Medical Spanish for NP Students: Pairing the Didactic with Clinical Application

The United States has a long history of immigration from non-English speaking countries. One result is that nearly 50 million Americans speak a language other than English at home. When these non-English speakers seek healthcare, they require interpreters when providers do not speak their language.  While translation is essential for optimal patient management, translation services are expensive, and may not be available in all settings. The School of Nursing is located in a major metropolitan county, where almost half of the population is of Hispanic heritage.  A growing challenge to our nurse practitioner student clinical placement has been the requirement of Spanish language skill at many potential preceptor sites.  To address this issue, and to prepare our graduates for work in underserved communities, in 2011 we designed a semester-long 3-unit Medical Spanish course for advanced practice nurses. The course includes 2 hours weekly of didactic work (culture, vocabulary, grammar, etc.) followed by a one-hour seminar to practice developing language skills. During the third hour, a Spanish-speaking nurse practitioner directs students working in pairs in a lab setting, where they apply what they are learning in pre-planned case scenarios. The nurse practitioner students learn to interview each other, take a history and conduct a focused physical exam in Spanish. By the end of the semester, they are able to complete a basic SOAP note in Spanish. Student feedback has been extremely positive overall and pre and post testing supports skill development. Minor changes in course structure have been implemented in response to student comments.  Future plans include a monthly Spanish club and the development of an advanced level Medical Spanish course. Speaking the language of our patients is foundational to providing quality health care, and preparing our nurse practitioner students to communicate well to a significant segment of our community is a vital component of our educational programs.