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Med Care. 2014 May;52(5):435-8. doi: 10.1097/MLR.0000000000000102.

Relationship between self-assessed and tested non-English-language proficiency among primary care providers.

Author information

1
Departments of *Psychiatry and Behavioral Sciences, Immigrant Health and Cancer Disparities Service †Medicine, Memorial Sloan-Kettering Cancer Center ‡Department of Public Health, Weill Cornell Medical College, New York, NY §Palo Alto Medical Foundation Research Institute, Palo Alto, CA ∥Department of Family Medicine and Community Health, University of Massachusetts Medical School, Worcester, MA ¶Department of Medicine & Health Innovation Program, University of Wisconsin, Madison, WI.

Abstract

BACKGROUND:

Individuals with limited English proficiency experience poor patient-clinician communication. Most studies of language concordance have not measured clinician non-English-language proficiency.

OBJECTIVES:

To evaluate the accuracy of the self-assessment of non-English-language proficiency by clinicians compared with an oral proficiency interview.

SUBJECTS:

Primary care providers (PCPs) in California and Massachusetts.

MEASURES:

PCPs first completed a self-assessment of non-English-language proficiency using a version of the Interagency Language Roundtable (ILR) Scale, followed by the Clinician Cultural and Linguistic Assessment (CCLA), a validated oral proficiency interview. We used nonparametric approaches to analyze CCLA scores at each ILR scale level and the correlation between CCLA and ILR scale scores.

RESULTS:

Sixteen PCPs in California and 51 in Massachusetts participated (n=67). Participants spoke Spanish (79%), followed by Cantonese, Mandarin, French, Portuguese, and Vietnamese. The respondents self-assessed as having "excellent" proficiency 9% of the time, "very good" proficiency 24% of the time, "good" proficiency 46% of the time, "fair" proficiency 18% of the time, and "poor" proficiency 3% of the time. The average CCLA score was 76/100. There was a positive correlation between self-reported ILR scale and CCLA score (σ=0.49, P<0.001). The variance in CCLA scores was wider in the middle categories than in the low or high ILR categories (P=0.003).

CONCLUSIONS:

Self-assessment of non-English-language proficiency using the ILR correlates to tested language proficiency, particularly on the low and high ends of the scale. Participants who self-assess in the middle of the scale may require additional testing. Further research needs to be conducted to identify the characteristics of PCP whose self-assessments are inaccurate and, thus, require proficiency testing.

PMID:
24556893
PMCID:
PMC3981942
DOI:
10.1097/MLR.0000000000000102
[Indexed for MEDLINE]
Free PMC Article
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