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Improving Communication Skills in Healthcare

esl rulesLynda Katz Wilner and Marjorie Feinstein-Whittaker, co-founders of ESL RULES  (, recently wrote an article published by The American Speech-Language-Hearing Association in the December 2013 issue of Perspectives on Communication Disorders in Culturally and Linguistically Diverse Populations. The following is an overview with excerpts from the article. Click the link at the end to read the article in its entirely.


Hospital reimbursements are linked to patient satisfaction surveys, which are directly related to interpersonal communication between provider and patient. In today’s healthcare environment, interactions are challenged by diversity-Limited English proficient (LEP) patients, medical interpreters, International Medical Graduate (IMG) physicians, nurses, and support staff. Accent modification training for health care professionals can improve patient satisfaction and reduce adverse events. Surveys were conducted with medical interpreters and trainers of medical interpreting programs to determine the existence and support for communication skills training, particularly accent modification, for interpreters and non-native English speaking medical professionals. Results of preliminary surveys suggest the need for these comprehensive services. 60.8% believed a heavy accent, poor diction, or a different dialect contributed to medical errors or miscommunication by a moderate to significant degree. Communication programs should also include cultural competency training to optimize patient care outcomes. Examples of strategies for training are included.

Key Points

  • Hospitals and medical centers in the United States are rich with diverse providers, ancillary staff, and patient populations. Each culture has its own value system, communication style, and beliefs about health and illness.
  • These diverse providers and patient populations provide a growing niche for speech-language pathologists (SLPs) and other communication consultants to provide communication training in the workplace. 
  • A comprehensive accent modification program should address skills for efficiency, adaptability, clarity, credibility, active listening, and empathy.
  • Assessment of the health care provider’s ability to pronounce medically related vocabulary and scenarios should be included. RULES  and materials for improving communication in healthcare are discussed.
  • Health care providers need to understand and know how to appropriately respond to the unique social, cultural, and economic influences affecting their patients (Gray, 2013).


Improved health care and cultural communication impacts the overall experience for both the English speaking  and LEP patient, IMGs or United States Medical Graduate physicians, and the diverse nursing and support staff. Consequently, patient satisfaction, delivery of positive outcomes, the facility’s reputation, and decreased risk exposure of the hospital are the end product of effective language and cultural communication. In the new health care model, this will ultimately improve the sustainability of medical systems in the United States. As SLPs, (speech-language pathologists) we can have a substantial and positive impact facilitating clear, understandable, and compassionate communication amongst all of the parties involved.

Perspectives article ASHA 2013

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