The Role of Language Proficiency Assessment in Improving Pharmacy Patient Communication

Studies have shown that medical staff who speak the language of the patients they serve can help increase access to patient care and improve health outcomes.¹ In the pharmacy environment, health care professionals who directly communicate with patients in their preferred language play a critical role. They ensure that patients understand the correct dosage, know how and when to take a medication, and are aware of the side effects they may experience.

A pharmacist who discloses inaccurate information due to a lack of fluency, cultural understanding, or proficiency in medical terminology can pose a risk both to patient safety and to the health care organization. Image Credit: © Marc Calleja - stock.adobe.com

But offering pharmacists who can speak with a patient in the patient’s preferred language isn’t as simple as recruiting bilingual employees. Not everyone who considers themselves to be bilingual has a level of fluency that enables effective communication with a patient.

That’s why pharmacies and health care systems that want to feel confident that their bilingual pharmacists are proficient in conducting language-concordant conversations are sufficiently verifying their language skills. Using rigorous third-party assessments helps organizations protect themselves against potential liability caused by a pharmacist accidentally giving inaccurate information about a medication or side effects. It also helps provide a better experience for the pharmacist and patient alike.

The Importance of Assessment and Validation of Bilingual Pharmacists

Health care communication often involves complex medical terminology that goes beyond everyday language. Bilingual pharmacists may not have the necessary proficiency in medical terminology in both languages to accurately convey medical information and pharmaceutical instructions to patients. For example, there isn’t always a direct equivalent of a medical term in another language. This makes it critical to be able to provide an explanation, and cultural nuances can sometimes require changes in how things are explained.

A pharmacist who discloses inaccurate information due to a lack of fluency, cultural understanding, or proficiency in medical terminology can pose a risk both to patient safety and to the health care organization.

Consider the case of Willie Ramirez, an 18-year-old man who was taken to the hospital after he lost consciousness. Both the emergency department doctor and Ramirez’ Cuban family thought they were communicating effectively, so neither requested a professional medical interpreter. But cultural misunderstandings over the Spanish word “intoxicado,” which when used by Cubans is not equivalent to the English word “intoxicated,” led to a medical error that resulted in brain damage that left Ramirez a quadriplegic.²

Assessing Your Pharmacists’ Ability to Talk to Patients In-Language

Many health care organizations have a pool of pharmacists who consider themselves to be bilingual, but multiple factors can affect their ability to communicate effectively with patients. In contrast to a medical interpreter who relays the conversation between a patient in 1 language and the pharmacist in a second language, a bilingual pharmacist communicates directly with the patient in the patient’s language.

Here’s what you need to consider when determining whether your bilingual pharmacists have the skills needed to speak to patients in-language.

• Ensure that you are assessing and documenting the language skills of self-reported bilingual staff with an assessment tool that is rigorous and reliable. Whether you are using an in-house assessment or partnering with a third party for this service, ensure that each assessment has undergone in-depth analysis, piloting, calibration, and a refinement period to guarantee validity and reliability. Only with a consistent measure of your pharmacists’ skills can you make informed decisions about the language abilities of your team.
• Ensure that your assessment covers all aspects of fluency needed for effective communication in the pharmacy environment. Medical terminology is something that can typically be memorized easily, but it’s much more challenging to improve language fluency. Test your bilingual pharmacists in the following categories:
  • Medical terminology in the target language: Do pharmacists have a firm grasp of specialized medical or pharmaceutical terminology?
  • Language comprehension: Can pharmacists accurately and efficiently comprehend the spoken target language?
  • Language production: Can pharmacists speak the target language clearly and efficiently?
• Only allow pharmacists whose language skills have been assessed and validated to provide services in-language. If you don’t have any bilingual pharmacists on hand who are fluent enough to communicate effectively with patients in the languages they speak, you should ensure that pharmacists have reliable access to professional interpreters. Given the breadth of languages your patients might speak, this is a good safeguard to have in place regardless of how many qualified bilingual pharmacists you staff.

Anyone who is speaking in-language with your pharmacy’s patients should have their language skills confirmed. With patients’ health and safety at stake, it’s just too important to leave it to a self-assessment. Poor communication regarding dosage or how to take medication can put a patient, and your organization, at risk. By assessing and validating your bilingual pharmacists’ knowledge of medical terminology and ability to comprehend and speak the language, you can feel confident that they are qualified to conduct these critical conversations in the patient’s language of choice, mitigating risk and improving the experience for pharmacists and patients alike.

REFERENCES

1. Al Shamsi H, Almutairi AG, Al Mashrafi S, et al. Implications of language barriers for healthcare: a systematic review. Oman Med J. April 30, 2020. doi:10.5001/omj.2020.40
2. Language, culture, and medical tragedy: the case of willie ramirez. Health Affairs Blog. November 19, 2008. doi:10.1377/hblog20081119.000463