Prevalence of Language Barriers, Impacts, and Coping Strategies among Medical Students during their Clinical Rotation in Peshawar
DOI:
https://doi.org/10.56101/rimj.v4i2.164Keywords:
Clinical Rotations, Communication Barrier, Patient Care, Linguistic Diversity, Medical Students, Quality of CareAbstract
Background: This study examines the Prevalence of Language Barriers, Impacts, and Coping Strategies among Medical Students during their Clinical Rotation in Peshawar, an area with a wide range of language diversity.
Methods: A cross-sectional survey was conducted among 663 medical students from six medical colleges in Peshawar to assess the prevalence, frequency, and severity of language barriers, their impact on patient interactions, and the coping mechanisms employed by students.
Results: The findings indicated that 39.1% of the students faced language barriers during clinical rotations; most of them were female and non-Pashto speakers. A vast proportion (69.1%) felt that these barriers negatively affected patient care due to difficulties in obtaining proper patient history and increased miscommunication. Moreover, students with language barriers reported anxiety and frustration during patient interaction. The primary coping strategy used by students was seeking support from colleagues at 80.7%. Figures showed that only 11.9% of students received formal training to overcome language barriers. Of course, students who received language barrier training were significantly more confident in clinical interactions.
Conclusion: These results suggest extreme reforms in medical curricula, such as including many languages and cultural training programs to overcome language barriers; this would better prepare the students to work in a multilingual setting, dramatically reducing communication errors, improving patient care, and enriching the education experience in diverse areas.
References
Narayan L. Addressing language barriers to healthcare in India. National Med J India. 2013 Jul 1;26(4):236-8.
Al Shamsi H, Almutairi AG, Al Mashrafi S, Al Kalbani T. Implications of language barriers for healthcare: a systematic review. Oman medical journal. 2020 Mar;35(2):e122.
Mustafa R, Mahboob U, Khan RA, Anjum A. Impact of language barriers in doctor–patient relationship: a qualitative study. Pakistan Journal of Medical Sciences. 2023 Jan;39(1):41.
Al-Yateem N, Hijazi H, Saifan AR, Ahmad A, Masa'Deh R, Alrimawi I, Rahman SA, Subu MA, Ahmed FR. Quality and safety issue: language barriers in healthcare, a qualitative study of non-Arab healthcare practitioners caring for Arabic patients in the UAE. BMJ open. 2023 Dec 1;13(12):e076326.
Chalabian J, Dunnington G. Impact of language barrier on quality of patient care, resident stress, and teaching. Teaching and Learning in Medicine: An International Journal. 1997 Jan 1;9(2):84-90.
Woloshin S, Bickell NA, Schwartz LM, Gany F, Welch HG. Language barriers in medicine in the United States. Jama. 1995 Mar 1;273(9):724-8.
Jain P, Krieger JL. Moving beyond the language barrier: The communication strategies used by international medical graduates in intercultural medical encounters. Patient education and counseling. 2011 Jul 1;84(1):98-104.
Malau-Aduli BS. Exploring the experiences and coping strategies of international medical students. BMC medical education. 2011 Dec;11:1-2.
Temirkhanova K. Stress Coping Strategies of International Medical Students (Master's thesis, Lithuanian University of Health Sciences (Lithuania)).
Abass MA, Said NS, Zahed ES, Hussein WF, Hamid OI. Effective communication barriers in clinical teaching among Malaysian medical students in Zagazig Faculty of Medicine (Egypt). Electronic Physician. 2015 Dec;7(8):1638.
SIGAEVA N, GULLU E. Psychological distress and coping mechanisms amongst International Students. Asst. Prof. Dr. Mehmet Necati CIZRELIOGULLARI, Ph. D.. 2020:159.
Jacobs EA, Agger-Gupta N, Chen AH, Piotrowski A, Hardt EJ. Language barriers in health care settings. An annotated bibliography of the research literature. Woodland Hils (Ca, USA): The California Endowment. 2003 Aug;7.
Hsieh E, Kramer EM. Rethinking culture in health communication: Social interactions as intercultural encounters. John Wiley & Sons; 2021 Mar 16.
