Pediatrician Children's Mercy Children's Mercy Hospitals and Clinics Kansas City, Missouri, United States
Background: The Clínica Hispana de Cuidados de Salud (CHiCoS) Program was created in 2009 to prepare bilingual (English-Spanish) pediatric residents to independently give safe, effective care to Spanish-speaking families. By providing 1:1 support from a culture and language coach over three years of residency, CHiCoS has improved residents’ cultural and linguistic skills and families' perceptions of care. The effects of such training on residents’ future careers have not been formally studied.
Objective: To describe the careers of former CHiCoS residents, the impact of culture and language training on their practice, and opportunities for post-CHiCoS cultural and language training.
Design/Methods: In this descriptive, cross-sectional study, we created and sent a digital survey (26-44 questions depending on branching logic) to former CHiCoS residents including details of their current and previous practice, Spanish utilization with patients/families, maintenance of Spanish proficiency, impact of CHiCoS on career satisfaction, and desire for ongoing culture and language training. All CHiCoS residents graduating from 2011-2019 were included, except those who did not complete the program or who were authors of this study.
Results: Twenty-four of 33 CHiCoS graduates (73%) completed the survey. A majority worked in academic (14/24) and urban (14/24) settings. Almost all who were qualified bilingual staff upon CHiCoS graduation (N=18) worked in settings with Spanish-speaking patients/families (94%) and used their Spanish skills in greater than half of their visits (89%). Among graduates seeing >20% Spanish speaking patients (N=9), all but one felt they maintained or improved their Spanish skills. Most of those with <20% Spanish-speaking patients (10/13) reported maintaining their proficiency level, while those with no Spanish-speaking patients (N=2) felt their skills had eroded. CHiCoS training had a moderate to large impact on career satisfaction for 83% of graduates (Table, Figure), and 71% reported a desire for further support in cultural and linguistic skill development, including post-CHiCoS culture and language coaching. Conclusion(s): Culture and language coaching for bilingual residents leads to careers serving culturally and linguistically diverse patients and families. Language skills developed in residency can be maintained through ongoing use in future practice, but most graduates would like to continue formal culture and language training, even after reaching a professional level of proficiency.
Authors/Institutions: Jodi J. Dickmeyer, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States; Katelyn R. McAnany, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States; Sarah E. Stone, Inova Fairfax Hospital, Rockville, Maryland, United States; John D. Cowden, Children's Mercy Hospitals and Clinics, Kansas City, Missouri, United States