--- title: "MDs non-English lang proficiency: self vs tested assessmt. | Sutter Health" description: "Non-English language self-assessment showed a moderate correlation with validated CCLA test. Additional testing may be required for MDs at the middle levels." url: "https://www.sutterhealth.org/research/publications/mds-non-english-lang-proficiency-self-vs-tested-assessmt-1055312513" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. MDs non-English lang proficiency: self vs tested assessmt. # Factors associated with accuracy of self-assessment compared with tested non-English language proficiency among primary care providers. Diamond L, Toro Bejarano M, Chung S, Ferguson W, Gonzalez J, Genoff Garzon M, Mujawar I, & Gany F. _Med Care. doi: 10.1097/MLR.0000000000001105. \[Epub ahead of print\]_ 2019-03-05 ## Abstract BACKGROUND: There are no accepted best practices for clinicians to report their non-English language (NEL) fluencies. Language discordance between patients with limited English proficiency and their clinicians may contribute to suboptimal quality of care. OBJECTIVES: To compare self-assessed clinician NEL proficiency with a validated oral language proficiency test. To identify clinician characteristics associated with self-assessment accuracy. SUBJECTS: Primary care providers from California and Massachusetts. RESEARCH DESIGN: We surveyed 98 clinicians about demographics and their NEL self-assessment using an adapted version of the Interagency Language Roundtable (ILR) scale followed by an oral proficiency interview: The Clinician Cultural and Linguistic Assessment (CCLA). We compared the ILR to the CCLA and analyzed factors associated with the accuracy of self-assessment. RESULTS: Ninety-eight primary care providers participated: 75.5% were women, 62.2% were white, and Spanish was the most common NEL reported (81.6%). The average CCLA score was 78/100 with a 70% passing-rate. There was a moderate correlation between the ILR and CCLA (0.512; P<0.0001). Participants whose self-reported levels were "fair" and "poor" had a 0% pass-rate and 100% who self-reported "excellent" passed the CCLA. Middle ILR levels showed a wider variance. Clinicians who reported a NEL other than Spanish and whose first language was not English were more likely to accurately self-assess their abilities. CONCLUSIONS: Self-assessment showed a moderate correlation with the validated CCLA test. Additional testing may be required for clinicians at the middle levels. Clinicians whose native languages were not English and those using languages other than Spanish with patients may be more accurate in their self-assessment. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/30844905) ## Research topics - [Health Disparities](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Disparities%5C%22%22) - [Health Services](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Services%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Clocks moving at different speeds: cultural variation in the satisfaction with wait time for outpatient care.](https://www.sutterhealth.org/research/publications/cultural-variation-satisfaction-outpt-wait-time-1055312330) Chung S, Johns N, Zhao B, Romanelli R, Pu J, Palaniappan LP, Luft H. Med Care. 2015 Dec 17. \[Epub ahead of print\] 2015 Dec 17 - Publication ### [An evaluation of two interventions to enhance patient-physician communication using the observer OPTION5 measure of shared decision making.](https://www.sutterhealth.org/research/publications/eval-2-interv-enhance-pt-md-comm-option5-measure-1055312393) Dillon EC, Stults CD, Wilson C, Chuang J, Meehan A, Li M, Elwyn G, Frosch DL, Yu E, Tai-Seale M. Patient Educ Couns. pii: S0738-3991(17)30254-9. doi: 10.1016/j.pec.2017.04.020. \[Epub ahead of print\] 2017 May 01 - Publication ### [Does this doctor speak my language? Improving the characterization of physician non-English language skills.](https://www.sutterhealth.org/research/publications/improve-characterization-of-md-non-english-skills-1055312681) Diamond LC, Luft HS, Chung S, Jacobs EA. Health Serv Res. 47(1 Pt 2):556-69. doi: 10.1111/j.1475-6773.2011.01338 2012 Feb 01 - Publication ### [Measuring health equity for ambulatory care sensitive conditions in a large integrated health care system: the development of an index.](https://www.sutterhealth.org/research/publications/measure-health-equity-in-primary-care-1055312457) Pressman A, Lockhart S, Petersen J, Robinson S, Moreno M, Azar KMJ. Health Equity. 