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BMC Health Serv Res. 2015 Sep 10;15:371. doi: 10.1186/s12913-015-1024-8.

Overcoming language barriers in healthcare: A protocol for investigating safe and effective communication when patients or clinicians use a second language.

Author information

School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia.
School of Psychology, The University of Queensland, St Lucia, QLD, Australia.
School of Psychology and Counselling, Queensland University of Technology, Brisbane, QLD, Australia.
Department of Psychology, Concordia University, Montreal, QC, Canada.
Culture and Mental Health Research Unit, Jewish General Hospital, Montreal, QC, Canada.



Miscommunication in the healthcare sector can be life-threatening. The rising number of migrant patients and foreign-trained staff means that communication errors between a healthcare practitioner and patient when one or both are speaking a second language are increasingly likely. However, there is limited research that addresses this issue systematically. This protocol outlines a hospital-based study examining interactions between healthcare practitioners and their patients who either share or do not share a first language. Of particular interest are the nature and efficacy of communication in language-discordant conversations, and the degree to which risk is communicated. Our aim is to understand language barriers and miscommunication that may occur in healthcare settings between patients and healthcare practitioners, especially where at least one of the speakers is using a second (weaker) language.


Eighty individual interactions between patients and practitioners who speak either English or Chinese (Mandarin or Cantonese) as their first language will be video recorded in a range of in- and out-patient departments at three hospitals in the Metro South area of Brisbane, Australia. All participants will complete a language background questionnaire. Patients will also complete a short survey rating the effectiveness of the interaction. Recordings will be transcribed and submitted to both quantitative and qualitative analyses to determine elements of the language used that might be particularly problematic and the extent to which language concordance and discordance impacts on the quality of the patient-practitioner consultation.


Understanding the role that language plays in creating barriers to healthcare is critical for healthcare systems that are experiencing an increasing range of culturally and linguistically diverse populations both amongst patients and practitioners. The data resulting from this study will inform policy and practical solutions for communication training, provide an agenda for future research, and extend theory in health communication.

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