PM2098: Perspectives of Language Barriers and Interpretive Services Use in the Neonatal Intensive Care Unit Among House Officers and Clinicians

Background: Language barriers are associated with unequal access to healthcare and poor patient outcomes. Despite the availability of interpretive services, patients and families with limited English proficiency (LEP) are more likely to experience medical errors, poor patient comprehension, longer hospital stays, and diminished patient satisfaction. Language barriers are especially challenging in the Neonatal Intensive Care Unit (NICU) given the acuity, chronic illnesses, and long-term follow-up associated with prematurity. Currently, there is no standard curriculum that educates neonatology medical learners about these barriers and how to address them. Due to this, we aimed to assess the knowledge, skills, and attitudes of current neonatology fellows and early career neonatologists regarding language barriers among LEP families and best practices using interpretive services (IS) in the NICU.

Methods: An anonymous needs assessment was created using Michigan Medicine’s Qualtrics software. It consisted of 32 questions grouped into demographic, knowledge, confidence, and attitude sections. Scores were created for each section and compared across various demographics. The needs assessment was distributed electronically using the American Academy of Pediatrics (AAP) Training and Early Career Neonatologists (TECaN) listserv to neonatology fellows and early career neonatologists. Aggregated data was analyzed using descriptive statistics and comparative analysis.

Results: One hundred and nineteen questionnaires were completed and analyzed. Demographics are referenced in Table 1. Respondents (88%) frequently used phone and video IS. However, 87% preferred in-person IS. While respondents almost always used IS when obtaining consent or breaking bad news, only 28% used IS half the time or less when providing families with daily patient updates. Mean confidence scores in using IS across different clinical encounters were significantly higher among respondents who received post-graduate education about IS (p=0.04). Equally, respondents who received specific training on cultural norms/sensitivities of ethnic minorities had higher mean confidence scores using IS compared to those who did not receive education (p=0.004).

Conclusion: Training in cultural sensitivity and IS skills that specifically addresses daily patient communication for LEP families are two areas to target when designing a health disparities educational curriculum for neonatology medical learners.