A review on cultural competency in medical education

Rukadikar, Charushila A; Mali, Snehalata; Bajpai, Ritu; Rukadikar, Atul; Singh, AmitK

doi:10.4103/jfmpc.jfmpc_2503_21

Cited by 17 publications

(10 citation statements)

References 74 publications

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“…Statement self-rating was on cultural interactions and the highest was on information exchange. These ndings are consistent with reported gaps in cultural competency and humility training in medical education [32][33][34].…”

Section: Discussionsupporting

confidence: 89%

WITHDRAWN: Medical Student Perspectives on Safe Use of Non-English Language Skills in Patient Care: Effects of an Educational Intervention to Teach Self-Assessment Tools

Coto,

Pena,

Iñiguez

et al. 2023

Preprint

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Introduction The common practices of doctors “getting by” with limited language skills or using multilingual students/staff as ad hoc interpreters endanger care for populations with non-English language preference. We developed a session for medical students to learn to use two validated self-assessment tools: the Interagency Language Roundtable adapted for Healthcare (ILR-H) and the American Council on the Teaching of Foreign Languages Can-Do Statements. Methods All 179 first-year students at an urban medical school attended the session. Students used the ILR-H (a single item scaled from poor 1 to excellent 5) and Can-Do Statements (four items each scaled from novice 1 to distinguished 5) to self-report their skill level in any non-English language (multilingual students) and the minimum language level they believed necessary for safe patient care (all students). We analyzed correlations between ILR-H and Can-Do Statement self-ratings and differences in multilingual vs. monolingual student perspectives. Results Overall, 139 respondents (83%) were multilingual. Multilingual students’ mean ILR-H self-rating (2.36 [SD = 1.17]) and Can-Do Statements composite score (3.64 [SD = 2.32]) were strongly correlated (r = .91, p < .001). Post-session, fewer students felt ready to provide language-concordant care (32% [51/158] post vs. 41% [64/158] pre; p < .001). The mean ILR-H level reported by multilingual students as needed for safe patient care was 3.25 (SD = .94), higher than that reported by monolingual English speakers (2.57 [SD = 1.40]; p = .001). Discussion Teaching language self-assessment can enhance medical students’ critical awareness of the nuances of communicating with linguistically diverse patients. Future work should evaluate whether teaching self-assessment impacts clinical decision-making around language and interpreter use.

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Section: Discussionsupporting

confidence: 89%

WITHDRAWN: Medical Student Perspectives on Safe Use of Non-English Language Skills in Patient Care: Effects of an Educational Intervention to Teach Self-Assessment Tools

Coto,

Pena,

Iñiguez

et al. 2023

Preprint

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“…Policymakers, healthcare leaders, and providers need to understand the barriers to effective care coordination policies in the United States. These include fragmented healthcare and payment systems, growing and complex chronic conditions, lack of team-based training and social and cultural competencies among healthcare professionals, and geographic variations (Clarke et al, 2017; Hung, Workman, & Mohan, 2020; Rukadikar et al, 2022). Future research could monitor changes in healthcare utilization over longer periods, as well as explore healthcare utilization with respect to cost.…”

Section: Discussionmentioning

confidence: 99%

Differences in Healthcare Utilization in Children with Developmental Disabilities Following Value-Based Care Coordination Policies

