The design and pilot of a translation aid to help ED clinicians enhance communication with the Portuguese-speaking patient
Bibliographic record
Abstract
BACKGROUND: Language barriers hinder health care delivery in settings with culturally diverse populations. Interventions to accommodate non-English-speaking patients have been shown to shorten length of stay and reduce non-urgent visits. AIMS: Our aim was to design and do a pilot study on an instrument to facilitate history taking with Portuguese-speaking patients in the emergency department (ED). METHODS: An instrument was designed to facilitate history taking with Portuguese-speaking patients (PSPs). A pocket-sized document incorporated, bilingual, problem-oriented, closed-ended questions for common ED presentations as well as numbers, measurements of time, and anatomy. A paired audio tutorial on a compact disk (CD) demonstrated correct pronunciation of each phrase. A 3-month pilot was undertaken in a downtown teaching hospital on a convenience sample of PSPs who indicated the need for a translator at triage. A trained Portuguese-speaking observer monitored clinician/patient pairs using the instrument and scored differential patient comprehension in a standardized manner. Qualitative patient and clinician impressions were assessed. A follow-up survey assessed emergency physician (EP) impressions of the instrument. RESULTS: Eight of nine eligible clinician/patient pairs were enrolled. The average proportions of questions answered appropriately in English and then using the instrument were 16.7% and 85.5%, respectively, with mean improvement of 68.8% (confidence interval: 45.6-92.1). Most (7/8) patients agreed that the instrument had helped in communication. Half (4/8) of the clinicians indicated that the tool had helped them communicate, and most (7/8) indicated that they would use the instrument in the future. Few (2/17) physicians utilized the audio guide. Suggested modifications included incorporation of phonetics. CONCLUSIONS: The pilot of the instrument was well received by patients and resulted in improved communication.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".