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Bridging Communication Gaps: Exploring Medical Students’ Understanding and Experiences in Caring for Patients with Hearing Impairments and Language Barriers
Kim, A. [3]
Nolin, J. R. [3]
Bracy, H. [1]
Berko, H. [1]
Mazzorana, A. [1]
Leiber, K. [1]
Hernandez, E. [1]

Journal: Journal of Osteopathic Medicine Date: 2025/12, 125(12):Pages: A711–712. doi: Subito , type of study: cross sectional study

Full text    (https://www.degruyterbrill.com/document/doi/10.1515/jom-2025-2000/html)

Keywords:

cross sectional study [821]
cultural competency [4]
hearing impairments [1]
hearing loss [13]
language barriers [1]
medical students [631]
osteopathic medicine [2010]
patients [134]
USA [1610]

Abstract:

Context: Deaf and hard-of-hearing (HoH) individuals make up approximately 3.6% of the United States population. Deafness and HoH can be attributed to genetics, environmental factors, age, and disease. However, there have been a lack of accommodations to account for the disparities which is apparent when comparing the rates of emergency department users and length of stays among hearing and deaf/HoH patients. “Deaf American Sign Language users appear to be at greater odds for elevated ED utilization when compared to the general hearing population”3 and “hospitalized nonspeaking deaf patients had higher mortality and longer hospital stays compared to those without this condition”2. However, there is a lack of education amongst healthcare providers on not just the medical needs, but the social needs of deaf and HoH individuals. Objective: To investigate the cultural competency levels of medical students at Alabama College of Osteopathic Medicine (ACOM) and comparing this with the level of exposure during clinical years. We would like medical schools to produce not just academically competent future physicians, but also be able to use their academic skills appropriately according to the present population in which they will serve. By providing opportunities to learn more about the Deaf community and how to connect better on a social level, we are hoping to provide evidence of the need for improved education regarding the Deaf community and American Sign Language to emphasize the lack of holistic patient-centered care when it comes to deaf and HoH patients. Methods: The study was conducted through a survey. Two separate surveys were sent out through school emails to medical students at ACOM depending on their status of pre-clinical (first- and second-year medical students at ACOM) vs. clinical experience (third- and fourth-year medical students at ACOM). The surveys were collected through Qualtrics, and no personal identifiers were collected in order to maintain anonymity. 101 reports were collected from pre-clinical students, and 57 reports were collected from clinical students. Through Qualtrics, we were able to analyze the distribution of answers utilizing the mean and mode to determine its relevance and significance overall. Osteopathic significance: These surveys assessed the gap in osteopathic education of medical students to provide a holistic approach to medicine for better outcomes in patient care. Results: When investigating the results of the survey, 94% of pre-clinical students at ACOM reported that they have never received formal training in communication with patients from the Deaf community or those requiring interpretive assistance, and on a scale of 0-5 with 0 being not confident and 5 being very confident, average confidence level of their ability to communicate with patients from the Deaf community was 1.20 while their views on the importance of the ability to communicate with these populations was a 4.22. 93% of students reported that increasing interactions with patients with communication barriers can improve communication skills overall and 97% of students believed that communication barriers impact patient outcomes and satisfactions during medical visits. 77% of medical students who were enrolled in their clinical years reported that they have experienced working with patients requiring interpretive assistance during their clinical years. The average confidence level in their ability to communicate with those requiring interpretive assistance was 2.44 and the average level of education on how to perform a physical exam and history on Deaf patients on a scale of 0-5, with 0 being no education and 5 being high level of education, was 1.43. 62% of students reported that they have had more than four instances during their clinical education experience where they have required interpretive assistance and 74% of medical students in their clinical years reported interest in learning more on how to effectively communicate with patients belonging in the Deaf community or requiring interpretive assistance. Conclusion: When comparing data from medical students in their pre-clinical to clinical years, confidence levels of communication skills when interacting with Deaf patients and those requiring interpretive assistance rose by 1.24. However, there still appears to be a need for greater education on how to effectively communicate with patients who are deaf or requiring interpretive assistance as greater than 90% of pre-clinical students reported that they have never received formal training in this field and a majority of clinical year students showed interest in learning more on how to effectively communicate with patients who are deaf and/or require interpretive assistance. Although the study focuses more heavily on the need for greater education on Deaf culture and American Sign Language, these results can additionally support for further research on the need for osteopathic schools to educate students on how to interact with patients when any communication barrier is present during patient-physician encounters. Additionally, these results can be further investigated in a hospital setting of not just physicians but all staff who interact with patients. This study was not conducted with the intention to promote osteopathic medical students to become fluent in an additional language, as a qualified interpreter is required for accurate, unbiased, and ethical interpretation between patient and physician. However, results can support the greater need for and training of interpretive service providers in underserved regions throughout the country.

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