language barriers

The Experiences of Non-Native English Speakers at UCLA

Christina Oghlian, Cia Evangelio, Nina Esteghlal, Rikuto Kawada, Yuka Tanaka

As a native speaker of a language, we never really stop to think about the experiences and challenges of those who are not native speakers. It is especially difficult for those who are studying in a foreign country where almost everyone is fluent in a different language than them. We decided to research what challenges international students face in order to gain a greater understanding of their experiences as non-native English speakers at an American university. In addition, we want to use the results of our findings to understand what resources are available for international students who are not English-proficient.

We conducted our research by interviewing 10 international students attending UCLA, 5 of which were male and 5 of which were female, about their English academic proficiency levels and their experiences in various social settings as non-native speakers. By creating more spaces where international students can meet one another or consult with fluent English speakers about difficulties they might have with the language, educational institutions can help their international students feel more safe and comfortable in both academic and social settings.

Introduction

Think about yourself living in other countries where people do not speak your native language. What would you feel, and what difficulties would you face? This curiosity makes us want to study how each international student struggles to live in other countries. We focus on the linguistic, social, and mental challenges that international students face during their study abroad experiences. Our research question is: “How does international students’ English proficiency affect their personal life to be fulfilling while they are studying abroad, and what are the difficulties for international students to achieve their ideal life in new countries?” We hypothesize that international students with higher proficiency in speaking English have more opportunities to socialize in groups. On the other hand, international students who have lower English proficiency will face more difficulties in socialization and having an awareness of their speaking English, increasing their anxieties while they are speaking English to native speakers.

Background

International students face new challenges in a new country. There can be many reasons and situations, such as the language barrier, socialization, and mental condition. Those challenges have a huge negative impact on international students in terms of their studying or speaking English. Many international students are willing to enhance their speaking skills and engage in new social interactions, such as engaging in conversation, making new friends, and so on, in the new countries they go to (Bernhard and Gregory, 2017). Depending on the individual international students, there are differences in these achievements to be different because their English proficiency will be affected.

The linguistic barrier can make people feel they are not in the conversation while people are speaking English because they cannot understand and speak out while people are using English. This can make international students feel socially excluded because of the differences in their English ability (Hilt, 2016). In addition, linguistic barriers are affecting not only the social life of international students but also their mental awareness of their English ability in many ways. While international students feel they are not good enough at speaking English, it can affect their feelings of anxiety (Idrissi, 2022). Moreover, the linguistic barrier can also affect international students’ confidence in speaking (Iris and Lopez, 2014). Therefore, English proficiency has a huge impact on the interactions with international students, their social lives, and their awareness of anxiety.

Methods

For our research study, we aim to interview 10 international UCLA students between the ages of 18-25. Out of the 10 international students, we will specifically interview 5 males and 5 females. Our research will examine how these international students face difficulties when they are speaking English to a native English speaker. Before the interview, the students will complete a Google form asking a couple of questions about their demographics, including identity, where they are from, previous schools they have attended, and for how long they have been attending UCLA. After completing the Google form, each participant will be notified with a follow-up interview and be asked questions based on their familiarity with English. The interviews will take approximately 30 minutes, and we will ask questions related to their knowledge of English, such as, “How comfortable are you speaking English”, “What is the most complicated part about speaking the English language”, “ How comfortable are you when slang is being used in conversation”, and “What linguistic features do you pay attention to when speaking with native speakers”. Based on the interview answers, we will analyze them to see what international students struggle with and which areas of linguistics they have difficulty understanding the most. We especially want to understand how international students have a difficult time with their English ability in social situations and mental interaction.

Results and Analysis

The results that we have found are quite intriguing. We conducted a total of nine interviews and created graphs to represent our findings. As represented on the charts, the demographic of our participants is a majority of Japanese participants followed by Indian, South Korean, and Armenian, as shown in Figure 1.

Figure 1: Demographics of Participants within the Study

A large majority of the participants were exposed to English in high school– whether that be that they went to an international school or they had an integrative English course as represented through Figure 2.

Figure 2: Percentage of Participants who were exposed to English in High School

While conducting our research, we realized it was only fair that we separate international students from what was shown in Figure 2. Out of those international students that were exposed to English in high school, Figure 3 represents what they found the most difficult when participating in conversation with native English speakers.

Figure 3: What International Students with strong English proficiency struggle with

On the other hand, Figure 4 shows what international students that have lesser English proficiency struggle with. Interestingly, both international students with strong English proficiency and students with lower English proficiency are most conscious about pronunciation.

