The Introduction to Medical Spanish Elective stands as a remarkable 10-lecture online course, gracefully offered multiple times annually through the seamless platform of Zoom. Each session lasts a generous 1 hour, providing students with a consistent and immersive learning experience. From 2022 to 2023, an impressive three cohorts of students have successfully completed this course, each embarking on a journey of language acquisition and clinical skill enhancement.

Course Curriculum: A Treasure Trove of Knowledge

This course curriculum is a comprehensive blend of grammar, anatomy, cultural competency, and standardized patient case videos accompanied by Spanish/English scripts. [Refer to Table 1 for a detailed breakdown.] The lecture videos serve as the bedrock of teaching, covering a wide range of common chief complaints such as vaginal discharge, back pain, abdominal pain, headache, chest pain, shortness of breath, and a general pediatric encounter. Prior to each class, students are provided with the lecture video link, allowing them ample time to familiarize themselves with the content. During the lecture, a dynamic interaction takes place as students play both the patient and the doctor roles, watching the video in perfect synchrony. They receive real-time feedback on grammar, pronunciation, and alternative phrases, enabling them to refine their communication skills. These videos adhere strictly to the standard United States Medical Licensure Examination Clinical Skills (USMLE Step 2 CS) vignette format, ensuring their relevance and practicality. Moreover, they are readily available on YouTube, making them easily accessible to all.

Session Timeline and Class Segments

The session timeline of this 1-hour online class is meticulously designed to maximize learning. Each segment plays a crucial role in shaping the students' understanding and proficiency. From grammar drills to cultural insights, every minute is utilized effectively. The variety of topics covered ensures that students are well-prepared to handle a wide array of clinical scenarios.The anatomy section, for instance, provides a detailed exploration of the human body, helping students connect medical terms with their corresponding anatomical structures. Cultural competency lessons delve into the nuances of different Spanish-speaking cultures, enabling students to interact with patients more empathetically. And the standardized patient case videos bring the learning to life, allowing students to practice their skills in a realistic setting.

Student Selection: Opening Doors to Learning

This course is open to all interested medical students, whether they are in the pre-clinical or clinical years, as well as residents. It is promoted through the vibrant St. George’s University School of Medicine (SGUSOM) “Clinical Students” Facebook Page. The initial post about the course provides a clear description and a link to a Google form for prospective students. [Refer to Supplemental Survey 1 for more details.] A remarkable 126 medical students responded to the initial invitation through this Google survey, sharing their availability in the schedule. This valuable information is collected in an excel sheet, which is then used to propose tentative times for the sessions when both instructors and participants are available. [See Supplemental Copy of IMS Reponses_Cohort1_2022 for reference.]The course description explicitly states that certification is not available at this time, emphasizing that participation is entirely voluntary. Students are asked to provide their contact information along with demographic details such as their level of medical education (pre-clinical vs. clinical years). Additionally, they are given the option to select their meeting preference – a fixed schedule (e.g., ‘every Saturday’) or a flexible schedule (e.g., a non-fixed day that suits the majority of students). They can also indicate their preferred days and times of the day for class. The student selection criteria include availability to participate in at least 80% of lectures, a commitment to take the final exam, and a preference for students in their clinical years (as it is assumed that this group aims to enhance their interview skills and patient interaction). Selected students receive an email confirming their acceptance to the course, along with a link to the YouTube channel containing the lecture videos and the tentative meeting days/time(s). The cohort size is limited to 15 students (or fewer) to ensure adequate participation and success.In addition to the Facebook announcement, students doing their rotation at Wyckoff Heights Medical Center in Brooklyn are also informed about the course and given the opportunity to apply via a Google form. Given the prevalent Spanish-speaking population at this medical institution and other SGUSOM clinical affiliate locations, it offers an ideal environment for students to practice medical Spanish.

Comfort Measures: Nurturing Confidence

During the pre-course and post-course surveys, students are asked about their comfort level when taking a patient's history and chief concern in Spanish using appropriate medical terminology. [Refer to Supplemental Survey 2 and 3 for details.] The comfort score level is measured on a scale from 0 to 5, where 0 indicates an inability to take the patient's history and 5 represents a high level of comfort. This measure helps students track their progress and identify areas where they need further improvement.

Final Exam Evaluation: Measuring Success

Only students who achieve an 80% participation attendance are eligible to take the exam. Those who meet the eligibility criteria are notified and encouraged to participate voluntarily. The final exam consists of a 20-minute patient encounter conducted via Zoom, with the course instructor playing the role of the patient and the student assuming the role of the physician. A standardized checklist [Refer to Supplemental Table 2] is used to evaluate the participant's performance. The questions are divided into subcategories, and each question is awarded 3 points, resulting in a total of 63 potential points. This total is then divided by 21 (the total number of questions), and a passing score ratio of 2 (equivalent to a 66.7% passing score) is set. This rigorous evaluation system ensures that students are truly prepared to handle real-life clinical situations.