Effect of Spanish language immersion rotations on medical student Spanish fluency.

BACKGROUND AND OBJECTIVES The study's objective was to determine whether participation in an international health rotation in a Spanish-speaking country (immersion) is associated with improved Spanish fluency compared to participation in domestic medical Spanish coursework alone. METHODS Participants matriculated at one US medical school in the years 2004--2008. At matriculation (baseline), all had intermediate to advanced Spanish fluency based on a standardized, oral fluency test. All took didactic coursework in years 1 and 2 of medical school. Some elected to participate in a post-year 1 immersion rotation in a Spanish-speaking Latin American country. Oral fluency was reassessed using the same method in years 2 and 4 by independent evaluators who were blind to individuals' immersion participation status and prior fluency scores. The authors compared participants' likelihood of demonstrating greater Spanish fluency over baseline among those who did post-year 1 immersion versus those who did US-based coursework alone (controls). RESULTS The likelihood of having greater Spanish fluency at the second-year assessment was 80% (45/56) among immersion participants, compared with 46% (21/46) for controls. The likelihood of having increased fluency at the fourth-year assessment was 65% (13/20) among those who did immersion versus 28% (7/25) for controls. Odds of having improved fluency for immersion participants remained statistically significantly higher after adjusting for baseline fluency (AOR [95%CI]=4.3 [1.7, 10.6], at year 2 and 5.1 [1.2, 21.6], at year 4). CONCLUSIONS Among medical students with intermediate to advanced baseline Spanish fluency, participants in a post-year 1 Spanish language international health immersion rotation were more likely to improve their Spanish fluency than participants in US-based coursework alone.