Students with English as a second language, it is important to not make assumptions of understanding as conversation is different than academic language proficiency. This is also important when reviewing general literacy of a class, as students with English has a first language may not have academic proficiency as well. In nursing this can also be discussed as a class when talking about community and patient education. In the not so distance past, the average literacy grade level in the community my previous hospital system served was reported to be at a third-grade level. Improper education at the wrong literacy level as a nurse can have grave impacts on medical health, especially those with chronic illnesses. It is important to weave this discussion into nursing classes as they move forward in the clinical space, as well as the instructor recognize academic language proficiency versus conversational fluency when instructing. For this exact reason, medical providers are required to used license medical interpreters with family. In the past, I have had discussions with students about translating without certification, as medical language fluency is different from conversational then additionally academic.
