relationships and rapport with patients, ability to communicate in Spanish, body language awareness, and alternative approaches to living. Key Words: Cultural diversity, Spanish language, Professionalism, Transformative learning. BACKGROUND AND PURPOSE Cultural competency has been recognized as one of essential skills for physical therapists working in clinical practice today. The importance of cultural competency is reflected in both Physical Therapy Core Values' and in Generic Abilities2 In order to develop culturally competent values and behaviors, one first must understand concept of cultural competence. Cultural competence was initially described by Cross, Bazron, Dennis, and Isaacs3 in 1989. They defined it as the set of congruent behaviors, attitudes and policies that come together in a system, agency, or among professionals to work effectively in cross-cultural situatJons.p In physical therapist practice it is essential to respect culture, evaluate cross-cultural relations, understand dynamics of cultural differences, appreciate expanse of cultural knowledge, and determine how to modify one's services to meet culturally diverse needs.5 A recent pilot study on proficiency of clinical Spanish in physical therapist students demonstrated that clinical Spanish may help non-Spanish-speaking physical therapist students to feel more adequate and to be more helpful to their Spanish-speaking patients/clients in their community. The students believed that by intetacting directly with a patient/client who speaks Spanish they would be able to build a patient-practitioner relationship which would not be possible with a translator. The students also indicated that having a translator slowed down entire process of evaluation and treatment.4 Indeed, recent research has demonstrated critical importance of effective communication skills.5,6 Lopopolo, Schaeffer, and Nosse5 indicated that physical therapists need to have extensive knowledge of communication techniques and they should be skilled in applying these techniques in a clinical environment. Although their study did not specifically address language differences, their research recognized critical importance of communication in clinical practice. The National Alliance for Hispanic Health reported that culture influences how people express their feelings, as well as what feelings are appropriate to express, in a given situation. The inability to communicate can make both parties feel alienated and helpless.6 According to 2000 US Census, 57.3% of individuals in Miami are of Hispanic/ Latino descent.7,8 This article describes a pilot Spanish language elective we conducted to provide opportunities for students to transform their patient/client communication to demonstrate caring, culturally competent professional behavior. …