Assessment in Medical Spanish: Challenges and Ideas

Assessment in Medical Spanish:Challenges and Ideas Alyssia Miller De Rutté, Diana Galarreta-Aima, and Andrea Nate Introduction The all-encompassing term "Medical Spanish" references the Spanish used by healthcare professionals. Medical Spanish courses have gained traction as the Spanish-speaking population in the U.S. continues to grow. On the one hand, the country's Hispanic population is estimated at around 60 million, or 18% of the total population; this number is expected to grow to 111 million, or 28% of the total population, by 2060 (U.S. Census Bureau 2018). On the other hand, only 6% of physicians identify as Hispanic, and there is no data on the number of Spanish-speaking physicians (Association of American Medical Colleges 2019). This significant language and cultural barrier in healthcare has created a great need for quality Medical Spanish education. Consequently, demand for courses in Medical Spanish and other areas of Spanish for Specific Purposes (SSP), a subfield of Languages for Specific Purposes (LSP), has grown. However, research on LSP focuses mostly on English for Specific Purposes, and relatively few publications examine SSP. As the SSP discipline grows, we need to understand curricular decisions and implementation, assessment, and learning activities for Medical Spanish courses. One area of Medical Spanish that has not been widely explored is that of assessment. This article discusses assessment challenges in teaching Medical Spanish and offers tips for instructors of these courses. Assessment Challenges in Medical Spanish Education Due to increasing popularity of Medical Spanish classes, it is helpful to consider the following questions when designing a program and assessments: • What are we assessing? Most Medical Spanish textbooks feature vocabulary lists and memorization of common phrases, but this approach falls short. There is a "need for a pragmatic and cultural approach to language teaching in Medical Spanish courses, shifting the focus from specific terminology to a broader set of communicative competencies" (Belpoliti and Perez 2016: 128). Profession-specific vocabulary is important, but "medical language is situated within and interacts with the general language domain, a domain that cannot, by its very nature, be rigidly defined" (O'Sullivan 2012: 73). [End Page 35] • How are we assessing? Despite increasing popularity of medical Spanish classes in post-secondary education, a uniform medical Spanish assessment examination and validated evaluation tools are still lacking. • How are we assessing cultural competence? Assessing cultural awareness in a clinical setting can be challenging. According to the ACTFL Performance Descriptors for Language Learners, an essential area in the evaluation of Medical Spanish students' skills should be the interpersonal domain that encompasses social awareness and cultural humility. Fernandez et al. (2004) found a correlation between high levels of cultural competence and linguistic proficiency of primary care physicians with higher levels of patient satisfaction. This suggests that courses that integrate cultural competence into their curriculum can help students better understand the needs of patients with limited English and the legal consequences of not providing health services in the patient's primary language (Lee et al. 2006). • Who are we assessing? Both L2 and Heritage speakers take Medical Spanish courses. Additionally, students from the beginner to the advanced level take these courses, as do students with little to no medical knowledge, current medical students, and health professionals. The wide variety of linguistic proficiency, medical knowledge, and cultural competence levels among Medical Spanish students creates the need for diverse, adaptable assessment guidelines and tools. Recommendations for Assessment • Evaluate students' proficiency before enrollment and compare results after course/program completion. • Use backward design to align learning goals, outcomes, and assessment tools. • Prioritize assessment of oral/aural proficiency and intercultural skills over grammatical accuracy and memorization of medical jargon. • Use standardized reliable assessment: e.g., ACTFL OPI or Can-Do Statements or modified Interagency Language Roundtable scale for medical settings and adapt these to your course learning objectives. • Use different assessment tools: rubrics, student's self-assessment, standardized patients' evaluations. • Offer opportunities for community engagement, and write clear guidelines and rubrics to assess students' cultural competence. • Determine longitudinal course/program effectiveness through surveys to measure the impact of the program on students' careers and community engagement. We will now summarize two learning activities—community service-learning and role playing—that can...