Integrating Cultural Humility Into Infant Safe Sleep Counseling: A Pediatric Resident Simulation

Abstract

Introduction: Co-sleeping with infants is a common practice across cultures, but pediatricians may struggle to engage in patient-centered conversations about infant sleep practices with non-native English-speaking families. Cultural humility is a critical skill to utilize when engaging in cross-cultural conversations. We designed a simulation for pediatric residents to counsel on safe sleep and enhance skills in self-perceived cultural humility and preparedness when caring for diverse patient populations.Methods: We created a simulation for the second year and senior pediatric residents at a large academic institution focused on a co-sleeping parent and infant from the Burmese community. The Multidimensional Cultural Humility Scale (MCHS) was administered prior to and after the simulation. We also included additional questions regarding changes in knowledge and preparation in engaging in co-sleeping conversations across cultures.Results: Fifty-seven residents participated. Overall, the mean score of the MCHS significantly increased after the simulation, indicating an increase in self-perceived cultural humility. All participants felt more prepared to have conversations about co-sleeping and to engage in difficult conversations with diverse patient populations, and all learned valuable skills to improve care for future patients. Comments regarding the scenario noted an appreciation for learning more about the Burmese population and understanding new approaches to safe sleep counseling. Discussion: After this simulated scenario, residents reported increased self-perceived cultural humility, preparedness in counseling on co-sleeping, and skills to engage in difficult conversations with diverse patient populations. Topics such as cultural humility can be incorporated into simulation-based medical education to help improve the care of diverse patient populations.

The importance of parental education and cultural humility when addressing co‐sleeping with infants

“…In many cultures, co‐sleeping is a deeply rooted tradition and is considered a way to foster a strong bond between parents and infants. One study notes that 57% of Asian mothers practice co‐sleeping and further, that co‐sleeping has shown striking increases in the US over the past twenty years (Moore et al, 2021). Additionally, single parents, especially those from lower socioeconomic backgrounds, may be more likely to engage in co‐sleeping due to various factors such as limited space, financial constraints, and lack of access to alternative sleeping arrangements.…”

“…Healthcare professionals must approach these discussions with sensitivity and cultural competence, considering the multifaceted influences on parental decisions around co‐sleeping. Moore et al (2021) described the results of integrating training for pediatric residents in cultural humility while engaging in sleeping interviews and risk mitigation with parents. This is promising for providing effective and non‐judgmental support and education to parents regarding safe sleep practices for infants.…”

Cultural Humility Curriculum to Address Healthcare Disparities for Emergency Medicine Residents

“…Previous studies describing cultural humility curricula with family medicine residents, pediatric residents, physical therapy students, and medical students have shown positive results. [11][12][13][14] As described in those studies, cultural humility is taught through instructor-led presentations, and cases are drawn from simulation, patient panels, or home visits. Our study introduces a novel healthcare disparities curriculum based on resident-led presentations, drawn from their own clinical encounters, that encourage the practice of self-directed learning and cultural humility.…”