Needs Assessment of Residents Regarding Cultural Competency

1
Needs Assessment of Residents Regarding Cultural
Competency

• Elisabeth L. Righter, MD, FAAFP

2
Introduction

• One way to eliminate racial and ethnic
  disparities in health care is to emphasize
  cultural proficiency training of physicians.
  (Smedley)
• Much room for expansion and improvement in
  graduate medical education training (Weissman)

3
Introduction

• Qualitative research described barriers to
  achieving cultural competence and skills needed
  to overcome them. (Shapiro)
• Common barriers for residents included time
  constraints, language/interpreter limitations and
  patient shortcomings.

4
Introduction

• Patients suggestions for improving
  doctor-patient cross-cultural communication
  included not to make assumptions about patients
  based on skin color or name.
• Patients wanted residents to incorporate their
  folk/homeopathic remedies.

5
Purpose

• The purpose of this study was to assess the
  educational needs of Family Medicine residents in
  our residency regarding cultural competency.

6
Methods

• A 21-item anonymous questionnaire was developed
  and distributed to our Family Medicine residents.

7
Methods

• One item focused on usefulness of making
  assumptions about patients based on information
  about skin color.
• One item focused on usefulness of making
  assumptions about patients based on information
  about patient name.

8
Methods

• One item asked about incorporation of
  folk/homeopathic remedies into patient care.
• Another item assessed the level of interest in
  learning how to incorporate folk/homeopathic
  remedies.

9
Methods

• Residents responded to statements about their
  opinions/needs using a 6 point agreement scale
  VSA (1)-VSD (6) and to statements of their
  levels of interest in learning using a 5 point
  interest scale VHI (1)-VLI (5).

10
Results

• There was an 82 (14/17) response rate.
• Population demographics included
• 11 females and 6 males
• 13 Caucasian, 1 African-American and 3 other
• 13 American medical school graduates and 4
  International medical school graduates

11
Results

• Residents disagreed that it is useful to make
  assumptions about patients based on skin color
  (X4.50) or based on name (X4.07).
• VSA (1)-VSD (6) scale

12
Results

• Residents disagreed that they incorporate
  folk/homeopathic remedies of patients into the
  care of their patients (X4.07).
• VSA (1)-VSD (6) scale
• Residents had moderate to high interest in
  learning how to incorporate folk/homeopathic
  remedies into the care of their patients
  (X2.50).
• VHI (1)-VLI (5) scale

13
Discussion

• Based on the results of this study, it will be a
  lower priority to teach residents not to make
  assumptions about patients based upon skin color
  or name.
• The curriculum should be revised to include
  teaching residents how to incorporate folk and
  homeopathic remedies into the care of their
  patients.

14
Discussion

• The study has limited generalizability since it
  was performed on a small group of residents in
  one program.
• Using the information from this needs assessment
  to guide our curricular revision should result in
  a more effective educational intervention.