Curricular Integration and Measurement of Cultural Competency Development in a Group of Physical Therapy Students

Abstract

Abstract
 
 Introduction and Background
 
 The link between cultural competence and effective physical therapy encounters is established. Physical therapist educational programs face the challenge of fostering the cultural competence of students in effective and meaningful ways within the curriculum. They also face the challenge of measuring the development of cultural competency to establish efficacy in the curriculum. One program measured the development of cultural competency in its students using the Inventory for Assessing the Process of Cultural Competence Among Healthcare Professionals-Student Version (IAPCC-SV) before and after the program’s various educational opportunities immersed throughout the curriculum that could serve to increase cultural competency. In the three-year curriculum, the students participated in both mandatory and voluntary experiential learning opportunities. Required didactic presentations and activities were integrated throughout the curriculum and designed to enhance cultural competency. Voluntary experiences included providing service and/or leadership to a student-run pro bono clinic. The program was interested in whether cultural competency increased after these experiences and whether leadership opportunities or additional hours of voluntary service beyond the class median caused increases that exceeded the minimal detectable change (MDC) reported in the literature.
 
 Methods 
 
 All students completed the IAPCC-SV at the beginning of their Doctor of Physical Therapy education and again at the end of their final year of didactic curriculum. 
 
 Results
 
 For the class of 2011, a Wilcoxon signed ranks test noted a significant increase in IAPCC-SV scores from pre-test (56.51 +/- 4.82) to post-test (64.16 +/- 6.19) in the Class of 2011, p  .001. For the class of 2012, a Wilcoxon signed ranks test noted a significant increase in IAPCC-SV scores from pre-test (58.87 +/- 5.67) to post-test (64.13 +/- 5.47) in the Class of 2012, p  .001. Sixteen students from the class of 2011 and 13 from the class of 2012 exceeded the 8.57-point MDC of the IAPCC-SV. 
 
 Discussion and Conclusion 
 
 Exposure to a variety of cross-cultural encounters throughout a physical therapy curriculum significantly increases self-rating of cultural competency in these graduate students. Students who take advantage of volunteer leadership roles in extensive cross-cultural encounters may be more likely to achieve an increase that exceeds the MDC on the IAPCC-SV. These results are particularly interesting given that the students themselves were ethnically homogeneous and did not experience cultural diversity within the constituents that made up their class or faculty.

Does Interprofessional Education Influence Self-Efficacy and Cultural Competence in Pre-Clinical Doctor of Physical Therapy Students?

“…The mean score for the IAPCC-SV was high (x ̅ = 61.0), yet is consistent with previous reports in dental hygiene students [Daugherty-Wood, 2015] and DPT students [Black, Palombaro, Dole, & Guay, 2015]. This finding and its implications on the self-perceived preparedness for DPT students before going to the clinic should be interpreted cautiously.…”

“…The frequency of participants ranking in the cultural incompetence (scores 20-40) was low (n=2) and is consistent with another study of health professions students in which no one rated culturally incompetent [Daugherty-Wood, 2015]. In fact, in a sample of 78 DPT students, everyone rated culturally aware to culturally proficient during their pre-test; no participants were rated culturally unaware [Black et al, 2015]. Similarly, in a study of 27 undergraduate dental hygiene students everyone rated culturally aware and above [Daugherty-Wood, 2015].…”

“…This occurred when comparing the DPT and Athletic Training and Rehabilitation Science students in their sample. A limitation is that the MDC for the IAPCC-SV is 8.57 for Doctor of Physical Therapy students [Black et al, 2015], making those with the highest pre-test scores unable to meet the MDC. Further, dichotomizing the cultural competence scores may pose a limitation as this may ignore individual differences and can impact the psychometric properties of the measure [MacCallum, Zhang, Preacher, & Rucker, 2002].…”

Do We Make a Difference? The Effect of a Doctor of Physical Therapy Program Curriculum on Student Cultural Competence

“…22 Positive outcomes based on selfperception following cross-cultural interactions have been reported within the context of health care education and practice. [23][24][25][26][27][28][29] Exposure to a variety of cross-cultural encounters throughout a DPT curriculum has been shown to significantly increase students' selfrating of cultural competence. 25 Two studies featuring DPT students demonstrated a significant increase in self-assessed cultural competence 23 and expanded worldview.…”

Recommendations for Cultural Competence Educational by Practicing Athletic Trainers

“…Various methods of educational intervention have enhanced cultural competence of healthcare professionals (Long, 2012). Successful educational formats included formal didactic instruction, professional workshops, seminars, and clinical placements (May & Potia, 2013;Nynas, 2015;Palombaro et al, 2015;Reyes et al, 2013). Cultural competence education development should include best practices that are inclusive of considerations of diverse patient backgrounds, awareness of prevalent health concerns by people groups, appreciation of cultural values different from self, and recognition of cultural stereotypes based on unsubstantiated thoughts rather than on particulars of the culture (Steed, 2014).…”