Alhamami M. Language barriers in multilingual Saudi hospitals: Causes, consequences, and solutions. International Journal of Multilingualism. 2022 Oct 2;19(4):553-65.
Gregg J, Saha S. Communicative competence: A framework for understanding language barriers in health care. Journal of General Internal Medicine. 2007 Nov;22:368-70.
Korkoryi Jr DM. Communication Barriers and Medical Errors Affecting Patients With Limited or Non-Existent Written or Spoken English Proficiency. South University; 2024.
Padela AI, Punekar IR. Emergency medical practice: advancing cultural competence and reducing health care disparities. Academic Emergency Medicine. 2009 Jan;16(1):69-75.
Al Shamsi H, Almutairi AG, Al Mashrafi S, Al Kalbani T. Implications of language barriers for healthcare: a systematic review. Oman medical journal. 2020 Mar;35(2):e122.
Diamond L, Izquierdo K, Canfield D, Matsoukas K, Gany F. A systematic review of the impact of patient–physician non-English language concordance on quality of care and outcomes. Journal of general internal medicine. 2019 Aug 15;34:1591-606.
Abbott WG, Geursen A, Peake JS, Simpson IJ, Skinner MA, Tan PL. U380. Ethnicity.;39(5):401-6.
Meuter RF, Gallois C, Segalowitz NS, Ryder AG, Hocking J. Overcoming language barriers in healthcare: A protocol for investigating safe and effective communication when patients or clinicians use a second language. BMC health services research. 2015 Jun;15:1-5.
Diamond LC, Schenker Y, Curry L, Bradley EH, Fernandez A. Getting by: underuse of interpreters by resident physicians. Journal of general internal medicine. 2009 Feb;24:256-62.
Squires A. Strategies for overcoming language barriers in healthcare. Nursing management. 2018 Apr 1;49(4):20-7.
Flores G. The impact of medical interpreter services on the quality of health care: a systematic review. Medical care research and review. 2005 Jun;62(3):255-99.
Karliner LS, Jacobs EA, Chen AH, Mutha S. Do professional interpreters improve clinical care for patients with limited English proficiency? A systematic review of the literature. Health services research. 2007 Apr;42(2):727-54.
Al-Kalaldeh M, Amro N, Qtait M, Alwawi A. Barriers to effective nurse-patient communication in the emergency department. Emergency Nurse. 2024 Sep 3;32(5).
Bischoff A, Hudelson P. Access to healthcare interpreter services: where are we and where do we need to go?. International journal of environmental research and public health. 2010 Jul;7(7):2838-44.
Schwei RJ, Del Pozo S, Agger-Gupta N, Alvarado-Little W, Bagchi A, Chen AH, Diamond L, Gany F, Wong D, Jacobs EA. Changes in research on language barriers in health care since 2003: A cross-sectional review study. International journal of nursing studies. 2016 Feb 1;54:36-44.
Bowen S. Language barriers in access to health care. Ottawa: Health Canada; 2001 Nov.
Horváth Á, Molnár P. A review of patient safety communication in multicultural and multilingual healthcare settings with special attention to the US and Canada. Developments in Health Sciences. 2022 Apr 11;4(3):49-57.
Bowen S. The impact of language barriers on patient safety and quality of care. Société Santé en français. 2015 Aug:603-23.
Kim KJ, Kang Y, Jeong J, Kim G. Student‐led creation and sharing of e‐learning resources. Medical Education. 2022 Aug 1;56(8).
Taira BR, Kim K, Mody N. Hospital and health system–level interventions to improve care for limited English proficiency patients: a systematic review. The Joint Commission Journal on Quality and Patient Safety. 2019 Jun 1;45(6):446-58.
Vela MB, Fritz C, Press VG, Girotti J. Medical students’ experiences and perspectives on interpreting for LEP patients at two US medical schools. Journal of Racial and Ethnic Health Disparities. 2016 Jun;3:245-9.
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Afsana Lal, Raheelah Amin, Eman Fatima Shah, Leema Ibrahimi, Ayesha Ashfaq, Maseera Shakir, Shaista Shaheen, Humna Saeed, Karishma Basir, Nosaibah Razaqi
This work is licensed under a Creative Commons Attribution 4.0 International License.