Tips for Teachers

9780300180596_ChaseAn Introduction to Spanish for Health Care Workers

Communication and Culture: Fourth Edition

Robert O. Chase and Clarisa B. Medina de Chase

Tips for Teachers

Marketing a course

Using the video in the classroom

Worksheets (29 pp. PDF file)

Sample Syllabus (6 pp. Word file)

Role plays and improvisation

Student projects

Drama imprevisto

Testbank with Answer Keys and Worksheet Answer Keys: Email us (language.yalepress@yale.edu) to request a download of these files. In your email, please indicate where you teach, the name of your class, and estimated enrollment so we can ensure you are an instructor.

Go to the Tips for Students page.

Marketing a course

You have an opportunity to relieve the critical communication gap between patients and their health care providers. Hospitals and other health care organizations need you. They yearn for bilingual staff and better communication with limited-English-proficient patients. The Joint Commission, which accredits hospitals, now requires that institutions document the primary language of patients. The United States Supreme Court determined that language discrimination is a form of national origin discrimination. Therefore, hospitals that receive federal funds are now required to provide care in a patient’s primary language.

An Introduction to Spanish for Health Care Workers is a beginner course. It assumes no previous knowledge of Spanish. Although it is not a substitute for the proper use of qualified interpreters in health care, it is an important component of a multi-level response to the need for effective communication. Doctors, nurses, and other health care providers have expressed the desire to acquire Spanish to help them to better collaborate with their patients. The benefits to hospitals include the following:

  • More accurate information for diagnosis and treatment;
  • Better treatment compliance;
  • Improved patient retention and satisfaction;
  • Malpractice risk management; and
  • Compliance with regulations and accreditation standards.

Here are possible benefits for your educational institution.

  • You may increase enrollment by offering a medical Spanish course;
  • Health care workers who are not matriculated in your school may enroll just for this course;
  • You can give credit for Spanish 101 to those who take this course, as the grammar closely follows an introductory course. (Exceptions to this are that we do not teach the progressive; the lexical load is largely medical; and we have added both modes of the past tense as well as the formal and informal commands.);
  • You may offer the course as a lab or fourth credit for people already taking SPA 101;
  • If you have an allied health program, you can better prepare your students for working in a multilingual society;
  • If you have an extension program, you can market medical Spanish classes that you can run at a hospital or large clinic.

Finally, if your institution chooses not to run a course, you can form your own business. Market a course to local clinics and hospitals. Most have continuing education departments or nursing education departments that would take charge of this. The hospital can purchase books for students or, to encourage consistent attendance, they can reimburse students for their book purchase upon successful completion of the course. A typical course to cover the book contents may be three hours per week for twelve to fifteen weeks. You can also offer to tutor health professionals at your home in the evening.

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Using the video in the classroom

The companion video is a very useful addition to the third edition of An Introduction to Spanish for Health Care Workers, because is places a new emphasis on target language input that is consistent with the lexical load and grammar focus of each chapter.

Note that there is a Trama and Demostración for each chapter. Trama is a series of progressive interactions between the Flores family, Doctor Vargas, and Rosemery the nurse. Demostración consists of ten segments that illustrate specific linguistic tasks in medicine. Chapter 11 and chapter 12 show Drama imprevisto segments, in which the actors demonstrate the use of these unstructured, unrehearsed classroom activities.

You can show the film in class both with and without Spanish subtitles. Segments are short, and each demonstrates structure and vocabulary from its corresponding chapter. The audio tracks may be downloaded from this Web site. The script appears in each chapter, with the exception of parts of the chapter 1 video. Each time the script appears in the book, it is followed by a related class exercise. After showing a video segment, try the following.

  • Students can “mirror,” or re-enact the video segment exactly as they recall it.
  • The instructor may ask comprehension questions. Better yet, students may ask comprehension questions or write them on the board or a flip chart for classmates to answer.
  • Re-enact the video segment while changing a variable. For example, with a doctor who prescribes “poly-pharmacy;” with a patient that hates to take medicine; or in the presence of the patient’s hypochondriacal family member.
  • Improvise a follow-up scene, for example one in which the patient is at dinner later that night telling what happened at the doctor’s office; or one in which the patient and visiting nurse are following up on the appointment. Conduct a second-opinion consultation. Change such variables as the presenting complaint, the diagnosis, etc.

