The Impact of Cooperative Learning Method on the Oral Proficiency of Learners of the Training Program for English Tourist Guides.
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SUBMITTER: Hong Y
PROVIDER: S-EPMC9245035 | biostudies-literature |
REPOSITORIES: biostudies-literature
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Project description:IntroductionResidents have been known to report a lack of self-efficacy in their ability to provide care for limited English proficiency (LEP) patients. Interpreters must be utilized to help navigate these patient encounters, but many institutions do not have a curriculum focused on utilizing interpreters effectively.MethodsWe created a 3-hour workshop for physician learners working with the pediatric population. It included a panel discussion, best-practices presentation, video demonstration, observing scenarios, and pre- and postworkshop objective structured clinical exams (OSCEs). The first OSCE introduced learners to a scenario (4-day-old with jaundice with an LEP parent) where interpreter use was imperative. The second OSCE allowed learners to perform another case (12-year-old with an abscess with an LEP parent) and practice newly obtained skills from the workshop. Both OSCEs were scored using a 16-item yes/no checklist. All pediatric residents filled out an eight-item survey to evaluate the workshop; a subset of that group performed the pre- and postworkshop OSCEs.ResultsForty pediatric residents attended the workshop and completed the survey. The workshop was well received, with the majority of residents stating they would change their current interpreter usage practices. Ten pediatric residents performed the pre- and postworkshop OSCEs; all improved their scores.DiscussionThe workshop was effective in improving how residents navigated LEP encounters. It is applicable to learners of all levels who want to improve their communication skills to provide better care for LEP patients and can be tailored to fit the needs of a specific institution.
| S-EPMC7970641 | biostudies-literature
Project description:Massive open online courses (MOOCs) generate learners' performance data that can be used to understand learners' proficiency and to improve their efficiency. However, the approaches currently used, such as assessing the proportion of correct responses in assessments, are oversimplified and may lead to poor conclusions and decisions because they do not account for additional information on learner, content, and context. There is a need for theoretically grounded data-driven explainable educational measurement approaches for MOOCs. In this conceptual paper, we try to establish a connection between psychometrics, a scientific discipline concerned with techniques for educational and psychological measurement, and MOOCs. First, we describe general principles of traditional measurement of learners' proficiency in education. Second, we discuss qualities of MOOCs which hamper direct application of approaches based on these general principles. Third, we discuss recent developments in measuring proficiency that may be relevant for analyzing MOOC data. Finally, we draw directions in psychometric modeling that might be interesting for future MOOC research.
| S-EPMC7243831 | biostudies-literature
Project description:This study examined the effect of using a digital game-based language learning mobile application "Liulishuo" (speaking English fluently) to develop complexity, accuracy, and fluency of English monologic oral production among 30 English language learners in China. Monologic oral production was measured using the same narrative picture description task in pre- and post-tests. The learners followed the "Imitation of English Monologues" game 30 minutes each time, twice a week, for 20 weeks. The oral production was measured using six indices: the mean words per T-unit and lexical density (i.e., complexity), the mean repairs and errors per 100 words (i.e., accuracy), speech rate and the mean length of pauses (i.e., fluency). The paired sample t-tests showed that the participants produced more complex monologic speech, had significantly fewer errors, and increased speech rate, but the mean repairs and mean length of pauses remained unchanged. The unchanged repairs and pauses could be possibly due to the non-proceduralized linguistic knowledge in oral production, which may require a more extended period of treatment. Our study showed positive effects of using a digital game-based language learning mobile application on the improvement of complexity, accuracy, and fluency of English language learners in China' monologic oral production with varying effects.
| S-EPMC7785230 | biostudies-literature
Project description:Background: Patients with limited English proficiency (LEP) experience lower quality end-of-life (EOL) care. This inequity may have been exacerbated during the COVID-19 pandemic. Objective: Compare health care utilization, EOL, and palliative care outcomes between COVID-19 decedents with and without LEP during the pandemic's first wave in Massachusetts. Methods: Retrospective cohort study of adult inpatients who died from COVID-19 between February 18, 2020 and May 18, 2020 at two academic and four community hospitals within a greater Boston health care system. We performed multivariable regression adjusting for patient sociodemographic variables and hospital characteristics. Primary outcome was place of death (intensive care unit [ICU] vs. non-ICU). Secondary outcomes included hospital and ICU length of stay and time to initial palliative care consultation. Results: Among 337 patients, 89 (26.4%) had LEP and 248 (73.6%) were English proficient. Patients with LEP were less often white (24 [27.0%] vs. 193 [77.8%]; p < 0.001); were more often Hispanic or Latinx (40 [45.0%] vs. 13 [5.2%]; p < 0.001); and less often had a medical order for life-sustaining treatment (MOLST) on admission (15 [16.9%] vs. 120 [48.4%]; p < 0.001) versus patients with English proficiency. In the multivariable analyses, LEP was not independently associated with ICU death, ICU length of stay, or time to palliative care consultation, but was independently associated with increased hospital length of stay (mean difference 4.12 days; 95% CI, 1.72-6.53; p < 0.001). Conclusions: Inpatient COVID-19 decedents with LEP were not at increased risk of an ICU death, but were associated with an increased hospital length of stay versus inpatient COVID-19 decedents with English proficiency.
