Interpreter Services The importance of teaching clinicians when and how to work with interpreters Elizabeth A. Jacobs a,b, *, Lisa C. Diamond c , Lisa Stevak d a John H. Stroger, Jr Hospital of Cook County, USA b Rush University Medical Center, USA c Palo Alto Medical Foundation Research Institute, USA d St. Mary and Elizabeth Medical Center, USA 1. Introduction Immigration contributes to national diversity around the world, especially in North America, Europe, and Australia where growing economies and democracy attract individuals looking for better economic conditions or political asylum. As a result, the health care systems in these and other countries are challenged to provide care across cultural and linguistic barriers. This challenge is felt most acutely by clinicians for whom communication is essential to diagnosis and treatment; however, as highlighted by the papers by Fatahi [1] and Hseih [2] in this issue, clinicians in these systems are rarely prepared to recognize and address these challenges. As a result they do not work effectively with interpreters [1] or use inappropriate interpreters [2]. Language barriers in health care pose multiple problems to providing safe, high quality medical care. They contribute to poorer health care processes and outcomes among patients who do not speak the same language as their health care providers [3] and they increase the risk of medical errors that can lead to serious consequences [4–6]. This risk can be reduced and/or eliminated when physicians use professional interpreters or communicate proficiently with patients in their preferred language [7–9]. Yet studies have shown that clinicians under-use appropriate inter- preters [7–13] and use their own limited language skills during clinical encounters, despite awareness of their own language limitations and the fact that it might negatively impact communi- cation and care [14]. An important factor in encouraging the use of appropriate interpreters in the health care setting is education. Studies have shown that clinicians who have received any training about how language barriers contribute to problems in health care or the use of interpreters are more likely to call on appropriate interpreters when needed [15,16]. In addition, it provides an opportunity to teach clinicians about cultural issues that frequently arise in the setting of language barriers and how to work in effective collaboration with interpreters, needs which have been highlight- ed by both Hseih and Fatahi, and others, in this issue [1,2]. In this paper, we describe a curriculum about how best to over come language barriers in health care for medical students in the Patient Education and Counseling 78 (2010) 149–153 ABSTRACT Objective: To describe the importance of teaching clinicians when and how to overcome language barriers in clinical practice, provide an example of a curriculum for teaching on this topic, and outline the critical issues that must be addressed in this type of teaching. Methods: We describe a 1.5 h educational program for students in a large urban medical school as an example curriculum and how it impacted student responses on a 28-item questionnaire measuring their knowledge, attitudes and likelihood of future behaviour before and after the course. The course components are described and highlight the essential components that should be included in teaching about overcoming language barriers in clinical practice. Results: There were significant improvments in knowledge, attitudes, and reported likelihood of future behaviors after the educational program. Recommendations for essetential curricular components are made. Conclusion: Teaching clinicians about language barriers in health care and how to overcome them should be essential to all clinical curricula. Brief educational interventions can meet this need and should include a core set of essential teaching points as outlined. Practice implications: Teaching clinicians when and how to overcome language barriers in health care will help to reduce the impact of this barrier, make clinicians and interpreters’ jobs easier and more transparent, and improve patient care and satisfaction. ß 2009 Elsevier Ireland Ltd. All rights reserved. * Corresponding author at: 1900 W Polk St, 16 th Floor, Chicago, IL 60612-9985, USA. Tel.: +1 312 864 7311; fax: +1 312 864 9694. E-mail address: ejacobs@rush.edu (E.A. Jacobs). Contents lists available at ScienceDirect Patient Education and Counseling journal homepage: www.elsevier.com/locate/pateducou 0738-3991/$ – see front matter ß 2009 Elsevier Ireland Ltd. All rights reserved. doi:10.1016/j.pec.2009.12.001