Abstract
Cross-CCCR and responsiveness (CCCRR) is an important aspect of clinical service delivery in speech-language pathology (SLP). Beyond the issue of CCCR, there is also a need to address how professional practices can facilitate justice in traditionally marginalized populations. Limited language access can facilitate inequities and disparities within institutions and systems when it is not considered in clinical service delivery. However, within the field of SLP there is a limited amount of information available on the effectiveness of pedagogical strategies needed to facilitate student CCCR and train SLPs in how to minimize barriers posed by language access. Simulation, using standardized patients, is a strategy from the medical field that has been used for such purposes. There are few published reports on the use of simulation for fostering various aspects of CCCR development among SLP students. Therefore, the purpose of this chapter is to provide an overview of a research project examining the effectiveness of a simulated interpreter encounter for multicultural training.
TopIntroduction
Health and educational disparities, along with shifting demographics among various racial/ethnic groups, make it necessary for training programs in allied health professions to adopt pedagogical frameworks, models, and strategies that will facilitate CCCR in pre-professional students (Franca & Harten, 2016; NCES, 2019; Frey, 2018). CCCR has been defined as the ability to effectively interact with and deliver services to individuals from diverse backgrounds (ASHA, 2017, Horton-Ikard et al., 2009). CCCR involves the acquisition and implementation of the awareness, knowledge, and skills needed to effectively deliver services to individuals from culturally and linguistically diverse backgrounds (Camphina-Bacote, 2002; Sue, 2001). It is one area of preparation that many pre-professional programs and instructors may struggle with as they attempt to train pre-professional students who enter into the field of speech-language pathology ([SLP], Stockman, Boult, & Robinson 2008).
Beyond the need to clarify teaching methods for CCCR, there is also a need to address how professional practices can facilitate justice in traditionally marginalized populations that SLPs serve. The shifting demographic trends indicate that there is continued growth in the number of individuals who are multi-lingual. However, the number of bilingual speech-language pathologists remains rather low. Monolingual English speaking SLPs comprise the majority of practicing clinicians in the United States (ASHA, 2021). This presents significant challenges to providing access and opportunity to culturally responsive services to clients and families in educational and healthcare settings. Language access is a topic that has received a great deal of attention over the last decade since it can impact who receives services.
Limited language access has been linked to inequities and disparities that can be facilitated or reproduced by institutions, systems, and practitioners when language is a significant component of the health literacy skills needed to make decisions about resources and support that should be available to them (Agency for Healthcare Research and Quality, 2019). The National Health Law Program (2019) notes that several federal laws guide the provision of language access for health care services including Title VI of the Civil Rights Act of 1964 and Section 1557 of the Affordable Care Act. In educational settings, IDEA speaks directly to the importance of language access for families and students who receive or will receive special education services. In efforts to facilitate justice for those with limited English proficiency, The Federal Interagency Working Group on LEP C/O Federal Coordination and Compliance Section for the Civil Rights Division U.S. Department of Justice (2011) developed a planning tool to guide organizations receiving federal funding on ways to improve language access. This planning tool specifically addresses the importance of training staff on the importance of language access and specifically notes that, “Training should explain how staff can identify the language needs of an LEP individual, access and provide the necessary language assistance services, work with interpreters” (p.6).
Key Terms in this Chapter
BID Framework: Acronynm for Langdon and Saenz (2016a) tripartite framework for interpreter and SLP collaborative encounters which is described as briefing, interaction, and debriefing.
Standardized Patient (SP) Encounter: Involves the use of actors to simulate a specific set of traits, behaviors, or characteristics of a patient with a particular condition (Shiarzi, et al., 2011 AU117: The in-text citation "Shiarzi, et al., 2011" is not in the reference list. Please correct the citation, add the reference to the list, or delete the citation. ). The SP is expected to carry out the encounter in the same fashion as a real patient who might find themselves in a similar situation.
Language Access: The degree of language mismatch that can occur within systems and between individuals when they do not share or use the same linguistic system.
Health Literacy: Set of skills focused on how an individual is able to gather, process, and understand information necessary for making health care decisions.
CLAS Standards: National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health and Health Care developed by the U.S. Department of Health and Human Services.
Simulation: Experiential learning instructional strategy used to help students develop knowledge and skills in a particular content area.
ART Framework: Acrononym for Action, Ratification, Task framework proposed by Krystallidou (2016) , discusses the role of the interpreter as a provider of verbal behavior but accounts for how non-verbal behavior is signaled, communicated, and negotiated within the collaboration.