Multicultural Clinical Learning Collaborative

The MCLC addresses a critical and persistent gap in health and STEM education: the limited availability of structured, evidence-based training models that prepare students for multilingual clinical practice in linguistically diverse communities. At Hispanic-Serving Institutions (HSIs), this gap is especially consequential because students train in multilingual communities while learning through largely monolingual curricula and clinical models. Research across health professions education indicates that students often graduate without systematic preparation to deliver equitable care to non-English-speaking populations, even though they enter a workforce where multilingual communication and cultural responsiveness are essential components of quality, patient-centered care (e.g., Arizmendi, 2025; Flores, 2006; Institute of Medicine, 2003).

 

In the Tucson borderlands, multilingualism is routine in clinical and educational environments. According to the U.S. Census Bureau, Tucson is 42.7% Hispanic/Latino, and 30.7% of residents ages 5 and older speak a language other than English at home (2019–2023 ACS 5-year estimates). The Arizona Department of Economic Security (2024) Language Access Plan identifies Spanish as the largest limited English proficiency language in the state. However, existing clinical training pathways often rely on informal exposure, individual student initiative, or isolated clinical placements rather than intentional, research-informed instructional design. Prior studies have demonstrated that ad hoc clinical experiences are insufficient for developing sustained competence in culturally and linguistically responsive care, especially when institutional curricula do not explicitly integrate language access, team-based perspectives, and community-focused clinical reasoning (Lie et al., 2011; Dogra et al.,2009; Ortega et al., 2022).

 

National workforce data further illustrate this misalignment between community needs and professional preparation. In medicine, approximately 6–7% of U.S. physicians report Spanish language proficiency (Association of American Medical Colleges [AAMC], 2019). Similarly, professional surveys in Communication Sciences and Disorders indicate that fewer than 8% of certified speech-language pathologists and audiologists can speak a non-English language, even though limited English-speaking patients are disproportionately represented in special education and healthcare settings (American Speech-Language-Hearing Association [ASHA],2023). Indeed, clinical training models often fail to align with the linguistic realities of the communities they serve, leaving graduates underprepared to serve multilingual communities. In clinical training contexts, knowledge of cultural and linguistic differences is often treated as an add-on rather than an integral part of professional preparation. This gap represents an underexamined challenge in STEM education research at HSIs in the borderlands: how to design, implement, and evaluate training models that reflect the linguistic realities of the communities institutions serve.

 

The MCLC responds to this challenge by developing an interprofessional, research-embedded training model that integrates multilingual clinical reasoning, team-based care, and applied learning across health-relateddisciplines. Rather than treating cultural and linguistic clinical competence as an individual skill the learner develops independently, the MCLC frames multilingual practice as a shared instructional responsibility shaped by curriculum design and supported by institutional structures. This approach aligns with evidence from implementation science and health professions education showing that sustained changes in professional practice require attention to learning environments and systems, not solely learner characteristics (Fixsen et al., 2005; Damschroder et al., 2009). The MCLC's instructional design draws on evidence-based practices in interprofessional education, experiential and case-based learning, and contextually responsive pedagogy. Empirical studies consistently show that interprofessional, applied learning environments improve clinical reasoning and readiness for team-based patient care, particularly when instruction is grounded in authentic community contexts (Reeves et al., 2016; Thistlethwaite et al., 2014).