To evaluate how a workshop teaching the focused neurologic exam in Spanish (FNES) affects the confidence of neurology residents in caring for Spanish-speaking monolingual (SSM) patients during neurologic emergencies 

An estimated 41 million U.S. residents report speaking Spanish at home. During time-sensitive neurologic emergencies, interpreter services may be delayed or have limitations (i.e. low volume for phone/iPad interpreters). Studies have shown that patient safety and outcomes suffer when language barriers impede communication.

A workshop was designed and implemented teaching the FNES to adult neurology residents at an academic, tertiary referral hospital. De-identified pre- and post-workshop surveys were distributed assessing past clinical experiences with SSM patients, confidence with the FNES, and comfortability managing SSM patients. Responses were collected using a mixture of Likert scale and numeric confidence scale. Data was analyzed using a paired t-test model.

Fifteen residents participated in the study. All participants reported managing a SSM patient during their training with fourteen of the fifteen reporting encounters with SSM patients during neurologic emergencies. Twenty percent either agreed or strongly agreed that interpretation services were readily available during neurologic emergencies. After the workshop, participants were significantly more confident managing SSM patients during neurologic emergencies with and without the aid of an interpreter service (p=0.023, p=0.0002). Fourteen of the fifteen residents agreed or strongly agreed that their confidence in performing the FNES improved after the workshop.

After the workshop, neurology residents were significantly more confident in performing the FNES and more comfortable managing SSM patients. The skills provided during the workshop should be seen as an adjunct resource to available certified medical interpreters. Future studies assessing skill competency of residents after the workshop and the effect of a series of similar workshops on stroke management metrics in SSM patients (i.e. time to stroke interventions) would be helpful in assessing workshop effects.