Research Report: Minimizing Language Barriers in Healthcare Settings

This research report investigates the impact of language barriers on healthcare communication, particularly within culturally and linguistically diverse (CALD) communities. The study analyzes two key research papers, exploring the challenges faced by healthcare providers and patients due to language differences. The report examines the need for targeted communication strategies and the effectiveness of communication skills training programs in addressing these barriers. It highlights the importance of effective communication in ensuring patient safety, satisfaction, and the delivery of patient-centered care. The research also explores the role of interpreters and other disciplines in facilitating better understanding between healthcare professionals and patients. The findings underscore the need for healthcare systems to address language barriers to provide equitable and effective care to all patients.

Running head: RESEARCH TOPIC 2
Language barrier when communicating with clients
Name of the Student
Name of the University
Author Note

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Executive summary:
For culturally diverse communities, the concept of communication can be a significant concern.
There are various restrictions and barriers to effective communication when it comes f to nursing
care and providing adequate care delivery. That is the reason there is need for better and more
targeted communication plans and strategies designed specifically with the needs of the
culturally diverse communities in mind. This assignment will review two studies that are
centered on the communication needs of the CALD communities in order to explore the different
needs and how to address them effectively.

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Table of Contents
Introduction- Planning the research activity:.............................................................................4
Discussion:......................................................................................................................................4
Reasons for undertaking research:...............................................................................................4
Research question/hypothesis:.....................................................................................................5
Research objective:......................................................................................................................5
Other discipline:...........................................................................................................................7
Sources of data and evidence:......................................................................................................7
Search strategy:............................................................................................................................7
Systematic approach....................................................................................................................8
Distinction between relevant and irrelevant information..........................................................10
Prioritising information:............................................................................................................11
Comparison................................................................................................................................11
Impact of findings......................................................................................................................13
Use of information in workplace:..............................................................................................13
Reflection...................................................................................................................................13
Issues that require further research and evaluation:..................................................................14
References:...................................................................................................................................15

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Appendix:.....................................................................................................................................17

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Introduction- Planning the research activity:
Topic: Minimising language barrier when communicating with clients
After spending a short amount of time employed in a healthcare environment, I can already see
that language barriers make healthcare extremely difficult. With Australia being an extremely
multicultural country, two areas that could be researched to improve practise of Nurses and
healthcare professionals would be:
 How to communicate with non-English speaking patients
 Healthcare workers finding communication difficult with non-English speaking patients.
Discussion:
Reasons for undertaking research:
The primary goal or purpose for conducting this study has been to enhance my own knowledge
and understanding, to ensure that i have understood the importance of the communication skills
and competences to enhance the safety and efficacy of the care provided to the patients. Along
with that this study will also help me to discover the different interpersonal and communication
barriers that exist in the health care scenario and the extent of impact of these barriers in the care
outcomes of the patient.

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It has to be mentioned in this context that the impact of the communication barriers have been
discovered to be extreme in case of the culturally and linguistically diverse individuals. Along
with the linguistic barriers, the cultural difference often has to be reported to pave way for a large
variety of different barriers and challenges that lead to impaired effective communication and
interaction among the patients receiving care and the care providers. Although, English
proficiency and understanding has been pegged as the most important contributing factor behind
the communicational challenges that predominates in the health care scenario involving the
CALD individuals (Hemsley, Balandin and Worrall 2012). This research will help in discovering
the different language barriers and how communication skills training can help overcoming the
different communication barriers identified.
Research question/hypothesis:
Q. Can communication skills training improve different communication barriers between care
providers and care receivers belonging to CALD backgrounds?
Hypothesis- Culturally and linguistically diverse patients that are non-English speaking or have
minimal understanding of the English language are less likely to have a positive health care
experience due to communication issues and lack of English proficiency. Communication skills
training and skill improvement can facilitate better interaction among the care providers and
care receivers belonging to CALD background and can enhance care outcomes.
Research objective:
 A research objective summarises what is to be achieved by the study.

