No abstract

No abstract

BackgroundHumanistic care in medicine has shown to improve healthcare outcomes. Language barriers are a significant obstacle to humanistic care, and trained medical interpreters have demonstrated to effectively bridge the gap for the vulnerable limited English proficiency (LEP) patient population. One way in which medical schools can train more humanistic physicians and provide language access is through the implementation of programs to train bilingual medical students as medical interpreters. The purpose of this prospective study was to evaluate whether such training had an impact on bilingual medical student’s interpretation skills and humanistic traits.MethodsBetween 2015 and 2017, whole-day (~ 8 h) workshops on medical interpretation were offered periodically to 80 bilingual medical students at the Penn State College of Medicine. Students completed a series of questionnaires before and after the training that assessed the program’s effectiveness and its overall impact on interpretation skills and humanistic traits. Students also had the opportunity to become certified medical interpreters.ResultsThe 80 student participants were first- to third- year medical students representing 21 languages. Following training, most students felt more confident interpreting (98%) and more empathetic towards LEP patients (87.5%). Students’ scores in the multiple-choice questions about medical interpretation/role of the interpreter were also significantly improved (Chi-Square test, p < 0.05). All students who decided to take the exam were able to successfully become certified interpreters. Ninety-two percent of participants reported they would recommend the program and would be willing to serve as a future “coaches” for interpreter training workshops delivered to peer students.ConclusionsOur program was successful in increasing self-reported measures of empathy and humanism in medical students. Our data suggests that implementation of medical interpreter training programs can be a successful strategy to develop of humanism in medical students, and aid in the development of sustainable language access for LEP patients.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1254-7) contains supplementary material, which is available to authorized users.

Hyperglycemia is frequently encountered in the inpatient setting and is distinctly associated with poor clinical outcomes. Recent literature suggests an association between stringent glycemic control and increased mortality, thus keeping optimal glycemic targets a relevant subject of debate. In the surgical population, hyperglycemia with or without diabetes mellitus may be unrecognized. Factors contributing to hyperglycemia in the hospital include critical illness, use of certain drugs, use of enteral or parenteral nutrition, and variability in oral or nutritional intake as can occur when patients are prepared for procedures or surgery. A sensible approach to managing hyperglycemia in this population includes preoperative recognition of diabetes mellitus and risks for inpatient hyperglycemia. Judicious control of glycemia during the pre-, intra-, and postoperative time periods with avoidance of hypoglycemia mandates the need for a strategy for patient management that extend to time of discharge. We review the consequences of uncontrolled perioperative hyperglycemia, discuss current clinical guidelines and recent controversies, and provide practical tools for glycemic control in the surgical population.

No abstract