Figure 4: What International Students with lesser English proficiency struggle with

The results show that the international students that have a strong English-speaking background are most likely to feel comfortable speaking English to individuals, and group settings however, international students with no English background feel less comfortable. International students have more difficulty grasping English morphological and syntactic structures due to the complicated grammatical structures that are used in academic settings. The use of slang terms and pop culture usually in social and school settings often would give international students confusion. Most international students mentioned how they struggled understanding slang terms and pop culture and that they are still learning.

Discussion and Conclusions

Previous studies have shown that the ability to speak English is highly related to one’s involvement with the surrounding environment in which he or she grew up. The results show that international students who received an academic English education before entering university are almost as confident and comfortable with their English skills as native English speakers, whereas international students who did not receive much English education before entering university are a little more hesitant to speak English. As our research indicates, they may feel anxious or difficult to speak depending on their proficiency in English and may feel that they do not belong in that group.

Moreover, our study allows us to speculate that difficulties in grasping specific and unique syntactic structures, such as pop culture references, may have an impact on the minds and bodies of international students. While it is difficult to draw conclusions, this phenomenon may be true for many international students who did not receive much English education before college. Proficiency in English is a necessary skill for international students to adapt to social life, but confusion often arises when slang and pop culture references are mixed in. Therefore, it could be argued that international students hang out with other international students to avoid being excluded because of differences in fluency or proficiency that they do not possess compared to native English speakers. This research can be applied to various university communication settings to help understand how to properly engage with international students and what type of environment is most effective for language learning.

References

Alkhammash, R. (2022). Processing figurative language: Evidence from native and non-native speakers of English. Frontiers in Psychology, 13, 1057662–1057662. https://doi.org/10.3389/fpsyg.2022.105766

Drljaca Margic, B. (2017). Communication courtesy or condescension? Linguistic accommodation of native to non-native speakers of English. Journal of English as a Lingua Franca, 6(1), 29–55. https://doi.org/10.1515/jelf-2017-0006

Halic, O., Greenberg, K. H., & Paulus, T. M. (2009). Language and Academic Identity: A study of the experiences of Non-Native English speaking international students. International Education, 38(2), 73–93.

Hilt, L. T. (2016). Education without a shared language: Dynamics of inclusion and exclusion in Norwegian introductory classes for newly arrived minority language students. International Journal of Inclusive Education, 21(6), 585–601. https://doi.org/10.1080/13603116.2016.1223179

Idrissi, O. (2022). Anxiety as a psychological barrier to students’ speaking fluency: IELTS as a case study. International Journal of Linguistics, Literature and Translation, 5(12), 111–120. https://doi.org/10.32996/ijllt.2022.5.12.14

Jessen, A., Festman, J., Boxell, O., & Felser, C. (2017). Native and Non-native Speakers’ Brain Responses to Filled Indirect Object Gaps. Journal of Psycholinguistic Research, 46(5), 1319–1338. https://doi.org/10.1007/s10936-017-9496-9

Lopez, I. Y., & Bui, N. H. (2014). Acculturation and linguistic factors on international students’ self-esteem and language confidence. Journal of International Students, 4(4), 314–329. https://doi.org/10.32674/jis.v4i4.451

Streitwieser, B. T., & Light, G. J. (2017). Student conceptions of international experience in the study abroad context. Higher Education, 75(3), 471–487. https://doi.org/10.1007/s10734-017-0150-0

Yu, X., & Peters, B. (2019). Let All Voices Be Heard!: Exploring International Students’ Communication Challenges in the Internationalized Classroom. Journal of Interdisciplinary Studies in Education, 8(1), 107–116. https://doi.org/10.32674/jise.v8i1.1080

Cross-referencing relevant info: https://www.youtube.com/watch?v=na04NxGZuKU

English, International Students, language barriers, language proficiency, social integration

Language Proficiency’s Impact on Healthcare Quality for Marginalized Patients: A Physician-Patient Communication Perspective

Sociolinguistics

Lilian Nguyen, Rebecca Kim, Lillian Thai, Ysabella Ballesteros-Barajas, Andrea Romero

Our study investigates language barriers’ impact on patient-physician relationships among marginalized racial and ethnic communities in Southern California. We aim to understand how limited English proficiency affects healthcare access and quality for non-native English speakers. This exploration is crucial in identifying and addressing disparities in healthcare settings, particularly how language barriers intensify existing challenges. We hypothesize that disparities in language proficiency significantly influence the quality of care received by ethnically marginalized patients. Our research highlights ongoing societal norms in America, which disproportionately affect immigrants. We emphasize the necessity of addressing healthcare disparities for ethnically marginalized communities, advocating for enhanced resources and support. Analysis of data patterns reveals the profound impact of limited English proficiency on patient understanding and comfort in medical settings. Additionally, we identify the added responsibilities shouldered by non-English patients and the minimization of patient-physician interaction in the US healthcare system. In conclusion, our findings underscore the urgency of improving communication and understanding between patients and providers. This entails training healthcare providers in cultural competency and ensuring multilingual health materials’ availability. By addressing language barriers, we can strive towards a more equitable healthcare system that meets the diverse needs of all patients.