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 Ensure your objective is S.M.A.R.T and relevant, logical, feasible, observable and
measurable.
 The objective should be clearly phrased – use verbs, e.g. to assess, to establish, to
determine, to compare, etc.
Communication or interpersonal interaction between the health professional and the care
receivers and their family members begins at the very first contact and it extends till the patients
is completely recovered and rejoins his former lifestyle, free for care needs. Hence, the
communication is the key factor which not only facilitates better information sharing but also
helps in ensuring optimal patient safety, efficacy and patient centeredness of the care provided
and ensuring establishment of a quality therapeutic relationship (Arnold and Boggs 2015).
Optimal communication attributes with respect to the CALD individuals facilitates the
CALD patients being able to communicate and share their personal preferences and grievances
with the care providers without any obstacles.
From my own knowledge and experience, communication skills required by Nurses
needs to be sincere and show positive intention. Having awareness and understanding of the role
that language plays in creating barriers to healthcare is important for healthcare systems that are
experiencing an increase in culturally and linguistically diverse populations, both among patients
and healthcare providers.

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Other discipline:
Language interpreters or translators can be the other discipline that can play a profound role
in assisting the care providers and facilitating the outcome of better understanding of the
condition of the patients, interpersonal care and patient satisfaction. Hence they can undoubtedly
be one additional discipline that can be connected to this research study
However, the presence of an interpreter does not substitute for complete understanding
between patient and healthcare professionals.
Sources of data and evidence:
 Cochrane Library- http://www.cochranelibrary.com/
 PubMed- https://www.ncbi.nlm.nih.gov/pubmed/
The aforementioned two sources were used to retrieve articles for the research activity as it
contained relevant and current articles that had been published on the effects of chlorhexidine
washcloth use in infection prevention.
Search strategy:
Methods of gathering include search engine using correct key words, literature reviews,
systematic reviews, interviews, surveys, seminars, and surveys.\
The most of the information and data for this research study has been collected from the
internet search engines. SMART key words with Boolean operators whilst searching has helped
to find a lot of the literature research reviews online, on the topic of communication barriers in a
multicultural healthcare setting, have given me a multitude of information.

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Systematic approach
Statement of the objectives: the objective statements for this research study can be the fact the
communication skill training and improvement will effectively improve the communication
barriers and challenges prevalent in the CALD care scenarios, and even in general
communication issues in care settings.
Data collection: For this research study we have included peer reviewed articles and systematic
reviews which provided s with authentic and reliable data from updated and recent research
studies. The first study that has been reviewed in this article is a randomized control study
design. Another study incorporated in the comparison is a observational study which serves as a
major piece of evidence.
Data evaluation:
The first piece of evidence in the study paper is a randomized control trail study indicates that
communication failures in any care setting is associated directly with the medication errors that
occur in the care setting. In this study in order to judge the efficacy of the communication skills
on the care outcomes, a particular communication training model (TeamSTEPPS) has been used
in a simulation based inter-professional setting. The sampling of participants had been random
and the toral number of participants were 306, they all had to participate in a 4 h training that
included a 1 h TeamSTEPPS didactic session and three 1 h team simulation and feedback
sessions in group settings. 48.7% completed the preassessments and postassessments, and
significant attitudinal shifts were reported in terms of team communication, motivation, utility of

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training, and self-efficacy. The study subjects showed visible signs of better advocating for the
patients and communicating in inter-professional teams, regardless of the cultural status or
background of the patients (Brock et al. 2013).
The second study is an observational study that examined the impact of the relationship based
physician communication skill training on the patient satisfaction and physician experience. 1537
participants were selected from a multispecialty academic medical center, and the
communication skill training had been between 1 August 2013 and 30 April 2014. The
intervention used had been 8-h block of interactive didactics, live or video skill demonstrations,
and small group and large group skills practice sessions using a relationship-centered model. The
results indicated at the overall CGCAHPS scores for physician communication to be higher for
intervention physicians than for controls ones. Follow up study discovered less depersonalization
and greater personal accomplishment sustaining at least for three months (Boissy et al. 2016).
The third study had been a systematic review on the efficacy of the CST training involving
medical students and physicians belonging to mainland China. There were more than 6 electronic
databases and the articles were given preference based on participant; training strategy;
assessment; and outcome. 90% of research studies affirmed that the CST training improved the
communication, most importantly in case of the studies that included a didactic component
combined with practical rehearsal and feedback. This study indicates that in ethnic care settings
CST based communication training can help in improving interaction between care provider and
care receiver (Liu et al. 2015).