Role plays and Improvisation

Design role-play activities that are consistent with the learning needs of the students in the classroom. Think of the acronym “ASAP.” Here these can stand for Actor, Setting, Action, and Purpose. For example,

  • You are a nurse (actor) at a public health clinic (setting). Explain (action) the results of a negative HIV test in a way that supports the patient’s infection-prevention behavior (purpose).

To make this more interactive, challenging, and unrehearsed, you may plan the partner’s role. It can be either supportive or confounding. For example,

  • You are a patient at a public health clinic. The nurse will explain your negative HIV test, but you are a person who has never been particularly careful to protect yourself, and do not believe in the value of precaution.

Student projects

The amount of homework that an instructor assigns often varies according to whether the course is taught as a workplace elective or as a credit course at a college or university. Here are some ideas that may have motivational value.

Students from varying disciplines have unique linguistic tasks. As a semester project, each student can focus on his or her most frequent patient interaction and prepare a presentation with a peer. Passing a draft (borrador) to the instructor at periodic intervals will result in better presentations and more accurate future patient interactions. Recently, a student who worked in a maternity center used a baby doll in her presentation to demonstrate the way that she taught her patients to give a baby his or her first bath.

As a semester project, students may keep a diary. They may track experiences speaking Spanish with patients and write about their feelings and the apparent reception of patients. They may write facsimile transcripts of the actual interactions in Spanish. Students with gallows humor may invent a “Diary of a Hypochondriac.” In this journal, students research the diseases that they most encounter at work. They may use www.medlineplus.gov/spanish or other search engines to seek resources. They may organize their entries by headings such as specialists consulted, symptoms, treatments, etceteras.

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Drama Imprevisto

A majority of teachers believe that students acquire language best when it is taught solely in the target language. This is supported by the ACTFL. In this fourth edition, we have removed a significant amount of English by presenting the instructions for activities in Spanish beginning in chapter 6. We waited until chapter six, because input should be comprehensible, and as a compromise with those teachers who are concerned for students who experience pathological second language anxiety when faced with oral or written information that they do not fully comprehend.

The drama imprevisto activities will help you relax and enjoy situations in which you express yourself in Spanish. In these, you can replace words with gestures as needed, and find ways to speak the Spanish words and phrases that come to mind, rather than fretting over what you cannot say. For example, in chapters one and two you play “The Host,” which is adapted from a popular theatre school and improvisation group activity. Here is an example.

In drama imprevisto 2.4, students are assigned a “feeling,” but saying the word is taboo. They act it and say other words that help to convey the feeling to others. At the close of the game, the vocabulary becomes associated with movement and expression that serve as strong mnemonic devices. More importantly, during wrap-up, students practice the verb estar by asking, “Paul, ¿estás preocupado?” and Paul states, “Sí, estoy preocupado.” In this way you are speaking Spanish quite effortlessly and in an anxiety-reducing atmosphere of play.

2.4 Drama imprevisto
Play another game of The Host. Choose a host, who leaves the room for a moment while the class chooses five students and assigns each a feeling from the vocabulary list. The host returns and is in the front of the room preparing a party. The chosen students take turns knocking on the door, entering the party, and exchanging small talk with each person while demonstrating the assigned feeling or emotion using gestures, questions, and statements. Say anything but the name of your assigned feeling. For example, student Paul receives “preocupado,” and circulates telling people with a worried expression, “Mi madre está enferma; mi padre está enfermo.” At the end of play, with the help of the remaining students, the host must guess each person’s affective state, for example, “Paul está preocupado,” and so on.

Unfortunately, not all classrooms have space for this type of practice. Be as imaginative as possible. Step outside, advocate for more space, and if all else fails, students may simply stand at their places when it is their turn to enter the game.

Some of these drama imprevisto activities constitute drills that are fun and challenging. For example, in chapter 4, Drama Imprevisto 4.6.

Play “One to Twenty,” which is like “Foot Bone Connected To,” from chapter 3. Form a circle. The first student points to another student anywhere in the circle and says uno. The student who was signaled then points to another student and says dos. Continue in this way until you reach the desired goal. It is important to set a rhythm and follow it. This promotes concentration and the coveted dynamic of working as a team. Variations include starting from a higher number and counting backwards.

Play this same game using the days of the week or months of the year from chapter 4.