Found in Translation
Dental students bridge language gap with Spanish-speaking patients
For Stony Brook School of Dental Medicine (SDM) students Sarah Ordonez and Alexandra Porcu, it’s not enough that they can communicate with patients who don’t speak English — they want their fellow students and all dentists across Suffolk County to be able to do the same.
Ordonez, a third-year student, and Porcu, who is in her second year, have been working on new ways to interact with the local Hispanic, non-English-speaking population, which includes many of the patients treated at the Dental Care Center. It seems only natural that bridging the language gap has become one of their priorities: As more people from Latin America immigrate to the United States every year, the number of those who speak Spanish is projected to rise, from 34.8 million today to between 39 million and 43 million by 2020, according to a recent report from the U.S. Census Bureau.
Efforts to beef up communication with this demographic at the SDM began in earnest last year when Ordonez approached Dr. Maria Cordero-Ricardo, DMD, an assistant professor in the Department of Orthodontics and Pediatric Dentistry and director of pre-doctoral pediatric dentistry. Ordonez had represented the SDM as an Ambassador for Diversity at the American Dental Association’s annual conference in San Francisco, where she met students from other backgrounds who spearheaded diversity initiatives at their dental schools. That’s when she got the idea to form a group aimed at helping SDM students to communicate better with the Hispanic community.
“I felt compelled to do something similar at Stony Brook,” Ordonez said. “Being of Ecuadorian descent, creating a chapter of the Hispanic Student Dental Association (HSDA) seemed like a no-brainer.”
Dr. Cordero-Ricardo liked Ordonez’s idea and signed on as an advisor. “I knew our school could benefit by making students more culturally receptive and understanding,” she said.
Around the time the HSDA formed, Porcu took a first-year course titled “Patient 1: Communication and Examination.” Taught by Dolores Cannella, PhD, an assistant professor in general dentistry and director of behavioral sciences at the SDM, the course prepares students to provide patient-centered care. Porcu said she loved the class but thought it could be enhanced with a Spanish-for-dentists component through which students learn to converse with non-English-speaking patients. She shared her idea with Cannella.
“Alex wanted students to know the Spanish translation of common phrases used in the dental office,” said Cannella. “She gathered information and developed a PowerPoint presentation to show to members of the HSDA. She received feedback, modified it, then presented it as a voluntary lunch and learn. Nearly her whole class attended.”
Spanish for dentists was such a hit that it became required reading material for first-year students. Equally well received is the HSDA, which counts several non-Hispanic students among its membership, which is at 30 and growing.
“The idea was to provide a means for all students to communicate better with their Hispanic patients at the dental clinic with the goal of fostering a more friendly environment,” said Ordonez, who is president of the group. “For students who are not Hispanic, an incentive to join was the development of various Spanish for dentists translation materials that they would be able to use in clinic. Most of my classmates jumped at the idea to make communicating with their non-English-speaking patients easier.”
As one of its first endeavors, the HSDA is joining forces with the Suffolk County Dental Society to develop a flipbook that will be distributed to dental offices throughout Suffolk County. It will help non-Spanish-speaking dentists who encounter emergencies with patients who don’t speak English.
“By using yes or no questions, the flipbook is a step-by-step guide in determining a patient’s chief complaint and the course of action that should be taken,” said Ordonez, who along with other HSDA members came up with the idea for the flipbook, which will be completed later this year.
Both Ordonez and Porcu are always looking for ways to augment Stony Brook’s available resources, which include interpreters and professionally translated consent forms. For Porcu, teaming up with Cannella to put together binders of basic clinical forms with multiple choice questions and English-Spanish translations helps students and patients speak the same language.
For students who don’t speak Spanish and non-English-speaking patients who are unable to read, questions can be sounded out. This enables students to communicate regardless of their fluency in Spanish. What’s more, the binders help novice speakers with conversational phrases, such as “open wide” and “rinse,” and expand the vocabulary of intermediate speakers by including dental and medical terms.
The binders and flipbook are resources that students could use after graduation when they establish their own practices, especially if they do not have easy access to translation services, such as those offered by Stony Brook.
With the SDM’s clinic and student translation tools firmly in place, Porcu has teamed up with Cannella and Dr. Cordero-Ricardo to determine the resources’ effectiveness.
“We are interested in students’ awareness and usage of clinic resources and patients’ satisfaction with translation resources,” Porcu said. “We are collecting data through surveys for the students, dental care providers and patients, as well as from the electronic health records and log sheets for the translator phones, to analyze usage.”
It would seem that with such a jam-packed dental school curriculum, neither Ordonez nor Porcu would have much time for extracurricular activities, but the two students stay after school and use lunch sessions to work on their projects.
“Our students are very community-minded, even though they have demanding schedules,” said Cannella. “They really do involve themselves in research, organized dentistry and community service. They have the motivation, and I think a lot of that has to do with their experiences.”
In both students’ cases, those experiences took place before they came to the SDM.
After she graduated from college, Ordonez worked at Shijiazhuang University in China as the principal oral English teacher for about 300 students. Despite having never taught English and unable to speak Mandarin, she pieced together a curriculum that catered to students’ specific interests. She supplemented what she taught in class by meeting at restaurants, various locations around the city, and even her apartment. She also organized a weekly “English Corner” to provide a forum for cross-cultural exchange between foreign teachers in the city and students at the university.
“English Corner somewhat was my inspiration for attempting to integrate the Spanish language into the Stony Brook curriculum,” she said.
When Porcu was an undergraduate pre-health student, she traveled twice to Costa Rica with an outreach organization to set up free medical and dental clinics. During those trips students took a medical Spanish seminar and received translated resources to use on site.
“I saw students who had no Spanish background interview their patients in Spanish by the end of the trip,” she said. “So I wanted to use this basic model to improve Spanish competency and translation resources at Stony Brook.”
She got her wish.
Now that the translation tools are catching on, the SDM has become a place where more students can say with assurance, “Se habla Español.”
“Talking to a patient and understanding their health problem is so much more effective than delegating it to somebody just because they could speak the language,” said Dr. Cordero-Ricardo. “We are giving our students an opportunity to be better dentists and practice some of the soft skills that show how much we care.”
— By Susan Tito; photos by John Griffin