Words matter: Translanguaging in medical communication skills training.

Pilar Ortega,Josh Prada

doi:10.1007/s40037-020-00595-z

Abstract

Medical communication across languages is gaining attention as the multilingual character of local, regional, and national populations across the world continues to grow. Effectively communicating with patients involves not only learning medical terminology, but also understanding the community’s linguistic practices, and gaining the ability to explain health concepts in patient-centered language. Language concordance between physicians and patients improves patient outcomes, but methods to teach communication skills for physicians are usually limited to the majority or official language. For example, in U.S. medical schools increased demand for physician skills in other languages, such as Spanish, has resulted in renewed academic discourse about best practices in teaching practical communication skills for physicians. In language education, translanguaging is an approach that integrates and validates multilingual individuals’ real use of language, which often includes non-standard words, regionalisms, and mixed influences from multiple languages, such as Spanglish or Chinglish. Efforts to improve medical language concordance by teaching a second language to medical students would benefit from an understanding of patient-centered communication strategies, such as is supported by translanguaging. Teaching effective communication skills to physicians should evolve and engage with the fluid linguistic attributes of culturally and linguistically diverse patient populations. In this eye opener, we first introduce the translanguaging perspective as an approach that can increase attention to patient-centered communication, which often includes spontaneous practices that transcend the traditional boundaries of named languages, and then present examples of how translanguaging can be implemented in medical education in order to sustainably enhance equity-minded patient-accessible medical communication.

Highlights

Expressing health-related concepts in ways that transcend or disregard normative language boundaries is common in multilingual, multicultural environments
Exploring the possibilities of translanguaging in medical education settings can be viewed as an opportunity to engage community members and heritage language speakers in the professional medical community as ambassadors of their day-to-day linguistic practices that can enhance accessible patient-physician communication both in general clinical skills training and in language-specific courses
Future studies should evaluate the incorporation elements that impact language concordant communication beyond medical terminology alone, such as regionalisms, cultural concepts, and observed communication skills assessment

Summary

Introduction

Expressing health-related concepts in ways that transcend or disregard normative language boundaries is common in multilingual, multicultural environments. Resources used for medical second language education, such as glossaries or sample cases, should address linguistic variation to represent those language varieties typically acknowledged as representative of purely monolingual communities, but should include local linguistic practices that transcend the boundaries of monolingualism and are often ascribed the rank of subpar or hybridized It is by unsettling the status quo in monolingual representations of medical language that medical language students will develop the skills to meaningfully establish connections with local multilingual (and often oppressed/marginalized) community members. Institutions can help keep medical language education up to date with evolving local, regional, national, and global linguistic realities by promoting collaborative educational research and team-teaching between professionals in medicine and those in applied linguistics [18] and by regularly assessing specific outcomes measures [19], including faculty and learner attitudes and ideologies with regards to combining community vernaculars—such as the so called Spanglish, Chinglish and Hinglish, as well as regionalisms of health-related terms—into patient communication. It is likely that many medical educators have already embraced translanguaging into general clinical skills education without realizing it, since patientcentered communication—not technical language knowledge—is the principal goal of clinical skills education for medical students and is considered to be “the foundation for the safe and effective practice of medicine” [20]

Conclusion

Compliance with ethical guidelines