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March 2, 2016

Building rapport: Medical Spanish class helps students connect with patients

Unlike many young children, the Class of 2016’s Arhanti Sadanand looked forward to going to the doctor.

“I loved my pediatrician,” she said. “I felt like there was always someone there to help me feel better. My doctors were always my role models, and that stuck with me.”

Once she entered VCU’s School of Medicine, she made it her mission to establish a similar rapport with her patients. One major tool she had at her disposal was her ability to speak Spanish.

There’s a big difference between avergonzado – embarrassed – and embarazada — pregnant. M4 Arhanti Sadanand leads her classmates through an OB patient case.

“I’m lucky enough to have a background in Spanish,” said Sadanand, who minored in Spanish at New York University. “But many doctors don’t. Part of our responsibility is to communicate with all our patients as best we can so that we can build rapport.”

To help other medical students on the MCV Campus form a closer relationship with Spanish-speaking patients, she is teaching a Medical Spanish elective. The four-week class, offered twice this year, has an emphasis on listening comprehension and oral fluency in realistic healthcare scenarios.

“This is critical for medical students,” she said. “The class has a focus on clinical dialogue they will use every day in the exam room.”

Sadanand is teaching common phrases and medical terms in a fun way. Participants often role play or compete in Spanish Jeopardy, bingo and other games to bring some fun to the classroom.

“I wanted to make it more interactive,” Sadanand said. “Still, I don’t want anyone overestimating their abilities when they leave the class. They won’t be fluent, but it’s a great start.”

The class is Sadanand’s community-based capstone project, a requirement of the school’s International/Inner City/Rural Preceptorship (I2CRP) Program. I2CRP is a four-year program that fosters the knowledge, skills and values needed by doctors to provide quality and compassionate care in medically underserved communities.

“This class helps bring our students much closer to making that all-important connection with patients,” said Mark Ryan, M’00, H’03, medical director of I2CRP.

Each session addresses specific topics: physicals, abdominal pain, respiratory infections, diabetes, hypertension, pregnancy, musculoskeletal complaints and pediatrics. At the end of the four weeks, Sadanand will assess Spanish proficiency with the help of a fluent Spanish speaker acting as the patient in a mock medical encounter.

“I’m lucky enough to have a background in Spanish,” said the Class of 2016’s Arhanti Sadanand. “But many doctors don’t. Part of our responsibility is to communicate with all our patients as best we can so that we can build rapport.”

Sadanand will also compare improvement of and confidence in Spanish proficiency by using standardized pre-tests, post-tests and student surveys. She will present the results to the school’s curriculum council with hopes the class will be added to the School of Medicine’s catalogue.

“The vision and the drive she has brought to this project has been extraordinary,” said Mary Lee Magee, M.S., who serves as educational director of I2CRP. “There are limited resources available for our medical students in this area, and the need is so great.”

The class, however, does not replace a medical student’s obligation to use certified Spanish interpreters. Healthcare providers can call on live interpreters to visit patients and translate for them or use technology assisted interpretation that are phone or web based.

But, “There’s nothing like the personal touch,” Sadanand said. “When I put myself in the patients’ shoes, it must be terrifying. Imagine not being able to communicate with your doctor.”

Sadanand’s class builds upon the work of two previous I2CRP students, Irving Phillips, M’15, and Patrick Lam, M’15. Their research showed the Teaching Proficiency through Reading and Storytelling method is an effective alternative to Rosetta Stone, which is more general. Sadanand’s fellow I2CRP student Deborah Me sees so much value in the approach that she volunteered to help out with teaching duties when Sadanand was busy with her fourth-year rotation in pediatric hematology-oncology.

Shanti Nambiar, M’16, is one of about 20 students enrolled in the class this year. “This has been extremely helpful,” she said. “It’s giving me the tools to get through a clinic visit.”

During her third year, when Sadanand completed her clinical rotations, she met at least one Spanish-speaking patient every day, she said. She is confident that number will only rise. According to the U.S. Census and other government sources, the United States is home to more than 41 million native Spanish speakers.

“What’s so important is building that trust with your patients,” said Sadanand, who is pursuing a pediatrics residency. “When you establish that link, when you bring your patients that comfort, everyone wins.”

By Janet Showalter

Virginia Commonwealth University
VCU Medical Center
School of Medicine
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Updated: 04/29/2016