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BilingualProficiencyStandardsinHealthCare

©2017CommonGroundInternational,LLC.

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Helping the underserved responsibly

Language, Culture and Patient Advocacy of the Bilingual Health Care Professional:

Standards of Practice and Competency

Common Ground International, LLC PO Box 174, Lafayette, CO 80026

Ph: (303) 684-5557 | 1 (888) 879-2575 www.CommonGroundInternational.com

[email protected]



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Language,Culture,andPatientAdvocacyoftheBilingualHealthCareProfessional:

StandardsofPracticeandCompetency

Withinthehealthcarefield,thebilingualprofessionalmaytakeondifferentroles

dependingonthecontextandobjectivesofthepatientinteraction.Qualitycarecommunication

entailscompetencyonthepartofthecareprovidertonotonlycommunicateinformationtothe

patientbutalsotoevaluatethepatient’sunderstandingofthecommunicatedmessageand

facilitatethepatients’informeddecision-makingprocesstothebestofherorhisability.This

requiresskillfullisteningandcomprehensiononthepartofthecareprofessionalaswellas

culturalsensitivity,knowledge,andnavigation.Fortheseskillstobemeasuredforcompetency,

fiveEssentialStandardshavebeendeveloped.Tofacilitateevaluation,certainProfessionalRoles

havebeenidentifiedfortheseStandardsalongwiththeircorrespondingCognitiveTasks.The

CommunicativePathwayhasalsobeenlabeledtobetterdefinetheperformanceandskills

requiredforcommunicationindifferentsettingsandfordifferentpurposes.Finally,two

distinctCompetencyLevelshavebeendefinedtodemarcatethegradedlevelofperformance

thatleadtotheProfessionalCompetencylevelrequiredforcertification,outlinedbelow.A

glossaryofkeytermsisincludedattheendofthesectiondescribingthestandards.

Thefiveessentialstandardsforthebilingualhealthcareprofessionalwithinthis

programare,Standard1PatientandCareProfessionalInteraction,Standard2Skilled

PresentationalAbility,Standard3CriticalListening,Standard4CriticalReading,andStandard

5CulturalNavigation.ThecorecertificationprogramusesStandard2,SkilledPresentational

Ability,initsoralexpressionandthereisacorrespondingstandardforthewrittenexpression

ofthisskillavailableforthoseorganizationsorprofessionalswhorequireevaluationof

professionalwritinginSpanish.

______________________________________________________________________________________________________________CatherynPhippsOrive,MA,MEd,ABD,&RoryFoster,MAareresponsiblefordevelopingtheseStandardsofPracticeforBilingualHealthCareProfessionalsandtheaccompanyingCertificationProgramAssessmentinstrumentsforCommonGroundInternational.Thisversion(2017)oftheStandardsisaworkingdocument.



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Standard1:PatientandCareProfessionalInteraction

Role:HealthcareprofessionalasFacilitator*

CognitiveTask:MeaningConstruction

CommunicativePathway:DirectPersontoPerson

CompetencyLevel:AtorAboveProfessional

AtthiscompetencyleveltheprofessionalwillinSpanish:

• Expresshimorherselffluidlyandwithouthesitation,

• Facilitateunderstandingofpatienthealth,wellbeing,andcareoptions,

• Engagewithpatientsonmultipletopicsrelatedtohealth,familyandprofessionallife,

andanyothers,whichmayimpactthepatient-providerrelationshipandpatientcare

overtime.

Performanceindicators:

BesidescommunicatingfluentlyinSpanish,thecareprofessionalwilluseSpanishto

evaluatewhatpatientsdoanddonotunderstandinagivenhealthcarescenario,ask

andanswerquestions,respondtopotentialpatienterrorsinthinking,andengage

inotherrelevantcommunicativetasks,toprovidepatientswithopportunitiesto:

a. Demonstrateunderstandingoftheirhealthcontextb. Recognizehealthcareoptionsandsetcaregoalsc. Makeconnectionsbetweenhealthbehavior,decisions,andoutcomesd. Makechoicesandmaximizeresourceswithinthehealthcarearenae. Developtheirknowledgeof,anddirectparticipationin,theimprovementoftheir

qualityofcare

*ThetermFacilitatorinthiscontextreferstothecognitivetasksofnegotiatingmeaningandevaluatingpatientunderstandinginthesecondlanguage.Thistermdoesnotrefertoa3rdpartyintermediary.