Introduction and Background

Our study explores the intricacies of patient-doctor relationships, with a specific focus on the ramifications of language barriers among individuals from marginalized racial and ethnic communities in California. Our objective is to comprehend how language proficiency, particularly among non-native English speakers, impacts their interactions with healthcare providers and their ability to access healthcare resources. This research holds significance in unveiling the challenges faced by these communities in healthcare settings, particularly how language barriers may exacerbate these challenges. Furthermore, we aim to explore the influence of language on the quality of care. Our hypothesis suggests that disparities in language proficiency between physicians and patients from ethnically marginalized communities significantly influence the quality of healthcare received. We seek to address the question: “Does language proficiency between physicians and patients from ethnically marginalized communities impact the quality of care?”

The ongoing Eurocentric-centric societal norms in America, profoundly affecting immigrants and refugees who have migrated to the country since the 20th century (Batlova 2018), have sparked discussions on the interpersonal and intrapersonal repercussions within marginalized communities. During this period, many immigrant groups encountered social and economic marginalization in American society, leading to their disconnection from the healthcare system (Anderson 2019). Our research endeavors to explore these effects within the framework of the US healthcare landscape, dissecting how the experiences of minority groups may differ from those of predominant communities through the analysis of language usage and conversations. Healthcare holds paramount importance for the living conditions of these burgeoning populations, as unequal access to adequate resources may jeopardize their overall well-being (Hsueh 2021). Previous studies have indicated physician bias as a limiting factor in physician-patient understanding, thus fueling ethnic disparities within healthcare settings.

Additionally, minority populations, including Hispanic, Black, and Asian communities, are expected to account for 40% of the US population by 2035 and 47% by 2050 (Cooper 2003). Therefore, as minority populations in America continue to grow (Cooper 2003), it becomes increasingly imperative to strive towards enhancing their quality of care by addressing potential barriers to access.

Hence, this research aims to further emphasize the correlations between English language proficiency and the quality of care in physician-patient relationships in America. Paying attention to recurrent themes in word choices used by participants will aid in highlighting how one’s ethnic identity may contribute to communication barriers (Irvine 2020). The selection of words by our participants when responding to questions regarding their relationship with their primary healthcare provider remains crucial in understanding their healthcare experiences and evaluating the quality of care they receive. This is because self-reported health status is imperative in raising awareness of vulnerable minority communities and their access to quality healthcare (Gandhi 2020). Analyzing recurrent themes in word choices will, therefore, offer a more nuanced insight into how ethnic identity influences communication barriers.

Methods

Our study investigates the impact of language barriers on patient-doctor relationships within marginalized communities, focusing on healthcare quality, resource access, and patient vulnerability. Employing a mixed-methods approach, we utilize surveys and structured interviews to gather data from individuals across diverse marginalized racial and ethnic backgrounds with varying English proficiency levels. The survey involves five participants from the target population, while in-depth interviews are conducted with another group of five individuals. Both methodologies are guided by specific formulated questions. Data collection occurs via online platforms for surveys and virtual or in-person settings for interviews, ensuring demographic diversity. Sampling aims to encompass individuals from various marginalized racial and ethnic backgrounds with differing English proficiency levels. Quantitative survey data is analyzed using Google Forms, while qualitative interview data is scrutinized for analysis.

Results

Figure 1: Patient satisfaction with medical provider’s explanation of healthcare treatment (i.e. medications, procedures, diagnosis).

Figure 2: Patient trust levels based on primary care physician’s native language fluency

Figure 3: Influence of Language Proficiency and Patient-Physician Interaction on Immigrant Patient Perceptions of Healthcare Quality.

Discussion and Conclusions

Upon analyzing our data, we have uncovered several underlying patterns (Figure 3).

