Cross-cultural communication with patients who use American Sign Language.
BACKGROUND: Although American Sign Language (ASL) is the third most commonly used primary language in the United States, physicians are often not adequately prepared for the challenges of conducting an interview with a deafpatient who signs. METHODS: A search of MEDLINE and PsychINFO databases for research on physician-patient communication and deaf people who use ASL was performed. Expert opinion helped guide discussion and recommendations. RESULTS: Few articles examined physician-patient communication involving ASL. Deaf people and their physicians report difficulties with physician-patient communication. Deaf people also report fear that their health care is substandard because of these difficulties. CONCLUSIONS: Preparing residents and medical students for working with patients and families who communicate in ASL presents many opportunities for teaching about physician-patient communication. ASL is quite different from English, and users of ASL often have sociocultural norms that differ from those of the majority culture. In addition to learning how to communicate with patients and families across languages and cultures, students and residents can learn how to collaborate with interpreters and how low literacy impacts physician-patient communication. Opportunities to teach about family dynamics, disability issues, and nonverbal communication also present themselves when working with families with Deaf members. Physician-patient communication involving ASL is an area that is ready for further research.