Huang,

Saint Onge

2024

Journal of Healthcare Management

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SUMMARY Goal: To address healthcare spending growth, coordinate care, and improve primary care utilization, a majority of states in the United States have adopted value-based care coordination programs. The objective of this study was to identify changes in national healthcare utilization for children with developmental disabilities (DDs), a high-cost and high-need population, following the broad adoption of value-based care coordination policies. Methods: This retrospective study included 9,109 children with DDs and used data from 2002–2018 Medical Expenditure Panel Survey. We applied an interrupted time series design approach to compare pre- and post-Affordable Care Act (ACA) care coordination policies concerning healthcare utilization outcomes, including outpatient visits, home provider days, emergency department (ED) visits, inpatient discharge, and inpatient nights of stay. Principal Findings: We found statistically significant increases in low-cost care post-ACA, including outpatient visits (5% higher, p < .001) and home provider days (11% higher, p < .001). The study findings also showed a statistically significant increase in inpatient nights of stay post-ACA (4% higher, p = .001). There were no changes in the number of ED and inpatient visits. Overall, broad implementation of care coordination programs was associated with increased utilization of low-cost care without increases in the number of high-cost ED and inpatient visits for children with DDs. Our study also found changes in population composition among children with DDs post-ACA, including increases in Hispanic (16.9% post-ACA vs. 13.4% pre-ACA, p = .006) and non-Hispanic multiracial children (9.1% post-ACA vs. 5.5% pre-ACA, p = .001), a decrease in non-Hispanic Whites (60.2% post-ACA vs. 68.6% pre-ACA, p = .001), more public-only insurance (44.3% post-ACA vs. 35.7% pre-ACA, p = .001), fewer children with DDs from middle-income families (27.4% post-ACA vs. 32.8% pre-ACA, p < .001), and more children with DDs from poor families (28.2% post-ACA vs. 25.1% pre-ACA, p = .043). Practical Applications: These findings highlight the importance of continued support for broad care coordination programs for U.S. children with DDs and potentially others with complex chronic conditions. Policymakers and healthcare leaders might consider improving care transitions from inpatient to community or home settings by overcoming barriers such as payment models and the lack of home care nurses who can manage complex chronic conditions. Healthcare leaders also need to understand and consider the changing population composition when implementing care coordination-related policies. This study provides data regarding trends in hospital and home care utilization and evidence of the effectiveness of care coordination policies before the COVID-19 interruption. These findings apply to current healthcare management because COVID-19 has incentivized home care, which may have a strong potential to minimize high-cost care for people with complex chronic conditions. More research is warranted to continue monitoring care coordination changes over a longer period.

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“…This can be done or achieved through education at institutional, organisational, and individual levels. At the educational institution level, cultural competence should be part of clinical education rather than single seminars, practical skills should be taught, utilizing interactive educational methods such as role-play, standardized patient encounters, and self-reflective journal assignments [ 55 ]. Health care organizations can institutionalize cultural competence through identified three levels: the clinical level, structural level, and organisational level [ 56 ].…”

Section: Discussionmentioning

confidence: 99%

Patterns and predictors of cultural competence practice among Nigerian hospital-based healthcare professionals

Ogunlana,

Oyewole,

Aderonmu

et al. 2023

BMC Med Educ

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Background Being culturally competent would enhance the quality of care in multicultural healthcare settings like Nigeria, with over 200 million people, 500 languages, and 250 ethnic groups. This study investigated the levels of training and practice of cultural competence among clinical healthcare professionals in two purposively selected Nigerian tertiary hospitals. Methods The research was a cross-sectional study. A multi-stage sampling technique was used to recruit participants who completed the adapted version of Cultural Competence Assessment Instrument (CCAI-UIC). Data were analysed using descriptive statistics, Pearson’s correlation, ANOVA, and multivariate linear regression. Results The participants were mainly women (66.4%), aged 34.98 ± 10.18 years, with ≤ 5 years of practice (64.6%). Personal competence had a positive weak correlation with age (p < 0.001), practice years (p = 0.01), training (p = 0.001), practice (p < 0.001), and organisational competence (p < 0.001). There were significant professional differences in the level of training (p = 0.005), and differences in training (p = 0.005), and personal competence (p = 0.015) across levels of educational qualifications. Increasing practise years (p = 0.05), medical/dental profession relative to nursing (p = 0.029), higher personal (p = 0.013), and organisational (p < 0.001) cultural competences were significant predictors of the level of training. Male gender (p = 0.005), higher years in practice (p = 0.05), local language ability (p = 0.037), rehabilitation professionals relative to nursing (p = 0.05), high culturally competent practice (p < 0.001), higher training opportunities (p = 0.013), and higher organisational competence (p = 0.001) were significant predictors of higher personal competence. Conclusion About a third of the participants had no formal training in cultural competence. Incorporating cultural competence in the Nigerian healthcare professionals’ education curricula may enhance the quality of care in the multicultural setting.

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A review on cultural competency in medical education

Cited by 17 publications

References 74 publications

WITHDRAWN: Medical Student Perspectives on Safe Use of Non-English Language Skills in Patient Care: Effects of an Educational Intervention to Teach Self-Assessment Tools

WITHDRAWN: Medical Student Perspectives on Safe Use of Non-English Language Skills in Patient Care: Effects of an Educational Intervention to Teach Self-Assessment Tools

Differences in Healthcare Utilization in Children with Developmental Disabilities Following Value-Based Care Coordination Policies

Patterns and predictors of cultural competence practice among Nigerian hospital-based healthcare professionals

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