Participants were tasked with evaluating their comprehension of the information and instructions provided by their medical providers. A notable observation was made by several participants who, while generally able to understand this information, encountered challenges in comprehending medical terminology that they are only familiar with in their native language (Figure 1). Consequently, our findings indicate a strong positive correlation between limited English proficiency and difficulties in understanding medical information. This correlation is particularly significant for immigrant patients who already face additional social and cultural barriers, such as cultural assimilation. Speaking in their native language with their primary care physician fosters a sense of familiarity and comfort (Figure 2). Additionally, ethnically marginalized patients who communicate in their native language with their physician feel more at ease expressing themselves and discussing sensitive health issues without fear of misunderstanding or judgment.

Moreover, we explored the ways in which patients may assume extra responsibility or seek support regarding their medical care. While some participants reported not assuming any additional responsibility, others mentioned making efforts to learn English to communicate with their English-speaking doctors or relying on family members for support during medical visits. This highlights the burden placed on non-English patients to bridge communication gaps with their physicians.

Furthermore, our study reveals a significant finding regarding the minimization of patient-physician interaction in the US healthcare system (Figure 3). Despite acknowledging advancements and modernity in US medicine compared to their countries, our data indicates a minimization of interaction and bonding. This may be attributed to factors such as limited appointment times, a national physician shortage, minimal physician cultural sensitivity, and an overarching focus on efficiency over personalized care (Silver 2019). Consequently, ethnically marginalized patients may feel disconnected from their healthcare providers, perceiving a lack of empathy and understanding during medical encounters.

In conclusion, our study underscores the necessity for additional resources and support for marginalized communities with limited English proficiency to achieve the same level of quality communication and care as native English speakers. Moreover, our research highlights significant health disparities among ethnically marginalized communities with limited English proficiency. This emphasizes the importance of addressing these disparities and implementing improvements in the healthcare system. Immigrants, in particular, face the challenge of mastering language, culture, and healthcare protocols to engage with providers and comprehend health information (Radl-Karimi 2020). Healthcare providers must receive training in cultural competency, health literacy, and patient education techniques. Additionally, ensuring the availability of health materials in multiple languages and formats tailored for low-literacy populations is crucial. Our study also reveals that participants sought assistance in understanding medical instructions when provided with written reference materials after their visits. By enhancing communication and understanding between patients and providers, we can strive towards a more equitable healthcare system that caters to the diverse needs of all patients.

References

Anderson, K. M., & Olson, S. (2019). Immigration as a Social Determinant of Health Proceedings of a Workshop. National Academies Press.

Batalova, J., & Alperin, E. (2018, September 13). Vietnamese immigrants in the United States. Migration Policy Institute. https://www.migrationpolicy.org/article/vietnamese-immigrants-united-states-5

Cooper, L. A., & Roter, D. L. (1970, January 1). Patient-provider Communication: The Effect of Race and Ethnicity on Process and Outcomes of Healthcare. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. https://www.ncbi.nlm.nih.gov/books/NBK220354/

Gandhi, K., Lim, E., Davis, J., & Chen, J. J. (2020, January). Racial-ethnic disparities in self-reported health status among US adults adjusted for sociodemographics and multimorbidities, National Health and Nutrition Examination Survey 2011-2014. Ethnicity & health, 25(1), 65-78. https://pubmed.ncbi.nlm.nih.gov/29092622/

Hsueh, L., Hirsh, A. T., & Stewart, J. C. (2019, July 10). Patient–provider Language Concordance and Health Outcomes: A Systematic Review, Evidence Map, and Research Agenda. Medical Care Research and Review, 78(1), 3-23. https://journals.sagepub.com/doi/10.1177/1077558719860708

Irvine, F. E., Roberts G. W., Jones, P., Spencer L. H., Baker C. R., & Williams C. (2006, January 31). Communicative Sensitivity in the Bilingual Healthcare Setting: A Qualitative Study of Language Awareness. Journal of Advanced Nursing, 53(4), 422-434. https://onlinelibrary.wiley.com/doi/10.1111/j.1365-2648.2006.03733.x

Radl-Karimi, C., Nicolaisen, A., Sodemann, M., Batalden, P., & von Plessen, C. (2020). Under what circumstances can immigrant patients and healthcare professionals co-produce health? – An Interpretive Scoping Review. International journal of qualitative studies on health and well-being, 15(1), 1838052. https://doi.org/10.1080/17482631.2020.1838052.

Silver, J. K., Bean, A. C., Slocum, C., Poorman, J. A., Tenforde, A., Blauwet, C. A., Kirch, R. A., Parekh, R., Amonoo, H. L., Zafonte, R., & Osterbur, D. (2019). Physician Workforce Disparities and Patient Care: A Narrative Review. Health equity, 3(1), 360–377. https://doi.org/10.1089/heq.2019.0040.

ethnic minorities, healthcare system, language barriers, patient-physician relationships