Relationship between self-assessed and tested non-English-language proficiency among primary care providers
Department of Family Medicine and Community Health
California; Communication Barriers; Female; Health Personnel; Humans; *Language; Male; Massachusetts; Multilingualism; Physicians; Primary Health Care; Professional-Patient Relations; *Self Report
Community Health and Preventive Medicine | Family Medicine | Preventive Medicine | Primary Care
BACKGROUND: Individuals with limited English proficiency experience poor patient-clinician communication. Most studies of language concordance have not measured clinician non-English-language proficiency.
OBJECTIVES: To evaluate the accuracy of the self-assessment of non-English-language proficiency by clinicians compared with an oral proficiency interview.
SUBJECTS: Primary care providers (PCPs) in California and Massachusetts.
MEASURES: PCPs first completed a self-assessment of non-English-language proficiency using a version of the Interagency Language Roundtable (ILR) Scale, followed by the Clinician Cultural and Linguistic Assessment (CCLA), a validated oral proficiency interview. We used nonparametric approaches to analyze CCLA scores at each ILR scale level and the correlation between CCLA and ILR scale scores.
RESULTS: Sixteen PCPs in California and 51 in Massachusetts participated (n=67). Participants spoke Spanish (79%), followed by Cantonese, Mandarin, French, Portuguese, and Vietnamese. The respondents self-assessed as having "excellent" proficiency 9% of the time, "very good" proficiency 24% of the time, "good" proficiency 46% of the time, "fair" proficiency 18% of the time, and "poor" proficiency 3% of the time. The average CCLA score was 76/100. There was a positive correlation between self-reported ILR scale and CCLA score (sigma=0.49, P < 0.001). The variance in CCLA scores was wider in the middle categories than in the low or high ILR categories (P=0.003).
CONCLUSIONS: Self-assessment of non-English-language proficiency using the ILR correlates to tested language proficiency, particularly on the low and high ends of the scale. Participants who self-assess in the middle of the scale may require additional testing. Further research needs to be conducted to identify the characteristics of PCP whose self-assessments are inaccurate and, thus, require proficiency testing.
health disparities, language, doctor-patient interaction, primary care, provider behavior
DOI of Published Version
Med Care. 2014 May;52(5):435-8. doi: 10.1097/MLR.0000000000000102. Link to article on publisher's site
Diamond, Lisa; Chung, Sukyung; Ferguson, Warren J.; Gonzalez, Javier; Jacobs, Elizabeth A.; and Gany, Francesca, "Relationship between self-assessed and tested non-English-language proficiency among primary care providers" (2014). Family Medicine and Community Health Publications and Presentations. 292.