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Standard2:SkilledPresentationalAbility

Role:HealthcareprofessionalasResourcePerson

CognitiveTask:KnowledgeSharing

CommunicativePathway:OralPresentational



• Createanddeliverwellorganizedpresentations*

• Conductorientationsonmultipletopicsrelatedtothepatientcarecontextandhealth

education

• Presentinformationrelevanttodifferentareasofpatientcareandthelocalhealthcare

systemingeneral


InSpanishthecareprofessionalwillusethemeappropriateterminologytofluidly

presentinformationandorientpatientsongivenhealthtopicsthatsupportpatient

accesstoservicesinthelocalhealthcarecontextwhichmayincludethefollowingtopics,

amongothers:

a. Healthcarechoicesandtreatmentoptions

b. Healthconditions

c. Patientresourcesandfinancialservices

d. Dietandnutrition

e. Communityoutreachprograms

f. Familyhealthandwellness

g. Substanceabusetreatment

h. Counselingservices



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Standard3:CriticalListening

Role:HealthcareprofessionalasInquirer

CognitiveTask:InformationAnalysis&Synthesis

CommunicativePathway:Listeningforunderstanding



• Understandthemainideasandsupportingdetailsfromoralaccountsspokenby

patientsandothers

• Followpersonalstoriesanddescriptionsspokenindifferentmodesandwith

variedvocabularyandsyntaxfrompatientsandotherpeopleinvolvedinthe

patientsituation

• Identifypotentialpatienterrorsinthinkingasexpressedorally

• Understandpatientrelatedcarecommunicationfromotherspecialists,including

videoandaudiorecordings


ThecareprofessionalwilldemonstrateunderstandingofspokenSpanishbyrestating

communicationandaskingforadditionalinformationfrompatientsorotherswho

maybeabletoproviderelevantandpatientrelatedinformationconcerningatopic,and

showgoodlisteningbehaviorbycommunicatingempathyinculturallyappropriate

ways.InSpanish,theprofessionalwill:

• Restatepatientcommunicationtoverifytheaccuracyofcommunicated

information

• Askclarifyingquestionstoextendknowledgeandinformationgathering

• Summarizetheinformationconveyedinthepatientcommunication

• Useculturallyappropriatephrasesandoralcommunicationtechniquestoshow

empathywithpatients



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Standard4:CriticalReading

Role:HealthcareprofessionalasInquirer

CognitiveTask:InformationAnalysis&Synthesis

CommunicativePathway:Readingforunderstanding


AtthiscompetencyleveltheprofessionalwillinSpanish:• Learnandobtaininformationfromtextswritteninthetargetlanguage

• Understandandsummarizemainideasandsupportingdetailsintextsrelatedto

patientcare

• Followpersonalstories,descriptions,andquestionswrittenindifferentmodes

andwithvariedvocabularyandsyntaxfrompatientsandotherpeopleinvolved

inthepatientsituation

• Understandpatientrelatedcarecommunicationfromotherspecialists

• Navigateandsummarizehealthrelateddocumentsandresearchoflengthwritteninavarietyofmodes,includingthoseonunfamiliartopics

Performanceindicators:ThecareprofessionalwilldemonstrateunderstandingofwrittenSpanishbysummarizingtexts,explainingdetailscontainedinthetext,andaskingforadditionalinformationfrompatientsorothers,whomaybeabletoproviderelevantinformationconcerningthetopicreferredtointhetextaswellasothernecessaryandconnectedinformation.Asappropriatetothecontext,andwhenneeded,inSpanishtheprofessionalwill:

• Restatethewrittencommunicationtoverifytheaccuracyofinformation

• Askclarifyingquestionstoextendknowledgeandinformationgathering

• Summarizetheinformationconveyedinthetexteitherorallyorinwriting

• Explaindetailscontainedinthetexttothepatientorotherrelatedcarescenario

participantsandstakeholders

• Useculturallyappropriatephrasesandoralcommunicationtechniquestoshow

empathyandsensitivitywithpatientswhendiscussingthewrittentextordetails

containedinit.



