Recognizing and Dismantling Raciolinguistic Hierarchies in Latinx Health

Ortega, Pilar; Martínez, Glenn A.; Alemán, Marco A; Zapién-Hidalgo, Alejandra; Shin, Tiffany M

doi:10.1001/amajethics.2022.296

Cited by 12 publications

(5 citation statements)

References 22 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…First, multiple varieties of Spanish should be represented in the teaching materials and among faculty, teaching assistants, guest speakers, and standardized patients. This can expose students to the variety of dialects, sounds/accents, regional words, 18 and the different practices and conceptualizations that exist therein. 19 Training for medical Spanish faculty should also incorporate these ideas, reinforcing that all varieties of the language should be equally valued in order to appropriately reflect the linguistic realities of everyday people and marginalized communities.…”

Section: Discussionmentioning

confidence: 99%

“…This is consistent with published literature that affirms that not all varieties or usages of a language are equally well-respected or considered to have the same level of prestige. 18 Spanglish is an example of non-standard Spanish which, popularly, is sometimes viewed as corroded.…”

Section: Discussionmentioning

confidence: 99%

“…Recognizing such hierarchies is important to providing equitable medical care because valuing some linguistic features over others is a form of bias and may result in health disparities. 18 Future research should explore the perceived challenges to translanguaging in medical interactions to better understand why medical Spanish learners or faculty would be hesitant to translanguage in patient care. This could be done by observing medical interactions and identifying translanguaging moments, or through qualitative study of the experiences of medical students, clinicians, and patients about the use of translanguaging in clinical encounters.…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Medical Student and Faculty Attitudes Toward Translanguaging with Spanish-Speaking Patients

Ortega,

Tan,

Prada

et al. 2024

JNHMA

View full text Add to dashboard Cite

Background: Spanish is the second most common US language, and Spanish speakers commonly translanguage—spontaneously integrate multiple languages. Medical language courses have proliferated, yet learner and faculty attitudes about translanguaging with patients remain unexplored. Also, it is unclear whether medical Spanish courses address real-world patient linguistic practices, such as translanguaging. Methods: We applied a community cultural wealth framework to identify translanguaging practices relevant to patient-physician communication: regionalisms, Spanglish, and non-standard language usage. From January 2020 to May 2021, we surveyed students (n=355) and faculty (n=14) in a standardized medical Spanish course at 14 sites on their attitudes toward translanguaging practices. Results: Regionalisms were the most widely accepted translanguaging practice by both students and faculty, and this opinion was reinforced by the course (94% pre vs. 95% post-course agreement; p=0.045). Student agreement with Spanglish was moderate and declined post-course (58% vs. 55%; p<0.001). Faculty were likelier than students to be accepting of non-standard language usage (57% faculty vs. 5% students; p<0.001). Conclusion: Medical students and faculty reported mixed attitudes about translanguaging practices in healthcare, and taking a medical Spanish course had variable effects on student responses. Future work should focus on developing and evaluating medical Spanish educational pedagogies that explicitly incorporate real-world patient perspectives and promote flexible language use that prioritizes mutual respect and understanding.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Medical Student and Faculty Attitudes Toward Translanguaging with Spanish-Speaking Patients

Ortega,

Tan,

Prada

et al. 2024

JNHMA

View full text Add to dashboard Cite

show abstract

“… 23 Intentionally craft the patient comments and responses so as to not propagate stereotypes, overgeneralizations, or inaccurate attributions regarding US Spanish speakers (e.g., the inaccurate perception that Hispanic/Latinx patients are likely to refuse treatment). 24 …”

Section: Methodsmentioning

confidence: 99%

Medical Spanish Graphic Activity: A MeGA Deliberate Practice Approach to Reducing Jargon Use With Spanish-Speaking Acute Care Patients

