Medical linguistic assessment & physician proficiency level


Subtopic: Prevention of false fluency
Subtopic: Use of simulation for medical communication skills assessment


  1. ACTFL. (2015). Oral proficiency levels in the workplace. ACTFL. Retrieved from
  2. ACTFL Oral proficiency assessment (including Oral Proficiency Interview [OPI] and Oral Interview-Computer [OPIc]
  3. ACTFL Proficiency Guidelines Spanish: Comunicación Oral. From ACTFL Proficiency 2012 Guidelines.ón-oral
  4. American Council on the Teaching of Foreign Languages Proficiency 2012 Guidelines.
  5. Andres E, Wynia M, Regenstein M, Maul L. Should I call an interpreter?—How do physicians with second language skills decide? J Health Care Poor Underserved. 2013;24:525–539.
  6. Chalabian J, Dunnington G. Standardized patients: a new method to assess the clinical skills of physicians. Best Pract Benchmarking Healthc. 1997 Jul-Aug;2(4):174-7.
  7. Chaufan C, Karter AJ, Moffet HH, et al. Identifying Spanish language competent physicians: The Diabetes Study of Northern California (DISTANCE). Ethn Dis. 2016;26:537–544. 
  8. Flores G, Mendoza FS. ¿Dolor aquí? ¿Fiebre?: A little knowledge requires caution. Arch Ped Adolesc Med 2002;156(7):638-640.
  9. Diamond, L.C., Toro Bejarano, M., Chung, S., Ferguson, W., Gonzalez, J., Genoff Gazon, M., Mujawar, I., Gany, F., "Factors Associated with Accuracy of Self-Assessment Compared to Tested Non-English Language Proficiency Among Primary Care Providers".  Journal of Medical Care (2019) accepted for publication.
  10. Diamond, L.C., Luft, H.S., Chung, S., Jacobs, E.A. “Does This Doctor Speak My Language?” Improving the Characterization of Physician Non-English Language Skills. Health Services Research. 2012; 47(1): 556 – 569. PMID:22091825. PMCID:PMC3393012.
  11. Diamond, L.C., Moreno, M., Otero-Sabogal, R. Bilingual Dual-Role Staff Interpreters – Factors Associated with Passing a Language Competency Test. International Journal of Interpreter Education, 2012; 4(1): 5 - 20.
  12. Diamond LC, Reuland DS. Describing physician language fluency: Deconstructing medical Spanish. JAMA. 2009;301(4): 426-8.
  13. Diamond L, Sukyung, Ferguson W, Gonzalez J, Jacobs EA, Gany F. Relationship between Self-Assessed and Tested Non-English Language Proficiency among Primary Care Providers. Medical care. 2014;52(5):435-438.
  14. Diamond LC, Tuot DS, Karliner LS. The use of Spanish language skills by physicians and nurses: policy implications for teaching and testing. J Gen Intern Med. 2012 Jan;27(1):117-23. doi: 10.1007/s11606-011-1779-5.
  15. Federation of State Medical Boards of the United States, Inc., and the National Board of Medical Examiners. USMLE Step 2 Clinical Skills Content Description and General Information. ( Revised October 2017.
  16. Interagency Language Roundtable.
  17. Interagency Language Roundtable. 2012. (
  18. Iramaneerat C, Myford CM, Yudkowsky R, Lowenstein T. Evaluating the effectiveness of rating instruments for a communication skills assessment of medical residents. Adv Health Sci Educ Theory Pract. 2009 Oct;14(4):575-94.
  19.  Jacobs, E.A., Diamond, L.C., Stevak, L. The Importance of Teaching Clinicians When and How to Work with Interpreters. Patient Educ Counts. 2010 Feb;78(2):149-53. doi: 10.1016/j.pec.2009.12.001. Epub 2009 Dec 29. PMID:20036480
  20. Karkowsky CE, Chazotte C. Simulation: improving communication with patients. Semin Perinatol. 2013 Jun;37(3):157-60.
  21. Lie DA, Forest CP, Richter-Lagha R. Evaluating Medical Spanish Proficiency: A Comparison of Physician Assistant Student Self-Assessment to Standardized Patient and Expert Faculty Member Ratings. J Physician Assist Educ. 2018 Sep;29(3):162-166. doi: 10.1097/JPA.0000000000000211.
  22. Lion KC, Thompson DA, Cowden JD, et al. Impact of language proficiency testing on provider use of Spanish for clinical care. Pediatrics. 2012 Jul;130(1):e80-7.
  23. National Council of State Supervisors for Languages. (2008). LinguaFolio Self-Assessment Grid. National Council of State Supervisors for Languages.
  24. Ortega P, Park YS, Girotti JA. Evaluation of a Medical Spanish Elective for Senior Medical Students: Improving Outcomes through OSCE Assessments. Med Sci Educ. 2017;27(2):329-337. 
  25. Regenstein, M., Ellie Andres, and Matthew K. Wynia. (2013). “Appropriate Use of Non-English Language Skills in Clinical Care.” Journal of the American Medical Association 309.2: 145–46.
  26. Reuland, Daniel, Pamela Y. Frasier, Matthew D. Olson, Lisa M. Slatt, Marco A. Aleman, and Alicia Fernandez. (2009). “Accuracy of Self-Assessed Spanish Fluency in Medical Students.” Teaching and Learning in Medicine. 21.4: 305-309.