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Dome - Bridging the Gap in Cross-Cultural Care

Dome October 2012

Bridging the Gap in Cross-Cultural Care

Date: October 5, 2012

Advanced medical Mandarin students (back row) with their instructor, Hsing-Chen Tsai (front left), and Mei Du (front right), an employee at the Chinese-speaking clinic in Ellicott City.
Advanced medical Mandarin students (back row) with their instructor, Hsing-Chen Tsai (front left), and Mei Du (front right), an employee at the Chinese-speaking clinic in Ellicott City.

Since coming to the United States from Taiwan six years ago to complete a doctoral program at the school of medicine, Hsing-Chen Tsai has seen firsthand the hurdles that Asian immigrants face in accessing health care.

Now a postdoctoral fellow and epigenetics researcher at the Cancer Center, Tsai says the language barrier is the top reason why immigrants she knows avoid coming to the hospital. “Many immigrants put off going to the doctor for as long as possible,” Tsai explains. “Those who do seek care will often only see a doctor who speaks Mandarin Chinese.”

After witnessing the impact of delayed care and misdiagnoses among friends and acquaintances, Tsai jumped at the chance to launch one of two language courses designed to teach Hopkins medical, nursing and public health students how to communicate with and care for Mandarin-speaking patients.

Recruited five years ago by the Hopkins chapter of the Asian Pacific American Medical Student Association, today Tsai and several of her colleagues lead a rigorous 14- to 16-week course that teaches already fluent students the medical terminology and skills needed to deliver culturally competent care. Through vocabulary exercises and role-play, students learn the Mandarin words for terms like cardiac catheterization and myocardial infarction. The course culminates with an opportunity to practice new language skills at the Asian American Healthcare Center, a Chinese-speaking clinic in Ellicott City, where students take patient histories and practice physical examinations.

In addition to communicating with Hopkins patients, some of Tsai’s students have gone on to complete research projects and clinical rotations in hospitals in China and Taiwan. “The class gives students the skills they need to create a meaningful cross-cultural connection with patients,” Tsai says. She adds that some graduates report another benefit that’s closer to home—the ability to discuss health matters with parents and grandparents who don’t speak English.

For students who speak little to no Mandarin, the beginner course covers pronunciation, grammar, vocabulary and sentence construction—building blocks needed to carry on basic conversations related to health and wellness. The curriculum for both classes also includes instruction on diseases that are more prevalent among Asians and Asian-Americans.

According to Tsai, more medical schools have expanded their language curriculum in recent years. “More and more people are becoming aware of the need for culturally sensitive care, but we need to keep promoting it,” she says.

Although the basic and advanced medical Mandarin classes don’t currently count toward elective credit hours, Tsai says that could change soon for medical students, who also can take two levels of medical Spanish.

            —Shannon Swiger


To learn more, contact Daniel Teraguchi, director of the School of Medicine Office of Student Diversity, at