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The next study is another narrative review that specializes on judging the efficacy of the
communication skill training in the dementia care setting. There were 8 electronic databases used
and the results were selected for the studies where the Didactic methods, training content, and
additional organizational features were qualitatively examined. 12 trials were selected involving
831 Dementia patients, 519 professional care givers, and 162 family care givers. The
intervention includes Didactic methods with lectures, hands-on training, group discussions, and
role-play. The cumulative review of all the articles indicated that the communication skill
training significantly improved quality of care and support provided in the dementia care
(Eggenberger, Heimerl and Bennett 2013).
Analysis:
Therefore, from the wide list of articles that we had collected from the two sources, the
aforementioned four articles were found to be most appropriate for gaining a sound
understanding of the direct influence or impact of different communication skill improvement
training on better care outcomes for patients, especially in the diverse care settings with language
restrictions.
Distinction between relevant and irrelevant information
The RCT paper that has been selected in this assignment focuses on a specific and
targeted communication skill enhancement training program to judge the efficacy of these model
based communication enhance programs to eradicate specific communication based issues in the
health care settings. Along with that the study has also included eradication of medication errors
which can be constituted as one of the most common consequences of communicational issues

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with potentially lethal impact on the health and welfare of the patients. Hence this study
incorporates a much targeted take on the research objectives are precise providing a selective and
reliable data that can be correlated with the research objective set for this study as well. It has ro
be understood that in the culturally diverse settings, medication errors are a very common
occurrence due to impaired interpersonal communication among the care provider and the
patient. This RCT study proved that the frequency of the medication errors can be reduced by a
specialized communication training model like the TeamSTEPPS (Brock et al. 2013). Hence,
this article had been accurate and relevant for the study.
Prioritising information:
1. Republished: Interprofessional education in team communication: working together to
improve patient safety
2. Communication Skills Training for Physicians Improves Patient Satisfaction
Comparison
The comparison for the two articles are given in the appendix.
Conclusion
It has to be mentioned in this context that communication is a key aspect when it comes to
providing care or support to the sick and ailing. Health care is a largely people based service,
where each and every step taken in the care aspect has to be crucially based on the issues and
grievances faced by the particular patients. No disease manifestation is identically same for two
different patients, hence the care strategy to be taken must also take into consideration the
differential care needs and desires of the individual patients going through a particular health
disorder. Along with that, effective communication is critically linked with the patient centred

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care scenario, where addressing the personal preferences and desires of the patients while
designing the care plan and implementing it is given the most importance (Brock et al. 2013).
On a more elaborative note, I would also like to add the fact that in case of the impaired
communicational settings, there are many harmful impacts on the patients and the most
important is the medic errors which can even lead to the death of the patient. Along with that,
lack of proper communication is also linked to the absence of an efficient therapeutic
relationship among the care provider and receiver. This in turn leads to the patients losing a
sense of value and respect in the care scenario and leads to reduced care outcomes and restricted
and withdrawn response. Both of these issues are prevalent in the culturally diverse settings as
well, where the communications issues are multiplied several folds due to the lack of English
proficiency and culture shock.
From the extensive review conducted in this study it can be safely concluded that communication
is a key aspect associated with care; and the communication skill improvement programs could
improve culturally competent communication competences drastically. It not only eradicated
medication errors, from the narrative review it can be mentioned that these communication
training initiatives can improve the patient satisfaction levels as well. However, I would like to
add in here that, in case of the training initiatives, the ones that are based of different models like
the TeamSTEPPS or the CST based models, the impact had been reported to be much intense
and the sustenance had been higher as well. Hence, for culturally diverse settings as well, these
model based communication skill improving initiatives would be effective to eradicate

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communication barriers especially involving better nonverbal communication cues (Weller,
Boyd and Cumin 2014).
Impact of findings
As per my own opinion, the communication models that utilize different nonverbal cues
and compassionate approach can be much more effective with respects to culturally diverse care
settings. Hence, the health care professional dealing to CALD patients population must once in a
year participate in a communication skill improvement program that incorporates models like
CST or STEPPs will be effective to understand the issues of the CALD patients with more
efficacy and will help the professional become capable of addressing their needs better (Brock et
al. 2013).
Use of information in workplace:
The steps of communication skill enhancement programs and their benefits can be
disseminated in the workplace (healthcare setting) by creating illustrative posters or pamphlets
that will contain relevant information on how the staff can participate in he communication
training programs and to what extent it will enhance their nursing competence (Hemsley,
Balandin and Worrall 2012)
Reflection
From this research activity I can conclude that there is lack of better knowledge and
information dissemination in my workplace regarding the communication training that is in place
in our health care facility and how the existing staff can participate in these programs. Hence ,
there should be monthly meetings held to help the staff understand the benefits of participating in

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these programs, along with that the communication training initiatives in our workplace can also
be improved with better model based interventions.
Issues that require further research and evaluation:
Further research can be conducted on the patient satisfaction levels after the conduction
of the communication training programs, so that the outcome measurement of the
communication training can be done based on the needs or the patients and to what extent these
needs are being met.

