Dr. Megan Milburn (in the background), a dentist at Bradley Free Clinic in Roanoke, demonstrates a new translation tool as dental student Ashley Casdillo sits in the patient chair. Photo by Emily Schabacker.

Asking someone to remove jewelry for dental X-rays is routine. But those instructions become much harder to communicate when patients and providers don’t share a language.

Three graduate students at Virginia Tech developed a translation tool designed to improve communication between Spanish-speaking patients and English-speaking dentists.

Roanoke’s Bradley Free Clinic, where about 30% to 40% of the clinic’s 3,800 annual patients speak Spanish as their primary language, is now rolling out the tool, said Megan Milburn, a general dentist at the clinic.

“It’s been especially helpful for new patients. Just explaining how to stand in front of the panoramic x-ray and how to bite on the tabs for bite wings,” she said.

The students are part of the second cohort of the Carilion Clinic Biodesign Program at Virginia Tech. Created through a partnership between Carilion and Virginia Tech, the initiative brings together students with clinical and engineering backgrounds to develop solutions to challenges in rural healthcare.

[Disclosure: Carilion is one of our donors, but donors have no say in news decisions; see our policy.]

Before building the tool, the students observed patient care at Carilion hospitals across Southwest Virginia and at the Bradley Free Clinic, said Sarah Scheerer, a 2024 graduate of Virginia Tech’s undergraduate biomedical engineering program. 

“We’re fresh faces coming in, so we can ask like, ‘Oh, why are things done that way?’” Scheerer said. “And that’s where we can come in and actually identify a bunch of needs.” 

Graduate students Ridi Barua (left), Mahrukh Siddiqui and Sarah Scheerer make up the second cohort of the Carilion Clinic Biodesign Program at Virginia Tech. Photo by Emily Schabacker.

Mahrukh Siddiqui, a pharmacist in the biodesign cohort, grew up in Pakistan. Watching Spanish-speaking patients struggle to communicate with English-speaking clinicians at the free clinic felt familiar: English was not her first language, either. 

“How frustrating, how intimidating, how stressful it must get for someone, especially as a dental patient,” Siddiqui said. 

With the click of a button, Milburn can pull up information about gingivitis, tooth extractions and bone loss on the translation webpage. The program reads the information aloud in Spanish, and a description comes up on the computer screen. Even simple instructions like “Turn your head toward me” are available on the monitor in the exam room.

The webpage was built using the open-access platform GitHub and is easily accessible on each computer in the dental clinic. 

Bradley Free Clinic’s patient population has become increasingly diverse in recent years, according to Janine Underwood, its executive director. To meet those needs, the clinic hired more bilingual staff and contracted with third-party translation services. 

During appointments, dentists can call into a translation service and connect with an interpreter who translates the conversation between the patient and the dentist. But clinicians sometimes must wait several minutes for an interpreter to become available. Calls occasionally drop in the middle of an appointment, and the process has to start over. 

Using an interpreter adds about 10 minutes to each appointment, Milburn said. Across several patients and multiple languages, the delays accumulate. By saving that time, dentists at the clinic could see another patient or two, Milburn said. 

The project also reflects the health equity goals built into the biodesign program, said Ridi Barua, a 2020 graduate of Virginia Tech’s mechanical engineering program.

Every translation call costs money, he said, and then, some key information between the patient and the dentist is lost. 

“When the procedure is done, you want to make sure that the patient understands what’s happening, what they need to do for their maintenance and care. So that in itself was, I feel like, was also being lost somewhere in translation,” Barua said.

The students worked with dentists and hygienists to build common scripts and procedure explanations into the platform. Development took about a year, and clinicians at the free clinic began testing the tool during patient exams this year. 

Siddiqui, Barua and Scheerer recently graduated from the program. They hope the next cohort will continue developing the platform and eventually expand it to support additional languages such as Urdu, Farsi and Dari. Other medical specialties could be added, too.

“The work that they’ve done has been just remarkable,” Underwood said. “They took something that we absolutely needed and then created a program that was really useful to us.”

Emily Schabacker is health care reporter for Cardinal News. She can be reached at emily@cardinalnews.org...