| S-EPMC9836680 | biostudies-literature
Project description:Informed consent is important for limited English proficient (LEP) patients undergoing surgery, as many surgical procedures are complicated, making patient comprehension difficult even without language barriers. The study objectives were to (1) understand surgeons' preoperative consenting process with LEP patients, (2) examine how surgeons self assess their non-English language proficiency levels using a standardized scale, and (3) identify the relationship between self assessed non-English language proficiency and surgeons' self-reported use of interpreters during preoperative informed consent.A thirty-two item survey assessing surgeons' reported preoperative informed consent process, with questions related to demographics, level of medical training, non-English language skills and their clinical use, language learning experiences, and hypothetical scenarios with LEP patients.Surgeons who were not fluent in non-English languages reported they often used those limited skills to obtain informed consent from their LEP patients. Many surgeons reported relying on bilingual hospital staff members, family members, and/or minors to serve as ad-hoc interpreters when obtaining informed consent. If a professional interpreter was not available in a timely manner, surgeons more frequently reported using ad-hoc interpreters or their own nonfluent language skills. Surgeons reported deferring to patient and family preferences when deciding whether to use professional interpreters and applied different thresholds for different clinical scenarios when deciding whether to use professional interpreters.Surgeons reported relying on their own non-English language skills, bilingual staff, and family and friends of patients to obtain informed consent from LEP patients, suggesting that further understanding of barriers to professional interpreter use is needed.
| S-EPMC4691361 | biostudies-literature
Project description:BackgroundLimited English proficiency (LEP) is associated with poor health status and worse outcomes.ObjectiveTo examine disparities in hypertension between National Health and Nutrition Examination Survey (NHANES) respondents with LEP versus adequate English proficiency.DesignRetrospective analysis of multi-year survey data.ParticipantsAdults 18 years of age and older who participated in the NHANES survey during the period 2003-2012.Main measuresWe defined participants with LEP as anyone who completed the NHANES survey in a language other than English or with the support of an interpreter. Using logistic regression, we estimated the odds ratio for undiagnosed or uncontrolled hypertension (systolic blood pressure (SBP) > 140 mmHg or diastolic blood pressure (DBP) > 90 mmHg) among LEP participants relative to those with adequate English proficiency. We adjusted for sociodemographic, acculturation-related, and hypertension-related variables.Key resultsFourteen percent (n = 3,269) of the participants had limited English proficiency: 12.4% (n = 2906) used a Spanish questionnaire and 1.6% (n = 363) used an interpreter to complete the survey in another language. Those with LEP had higher odds of elevated blood pressure on physical examination (adjusted odds ratio [AOR] = 1.47 [1.07-2.03]). This finding persisted among participants using an interpreter (AOR = 1.88 [1.15-3.06]) but not among those using the Spanish questionnaire (AOR = 1.32 [0.98-1.80]). In a subgroup analysis, we found that the majority of uncontrolled hypertension was concentrated among individuals with a known diagnosis of hypertension (AOR = 1.80 [1.16-2.81]) rather than those with undiagnosed hypertension (AOR = 1.14 [0.74-1.75]). Interpreter use was associated with increased odds of uncontrolled hypertension, especially among patients who were not being medically managed for hypertension (AOR = 6.56 [1.30-33.12]).ConclusionsIn a nationally representative sample, participants with LEP were more likely to have poorly controlled hypertension than those with adequate English proficiency. LEP is an important driver of disparities in hypertension management and outcomes.
| S-EPMC5442015 | biostudies-literature
Project description:Noncoding RNAs form unique 3D structures, which perform many regulatory functions. To understand how RNAs fold uniquely despite a small number of tertiary interaction motifs, we mutated the major tertiary interactions in a group I ribozyme by single-base substitutions. The resulting perturbations to the folding energy landscape were measured using SAXS, ribozyme activity, hydroxyl radical footprinting, and native PAGE. Double- and triple-mutant cycles show that most tertiary interactions have a small effect on the stability of the native state. Instead, the formation of core and peripheral structural motifs is cooperatively linked in near-native folding intermediates, and this cooperativity depends on the native helix orientation. The emergence of a cooperative interaction network at an early stage of folding suppresses nonnative structures and guides the search for the native state. We suggest that cooperativity in noncoding RNAs arose from natural selection of architectures conducive to forming a unique, stable fold.
