Training In American English Intonation For International Health Care Professionals

Objective: The increasingly diverse nature of health care in the United States demands a critical need for clear, accurate, and appropriate communication in the scientific and medical setting to ensure patient safety. International medical graduates (IMGs) comprise 25% of the US physician work force. While IMGs bring all their knowledge and expertise, their pronunciation and intonation patterns often become a barrier in their ability to be understood. This breakdown in communication can affect physician-patient or physician-staff understanding and hence patient care. To address these communications problems, an ‘American English for Internationals’ course was developed to train nonnative English-speaking medical professionals.

Method: The participants were IMGs and researchers. Instructors specialized in teaching accent reduction and clinical-skills evaluation director were recruited for the training and research program. A key focus of the training was speech modification with accent reduction. The course included 8-12 weekly classes of 90-120 minutes duration. Our study assessed the efficacy of the program and included three components: a pre and post course self-evaluation by the participants, a pre and post audio-tape assessment by the course instructor and a pre and post videotape assessment by two independent observers from the Clinical Skills Evaluation Center.

Result: Analysis of results from the first 82 participants completing the program indicates that at the end of the training, the participants noted improvement in their ability to be clearly understood. There was improvement in their ability to pronounce words distinctly, stress words or syllables more accurately and use body language/facial expressions appropriately. The assessment by independent observers and instructors revealed similar findings. Together, these results suggest that programs directed at improving the communication skills of non-native English speakers can be successful through appropriate and focused training.

Conclusion: The American English program for International medical graduates and researchers significantly improves verbal and body-language communication skills.