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When a student walks into a Medical Spanish program
with meager skills and walks out being able to take a
Complete History - in Spanish - by himself - something
went right. It's the same technique horse trainers use. . .
well, almost.
Just after going into practice, I bought a horse. One day,
I was standing around with the other cowboys watching
a stallion mate. The owner was a crusty, old cowboy, who
was bragging about his horses attributes. One of those was
quite apparent, but he made us aware that the horse knew
all kinds of tricks and commands. When he wanted oats, for
example, he would stomp his left foot.
At one point, he turned to me and said, “Doc, do you know
how to teach a horse?” Because I looked and felt bewildered,
he answered his own question, “Pain and repetition.”
To this day, I have never been able to get those words out
of my mind. The reality is that the same technique works for
people - but most of the time we can leave out the pain part.
So, when a first-year medical student showed up in
Guatemala to take our Medical Spanish course, his lack of
Spanish-speaking ability did not deter me. We scheduled
him for three to four hours of didactic teaching in the mornings
and following me around in the Clinic for a similar amount of
time in the afternoons.
At first, he was asking me continuously, “What do I say?”
And so I told him. But we also used a special, patient chart,
which had all of the pertinent questions in Spanish. Within a
few days, he stopped asking me questions and directed them
to the patients.
Each day, we would go through the same exercise -
different patients and different problems - but taking the
same basic history from each. After a week, he asked me
if he could just see the patients on his own and present them
to me. I consented.
To my amazement and delight, the reiterative process we
use in our program was bearing bushels of fruit. After three
weeks, this student, who had not yet had his clinical rotations,
not only was taking a complete history on his own in Spanish,
but also he was performing the physical exam to boot.
And so the cowboy's advice worked: repetition and practice,
repetition and practice. My only concern came one day
when the student started stomping his left foot.
by Craig A. Sinkinson, M.D.
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