| S-EPMC3384715 | biostudies-literature
Project description:The aim of this study was to investigate whether early-English education benefits the perception of English phonetic contrasts that are known to be perceptually confusable for Dutch native speakers, comparing Dutch pupils who were enrolled in an early-English programme at school from the age of four with pupils in a mainstream programme with English instruction from the age of 11, and English-Dutch early bilingual children. Children were 4-5-year-olds (start of primary school), 8-9-year-olds, or 11-12-year-olds (end of primary school). Children were tested on four contrasts that varied in difficulty: /b/-/s/ (easy), /k/-/?/ (intermediate), /f/-/?/ (difficult), /?/-/æ/ (very difficult). Bilingual children outperformed the two other groups on all contrasts except /b/-/s/. Early-English pupils did not outperform mainstream pupils on any of the contrasts. This shows that early-English education as it is currently implemented is not beneficial for pupils' perception of non-native contrasts.
| S-EPMC7065789 | biostudies-literature
Project description:BACKGROUND:Limited English proficiency (LEP) has been implicated in poor health outcomes. Sepsis is a frequently fatal syndrome that is commonly encountered in hospital medicine. The impact of LEP on sepsis mortality is not currently known. OBJECTIVE:To determine the association between LEP and sepsis mortality. DESIGN:Retrospective cohort study. SETTING:800-bed, tertiary care, academic medical center. PATIENTS:Electronic health record data were obtained for adults admitted to the hospital with sepsis between June 1, 2012 and December 31, 2016. MEASUREMENTS:The primary predictor was LEP. Patients were defined as having LEP if their self-reported primary language was anything other than English and interpreter services were required during hospitalization. The primary outcome was inpatient mortality. Mortality was compared across races stratified by LEP using chi-squared tests of significance. Bivariable and multivariable logistic regressions were performed to investigate the association between mortality, race, and LEP, adjusting for baseline characteristics, comorbidities, and illness severity. RESULTS:Among 8,974 patients with sepsis, we found that 1 in 5 had LEP, 62% of whom were Asian. LEP was highly associated with death across all races except those identifying as Black and Latino. LEP was associated with a 31% increased odds of mortality after adjusting for illness severity, comorbidities, and other baseline characteristics, including race (OR 1.31, 95% CI 1.06-1.63, P = .02). CONCLUSIONS:In a single-center study of patients hospitalized with sepsis, LEP was associated with mortality across nearly all races. This is a novel finding that will require further exploration into the causal nature of this association.
| S-EPMC7064297 | biostudies-literature
Project description:BackgroundThere are approximately 25.6 million individuals with limited English proficiency (LEP) in the USA, and this number is increasing.ObjectiveInvestigate associations between LEP and access to care in adults.DesignCross-sectional nationally representative survey.ParticipantsAdults with (n = 18,908) and without (n = 98,060) LEP aged ≥ 18 years identified from the 2014-2018 Medical Expenditure Panel Survey MAIN MEASURES: Associations between LEP and access to healthcare and preventive services were evaluated with multivariable logistic regression models, stratified by age group (18-64 and ≥ 65 years). The official government definition of LEP (answers "not at all/not well/well" to the question "How well do you speak English?") was used. Access to care included having a usual source of care (and if so, distance from usual source of care, difficulty contacting usual source of care, and provision of extended hours), visiting a medical provider in the past 12 months, having to forego or delay care, and having trouble paying for medical bills. Preventive services included blood pressure and cholesterol check, flu vaccination, and cancer screening.Key resultsAdults aged 18-64 years with LEP were significantly more likely to lack a usual source of care (adjusted odds ratios [aOR] = 2.48; 95% confidence interval [CI] = 2.27-2.70), not have visited a medical provider (aOR = 2.02; CI = 1.89-2.16), and to be overdue for receipt of preventive services, including blood pressure check (aOR = 2.00; CI = 1.79-2.23), cholesterol check (aOR = 1.22; CI = 1.03-1.44), and colorectal cancer screening (aOR = 1.58; CI = 1.37-1.83) than adults without LEP. Results were similar among adults aged ≥ 65 years.ConclusionsAdults with LEP had consistently worse access to care than adults without LEP. System-level interventions, such as expanding access to health insurance coverage, providing language services, improving provider training in cultural competence, and increasing diversity in the medical workforce may minimize barriers and improve equity in access to care.
| S-EPMC9971409 | biostudies-literature