Abstract
Objective
To assess residents' self-efficacy, satisfaction and frustration in the care of limited
English proficient (LEP) families and to identify individual and programmatic factors
associated with the above outcomes.
Methods
A multisite cross-sectional survey of pediatric residents currently in training and
caring for LEP families was conducted. Resident self-efficacy scores in specific skill
domains were assessed. Clustered multivariate logistic regression analyses were used
to identify individual and programmatic factors associated with increased satisfaction
and frustration. Qualitative analyses were also utilized to identify themes related
to frustrating aspects of care.
Results
A total of 271 of 449 eligible residents representing 7 US pediatric residency programs
participated in our study (60% response rate). A majority of residents (51%) rated
their self-efficacy in the overall care of LEP families as low. Satisfaction was associated
with a high self-efficacy score (odds ratio [OR] 4.7, 95% confidence interval [CI]
1.8–12.6), increasing year in training (OR 3.2, 95% CI 1.01–10.2), frequent non-English
language use (OR 3.1, 95% CI 1.1–8.8), and instruction on the use of interpreters
(OR 1.9, 95% CI 1.02–3.64). Satisfaction was inversely associated with increased LEP
patient volumes (OR 0.40, 95% CI 0.18–0.91). Clinical inefficiency related to interpreter
use and distrust of interpreter skills were frequently cited as aspects that contribute
to overall frustration.
Conclusions
A majority of residents reported lacking self-efficacy in their ability to deliver
care to LEP patients, which may influence overall satisfaction with such encounters.
Strategies that promote resident self-efficacy and assess non-English language proficiency
should be included in future training curricula. Exposing trainees to best practices
in interpreter-based encounters may further promote resident satisfaction.
Keywords
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Article Info
Publication History
Accepted:
December 17,
2013
Received:
March 19,
2013
Footnotes
The authors declare that they have no conflict of interest.
Identification
Copyright
© 2014 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.
