Spanish Curriculum

Learning Spanish at Lawrence Family Medicine Residency.

Goal and Objectives

The mission of the Lawrence Family Medicine Residency is to train family medicine physicians to provide patient-centered care for the underserved populations. Our own patient population is predominantly Spanish-speaking; our goal therefore is for each resident to complete residency proficient to provide medical care in Spanish without the need for an interpreter. Our focus is on verbal Spanish language skills.

Overview of the Curriculum:

It is neither expected nor required that residency applicants speak Spanish – just a desire to learn. LFMR has a nationally-known Spanish acquisition track record; residents here invariably develop strong Spanish communication skills by the end of their first year of residency and continue to build throughout their residency training.
9-day intensive language program at Dartmouth College (using the Rassias Method) during orientation in June/July prior to seeing any patients. (http://rassias.dartmouth.edu/).
On site Spanish teacher/translator. A now retired high school Spanish teacher (Pat Donahue) provides scheduled one-on-one lessons for residents and shadows residents in their continuity clinics throughout their first year (and beyond if desired) for real world instruction.
Immersion in a clinic where the vast majority of staff are fluent in Spanish.
The best way to learn a language is daily immersion (with support); the majority of patient interactions are in Spanish with formal interpreter services readily available at all times. First year residents who do not enter residency with Spanish proficiency participate in a 2-week language elective to obtain both a second intensive linguistic training experience in a Spanish-speaking country. The program provides funding to support the elective.
- Residents who come into residency testing at Spanish competency are able to opt-in to study another language spoken by our patient population, and are allotted the same elective time, tutoring time, and residency funding.

Components of the Curriculum

R1 Rassias Spanish Training

1 week: Dartmouth College – Hanover, NH

Entering first year class attends this 9-day course together at Dartmouth; tuition, room & board covered by residency.
Rassias Method is a unique approach that speeds language learning, increases language retention and has you speaking and understanding in “Nine days that make a difference.”
Originally developed for Peace Corps training, it has been adapted by language teachers in North America, Europe, Africa, and Asia.
Instruction is individualized to meet each resident’s needs, from those with no Spanish language at program entry to those with advanced Spanish proficiency.

For more information: http://rassias.dartmouth.edu/.

R1 Spanish Language Elective

2 weeks. Faculty Coordinator: Anthony Valdini, MD, MS

In addition to the 9-day intensive Spanish Rasisias course at Dartmouth College during Orientation, and individualized instruction in Lawrence throughout the year, the residency provides a supported Spanish language school experience during the R1 year for residents who do not have Spanish proficiency on entry to acquire a second intensive linguistic experience.
Residents select the language school from a list of recommended overseas schools in the Caribbean, Mexico, and Central America.

Programs our residents have reviewed well:

Columbia: Centro Catalina Language School http://www.centrocatalina.com/en/

Costa Rica: CPI (Centro Panamericanos de Idiomas) Spanish Immersion School http://www.cpi-edu.com

Costa Rica: Incultura Spanish Language School http://www.interculturacostarica.com/

Guatemala: San Pedro Spanish School https://sanpedrospanishschool.com/

Mexico: Instituto Cultural Oaxaca https://icomexico.com/

R1 Spanish Longitudinal Immersion and 1:1 teaching

Faculty Coordinator: Patricia Donahue

On-site Spanish teacher/translator. A (now retired) high school Spanish teacher provides individualized lessons for resident and shadows residents in their continuity clinics for real-world instruction.
The best way to learn a language is immersion (with support) – majority of daily patient interaction are in Spanish, so residents can get lots of practice.

R1 Evaluation of Our Spanish Curriculum

Valdini A, Early S, Augart C, Miles HCR, Cleghorn D. Spanish Language Immersion and Reinforcement During Residency: A Model for Rapid Acquisition of Competency. Teaching and Learning Medicine. 2009;21(3):1-6. (https://www.tandfonline.com/doi/full/10.1080/10401330903020647)

Barr WB, Valdini A, St. Louis J, Weida N, and Marshall C. Si, Tu Puedes: An integrated Spanish Language Acquisition in Residency Utilizing Personal Instruction. Journal of Graduate Medical Education. Journal of Graduate Medical Education. 2018; 10(3):343-344. (https://www.jgme.org/doi/pdf/10.4300/JGME-D-17-00919.1)

ALTA Language Testing-Clinician Cultural and Linguistic Assessment (http://www.altalang.com/language-testing/) – Developed by Kaiser Permanente to determine level of language proficiency of physicians. *Passing score” is 80% (level determined by Kaiser as proficient to see patients without an interpreter). Residents offered free testing (paid by residency) to certify their fluency to future employers, NGOs, or other entities.

Invited National Presentations on our Spanish Curriculum:

AAFP Program Directors/ Workshop / Residency Program Solutions Residency Education Symposium “Innovation Showcase: Learning Spanish to Proficiency in Residency – ¡Si Tu Puedes!” Barr WB, Valdini A, Gravel JW, Augart C. March 2015 Kansas City, MO.
2014 Society of Teachers of Family Medicine Spring Conference – “Learning Spanish in Residency – Yes it is Possible (It Can Be Done!)” Barr WB, Valdini A, Gravel JW, Augart C, Davids A. May 2014 San Antonio, TX.