Ortega,

Cisneros,

Park

2024

MedEdPORTAL

View full text Add to dashboard Cite

Introduction Medical Spanish courses in US medical schools aim to teach patient-centered communication, yet many existing resources focus on technical vocabulary and may inadvertently increase jargon use with patients. Graphic medicine presents an opportunity for interactive learning that centers the patient experience, yet it has never been explored in medical Spanish education. Methods We developed a Medical Spanish Graphic Activity (MeGA) for medical student deliberate practice of patient-centered verbal communication focused on three aspects: diagnosis, treatment, and follow-up care. Each 30-minute activity included a comics handout depicting a patient with a common problem. Students used voice-to-text technology to record their explanations in response to prompts. Transcripts were analyzed for jargon use, including total jargon, unexplained jargon, and problem words (non-Spanish words plus unexplained jargon), utilizing a previously published, reliable protocol for Spanish medical jargon classification. Participants voluntarily provided postactivity feedback. Results Twenty-nine fourth-year students with intermediate or greater Spanish skills participated in a series of 10 MeGA activities between January and April 2022. Unexplained jargon use and problem words progressively decreased for all transcripts (diagnosis, treatment, and follow-up; all p s < .001). Total jargon use also decreased, but this was not significant in follow-up transcripts ( p = .38). All students agreed that MeGA helped them enhance communication skills applicable to patient care and self-identify strengths and limitations. Discussion MeGA is realistic to implement, engages students' active participation in the speaking domain, and reduces unexplained jargon use. Future studies should explore the broader application of this model and engage patient perspectives.

show abstract

“…The gender-neutral category Latinx is consistent with the literature, which supports the complex definition of race and ethnicity for Hispanic patients. 20 We acknowledge that these categorizations may overlook significant heterogeneity within these groups. We further recognize that race and ethnicity reflect socially constructed categories, rather than biological or genetic groups, and may serve as a surrogate for structural factors that underlie racism.…”

Section: Primary Predictorsmentioning

confidence: 99%

Across race, ethnicity, and language: An intervention to improve advance care planning documentation unmasks health disparities

Dutta,

Flynn,

Oreper

et al. 2023

Journal of Hospital Medicine

View full text Add to dashboard Cite

BackgroundRacial and ethnic minority groups are less likely to have advance directives and living wills, despite the importance of advanced care planning (ACP) in end‐of‐life care. We aimed to understand the impact of an intervention to improve ACP documentation across race, ethnicity, and language on hospitalized patients at our institution.MethodsWe launched an intervention to improve the rates of ACP documentation for hospitalized patients aged >75 or with advanced illness defined by the International Classification of Diseases 10th Revision codes. We analyzed ACP completion rates, preintervention, and intervention, and used interrupted time‐series analyses to measure the differential impact of the intervention across race, ethnicity, and language.Key ResultsA total of 10,220 patients met the inclusion criteria. Overall rates of ACP documentation improved from 13.9% to 43.7% in the intervention period, with a 2.47% monthly increase in ACP documentation compared to baseline (p < .001). During the intervention period, the rate of ACP documentation increased by 2.72% per month for non‐Hispanic White patients (p < .001), by 1.84% per month for Latinx patients (p < .001), and by 1.9% per month for Black patients (p < .001). Differences in the intervention trends between non‐Hispanic White and Latinx patients (p = .04) and Black patients (p = .04) were significant.ConclusionsAn intervention designed to improve ACP documentation in hospitalized patients widened a disparity across race and ethnicity with Latinx and Black patients having lower rates of improvement. Our findings reinforce the need to measure the impact of quality improvement interventions on existing health disparities and to implement specific strategies to prevent worsening disparities.

show abstract

Recognizing and Dismantling Raciolinguistic Hierarchies in Latinx Health

Cited by 12 publications

References 22 publications

Medical Student and Faculty Attitudes Toward Translanguaging with Spanish-Speaking Patients

Medical Student and Faculty Attitudes Toward Translanguaging with Spanish-Speaking Patients

Medical Spanish Graphic Activity: A MeGA Deliberate Practice Approach to Reducing Jargon Use With Spanish-Speaking Acute Care Patients

Across race, ethnicity, and language: An intervention to improve advance care planning documentation unmasks health disparities

Contact Info

Product

Resources

About