Bilingual Certification in Healthcare: Proficiency Standards

Bilingual Certification in Healthcare: Proficiency Standards


The healthcare industry desperately needs a bilingual certification for healthcare workers. What does it mean to be Certified Bilingual and how is that different from interpreter certification?

Interpreter certification in healthcare is relatively well-established in the USA with a few possible routes to attain certification. It is surprisingly not required by the majority of states across the country, but a clear path exists that assesses proper skills to become nationally certified to interpret in healthcare. The proficiency standards outlined in this bilingual certification do not compete with, nor duplicate, existing interpreter certification. The language proficiency standards below identify standards for bilingual healthcare workers to attain certification to use two languages responsibly with patients.

Since 2001 we’ve been training healthcare professionals and students to gain enough Spanish proficiency to work responsibly and carefully with their Spanish-only patients. It is a noble goal that many in healthcare seek to achieve, because they know that the quality of care that patients receive will improve if services are delivered in the patient’s native language.

Looking to get Certified for Medical Spanish? Let us know who you are and we’ll make sure you get the information you need!

Over the years we’ve noticed a sharp increase in the percentage of students and professionals coming to our medical Spanish courses with higher levels of proficiency. After specific training in medical terminology and intercultural communicative competency, the natural progression is to document and approve that these proficient speakers are certified bilingual. We have faced many problems in finding a test that will assess the proficiency of an individual in a specific industry. Here are some of the hurdles we’ve run into in the last several years. These are anecdotal, but probably familiar to you as well if you’re working in this field:

  • Many people on staff at clinics and hospitals are “bilingual” Spanish/English but may or may not have enough bilingual proficiency in both languages to use a second language in the healthcare setting. In order to be a successful communicator in healthcare, one must be able to maintain professional tone, employ the appropriate use of medical terminology, and sufficiently grasp the patient’s account of their presenting problem and history. This professional level of bilingualism is what healthcare institutions want to certify.
  • Facilities and institutions need a way to assess bilingual workers’ abilities to use professional Spanish/English with patients in order to ensure quality of care.
  • General language proficiency tests exist – but they are general and don’t assess industry-specific vocabulary.
  • Healthcare facilities naturally turn to their interpreting departments for approval of bilingual staff to use a second language with patients. Interpreting departments may become mildly anxious about this notion of testing coworkers because they have the professional obligation of ensuring quality communication with limited English patients, and have received specialized training to do so. There may also exist a perception among some interpreters that job security could be at stake, but for the most part professional interpreters are trained to interpret – not necessarily to teach a language.
  • Most testing of bilingual staff is currently delivered through a small handful of 3rd party companies which often run the telephonic interpreting services for the facility as well. These tests tend to include interpreting competencies which are completely different, on a cognitive level, than bilingualism.
  • We recognize that intercultural communicative competence plays a large role in the success or failure of an interaction between two people of different languages and cultures. This competency, however, is rarely assessed among the current tests available for documenting second language proficiency.
  • We see facilities in our geographical area limit the use of second language that clinicians and staff can use with patients until they pass a third party test. As discussed above, the problem in many cases is that these tests are either the same used for interpreter certification or significantly similar to such tests. Many who are responsible speakers of that second language (using professional tone, precise vocabulary, etc) don’t pass because of the interpreter competencies required to successfully complete the test.
  • We see facilities struggle to staff interpreters for their patients in a timely and consistent fashion within a reasonable budget.

For these reasons above, and several more, we are developing a medical Spanish certification program that will approve bilingual healthcare workers to use Spanish and English with patients in a responsible and ethical way without the assistance of interpreting services in most cases.

The first step in developing this certification program is to establish the standard of bilingual proficiency required for certification. This standard for proficiency must meet or exceed federal requirements for the use of second language in healthcare, and must also correlate in certain ways to the current proficiency standards accepted and promoted in the general language industry.

Below is the first draft of our bilingual proficiency standards in healthcare. We have identified 5 proficiency standards that must be addressed in order to certify a bilingual healthcare worker to use a second language with patients. The 5 standards are:

  1. Patient and Care Professional Interaction
  2. Skilled Presentational Ability
  3. Critical Listening
  4. Critical Reading
  5. Cultural Navigation

Please add your comment below on these standards while this is still a working document. When commenting, we respectfully request that you include your profession so that we can track perspectives from various fields in healthcare and linguistics.

Btw: If you’re working on learning Spanish for your healthcare career, we have the medical Spanish you need!

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