It is important to give medical personnel being trained in second languages and cultures access to information necessary to their specific immediate needs. The University of California, San Diego, is used as an example of a communicative approach to helping health care providers establish an appropriate relationship with their Latino patients and to be aware of the cultural context in which they work. Acquisition of communicative competence is discussed in terms of social relations, interviewing, giving instructions, following up, and vocabulary drill activities. Areas covered related to cultural contexts are extended family relationships, family planning, beliefs related to illnesses and folk medicine, and language and social attitudes. Contains 19 references. (LB)