1. English Health Train Bridges to Opportunity: Workforce Development for English Language Learners Workforce Development for English Language Learners October, 2006

2. San Francisco Welcome Back Center International Health Workers Assistance Centers A program of Community Health Works of San Francisco, a partnership of CCSF & SFSU EHT project funded by The California Endowment, The California Wellness Foundation, and Kaiser Permanente

3. Mission Statement To build a bridge between the need for linguistically and culturally competent health services in underserved communities and the pool of internationally trained health experts living in California.

4. Identified Barriers Participant level English language proficiency Loss of professional identity Economic issues Lack of familiarity w/ U.S. health system Structural level Complexity of licensing processes De-value of foreign credentials Professional associations’ reservations

5. Profile of Target Learners Diverse languages and cultures Diverse languages and cultures Length of time in U.S. varies greatly Length of time in U.S. varies greatly Majority trained as doctors, nurses, Majority trained as doctors, nurses, dentists dentists Lack of clarity about career goals in U.S. Lack of clarity about career goals in U.S. Completed variety of ESL classes Completed variety of ESL classes

6. The Pilot Program One year, 360 hrs. One year, 360 hrs. Three courses Three courses Core group Core group Diverse FTHPs Diverse FTHPs Low intermediate ESL Low intermediate ESL Rigorous evaluation Rigorous evaluation

7. Profile of Pilot Participants 13 countries 13 countries 7 languages 7 languages 8 health professions 8 health professions 2 mos. > 10 yrs. in U.S. 2 mos. > 10 yrs. in U.S. 75% females, 25% males 75% females, 25% males different obstacles, goals, different obstacles, goals, & levels of confidence & levels of confidence

8. Sources of Content Health care professionals Health care professionals Health care texts & journals Health care texts & journals Authentic materials Authentic materials Current media Current media Internet sites Internet sites

9. Materials Design Modules Exploring Career Goals in Health Care Communicating with Patients and Families Communicating with other Health Workers Exploring Critical Issues in Health Care Intercultural Communication in Health Care

10. Module 1  Career Paths in Health  Job Search Strategies  Workplace Expectations  Professional Development Exploring Career Goals in Health Care

11. Module 2  The Patient-Health Professional Relationship  Patient-Centered Interviews  Communicating with At-Risk Patients  Handling Challenging Situations Communicating with Patients and Families

12. Module 3  Assertive Communication with Co-Workers Co-Workers  Working on a Health Care Team  Telephone & Email Communication  Instructing & Supervising other Health Professionals Communicating with other Health Professionals

13. Module 4  Understanding U.S. Health Care Systems & Issues  Alternative Health Perspectives  Caring for an Aging Population  Legal & Ethical Issues in Health Exploring Critical Issues in Health Care

14. Module 5  Beliefs & Traditions about Health and Illness  Cultural Diversity in Health Care  Racial & Ethnic Health Disparities  Exploring the Needs of our Communities Intercultural Communication in Health Care

15. Course Components Student materials (5 modules/40 units) Student materials (5 modules/40 units) Teacher guides (5 modules/40 units) Teacher guides (5 modules/40 units) Listening CD (by module/unit) Listening CD (by module/unit) Project Workbook (w/ online activities) Project Workbook (w/ online activities) Assessment tools Assessment tools

16. Course Options One-year program One-year program Two courses Two courses One course One course Series of workshops Series of workshops One-day workshop One-day workshop

17. Evaluating the Courses Feedback from participants Feedback from participants Feedback from instructors Feedback from instructors Review by ESL experts Review by ESL experts Review by Advisory Committee Review by Advisory Committee Achievement of objectives Achievement of objectives

18. Final Results of Pilot Level 1 Level 2 Level 3 97% satisfaction 97% satisfaction Oral assessment: Oral assessment: average 55% gain average 55% gain Written assessment: Written assessment: average 98% gain average 98% gain (Unintended outcomes) (Unintended outcomes)

19. Unintended Outcomes 11% took and passed licensing exams 11% took and passed licensing exams 22% enrolled in health programs 22% enrolled in health programs 28% got jobs in health 28% got jobs in health care care Formed community Formed community of support of support Gained confidence to Gained confidence to achieve goals achieve goals

20. …I improved my English, I learned a lot about the health care workplace, but above all, I regained self-confidence. …Now I know what I want to do. I have no doubt I can work in this country, pursue my education and be successful. …We come from different countries and cultures, but we all have the same goals: to work in the health care field, serve the whole community with our skills…and gain personal satisfaction.

21. San FranciscoWelcome Back Center 1860 Hayes Street San Francisco, CA 94117 (415) 561-1833 aechever@ccsf.edu Hosted by City College of San Francisco and San Francisco State University www.e-welcomeback.org