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Standard5:CulturalNavigation

Role:HealthcareprofessionalasMediator

CognitiveTask:SocialLeadership

CommunicativePathway:All


Atthiscompetencyleveltheprofessionalwill:• Consistentlyutilizeculturallyrelevantunderstandingandbehaviortoenhance

patientcareprovisionandgoalsetting• Facilitatepatientempowermentwithinthehealthcarearenaandimprovecare

access• Actasapatientadvocateandmentor• Identifyandcommunicatepatientresourceswithpatientsandotherrelevant

stakeholders• Learnaboutapatient’sculturalbeliefsandneedstoimprovequalityofcareand

accesstoservices• Providefeedbackandinformationrelevantforpatientnavigationofhealthcare

resourcesandknowledgeinthelocalhealthcarecontext• Actasculturalnavigatorinthehealthcarecontexttoimproveunderstanding

betweenpeople


Tofacilitatebetteraccessandqualityofcareforpatients,thecareprofessionalwill

accomplishtheobjectivesofculturalnavigatorthroughengagingsuccessfullyinthe

followingactivitiesrelatedtotheabovetasks:

• Useknowledgeofculturallyappropriatebodylanguageandsocialnorms,

includingphysicalgestures,eyecontact,andsocialrolerepresentationwith

patients

• Accommodatepatients’varyingbeliefsandassumptionsunderlyingconceptsof

healthandthehumanbodywiththepurposeofimprovingcareandcollaboration

throughunderstanding

• Assistpatientsandotherstakeholdersinfindingandusingcommunityandhealth

careresourcestoenhancepatientengagementandresponsibilityinthehealth

carecontext



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PerformanceIndicatorscontinued:

• Provideresourcesandeducatepatientsonculturalandlogisticalprocessesthat

willimprovepatientnavigationandtreatmentorhealthcaregoal

accomplishmentthroughthelocalhealthcaresystem

• Provideinformationandeducateotherprofessionalsabouttheculturalpractices,

norms,andformsofcommunicationrelatedtopatientswhichwillenhance

overallcommunication,access,andqualitycareforLimitedEnglishProficient

(LEP)patientsandtheirfamilies

• Makerelevantandappropriateinquiriesabouttheculturalbeliefsofpatients

thatmayimpacthealthcareprovision

• Askquestionsandgivefeedbacktopatientsabouttheirknowledgeofthehealth

caresystemtoensurepatientunderstandingandimprovedengagementinthe

careprocess

• Helpothercareprofessionalsbridgeculturaldifferencestofacilitate

understandingbetweenpeopleandscaffoldthesmootherprovisionofquality

care



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GlossaryofKeyTerms

Bilingualism–Pertainingtothecognitiveincorporationoftwolanguagesystemsforthe

purposeofcommunication.

BilingualHealthCareProfessional-Atrainedhealthcareworkerwhodemonstrates

functionaltofluentcommunicativecompetencyintwolanguagesforcommunicationwithLEP

patientsandotherstakeholdersandprofessionalswithinthehealthcarecontext.

Fluency–Acognitive-linguisticskillmarkerusedtoindicatethecapacitytocommunicateina

languagewithoutpausesthatmightimpedemeaning.Doesnotdenotevaryingdegreesof

inherentlexicalsophisticationorsyntacticcomplexity.

ProfessionalCompetency–Demonstratedskillandknowledgeproficiencywithinaspecific

areaofremuneratedactivity,measurableatdistinctlevels.

QualityCareCommunication–Communicationwithpatientswithinacomprehensive

frameworkwhichentailsthesharingofknowledge,andevaluationandscaffoldingofpatients’

understandingofthehealthcaresituationtoenhanceengagement,responsibledecision

making,andinformedaction.



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