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References:
Arnold, E.C. and Boggs, K.U., 2015. Interpersonal Relationships-E-Book: Professional
Communication Skills for Nurses. Elsevier Health Sciences.
Boissy, A., Windover, A.K., Bokar, D., Karafa, M., Neuendorf, K., Frankel, R.M., Merlino, J.
and Rothberg, M.B., 2016. Communication skills training for physicians improves patient
satisfaction. Journal of general internal medicine, 31(7), pp.755-761.
Brock, D., Abu-Rish, E., Chiu, C.R., Hammer, D., Wilson, S., Vorvick, L., Blondon, K., Schaad,
D., Liner, D. and Zierler, B., 2013. Republished: interprofessional education in team
communication: working together to improve patient safety. Postgraduate medical
journal, 89(1057), pp.642-651.
Eggenberger, E., Heimerl, K. and Bennett, M.I., 2013. Communication skills training in
dementia care: a systematic review of effectiveness, training content, and didactic methods in
different care settings. International Psychogeriatrics, 25(3), pp.345-358.
Hemsley, B., Balandin, S. and Worrall, L., 2012. Nursing the patient with complex
communication needs: time as a barrier and a facilitator to successful communication in
hospital. Journal of advanced nursing, 68(1), pp.116-126.
Liu, X., Rohrer, W., Luo, A., Fang, Z., He, T. and Xie, W., 2015. Doctor–patient communication
skills training in mainland China: A systematic review of the literature. Patient education and
counseling, 98(1), pp.3-14.
Weller, J., Boyd, M. and Cumin, D., 2014. Teams, tribes and patient safety: overcoming barriers
to effective teamwork in healthcare. Postgraduate medical journal, pp.postgradmedj-2012.

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Appendix:
Article 1 – Republished:
Interprofessional education in
team communication: working
together to improve patient safety
Article 2 - Communication Skills
Training for Physicians Improves
Patient Satisfaction
Currency 2013 2016
Study
findings
That TeamSTEPPs model based
communication skill training can
improve patient safety by
eradicating communication gaps
Experiential relationship-centered
physician communication skills training
can enhance patient satisfaction .
Strength
of study
Randomized control trial Observational study
Relevance
to
objectives
This article was particularly relevant
to my research assignment because
it was a article that used a
specialized model based
communication skill training
directed at reducing the medication
errors and enhancing patient safety,
a key issue stemmed from
This article was relevant because it also
utilized a specific model of
communication skill training initiative and
measured the outcome in terms of patient
satisfaction, which is a key concern in
culturally diverse care setting.

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miscommunication and
misinterpretation in care setting.
Reliabilit
y
The study can successfully yield
similar results in repeated trials
This study is also reliable as the results
can be generated in a different sample
setting as well.
Validity Internal validity: would be very
useful within a healthcare setting
where communication issues lead to
medical errors.
External validity: specific to
eradication of medication errors
Internal validity: only performed on
physicians.
External validity: specific to a
multispecialty hospital .
Benefits A specialized detailed study that
targets one of the major health care
concerns, the medical errors due t
communication
A detailed study that focussed on impact
of better communication on the increasing
levels of patient satisfaction
Risks The integration of the
communication model can be
difficult in large scale settings.
The integration of the communication
model can be difficult in large scale
settings
Feasibilit
y
associated
The communication outcomes can
be integrated in a CALD setting.
Patients satisfaction is directly linked with
better health outcomes and initiatives can

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with
informati
on
be easily linked to CALD settings.
Conclusio
ns
Not only is there a rising number of migrant patients, there is also a high number
of foreign staff members in the healthcare industry. The risk of communication
errors between patient and nurse when one or both are speaking English as a
second language, is highly likely