3(1):92-98. doi: 10.1089/heq.2018.0092. eCollection 2019. 2019 Apr 03 - Publication ### [Community health worker training and certification programs in the United States: findings from a national survey.](https://www.sutterhealth.org/research/publications/comm-health-wker-training-certif-progrms-us-1055312544) Kash BA, May ML, Tai-Seale M. Health Policy. 80(1):32-42. Epub 2006 Mar 29. 2007 Jan 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/mds-non-english-lang-proficiency-self-vs-tested-assessmt-1055312513#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"MDs non-English lang proficiency: self vs tested assessmt."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/mds-non-english-lang-proficiency-self-vs-tested-assessmt-1055312513#medicalscholarlyarticle","name":"Factors associated with accuracy of self-assessment compared with tested non-English language proficiency among primary care providers.","headline":"MDs non-English lang proficiency: self vs tested assessmt.","abstract":"BACKGROUND: There are no accepted best practices for clinicians to report their non-English language (NEL) fluencies. Language discordance between patients with limited English proficiency and their clinicians may contribute to suboptimal quality of care. OBJECTIVES: To compare self-assessed clinician NEL proficiency with a validated oral language proficiency test. To identify clinician characteristics associated with self-assessment accuracy. SUBJECTS: Primary care providers from California and Massachusetts. RESEARCH DESIGN: We surveyed 98 clinicians about demographics and their NEL self-assessment using an adapted version of the Interagency Language Roundtable (ILR) scale followed by an oral proficiency interview: The Clinician Cultural and Linguistic Assessment (CCLA). We compared the ILR to the CCLA and analyzed factors associated with the accuracy of self-assessment. RESULTS: Ninety-eight primary care providers participated: 75.5% were women, 62.2% were white, and Spanish was the most common NEL reported (81.6%). The average CCLA score was 78/100 with a 70% passing-rate. There was a moderate correlation between the ILR and CCLA (0.512; P\u003c0.0001). Participants whose self-reported levels were \"fair\" and \"poor\" had a 0% pass-rate and 100% who self-reported \"excellent\" passed the CCLA. Middle ILR levels showed a wider variance. Clinicians who reported a NEL other than Spanish and whose first language was not English were more likely to accurately self-assess their abilities. CONCLUSIONS: Self-assessment showed a moderate correlation with the validated CCLA test. Additional testing may be required for clinicians at the middle levels. Clinicians whose native languages were not English and those using languages other than Spanish with patients may be more accurate in their self-assessment.","description":"Non-English language self-assessment showed a moderate correlation with validated CCLA test. Additional testing may be required for MDs at the middle levels.","keywords":["Health Disparities","Health Services"],"datePublished":"2019-03-05","url":"https://www.sutterhealth.org/research/publications/mds-non-english-lang-proficiency-self-vs-tested-assessmt-1055312513","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"30844905"},{"@type":"PropertyValue","propertyID":"DOI","value":"10.1097/MLR.0000000000001105"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/30844905/","https://doi.org/10.1097/MLR.0000000000001105"],"isPartOf":{"@type":"Periodical","name":"Med Care"},"author":[{"@type":"Person","name":"Diamond L"},{"@type":"Person","name":"Toro Bejarano M"},{"@type":"Person","name":"Chung S"},{"@type":"Person","name":"Ferguson W"},{"@type":"Person","name":"Gonzalez J"},{"@type":"Person","name":"Genoff Garzon M"},{"@type":"Person","name":"Mujawar I"},{"@type":"Person","name":"Gany F"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Health Disparities","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Disparities%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Services","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Services%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/mds-non-english-lang-proficiency-self-vs-tested-assessmt-1055312513","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/mds-non-english-lang-proficiency-self-vs-tested-assessmt-1055312513#breadcrumblist"}}} ```